Yoga in the workplace and health outcomes: a systematic review.

BACKGROUND: Health promotion in the workplace is intended to enhance employee health and well-being. Yoga programmes are easy to implement and have been effective in the management of various health conditions. AIMS: To assess the evidence regarding the effectiveness of yoga programmes at work. METHODS: A search of electronic databases of published studies up until the 1st of April 2017. Inclusion criteria for the systematic review were randomized controlled trials of adult employees and yoga in the workplace. Quality appraisal was carried out using the Cochrane Collaboration's tool for assessing risk of bias in randomized trials. RESULTS: Of 1343 papers identified, 13 studies met the inclusion criteria. Nine out of 13 trials were classified as having an unclear risk of bias. The overall effects of yoga on mental health outcomes were beneficial, mainly on stress. Most of the cardiovascular endpoints showed no differences between yoga and controls. Other outcomes reported positive effects of yoga or no change. CONCLUSIONS: The findings of this study suggest that yoga has a positive effect on health in the workplace, particularly in reducing stress, and no negative effects were reported in any of the randomized controlled trials. Further larger studies are required to confirm this.

[Preoperational study for the improvement of hygiene conditions in long-term care facilities]. / Modellprojekt zur Verbesserung der Hygiene in stationären Pflegeeinrichtungen.

Hygiene is becoming more and more important in long-term care facilities. Long-term care facilities are subject to monitoring by the Public Health Service (PHS) and other authorities. For the PHS in Bavaria the Bavarian Health and Food Safety Authority (Landesamt für Gesundheit und Lebensmittelsicherheit, LGL) published a hygiene monitoring concept and there exists an inspection guide developed by a specialist department for nursing homes and institutions for the handicapped (Fachstelle für Pflege und Behinderteneinrichtungen, FQA). Because inspections are performed in multiprofessional teams, it makes sense to use a coordinated inspection catalog. The aim was to integrate hygienic requirements specified in the Bavarian guidelines for hygiene by the LGL into the inspection guide published by the FQA to obtain a quality assured surveillance. The involved parties were questioned about the inspection guide and their hygiene management and then the hygiene criteria of the LGL were implemented into the inspection guide. Questions dealing with hygiene requirements concerning intensive care, management of multidrug resistant bacteria and interviews with the person responsible for infection control in the facility itself were developed for the first time and were integrated into the inspection guide. The revised inspection guide was tested for its applicability. With the revised inspection guide there now exists a tool which allows not only comprehensive inspections of the facilities including hygiene issues but also a good cooperation of the various parties involved. There are many actions which have to be conveyed into the future, especially programs to train staff to apply the inspection guide and to enhance the ability of all participants to act in cooperation. The guide will also allow the facilities to cooperate more easily and more closely, as the guide takes the respective problems and challenges of the different facilities into consideration. Additionally the development of legal guidelines regarding hygiene can support general healthcare of residents.

[Infection control management and practice in home care - analysis of structure quality]. / Infektionshygiene in der ambulanten Pflege - Eine Untersuchung zur Strukturqualität.

BACKGROUND: Surveillance of infection control management and practices in home care is an important task of the public health service. While infection control aspects in residential homes for the aged and nursing are increasingly being discussed this subject has been poorly recognised in home care. AIM: The aim of this study was to identify problems in hygiene regarding the transmission of infectious diseases as well as quality assessment in home care. Based on the results of this study implications for infection control in home care facilities for public health services should be developed. METHOD: Statistical analyses were performed on the primary quality assessment data of home care facilities collected by the medical service of health insurances via computer-assisted personal interviews between March 2006 and March 2009. Structure quality in 194 home care facilities was analysed as well as human resources and organisational conditions. Analyses were also done in the context of the clients' risk factor load. All analyses were performed by stratifying for the size of the home care services. To assess how the involved characteristics vary according to the size of the home care services chi-square tests and non-parametric tests were calculated. RESULTS: About 80% of the assessed home care services disposed of an infection control management plan. Compared to larger services smaller home care services, especially services with less than 10 clients had a poor structure in infection control management and practice. They also carried a higher load of risk factors in clients. The larger services had significantly less human resources. CONCLUSIONS: Surveillance of infection control management and practices by the public health services should focus on the structure of the smaller home care services. At the same time smaller home care services should be supported by offering training for the staff or counselling regarding hygiene-related aspects. Furthermore, the outcome quality of the larger home care services with poorer human resources (one full-time nurse cares for more than 10 dependants) should also be assessed in the frame of infection surveillance.

Effect of classroom air quality on students' concentration: results of a cluster-randomized cross-over experimental study.

UNLABELLED: To assess the effect of indoor air quality as indicated by the median carbon dioxide (CO2) level in the classroom on the concentration performance (CP) of students, a cross-over cluster-randomized experimental study was conducted in 20 classrooms with mechanical ventilation systems. Test conditions 'worse' (median CO2 level on average 2115 ppm) and 'better' (median CO2 level on average 1045 ppm) were established by the regulation of the mechanical ventilation system on two days in one week each in every classroom. Concentration performance was quantified in students of grade three and four by the use of the d2-test and its primary parameter 'CP' and secondary parameters 'total number of characters processed' (TN) and 'total number of errors' (TE). 2366 d2-tests from 417 students could be used in analysis. In hierarchical linear regression accounting for repeated measurements, no significant effect of the experimental condition on CP or TN could be observed. However, TE was increased significantly by 1.65 (95% confidence interval 0.42-2.87) in 'worse' compared to 'better' condition. Thus, low air quality in classrooms as indicated by increased CO2 levels does not reduce overall short-term CP in students, but appears to increase the error rate. PRACTICAL IMPLICATIONS: This study could not confirm that low air quality in classrooms as indicated by increased CO2 levels reduces short-term concentration performance (CP) in students; however, it appears to affect processing accuracy negatively. To ensure a high level of accuracy, good air quality characterized, for example, by low CO2 concentration should be maintained in classrooms.

[Strategies to prevent the transmission of multidrug-resistant pathogens and their practical implementation in oupatient care]. / Präventionsstrategien zur Vermeidung der Übertragung multiresistenter Erreger und praktische Umsetzung in der ambulanten Pflege.

BACKGROUND: Multidrugresistant pathogens which are highly relevant for infection control in hospitals and other health-care facilities are a serious public health problem and a big challenge for all players in the health sector. In order to prevent the spread of multi-resistant pathogens the Commission for Hospital Hygiene of the Robert Koch-Institute (RKI) has published guidelines. These recommendations refer to the consequent implementation of an infection control management in all health care settings, including outpatient care. In Germany there are only few data available concerning infection control management and the implementation of preventive strategies in outpatient care. SUBJECT: To what extent are national guidelines concerning infection control of multidrugresistant pathogens (i.e. methicillin-resistant Staphylococcus aureus, MRSA) feasible and practicable in outpatient care? And what are the reasons not to practice these strategies. METHOD: In outpatient care the status of the infection control management and the implementation of prevention strategies was surveyed and assessed. Data were collected by structured interviews - a face to face method. RESULT: Guidelines concerning infection control management are not always sufficiently implemented in outpatient care. There are multiple reasons for this, such as, e.g., lack of compliance with the recommendations as well as structural problems in the health-care system, and special challenges of outpatient care. CONCLUSION: Implementation of an infection control management concerning multidrug-resistant pathogens in outpatient care is problematic. Prevention strategies are commonly not known or not adequately implemented into daily practice. Actions to improve the situation should focus at the individual level (e.g., trainings in the context of the initiative "clean hands" ), the institutional level (improving networking, bonus schemes) and the social level (financial and legal support for outpatient care centres to bear the expenses of infection control management, "search and destroy").

[Breast-feeding training programme as intervention approach at the hospital level: results of evaluation of the first phase of the STELLA study]. / Personalschulung als Interventionsansatz auf Klinikebene zur Stillförderung: Evaluationsergebnisse der ersten Phase der STELLA-Studie.

BACKGROUND: The health-promoting short- and long-term effects of breast-feeding are supported by a vast scientific literature. The Bavarian prospective cohort study 2005/2006 showed regional variations of breast-feeding rates. Furthermore, improvement in counselling mothers, particularly with regard to prevention and handling of breast-feeding problems, has a great potential for health promotion. The objective of this study is to promote breast-feeding in maternity clinics by improving the surrounding conditions. STUDY DESIGN: A clinic-based and community-related intervention trial was carried out in Lower Bavaria as a model region with below average breast-feeding rates. (1) INTERVENTION: an advanced training of maternity ward professionals of 10 hospitals and after-care midwives was performed from May until December 2008. The training programme was based on the WHO/UNICEF criteria of the "Ten Steps to Successful Breastfeeding" to deepen the breast-feeding knowledge and to improve the breast-feeding management. (2) EVALUATION: A singular assessment of the advanced training programme was undertaken concerning an increase of knowledge and the practicability in clinical everyday life by participants; improvements of the maternity wards were assessed via structural interviews with maternity ward staff before and after intervention. RESULTS: Approximately 85% (n=378) of the staff of the 10 maternity clinics attended the training course. The survey after the training programme (response rate 83%) indicated that more than 80% of the participants stated to have learned something new and to be able to use the knowledge acquired for their own practice. Results of the clinic interviews showed a transfer of training contents into clinical work routines. Improvements at interview date were shown best for bonding (all 10 maternity clinics), for additional feeding (8 maternity clinics) as well as for 24-h rooming-in and mother counselling (7 maternal clinics each). CONCLUSION: Training of maternity ward professionals accounts for baby-friendly conditions in maternity clinics. Most willingness for improvements was shown by maternity ward staff particularly for bonding between mother and child as well as for additional feeding. Considerable differences between the hospitals were observed for the promotion of infant formulas before and after the intervention.

[Psychosocial aspects and body pain: results from an employee survey in the frame of the MAF-project "integrated health management in companies: employee survey about working conditions as management tool"]. / Psychosoziale Aspekte und körperliche Beschwerden - Ergebnisse einer Mitarbeiterbefragung im Rahmen des MAF-Projekts "Ganzheitliches betriebliches Gesundheitsmanagement: Mitarbeiterbefragung über Arbeitsbedingungen als Führungselement"

INTRODUCTION: The aim of the study is to present a compact employee attitude survey for companies within a health care management tool. Beside body pains work-related psychosocial risk factors as well as further influencing factors, are taken into consideration. The questionnaire was evaluated by 6 Bavarian companies. METHOD: Potential influencing factors on physical problems like back pain, neck- and shoulder tension, gastro-intestinal diseases and headache were examined by multiple analysis. Dissatisfaction with working conditions was also examined in the same way. All analyses were carried out age and sex adjusted. RESULTS: Statistical analyses are based on 3,720 employees of 3 companies out of a total of 6 companies who answered the questionnaires. Response rates of the different companies ranged from 34 to 60%. Psychomental demands and psychosocial strains were found to be the strongest predictors for body pains as well as for dissatisfaction with working conditions. CONCLUSIONS: The introduced questionnaire is easy to implement within the framework of a company health care management. It has an holistic approach. We could demonstrate that this instrument is able to reveal multiple aspects of work-related body pain as well as multiple aspects of dissatisfaction with working conditions. Thus it is a starting point for the development of necessary measures for health promotion.