Validation of a Short Form for Health Literacy Assessment Using Talking Touchscreen Technology.

BACKGROUND: Health literacy is an area of growing research and clinical interest, necessitating short, accurate measures of this complex construct. Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT) measures prose, document, and quantitative literacy by self-administration on a touchscreen computer. OBJECTIVE: The objective of this study was to assess the validity of a short form of Health LiTT and to identify a meaningful cutoff score for adequate health literacy. METHODS: A subsample of 137 participants from the Literacy and Cognitive Function among Older Adults study completed a 10-item Health LiTT short form and three interviewer-administered health literacy measures: Test of Functional Health Literacy in Adults (TOFHLA), Rapid Estimate of Adult Literacy in Medicine (REALM), and Newest Vital Sign (NVS). Convergent validity was assessed by correlating scores for all measures, and known-groups validity was assessed by comparing mean Health LITT scores across TOFHLA levels (inadequate, marginal, adequate). Internal consistency reliability was estimated with Cronbach's alpha. A cutoff score for adequate health literacy was established using the TOFHLA cutoff for adequate versus inadequate/marginal health literacy. KEY RESULTS: Spearman correlations between Health LiTT scores and total TOFHLA, REALM, and NVS scores were 0.65, 0.69, and 0.56, respectively (all p < .001). Mean Health LiTT scores were significantly and meaningfully different across inadequate (40.4), marginal (50.1), and adequate (57.1) TOFHLA categories (F = 60.6; p < .001). Cronbach's alpha for the Health LiTT short form was .73. A cutoff score of 55 on Health LiTT showed acceptable sensitivity and specificity to identify adequate health literacy. CONCLUSIONS: This 10-item Health LiTT short form demonstrated excellent convergent and known-groups validity and acceptable internal consistency reliability in older adults. The established cutoff also showed excellent sensitivity and specificity. Validation of other custom Health LiTT short forms with varying items from the bank and computer adaptive test-generated Health LiTT scores is ongoing. [HLRP: Health Literacy Research and Practice. 2020;4(4):e200-e207.] PLAIN LANGUAGE SUMMARY: This article provides evidence of the need for and psychometric properties of a valid and reliable short form of the flexible, technologically advanced Health Literacy Assessment Using Talking Touchscreen Technology measure, as well as a cutoff score to note adequate versus marginal/inadequate health literacy.

Visual fatigue during control room work in process industries.

BACKGROUND: Working in front of computer screens is visually demanding and related to adverse eye symptoms. Occurrence of glare further increases visual fatigue. OBJECTIVE: This paper presents results from an examination of visual ergonomics in control room environments at two Swedish process industries. METHODS: Visual conditions were examined and evaluated in nine control rooms and eighteen process operators answered questions about their perceived workload and visual experiences. RESULTS: When working in the control rooms, the mental workload was rated significantly higher by the participants, compared to experienced performance. The operators further experienced significantly higher visual fatigue and blurred vision compared to double vision and sore eyes. Visual demands were increased in conditions where contrast glare was present, as well as frequent changes of focusing distances, and low contrast between background and characters in computer screens. CONCLUSIONS: Suboptimal visual working conditions in the control rooms contributes to increased visual demands on the operators. Presence of glare is leading to visual fatigue and an unnecessary high mental load. The findings support the relevance of considering principles of general and visual ergonomics when designing and organizing work in control rooms. Workstation design should also be flexible to allow for individual and contextual adjustments.

Digital Asthenopia: Portuguese Group of Ergophthalmology Survey.

INTRODUCTION: Given the increasing use of electronic devices, and the increasing number of complaints with its use, we intend to evaluate the prevalence of manifestations of dry eye and ocular fatigue in a population of individuals, who use the computer daily to perform all their professional tasks, as well as to correlate these complaints with the number of hours of digital use as well as their possible improvement with behavioural measures and use of tear drops. MATERIAL AND METHODS: A total of 77 individuals (154 eyes) were evaluated on two separate days with a 1-month interval. They completed two questionnaires: OSDI and PEG Eye Fatigue. An objective ocular surface assessment was performed: Schirmer test without anesthetic, DR-1a Dry Eye Monitor™, hyperemia evaluation, lacrimal break up, presence of keratitis and lesions in the conjunctiva, as well as near accommodation point and near convergence point. After the first evaluation, the subjects were divided into two groups: group A (< 2 hours of computer working) and group B (> 2 hours of computer working). Some environmental measures to reduce complaints and recommendation of use of artificial tears were explained to the latter. RESULTS: There was a statistically significant difference in the majority of the parameters evaluated in the group B, in relation to the morning period (group A) - tear film (p = 0.032), hyperemia (p < 0.001), BUT (p < 0.001), keratitis (p < 0.001), conjunctival lesion (p = 0.002) and accommodation point (p < 0.001). In the evaluation - one month later - there were no statistically significant differences in any of the parameters analysed in the group A, and in group B there was a decrease in most parameters at the end of that period - Schirmer test (p = 0.005), lacrimal film (p = 0.022), keratitis (p < 0.001), conjunctival lesion (p = 0.005) and fatigue score (p < 0.001). DISCUSSION: It was thus possible to show the appearance of ocular fatigue and ocular surface changes with prolonged use of computers (> 2 hours) as well as a significant improvement in symptomatology (subjective assessment) as well as of ocular surface changes (objective evaluation) with the implementation of postural measures, regular breaks and use of lubricants. This is the first study, to the best of our knowledge, of digital asthenopia in which, in addition to the subjective evaluation, the presence of ocular surface modifications (objective assessment) were evaluated and the respective improvement with the aforementioned ergophthalmological measures were evaluated. CONCLUSION: This survey highlights the increased overall level of awareness that we need to have to face the rapid and wide-scale changes driven by the emergence of digital technology and, more particularly, its impact on user's vision and posture. We concluded that the longer we use the electronic devices (more than two hours) the more severe the complaints and rates of ocular surface changes are. Environmental and ocular strategies can attenuate or even eliminate the discomfort caused by this syndrome, and increase professional performance and quality of life.

Introdução: Atendendo ao uso crescente dos dispositivos eletrônicos, e o consequente aumento de queixas oftalmológicas com o seu uso, pretendemos com este estudo avaliar a prevalência de manifestações de olho seco e fadiga ocular numa população de indivíduos, de uma empresa de 'outsourcing services' e que utilizam o computador diariamente para realizar todas as suas tarefas. Material e Métodos: Um total de 77 indivíduos (154 olhos) foram avaliados em dois dias separados por um intervalo de um mês. Completaram dois questionários: OSDI e GPE Fadiga Ocular. Foi realizada uma avaliação objetiva da superfície ocular: teste de Schirmer sem anestesia, DR-1a Dry Eye Monitor™, avaliação hiperémia, rotura lacrimal, presença de queratite e lesões da conjuntiva, bem como avaliação do ponto próximo de acomodação e ponto próximo de convergência. Após a primeira avaliação, dividiu-se a amostra em dois grupos: grupo A (< 2 horas de trabalho no computador) e grupo B (> 2 horas de trabalho no computador). Ao grupo B foram explicadas algumas medidas ambientais para reduzir as queixas de astenopia digital e recomendou-se uso de lágrima artificial de acordo com as necessidades. Resultados: Observou-se uma diferença estatisticamente significante na maioria dos parâmetros avaliados no grupo B, quando comparado com o grupo no período da manhã (grupo A) - filme lacrimal (p = 0,032), hiperémia (p < 0,001), BUT (p < 0,001), queratite (p < 0,001), lesões da conjuntiva (p = 0,002) e ponto próximo de acomodação (p < 0,001). Na avaliaçã o - um mês depois - não houveram diferenças estatisticamente significativas em nenhum dos parâmetros analisados no grupo A, enquanto que no grupo B houve redução na maioria dos parâmetros ao final desse período - teste de Schirmer (p = 0,005), filme lacrimal (p = 0,022), queratite (p < 0,001), lesões da conjuntiva (p = 0,005), ponto de convergência próximo (p = 0,001) e score de fadiga (p < 0,001). Discussão: Foi assim possível objetivar o aparecimento de fadiga ocular e alterações da superfície ocular com o uso prolongado de computadores (> 2 horas) bem como uma melhoria significativa da sintomatologia (avaliação subjetiva) e melhoria da superfície ocular (avaliação objetiva) com a implementação de medidas posturais, pausas regulares e uso de lubrificantes. Este é o primeiro estudo, tanto quanto temos conhecimento, de astenopia digital em que para além da avaliação subjetiva se avalia a presença das referidas alterações da superfície ocular e a sua melhoria com as medidas ergoftalmológicas mencionadas. Conclusão: Este estudo realça a necessidade de estarmos alerta para as constantes e rápidas mudanças relacionadas com o uso crescente dos diferentes dispositivos digitais, bem como com o seu impacto oftalmológico e postural. Concluímos desta forma que quanto mais tempo usamos os dispositivos eletrónicos (> 2 horas), maiores são a probabilidade de desenvolver queixas e alterações da superfície ocular. As estratégias ambientais e oculares podem atenuar ou até mesmo eliminar o desconforto causado por esta síndrome e melhorar a qualidade de vida e o desempenho profissional.

Comparing the Consumption of CPU Hours with Scientific Output for the Extreme Science and Engineering Discovery Environment (XSEDE).

This paper presents the results of a study that compares resource usage with publication output using data about the consumption of CPU cycles from the Extreme Science and Engineering Discovery Environment (XSEDE) and resulting scientific publications for 2,691 institutions/teams. Specifically, the datasets comprise a total of 5,374,032,696 central processing unit (CPU) hours run in XSEDE during July 1, 2011 to August 18, 2015 and 2,882 publications that cite the XSEDE resource. Three types of studies were conducted: a geospatial analysis of XSEDE providers and consumers, co-authorship network analysis of XSEDE publications, and bi-modal network analysis of how XSEDE resources are used by different research fields. Resulting visualizations show that a diverse set of consumers make use of XSEDE resources, that users of XSEDE publish together frequently, and that the users of XSEDE with the highest resource usage tend to be "traditional" high-performance computing (HPC) community members from astronomy, atmospheric science, physics, chemistry, and biology.

Epidemiology of symptoms of dry eye disease (DED) in Jordan: A cross-sectional non-clinical population-based study.

PURPOSE: To describe the prevalence of dry eye disease (DED) symptoms and to identify associated risk factors in a general non-clinical population in Jordan. METHODS: In this cross-sectional study, participants were selected randomly from the general non-clinical population in Jordan. Participants aged 18 years or over completed the Arabic version of Ocular Surface Disease Index (OSDI) questionnaire on dry eye symptoms. RESULTS: The OSDI questionnaire was completed by 1039 subjects (609 female and 430 male). The mean OSDI score for the study population was 27, with 59% of subjects showed OSDI score ≥20 (a cut off score for mild DED symptoms). Females showed significantly higher mean OSDI score than males in the older age group (p=0.01). The prevalence of all dryness symptoms was markedly reported in older age group >45 years and contact lens wearers (p<0.05). The most commonly reported DED symptom was sensitivity to light and intense symptoms were markedly reported during windy conditions. Vision-related quality of life was also affected in subjects with dryness symptoms. Working with computers and ATM was among those that highly affected. CONCLUSION: The results show that symptoms of dry eye were prevalent in this non-clinical population. Contact lenses wear and older age were found to be associated with dry eye symptoms.

Touch-screen technology usage in toddlers.

OBJECTIVE: To establish the prevalence and patterns of use of touch-screen technologies in the toddler population. DESIGN: Parental questionnaires were completed for children aged 12 months to 3 years examining access to touch-screen devices and ability to perform common forms of interaction with touch-screen technologies. RESULTS: The 82 questionnaires completed on typically developing children revealed 71% of toddlers had access to touch-screen devices for a median of 15 min (IQR: 9.375-26.25) per day. By parental report, 24 months was the median age of ability to swipe (IQR: 19.5-30.5), unlock (IQR: 20.5-31.5) and active looking for touch-screen features (IQR: 22-30.5), while 25 months (IQR: 21-31.25) was the median age of ability to identify and use specific touch-screen features. Overall, 32.8% of toddlers could perform all four skills. CONCLUSIONS: From 2 years of age toddlers have the ability to interact purposefully with touch-screen devices and demonstrate a variety of common skills required to utilise touch-screen technology.

Change in tear film characteristics in visual display terminal users.

PURPOSE: To evaluate changes in symptoms and tear film characteristics in young computer users. METHODS: Fifty-one computer users and 26 controls were evaluated at the beginning and the end of the working day. Subjects with ocular or systemic disease, history of ocular surgery, use of contact lenses or glasses with antireflective surfaces, and use of topical or systemic medications were excluded from the study. Computer use duration, Ocular Surface Disease Index (OSDI) questionnaire, tear osmolarity, Schirmer test, tear break-up time (TBUT), and ocular surface vital dye staining were performed prevocationally and postvocationally. RESULTS: The mean age was 31.2 ± 6.3 years in computer users and 33.7 ± 5.8 in controls. The mean reported computer use was 6.9 ± 2.7 hours/day in computer users and 0.4 ± 0.5 hours/day in controls. The mean prevocational and postvocational values in computer users for OSDI, osmolarity, TBUT, and Schirmer test were 23.2 ± 16.6 and 27.0 ± 17.6, 306.6 ± 14.9 and 311.0 ± 12.5 mOsm/L, 13.9 ± 4.0 and 13.2 ± 3.8 seconds, 22.7 ± 11.8 and 20.6 ± 12.5 mm, respectively. The vocational change was significant for all parameters in the computer user group but not in the control group. The osmolarity-based dry eye diagnosis was 27.4% in the computer users while it was 15.4% in the control group. Oxford score was only grade 1 in 5.9% of visual display terminal users and did not change at the end of the day. CONCLUSIONS: Both symptoms and signs of dry eye increased significantly with computer use. Approximately 1 of every 3-4 computer users was found to have dry eye with higher tear osmolarity values.

Dual computer monitors to increase efficiency of conducting systematic reviews.

OBJECTIVE: Systematic reviews (SRs) are the cornerstone of evidence-based medicine. In this study, we evaluated the effectiveness of using two computer screens on the efficiency of conducting SRs. STUDY DESIGN AND SETTING: A cohort of reviewers before and after using dual monitors were compared with a control group that did not use dual monitors. The outcomes were time spent for abstract screening, full-text screening and data extraction, and inter-rater agreement. We adopted multivariate difference-in-differences linear regression models. RESULTS: A total of 60 SRs conducted by 54 reviewers were included in this analysis. We found a significant reduction of 23.81 minutes per article in data extraction in the intervention group relative to the control group (95% confidence interval: -46.03, -1.58, P = 0.04), which was a 36.85% reduction in time. There was no significant difference in time spent on abstract screening, full-text screening, or inter-rater agreement between the two groups. CONCLUSION: Using dual monitors when conducting SRs is associated with significant reduction of time spent on data extraction. No significant difference was observed on time spent on abstract screening or full-text screening. Using dual monitors is one strategy that may improve the efficiency of conducting SRs.

DICOM gray-scale standard display function: clinical diagnostic accuracy of chest radiography in medical-grade gray-scale and consumer-grade color displays.

OBJECTIVE: The purpose of this study was to compare the diagnostic accuracy achieved with and without the calibration method established by the DICOM standard in both medical-grade gray-scale displays and consumer-grade color displays. MATERIALS AND METHODS: This study involved 76 cases, six radiologists, three displays, and two display calibrations for a total of 2736 observations in a multireader-multicase factorial design. The evaluated conditions were interstitial opacities, pneumothorax, and nodules. CT was adopted as the reference standard. One medical-grade gray-scale display and two consumer-grade color displays were evaluated. Analyses of ROC curves, diagnostic accuracy (measured as AUC), accuracy of condition classification, and false-positive and false-negative rate comparisons were performed. The degree of agreement between readers was also evaluated. RESULTS: No significant differences in image quality perception by the readers in the presence or absence of calibration were observed. Similar forms of the ROC curves were observed. No significant differences were detected in the observed variables (diagnostic accuracy, accuracy of condition classification, false-positive rates, false-negative rates, and image-quality perception). Strong agreement between readers was also determined for each display with and without calibration. CONCLUSION: For the chest conditions and selected observers included in this study, no significant differences were observed between the three evaluated displays with respect to accuracy performance with and without calibration.

Trends in screen time on week and weekend days in a representative sample of Southern Brazil students.

BACKGROUND: Economic and technological improvements can help increase screen time use among adolescents, but evidence in developing countries is scarce. The aim of this study was to examine changes in TV watching and computer/video game use patterns on week and weekend days after a decade (2001 and 2011), among students in Santa Catarina, southern Brazil. METHODS: A comparative analysis of two cross-sectional surveys that included 5 028 and 6 529 students in 2001 and 2011, respectively, aged 15-19 years. The screen time use indicators were self-reported. 95% Confidence intervals were used to compare the prevalence rates. All analyses were separated by gender. RESULTS: After a decade, there was a significant increase in computer/video game use. Inversely, a significant reduction in TV watching was observed, with a similar magnitude to the change in computer/video game use. The worst trends were identified on weekend days. CONCLUSIONS: The decrease in TV watching after a decade appears to be compensated by the increase in computer/video game use, both in boys and girls. Interventions are needed to reduce the negative impact of technological improvements in the lifestyles of young people, especially on weekend days.

Dry eye disease and work productivity loss in visual display users: the Osaka study.

PURPOSE: To estimate the impact of dry eye disease (DED) on work performance and productivity in office workers using visual display terminals (VDTs). DESIGN: Cross-sectional study. METHODS: Six hundred seventy-two Japanese young and middle-aged office workers using VDTs completed a questionnaire that was designed to measured at-work performance deficits and productivity losses using the Japanese version of the Work Limitations Questionnaire, completed by e-mail. Using the Japanese dry eye diagnostic criteria, respondents were classified into 3 groups: definite DED, probable DED, and non DED. RESULTS: Of the 672 office workers, 553 subjects (82.3%), including 366 men and 187 women, completed the questionnaire and underwent clinical evaluation. As for the total workplace productivity loss, the non DED group demonstrated a loss of 3.56%, those with probable DED demonstrated a loss of 4.06%, and those with definite DED demonstrated a loss of 4.82%, indicating significantly worse performance and productivity (P = .014, trend test). For the 4 subscales, DED was associated with significantly lower on-the-job time management (P = .009, trend test) and combined mental performance and interpersonal functioning (P = .011, trend test). After controlling for age, sex, VDT working hours, and diagnosis of DED, time management, physical demands, and mental and interpersonal functioning showed a significant relationship to DED (each P > .05). Annual DED productivity losses were estimated to be $6160 per employee when measured by total production and $1178 per employee calculated by wage. CONCLUSIONS: This study indicated that there is a significant impact of DED on the total productivity of Japanese VDT users.

Prevalence of dry eye disease and its risk factors in visual display terminal users: the Osaka study.

PURPOSE: To investigate tear function and prevalence of dry eye disease (DED) in visual display terminal (VDT) users. DESIGN: Cross-sectional study. METHODS: Six hundred and seventy-two young and middle-aged Japanese office workers who used VDT completed questionnaires and underwent dry eye testing. We estimated the prevalence of DED using logistic regression analysis to examine associations between DED and possible risk factors. The ocular surface feature, prevalence of DED, and risk factors were evaluated. RESULTS: Of the 672 workers, 561 (83.5%, mean age: 43.3 ± 9.1 years) completed the questionnaire. The percentage of women with a composite outcome of definite DED or probable DED was 76.5%, which was higher than that among men (60.2%; odds ratio [OR] = 2.00; 95% confidence interval [CI], 1.29-3.10, P = .002). Workers over 30 years of age had a higher risk of DED (OR = 2.22; 95% CI, 1.06-4.66), as did workers using a VDT >8 hours per day (OR = 1.94; 95% CI, 1.22-3.09). Average Schirmer value was 18.7 ± 11.7 mm and tear break-up time (TBUT) was 4.0 ± 2.5 seconds (78.6% of study participants had TBUT ≤5 seconds). CONCLUSIONS: DED is prevalent among young to middle-aged Japanese VDT users. Ophthalmic findings revealed short TBUT and corneal staining accompanied by normal Schirmer test values. Increased risk for DED was noted for women aged over 30 years and prolonged VDT use. Measures to modify the adverse impact of VDT use on the ocular surface may provide a positive impact on public health and quality of life for office workers using VDTs.

Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children's sleep habits in a longitudinal study?

BACKGROUND: Electronic media use is becoming an increasingly important part of life for today's school-aged children. At the same time, concern of children's sleep habits has arisen, and cross-sectional studies have shown that electronic media use is associated with short sleep duration and sleep disturbances. The purpose of this longitudinal study was to investigate whether baseline electronic media use and media presence in a child's bedroom predicted sleep habits as well as changes in these sleep habits 18 months later among 10- to 11-year-old children in Finland. METHODS: The school-aged children (n=353, 51% girls) from 27 schools answered a questionnaire in 2006 and again 2008 in the Helsinki region of Finland. Electronic media use was measured by computer use and TV viewing. Media presence in a child's bedroom means the presence of a TV or a computer in a child's bedroom. Sleep habits were measured by bedtimes on school days and at the weekend days, sleep duration, discrepancy of bedtimes, and discrepancy of sleep duration between school days and weekends. Linear regression analyses were used to examine whether electronic media use and media presence predicted sleep habits with adjustments for grade, family structure, and baseline sleep. Gender differences were also examined. RESULTS: The children used a computer for one hour per day and watched TV over one hour a day in 2006. They slept over nine hours on school days and over ten hours at the weekends in 2008. Computer use and television viewing predicted significantly shorter sleep duration (p<0.001, p<0.05 respectively) and later bedtimes (p<0.001, p<0.01, respectively). Computer use also predicted unfavourable changes in sleep duration (p<0.001) and bedtimes on school days (p<0.001) and weekends (p<0.01). Among boys, media presence in the bedroom predicted poorer sleep habits and irregularity of sleep habits. CONCLUSIONS: Computer use, TV viewing, and the presence of media in children's bedrooms may reduce sleep duration, and delay bedtimes.

Smart boards: a reemerging technology.

Smart boards, also known as interactive whiteboards (IWBs), are large, interactive, touch-sensitive displays that are mainly used for presentation or educational purposes. While some may not consider this an emerging technology today, changes in the design and capabilities challenge that line of thinking. This column will explain what a smart board is, provide a brief history about it, and describe where it is currently used and why it might be a technology to consider having in a library today.

Evaluating audio computer assisted self-interviews in urban South African communities: evidence for good suitability and reduced social desirability bias of a cross-sectional survey on sexual behaviour.

BACKGROUND: Efficient HIV prevention requires accurate identification of individuals with risky sexual behaviour. However, self-reported data from sexual behaviour surveys are prone to social desirability bias (SDB). Audio Computer-Assisted Self-Interviewing (ACASI) has been suggested as an alternative to face-to-face interviewing (FTFI), because it may promote interview privacy and reduce SDB. However, little is known about the suitability and accuracy of ACASI in urban communities with high HIV prevalence in South Africa. To test this, we conducted a sexual behaviour survey in Cape Town, South Africa, using ACASI methods. METHODS: Participants (n = 878) answered questions about their sexual relationships on a touch screen computer in a private mobile office. We included questions at the end of the ACASI survey that were used to assess participants' perceived ease of use, privacy, and truthfulness. Univariate logistic regression models, supported by multivariate models, were applied to identify groups of people who had adverse interviewing experiences. Further, we constructed male-female ratios of self-reported sexual behaviours as indicators of SDB. We used these indicators to compare SDB in our survey and in recent FTFI-based Demographic and Health Surveys (DHSs) from Lesotho, Swaziland, and Zimbabwe. RESULTS: Most participants found our methods easy to use (85.9%), perceived privacy (96.3%) and preferred ACASI to other modes of inquiry (82.5%) when reporting on sexual behaviours. Unemployed participants and those in the 40-70 year old age group were the least likely to find our methods easy to use (OR 0.69; 95% CI: 0.47-1.01 and OR 0.37; 95% CI: 0.23-0.58, respectively). In our survey, the male-female ratio for reporting >2 sexual partners in the past year, a concurrent relationship in the past year, and > 2 sexual partners in a lifetime was 3.4, 2.6, and 1.2, respectively- far lower than the ratios observed in the Demographic and Health Surveys. CONCLUSIONS: Our analysis suggests that most participants in our survey found the ACASI modality to be acceptable, private, and user-friendly. Moreover, our results indicate lower SDB than in FTFI techniques. Targeting older and unemployed participants for ACASI training prior to taking the survey may help to improve their perception of ease and privacy.

Effort-reward imbalance and video display unit postural risk factors interact in women on the incidence of musculoskeletal symptoms.

OBJECTIVE: This study investigated gender-specific interaction between effort-reward imbalance and video display unit (VDU) postural risk factors at work on the incidence of self-reported musculoskeletal symptoms in the shoulder-neck, lower back and upper limbs regions. PARTICIPANTS: A cohort of 2,431 VDU users - consisting of white-collar workers in three Canadian public service organizations - was assessed on postural risk factors and effort-reward imbalance at work. METHODS: After a mean follow-up time of three years, the six-month incidence proportion of musculoskeletal symptoms in each body region was measured. Interaction was estimated with the attributable proportion of cases due to interaction. RESULTS: For women, two significant attributable proportions due to interaction between effort-reward imbalance and postural risk factors were observed in the shoulder-neck (64%) and upper limbs (57%) regions, while an interaction of 25%, although not significant, was observed in the lower back. No interaction was observed for men. CONCLUSIONS: This interaction means that, among women, when effort-reward imbalance and postural risk factors are simultaneously present, the incidence of musculoskeletal symptoms is greater than the sum of effects of the individual factors. Successful interventions on either one of these exposures would thus have the supplemental benefit of preventing cases due to interaction.

Effect of computer-assisted interviewing on self-reported sexual behavior data in a microbicide clinical trial.

In a microbicide safety and effectiveness trial (HPTN 035) in Malawi, 585 women completed the same questionnaire through a face-to-face interview (FTFI) and an audio computer-assisted self-interview (ACASI). Concordance between FTFI and ACASI responses ranged from 72.0 % for frequency of sex in the past week to 95.2 % for anal intercourse (AI) in the past 3 months. Reported gel and condom use at last sex act were marginally lower with ACASI than FTFI (73.5 % vs. 77.2 %, p = 0.11 and 60.9 % vs. 65.5 %, p = 0.05, respectively). More women reported AI with ACASI than FTFI (5.0 % vs. 0.2 %, p < 0.001). Analyses of consistency of responses within ACASI revealed that 15.0 % of participants in the condom-only arm and 28.7 % in the gel arm provided at least one discrepant answer regarding total sex acts and sex acts where condom and gel were used (19.2 % reported one inconsistent answer, 8.1 % reported two inconsistent answers, and 1.4 % reported three inconsistent answers). While ACASI may provide more accurate assessments of sensitive behaviors in HIV prevention trials, it also results in a high level of internally inconsistent responses.

Centralized video monitoring for patient safety: a Denver Health Lean journey.

The demand for certified nursing assistant (CNA) staff used as 1:1 sitters for safety enhancement and fall prevention can be costly. Through Lean thinking and tools and brainstorming, leaders at Denver Health conceptualized the centralized video monitoring (CVM) program for patient safety. The CVM program reallocated the underutilized talents of CNA sitters as video monitoring technicians (VMT) to meet the challenge of delivering high-quality, cost-effective patient care. Implementing the CVM program required tight connections and collaboration with a multidisciplinary team of individuals. Actual program performance exceeded the initial projected benefits. The CVM program supports the high level of vigilance required by nursing staff to ensure patient safety and quality.