The impact of the Maritime Labor Convention on seafarers' working and living conditions: an analysis of port state control statistics.

BACKGROUND: The Maritime Labour Convention, 2006 (MLC2006) entered into force in August 2013 and is a milestone for better working and living conditions (WLC) for seafarers. As of March 2020, 96 countries have ratified the MLC2006, covering more than 90% of the world's shipping fleet. A system of port state control (PSC) allows ratifying countries to inspect any foreign ship arriving in their ports for compliance with the convention. It is intended as a second safety measure for the identification of substandard ships that sail all over the world. Nine regional agreements, so-called Memoranda of Understanding (MoU), have been signed to coordinate and standardize PSC inspections and to increase efficiency by sharing inspections and information. This paper uses public PSC statistics to evaluate the impact of the MLC2006. METHODS: A preliminary analysis using registered tonnage and MLC2006 ratification was conducted and seven MoU were selected for the analysis. The annual reports of these MoU have been viewed in September 2019. Numbers on annual inspections, deficiencies and detentions and in particular data for deficiencies related to living and working conditions and certificates and documents, have been extracted and analyzed for the years 2010 to 2017. RESULTS: Across the eight-year period analyzed, inspection numbers remained stable among all MoU authorities. Deficiencies overall and deficiencies related to WLC declined, indicating an improvement in conditions overall and an increased focus on seafarers' conditions on board. After the MLC2006 entered into force, three MoU reported WLC-ratios above 14%, while the numbers didn't rise above 10% in the other four authorities. Deficiencies related to certificates and documents did not rise significantly between 2010 and 2017. Two European MoU showed the highest ratios for deficiencies in both categories analyzed. CONCLUSION: The analysis confirmed that an increasing attention is being paid to the inspection of working and living conditions, especially in European countries. However, a clear positive impact of the MLC2006 could not be determined from the PSC statistics in this analysis. A large variation still exists among the MoU, a fact that demands increased efforts for harmonization of PSC procedures.

Perceived Benefit and Satisfaction With a Tablet Computer and an Emergency Smartwatch by Older Adults and Their Relatives: Prospective Real-World Pilot Study.

Background: Assistive technologies (ATs) have the potential to promote the quality of life and independent living of older adults and, further, to relieve the burden of formal and informal caregivers and relatives. Technological developments over the last decades have led to a boost of available ATs. However, evidence on the benefits and satisfaction with ATs in real-world applications remains scarce. Objective: This prospective, real-world, pilot study tested the perceived benefit and satisfaction with different ATs in the real-world environment. Methods: Community-dwelling adults aged ≥65 and their relatives tested a tablet computer with a simplified interface or a smartwatch with programmable emergency contacts for 8 weeks in their everyday life. Perceived benefits and satisfaction with ATs were assessed by all older adults and their relatives using different assessment tools before and after the intervention. Outcome measures included the Technology Usage Inventory, Quebec User Evaluation of Satisfaction with Assistive Technology 2.0, and Canadian Occupational Performance Measure. Results: A total of 17 older adults (tablet computer: n=8, 47% and smartwatch: n=9, 53%) and 16 relatives (tablet computer: n=7, 44% and smartwatch: n=9, 56%) were included in the study. The number of participants that were frail (according to the Clinical Frailty Scale) and received care was higher in the smartwatch group than in the tablet computer group. Older adults of the smartwatch group reported higher technology acceptance (Technology Usage Inventory) and satisfaction (Quebec User Evaluation of Satisfaction with Assistive Technology 2.0) scores than those of the tablet computer group, although the differences were not significant (all P>.05). In the tablet computer group, relatives had significantly higher ratings on the item intention to use than older adults (t12.3=3.3, P=.006). Identified everyday issues with the Canadian Occupational Performance Measure included contact/communication and entertainment/information for the tablet computer, safety and getting help in emergency situations for the smartwatch, and the usability of the AT for both devices. While the performance (t8=3.5, P=.008) and satisfaction (t8=3.2, P=.01) in these domains significantly improved in the smartwatch group, changes in the tablet computer group were inconsistent (all P>.05). Conclusions: This study highlights the remaining obstacles for the widespread and effective application of ATs in the everyday life of older adults and their relatives. While the results do not provide evidence for a positive effect regarding communication deficits, perceived benefits could be shown for the area of safety. Future research and technical developments need to consider not only the preferences, problems, and goals of older adults but also their relatives and caregivers to improve the acceptability and effectiveness of ATs.

The Effectiveness of Assistive Technologies for Older Adults and the Influence of Frailty: Systematic Literature Review of Randomized Controlled Trials.

BACKGROUND: The use of assistive technologies (ATs) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties. OBJECTIVE: We aimed to evaluate the effectiveness of ATs on relevant outcomes with a focus on frail older adults. METHODS: A systematic literature review of randomized controlled trials evaluating ATs was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Ovid Medline, PsycINFO, SocIndex, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and IEEEXplore databases were searched from January 1, 2009, to March 15, 2019. ATs were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ≥65 years. Trials performed within a laboratory setting were excluded. Studies were retrospectively categorized according to the physical frailty status of participants. RESULTS: A total of 19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective, with four out of five studies showing significant improvement of disease-related outcomes. Frailty could only be assessed for seven trials. Studies including participants with significant or severe impairment showed no effectiveness. CONCLUSIONS: Different ATs show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated ATs might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of ATs and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives. TRIAL REGISTRATION: PROSPERO CRD42019130249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130249.

Seafarers' views on the impact of the Maritime Labour Convention 2006 on their living and working conditions: results from a pilot study.

BACKGROUND: The Maritime Labour Convention 2006 (MLC2006) entered into force in 2013 and is the first comprehensive set of standards for better living and working conditions covering aspects such as wages, contracts, food, medical care and social security. Currently, the Convention covers more than 90% of the world's shipping fleet. The aim of the study was to investigate the impact of the MLC2006 on the living and working conditions of seafarers and to test and adjust the methods for future use through a pilot study. This article presents the seafarers' perceived impact of MLC2006. MATERIALS AND METHODS: A mixed-method research approach was used (February to April 2018). The quantitative data of 55 seafarers were analysed using descriptive statistics. Qualitative data obtained through a focus group interview and thematic content analysis was applied. RESULTS: Remarkably, one third of the respondents pointed out a complete lack of improvement, while 43.6% stated that the MLC2006 had improved their working and living conditions "somewhat" and only 7.3% "to a great extend". The focus group participants agreed that the MLC2006 did not improve working conditions but mostly increased paperwork. Other issues of concern were the safety on board including safety training, long working hours connected to low manning, food and social difficulties. CONCLUSIONS: For Danish seafarers, the MLC2006 did not have a significant impact, as most standards were in place before. It must be further investigated what the MLC2006 achieved for other flag states, especially in the light of its 5-year anniversary. Both methods yielded valuable data. Focus groups are an ideal setting to study the views of seafarers.