WORK: A Journal of Prevention,Assessment & Rehabilitation

Scientific literacy driven by the underlying habits of scientific thinking should be the focus of educating people in the health professions. This article identifies 23 characteristics of scientific thinking as well as other concepts relevant to scientific literacy. Examples are provided as to how these characteristics and concepts apply to the work of medical lab technicians, nurses and medical researchers.

The concept of work has been close to the core of occupational therapy theory and practice since the foundation of the profession in the early part of this century. The way in which occupational therapists have dealt with this area of occupational performance, however, has been quite diverse. Current work programs in occupational therapy practice have evolved from struggles characterized by the influence of holistic and reductionistic thinking. The holistic view inherited from moral treatment formed the very base upon which the emerging profession was built. The external world in which occupational therapy grew demanded reductionism for validation due to the influence of the medical model in all areas of practice. This struggle contributed to the separation of pre-vocational training as the domain of Occupational Therapy, and vocational training as the domain of Vocational Rehabilitation. This article describes the struggle that resulted from this separation and chronicles the profession's attempt to keep holism in this area of practice.

Education and training programs are popular approaches to deal with the prevention of occupational injuries and diseases. Although they are one of the less preferred injury control options, they can be effective in reducing risk and injury when used in combination with other control systems. An examination of the literature evaluating the effectiveness of injury prevention programs, particularly associated with back injury, is presented. Format, structure and content of programs is discussed and applied to a model addressing behaviour change (the Health Belief Model). This model is used to suggest ways of improving education and training programs to ensure the development and maintenance of behaviour change.

Workers' compensation in New South Wales Australia, changed in 1987 to emphasise rehabilitation back into the workforce. This change has expanded the field in which occupational therapists can contribute to work-related injuries. The Occupational Therapists' wide ranging approach to workers with injuries, and their ability to take a multifactorial approach to problem solving, puts them in a good position to resolve complex issues relating to return to work.

This article provides an overview of the philosophical and practical aspects of supported employment. The authors describe: (1) the primary supported employment clientele; (2) the disciplines and professions involved in delivering community-based employment services for the population; and (3) selected intervention strategies that maximize supported employees' job tenure and satisfaction. Guidelines for interdisciplinary collaboration in identifying and implementing supported employment services are offered.

The purpose of this paper is to provide a critical review of three variables considered important in the return to work of a worker with a low-back injury. These are: (1) worker's compensation; (2) litigation; and (3) employment factors, including length of time at pre-injury employment, availability of a job after injury, and duration of time off work due to low-back pain. Although the literature is inconclusive regarding the effects of worker's compensation, research suggests that litigation, pre-morbid employment, length of unemployment due to disability, and availability of a job following injury impact on employment prognosis after rehabilitation.

This study examined the differences in wrist motion using three types of keyboards: a standard QWERTY design and two alternative designs, the Truform Ergonomic keyboard and the Health Care Comfort keyboard. The Comfort keyboard (adjusted at a lateral slope of 30° and horizontal split of 20° and the Truform keyboard (with a 20° horizontal split) were compared with the standard flat QWERTY keyboard. Twenty adult video display terminal (VDT) workers from the Boston area ranging from 22 to 68 years of age volunteered to participate in this study. In randomly assigned sequences, participants typed for 5 min on each keyboard while their wrist motions were measured using the WristSystem by Greenleaf Medical Systems, Inc. Contrast score analysis was used to analyze mean values in flexion–extension and radial–ulnar deviation of the right and left hands between the three sessions. The alternative keyboards significantly reduced ulnar deviation (left: t(19) = 3.46, P < 0.0025; right: t(19) = 5.83, P < 0.00001), and extension (left: t(19) = 2.82, P < 0.001; right: t(19) = 3.99, P < 0.0005). Results suggest that the Comfort keyboard yielded less ulnar deviation and extension as compared to the standard QWERTY keyboard (Left Extension: QWERTY mean = 21.45, Comfort mean = 18.67; Right Extension: QWERTY mean = 22.9, Comfort mean = 14.45; Left Ulnar Deviation: QWERTY mean = 14.54, Comfort mean = 7.44; Right Ulnar Deviation: QWERTY mean = 17.1, Comfort mean = 6.12). Although the Truform keyboard reduced ulnar deviation (Left: QWERTY mean = 14.54, Truform mean = 9.42; Right: QWERTY mean = 17.1, Truform mean = 9.67), it also yielded extension values comparable to those using the QWERTY (Left Extension: QWERTY mean = 21.45, Truform mean = 24.66; Right Extension: QWERTY mean = 22.9; Truform mean = 22.4). Both alternative designs yielded slightly higher values for radial deviation (left: t(19)=−2.4, P > 0.25; right: t(19)=−3.75, P > 0.25) and flexion (left: t(19)=−1.39, P > 0.25; right: t(19)=−3.75, P > 0.25). Still, these increases remained well within the ‘neutral’ zone (< 15–20°). The results suggest that among the three keyboard designs, the Comfort keyboard was the most effective in maintaining a neutral wrist posture. Although the Truform significantly reduced ulnar devation, it also yielded extension values beyond the neutral range (> 15°). Clinically, these findings may assist occupational therapists in suggesting appropriate keyboard designs during workstation ergonomic modification or consultation. Further research is needed to reinforce these findings.

Objectives: The purpose of this paper is to provide background information on the epidemic proportions of hand injuries related to computer use. It offers a solution of early health education in prevention of cumulative trauma disorders (CTDs) through specially designed instruction in elementary schools.

Study design: The current literature is reviewed. Some physical impairments caused by poor biomechanics and computer overuse are identified. Disability factors are highlighted in relation to how the physical impairment affects an individual's performance in the domain of work. Handicapping factors that are the result of the individual's decline in performance roles of worker are noted. These factors impact our society in dollars spent on medical insurance and worker's compensation claims. A review of a pilot project aimed at early education in hand health basics is introduced, as a proactive ergonomic solution to the present epidemic of cumulative trauma disorders.

Results: A positive response was displayed by the 950 elementary students and their staff to a 20-min program that introduced concepts of posture at the keyboard and basic upper body stretches. Children were instructed in their individual classes during their computer lab time. Daily follow-up, particularly for the forearm and hand stretches, was fostered by the computer lab coordinator, teachers, and wall posters. Parents were informed through a summary article printed in the monthly school newsletter.

Conclusions: Wellness thinking and living can be learned at an early age to assure that basic principles of work practice such as posture and upper body stretches become a life skill. Review of the literature supports programs to educate individuals at an early age to develop life skills that would minimize the occurrence of cumulative trauma disorders, especially in relation to the use of computers.

Objectives: This study examined the prevalence of cumulative trauma disorders (CTDs) among hand therapists. Factors such as hand therapy tasks and number of years spent performing these tasks were examined in their contribution to CTD symptoms of the upper extremity.

Study design: Of the 356 questionnaires distributed to registrants at the 1996 Hand Conference, 195 (55%) were returned. A t-test was used to determine whether the number of years spent practicing hand therapy was a significant factor in the development of CTD symptoms among hand therapists.

Results: Of the 195 respondents, 73% reported they had previously experienced CTD symptoms, and 46% reported they were currently experiencing CTD symptoms. A significant difference was found (P < 0.05) in the development of CTD symptoms with regard to number of years practiced.

Conclusion: The work practices of hand therapists place them at risk for developing CTDs. Hand therapists who spend more years practicing are more likely to incur CTDs.

This article provides an overview of animal assisted therapy, or the use of animals as a treatment modality, specifically with children and adolescents. Animal assisted therapy is defined within the context of occupational therapy, and its benefits on the communicative, psychosocial, and academic/pre-vocational functioning of youths with disabilities are explored. The paper concludes with resources, including organizations specializing in the advancement of animal assisted therapy as well as literature explaining how to create and implement a program within one's existing practice.

Health care research has shown that immunization can play a crucial role in fighting infectious diseases. A global effort was launched to decrease the incidence of infectious disease worldwide through immunization. This paper highlights many of the problems which have contributed to an immunization crisis, in which developing countries are not receiving the benefits of vaccines due to slow vaccine delivery systems; the increasing cost of vaccines; and vaccine and immunization program deficiencies. Consequences of the crisis, solutions, and the role of health care professionals in supporting immunization programs are presented.