Alison F Bell

Risk of musculoskeletal injury among cleaners during vacuuming

This study aimed to examine the risk of work-related upper-limb musculoskeletal disorders in cleaning workers during the work task of vacuuming. In total, 24 cleaning workers were observed while they performed vacuum cleaning tasks in the normal course of their employment in government schools, hospitality and commercial office space sectors. Risk of upper-limb musculoskeletal disorders were rated using three observational assessment tools: Manual Task Risk Assessment (ManTRA); Quick Exposure Check (QEC); the Rapid Upper Limb Assessment (RULA). Mean results (e.g. ManTRA wrist/hand cumulative wrist score 18.67 ± 1.27, QEC neck score 13 ± 1.77, RULA score 6.54 ± 0.509) demonstrated that cleaning workers who perform the task of vacuum cleaning are at risk of work-related upper-limb musculoskeletal injury, regardless of whether they use a back-pack or canister machine. Government school cleaners experienced greater risk of work-related upper-limb musculoskeletal disorders than workers in either the hospitality or commercial office space sectors. Practitioner Summary: Cleaning workers in Australia are mostly female, ageing and of non-English-speaking backgrounds and involved in repetitive manual tasks. Their occupation is low status. This research confirms that vacuuming tasks are a risk for cleaning workers and highlights the need for further research to improve conditions for these workers.

Work boot design affects the way workers walk: A systematic review of the literature

Safety boots are compulsory in many occupations to protect the feet of workers from undesirable external stimuli, particularly in harsh work environments. The unique environmental conditions and varying tasks performed in different occupations necessitate a variety of boot designs to match each workers occupational safety and functional requirements. Unfortunately, safety boots are often designed more for occupational safety at the expense of functionality and comfort. In fact, there is a paucity of published research investigating the influence that specific variations in work boot design have on fundamental tasks common to many occupations, such as walking. This literature review aimed to collate and examine what is currently known about the influence of boot design on walking in order to identify gaps in the literature and develop evidence-based recommendations upon which to design future research studies investigating work boot design.

Precision markedly attenuates repetitive lift capacity

This study investigated the effect of precision on time to task failure in a repetitive whole-body manual handling task. Twelve participants were required to repetitively lift a box weighing 65% of their single repetition maximum to shoulder height using either precise or unconstrained box placement. Muscle activity, forces exerted at the ground, 2D body kinematics, box acceleration and psychophysical measures of performance were recorded until task failure was reached. With precision, time to task failure for repetitive lifting was reduced by 72%, whereas the duration taken to complete a single lift and anterior deltoid muscle activation increased by 39% and 25%, respectively. Yet, no significant difference was observed in ratings of perceived exertion or heart rate at task failure. In conclusion, our results suggest that when accuracy is a characteristic of a repetitive manual handling task, physical work capacity will decline markedly. Practitioner Summary: The capacity to lift repetitively to shoulder height was reduced by 72% when increased accuracy was required to place a box upon a shelf. Lifting strategy and muscle activity were also modified, confirming practitioners should take into consideration movement precision when evaluating the demands of repetitive manual handling tasks.

The three-dimensional shapes of underground coal miners’ feet do not match the internal dimensions of their work boots

Abstract Mining work boots provide an interface between the foot and the ground, protecting and supporting miners’ feet during lengthy coal mining shifts. Although underground coal miners report the fit of their work boots as reasonable to good, they frequently rate their boots as uncomfortable, suggesting that there is a mismatch between the shape of their feet and their boots. This study aimed to identify whether dimensions derived from the three-dimensional scans of 208 underground coal miners’ feet (age 38.3 ± 9.8 years) differed from the internal dimensions of their work boots. The results revealed underground coal miners wore boots that were substantially longer than their feet, possibly because boots available in their correct length were too narrow. It is recommended boot manufacturers reassess the algorithms used to create boot lasts, focusing on adjusting boot circumference at the instep and heel relative to increases in foot length. Practitioner Summary: Fit and comfort ratings suggest a mismatch between the shape of underground coal miners’ feet and their boots exists. This study examined whether three-dimensional scans of 208 miners’ feet differed from their boot internal dimensions. Miners wore boots substantially longer than their feet, possibly due to inadequate width.

How do we fit underground coal mining work boots

Abstract Acceptable footwear fit, particularly width, is subjective and vaguely quantified. Proper shoe fit is important because it affects both comfort and the potential to prevent injury. Although mismatches between the feet of underground coal miners and their internal boot dimensions are known, no research has been undertaken to determine the impact of these mismatches on worker perceptions of fit, comfort and pain. This study aimed to quantitatively assess mining work boot fit relative to underground coal miners’ subjectively rated work boot fit and comfort, reported foot problems, lower limb pain and lower back pain in order to develop evidence-based work boot fit recommendations. Traditional footwear fitting methods based predominantly on foot length are insufficient for underground coal mining-specific footwear. Instead, fit at the heel, instep and forefoot must be considered when fitting underground coal mining work boots, in conjunction with the traditional length measurement.Practitioner summary: Underground coal miners report their work boots fit but are uncomfortable. This study assessed actual fit relative to perceived fit, comfort, foot problems, lower limb pain and lower back pain of 197 miners. Fit at the heel, instep and forefoot must be considered when fitting mining work boots.

Accessing hospital packaged foods and beverages: the importance of a seated posture when eating

BACKGROUND Hospitalised and community dwelling older people (aged 65 years and over) have difficulties opening certain food and beverage items (e.g. cheese portions and tetra packs) served in public hospitals. Previously, the role of hand strength on successful pack opening has been explored in a seated position. However, because many people in hospital eat in bed, the present laboratory study examined the differences between participants opening a selection of products in a hospital bed and a chair. METHODS The present study used a qualitative method (satisfaction) and quantitative methods (grip and pinch strength, dexterity, time and attempts) in two conditions (bed; chair) in a sample of well older community dwelling adults (n = 34). Packs tested included foil sealed thickened pudding, foil sealed thickened water, tetra pack, dessert, custard, jam, cereal, honey sachet and cheese portions. RESULTS Honey sachets, cheese portions, foil sealed thickened pudding and tetra packs were the most difficult packs to open, with 15% of cheese portions unable to be opened in either the bed or chair posture. Although grip strength was consistent for each posture, pinch grips and dexterity were adversely affected by the bed posture. Lying in a hospital bed required greater pinch strength and dexterity to open packs. CONCLUSIONS Eating in a seated position when in hospital has been shown to improve intake. The present study demonstrates that eating in a seated posture is also advantageous for opening the food and beverage packs used in the NSW hospital food service and supports the notion that patients should sit to eat in hospital.

Food Packaging and Older Adults

Abstract Using food and beverage packaging is a universal experience. For many older people, grappling with packaging can be a frustrating encounter. The rapidly aging global population is an important consideration in the design and provision of packaged food and beverage items in the community and within care environments such as hospitals. This chapter explores the interface between packaging and older people, outlining research and methods for pack assessment, as well as considerations for optimal pack design that is inclusive of older people.

Evaluating the effect of common hospital food and beverage packaging on the total nutritional intake by older Australians

Up to 30% of acute care patients consume less than half of the food provided in hospital. Inadequate dietary intake can have adverse clinical outcomes, including a higher risk of in-hospital mortality. This study aimed to investigate the reasons for poor intake among acute care patients in hospital. Patients with an observed intake of ≤50% of the food provided at lunch were approached to participate in the study. Thirty-two patients participated in semi-structured interviews over a three week period, to provide their perspective of food and mealtimes in hospital and discuss the reasons and factors influencing inadequate intake. Responses were coded and analysed thematically using the framework method. Patients reported both individual and organisational factors contribute to their inadequate intake. Half the patients reported the size of the meals were too large, with some patients reporting that large meal sizes puts them off their food and reduced their intake. ‘Not important to eat all the food provided’, and ‘do not need to eat much food in hospital’ were common attitudes among the patients. Half the patients reported that nurses did not observe their intake and were not concerned if all the food was not eaten. Identifying the reasons for poor intake can assist with the development of suitable interventions to improve dietary intake and reduce the risk of adverse clinical outcomes. Further investigation of suitable interventions to reduce portion sizes and improve both staff and patient perceptions of the importance of food in hospital is recommended.Despite being commonly prevalent in acute care hospitals worldwide, malnutrition often goes unidentified and untreated due to a lack in the implementation of a nutrition care pathway. The aim of this study was to validate nutrition screening and assessment tools in Vietnamese language. After converting into Vietnamese, Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) were used to identify malnutrition in the adult setting; and the Paediatric Nutrition Screening Tool (PNST) and paediatric Subjective Global Nutritional Assessment (SGNA) were used in the paediatric setting in two acute care hospitals in Vietnam. This cross-sectional observational study sampled 123 adults (median age 78 years [39–96 years], 63% males) and 105 children (median age 20 months [2–100 months], 66% males). In adults, nutrition risk and malnutrition were identified in 29% and 45% of the cohort respectively. Nutrition risk and malnutrition were identified in 71% and 43% of the paediatric cohort respectively. The sensitivity and specificity of the screening tools were: 62% and 99% for the MST compared to the SGA; 89% and 42% for the PNST compared to the SGNA. This study provides a stepping stone to the potential use of evidence-based nutrition screening and assessment tools in Vietnamese language within the adult and paediatric Vietnamese acute care setting. Further work is required into integrating a complete nutrition care pathway within the acute care setting in Vietnamese hospitals.Abstract of a poster presented at 32nd DAA National Conference, 13-16 May 2015, Crown Perth Conference Centre, Perth, Western Australia. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication Details Ryman, S., Bell, A., Walton, K. & Jenkins, E. (2015). Exploring the impact of two different food and beverage packaging conditions on the dietary intakes of older adults in a simulated hospital environment. Nutrition and Dietetics, 72 (Suppl. 1), 63-63. This journal article is available at Research Online: http://ro.uow.edu.au/smhpapers/2781 Abstract of a poster presented at 32nd DAA National Conference, 13–16 May 2015, Crown Perth Conference Centre, Perth, Western Australia.of a poster presented at 32nd DAA National Conference, 13–16 May 2015, Crown Perth Conference Centre, Perth, Western Australia. Exploring the impact of two different food and beverage packaging conditions on the dietary intakes of older adults in a simulated hospital environment SARAH RYMAN, ALISON BELL, KAREN WALTON, EMMAJENKINS School of Medicine, University of Wollongong, NSW This study aimed to determine the impact of food and beverage packaging on the dietary intakes of older adults. Malnutrition is a common issue in hospitals that can be often overlooked. In the literature food and beverage packaging has consistently been identified as negatively impacting dietary intakes of older inpatients. All 31 participants (aged 65 years and over) experienced two conditions which included unopened packaging and pre-opened packaging in the Nursing Simulation Laboratory at the University of Wollongong. A food waste audit was conducted, post meal questionnaire, meal time observations and malnutrition screening. Data were analysed through paired t-tests, independent t-tests and descriptive statistics using the Statistical Package for Social Science (SPSS). There was no significant difference in participants’ dietary intakes between the two packaging conditions. Cheese and biscuit packaging were found to be the most difficult to open. The average attempts to open the cheese packaging was 5.6 and took 28.5 s. The average attempts to open biscuits was 5.8 and took 16.4 s. It was found that there was a significant difference between malnutrition status and attempts to open cheese packaging. There was no significant difference in dietary intake, malnutrition status or gender. Although no statistical significant difference in dietary intakes was found, these results may reflect a clinically significant finding for a person who is malnourished. The study did find that some packaging was more difficult for participants’ to open and any barriers to dietary intake should be minimised to prevent malnutrition. Funding source: Global Challenges and University International Collaboration Grants from the University of Wollongong supported this research Contact author: Sarah Ryman – sjr659@uowmail.edu.au

Exploring the impact of two different food and beverage packaging conditions on the dietary intakes of older adults in a simulated hospital environment

Up to 30% of acute care patients consume less than half of the food provided in hospital. Inadequate dietary intake can have adverse clinical outcomes, including a higher risk of in-hospital mortality. This study aimed to investigate the reasons for poor intake among acute care patients in hospital. Patients with an observed intake of ≤50% of the food provided at lunch were approached to participate in the study. Thirty-two patients participated in semi-structured interviews over a three week period, to provide their perspective of food and mealtimes in hospital and discuss the reasons and factors influencing inadequate intake. Responses were coded and analysed thematically using the framework method. Patients reported both individual and organisational factors contribute to their inadequate intake. Half the patients reported the size of the meals were too large, with some patients reporting that large meal sizes puts them off their food and reduced their intake. ‘Not important to eat all the food provided’, and ‘do not need to eat much food in hospital’ were common attitudes among the patients. Half the patients reported that nurses did not observe their intake and were not concerned if all the food was not eaten. Identifying the reasons for poor intake can assist with the development of suitable interventions to improve dietary intake and reduce the risk of adverse clinical outcomes. Further investigation of suitable interventions to reduce portion sizes and improve both staff and patient perceptions of the importance of food in hospital is recommended.Despite being commonly prevalent in acute care hospitals worldwide, malnutrition often goes unidentified and untreated due to a lack in the implementation of a nutrition care pathway. The aim of this study was to validate nutrition screening and assessment tools in Vietnamese language. After converting into Vietnamese, Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) were used to identify malnutrition in the adult setting; and the Paediatric Nutrition Screening Tool (PNST) and paediatric Subjective Global Nutritional Assessment (SGNA) were used in the paediatric setting in two acute care hospitals in Vietnam. This cross-sectional observational study sampled 123 adults (median age 78 years [39–96 years], 63% males) and 105 children (median age 20 months [2–100 months], 66% males). In adults, nutrition risk and malnutrition were identified in 29% and 45% of the cohort respectively. Nutrition risk and malnutrition were identified in 71% and 43% of the paediatric cohort respectively. The sensitivity and specificity of the screening tools were: 62% and 99% for the MST compared to the SGA; 89% and 42% for the PNST compared to the SGNA. This study provides a stepping stone to the potential use of evidence-based nutrition screening and assessment tools in Vietnamese language within the adult and paediatric Vietnamese acute care setting. Further work is required into integrating a complete nutrition care pathway within the acute care setting in Vietnamese hospitals.Abstract of a poster presented at 32nd DAA National Conference, 13-16 May 2015, Crown Perth Conference Centre, Perth, Western Australia. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication Details Ryman, S., Bell, A., Walton, K. & Jenkins, E. (2015). Exploring the impact of two different food and beverage packaging conditions on the dietary intakes of older adults in a simulated hospital environment. Nutrition and Dietetics, 72 (Suppl. 1), 63-63. This journal article is available at Research Online: http://ro.uow.edu.au/smhpapers/2781 Abstract of a poster presented at 32nd DAA National Conference, 13–16 May 2015, Crown Perth Conference Centre, Perth, Western Australia.of a poster presented at 32nd DAA National Conference, 13–16 May 2015, Crown Perth Conference Centre, Perth, Western Australia. Exploring the impact of two different food and beverage packaging conditions on the dietary intakes of older adults in a simulated hospital environment SARAH RYMAN, ALISON BELL, KAREN WALTON, EMMAJENKINS School of Medicine, University of Wollongong, NSW This study aimed to determine the impact of food and beverage packaging on the dietary intakes of older adults. Malnutrition is a common issue in hospitals that can be often overlooked. In the literature food and beverage packaging has consistently been identified as negatively impacting dietary intakes of older inpatients. All 31 participants (aged 65 years and over) experienced two conditions which included unopened packaging and pre-opened packaging in the Nursing Simulation Laboratory at the University of Wollongong. A food waste audit was conducted, post meal questionnaire, meal time observations and malnutrition screening. Data were analysed through paired t-tests, independent t-tests and descriptive statistics using the Statistical Package for Social Science (SPSS). There was no significant difference in participants’ dietary intakes between the two packaging conditions. Cheese and biscuit packaging were found to be the most difficult to open. The average attempts to open the cheese packaging was 5.6 and took 28.5 s. The average attempts to open biscuits was 5.8 and took 16.4 s. It was found that there was a significant difference between malnutrition status and attempts to open cheese packaging. There was no significant difference in dietary intake, malnutrition status or gender. Although no statistical significant difference in dietary intakes was found, these results may reflect a clinically significant finding for a person who is malnourished. The study did find that some packaging was more difficult for participants’ to open and any barriers to dietary intake should be minimised to prevent malnutrition. Funding source: Global Challenges and University International Collaboration Grants from the University of Wollongong supported this research Contact author: Sarah Ryman – sjr659@uowmail.edu.au

Lying down on the job- does posture affect grip strength and opening hospital food and beverage packaging?

Abstract of paper that presented at the Occupational Therapy Australia, 25th National Conference and Exhibition, 24-26 July 2013, Adelaide Convention Centre.Abstract of paper that presented at the Occupational Therapy Australia, 25th National Conference and Exhibition, 24-26 July 2013, Adelaide Convention Centre.Abstract of paper that presented at the Occupational Therapy Australia, 25th National Conference and Exhibition, 24-26 July 2013, Adelaide Convention Centre.