Marina Ciccarelli

Overcoming Problems in Problem-Based Learning: A Trial of Strategies in an Undergraduate Unit.

Professionally oriented tertiary‐level courses such as allied health courses in Australia are under pressure from both their professions and the federal government to provide educational outcomes that prepare graduates for the workplace. This has resulted in a number of allied courses adopting problem‐based learning (PBL), a teaching approach in which students can gain knowledge through solving real‐life work‐based problems. Problems with the approach, however, have been reported in the tertiary classroom setting including students inadequately preparing for class work, not working effectively in groups, and not discussing problems to an appropriate depth. In addition, both students and staff have expressed concerns about its time‐consuming nature. This paper reports on a range of strategies trialled in a tertiary classroom setting to overcome many of these commonly reported problems. The trial found that the combination of strategies used resulted in high rates of student preparation and participation in group discussion. It also found that these strategies resulted in students investing time that was within university guidelines and expectations thus providing a set of useful solutions for PBL practitioners and their students.

ITKids Part II : Variation of postures and muscle activity in children using different information and communication technologies

OBJECTIVE There are concerns that insufficient variation in postural and muscle activity associated with use of modern information and communication technology (ICT) presents a risk for musculoskeletal ill-health among school children. However, scientific knowledge on physical exposure variation in this group is limited. The purpose of this study was to quantify postures and muscle activity of school children using different types of ICT. METHOD Postures of the head, upper back and upper arm, and muscle activity of the right and left upper trapezius and right forearm extensors were measured over 10-12 hours in nine school children using different types of ICT at school and away-from-school. Variation in postures and muscle activity was quantified using two indices, EVA{sd} and APDF₉₀-₁₀. RESULTS Paper-based (Old) ICT tasks produced postures that were less neutral but more variable than electronics-based (New ICT) and Non-ICT tasks. Non-ICT tasks involved mean postures similar to New ICT tasks, but with greater variation. Variation of muscle activity was similar between ICT types in the right and left upper trapezius muscles. Non-ICT tasks produced more muscle activity variation in the right forearm extensor group compared to New and Old ICT tasks. CONCLUSION Different ICT tasks produce different degrees of variation in posture and muscle activity. Combining tasks that use different ICT may increase overall exposure variation. More research is needed to determine what degree of postural and muscle activity variation is associated with reduced risk of musculoskeletal ill-health.

In vivo laboratory validation of the physiometer: a measurement system for long-term recording of posture and movements in the workplace

Posture and movement are thought to be important risk factors for the development of work-related musculoskeletal disorders. Whole day occupational exposure assessment has typically used self-report or observation techniques, but the need for more accurate measurement is now recognised. The aim of this study was to compare the kinematic recordings of a frequently used field system (physiometer) with two laboratory-based systems (Fastrak and Peak) in vivo. Head, thorax and right arm kinematics were recorded simultaneously by the three systems whilst a subject performed 27 single and multiple plane physiological and simulated daily living task movement trials. Errors observed in the Fastrak and Peak data included gimbal lock and quadrant errors. Physiometer data errors included undervalues, overvalues and temporal errors of slow response and resonance. All three systems showed some cross-talk. Agreement between the physiometer and the other systems was generally high for physiological movements (R2 > 0.8) and less for functional movements (R2 > 0.5). Statement of Relevance: The physiometer recording device can provide an indication of posture across time in the workplace; however, its accuracy is limited, particularly during functional movements. Further technology should be developed to unobtrusively capture accurate all day 3-D kinematics.

Diversity of tasks and information technologies used by office workers at and away-from-work

Background. Computer use is associated with musculoskeletal complaints among office workers. Insufficient exposure diversity between tasks is a proposed etiological factor, but little information exists on diversity of tasks and information and communication technologies (ICT) among office workers. Method. Direct observation and self-report data were collected on tasks performed and ICT used among 24 office workers, over 12 h in work and non-work environments. Self-reports were repeated on four additional days. Results. Observations were for a mean [SD] 642[40] min. Productive tasks comprised 63% of observations, instrumental 17%, self-care 12% and leisure 8%. Non-ICT tasks comprised 44% of observations; New electronic-based ICT 36%; Old paper-based ICT 15%, and Combined ICT tasks 4%. Proportions of tasks and ICT use differed between environments and days. Conclusion. Information about diversity in tasks and ICT provides the basis for future investigations into exposure variation in ICT-intensive environments and possible musculoskeletal health risks. Statement of relevance: Information and communication technologies (ICT) provide office workers access to perform work-related tasks after work hours and in away-from-work locations. Musculoskeletal disorder risk assessment for office workers should account for actual tasks performed over a work day, including away from work exposures. This study provides rich, detailed data on occurrence of tasks performed and ICT used by office workers throughout the day.

Impact of experience when using the Rapid Upper Limb Assessment to assess postural risk in children using information and communication technologies

The Rapid Upper Limb Assessment (RULA) is an observation-based screening tool that has been used to assess postural risks of children in school settings. Studies using eye-tracking technology suggest that visual search strategies are influenced by experience in the task performed. This study investigated if experience in postural risk assessments contributed to differences in outcome scores on the RULA and the visual search strategies utilized. While wearing an eye-tracker, 16 student occupational therapists and 16 experienced occupational therapists used the RULA to assess 11 video scenarios of a child using different mobile information and communication technologies (ICT) in the home environment. No significant differences in RULA outcome scores, and no conclusive differences in visual search strategies between groups were found. RULA can be used as a screening tool for postural risks following a short training session regardless of the assessors experience in postural risk assessments.

Variation in Muscle Activity Among Office Workers When Using Different Information Technologies at Work and Away From Work

Objective: To determine differences in muscle activity amplitudes and variation of amplitudes when using different information and communication technologies (ICT). Background: Office workers use different ICT to perform tasks. Upper body musculoskeletal complaints are frequently reported by this occupational group. Increased muscle activity and insufficient variation are potential risk factors for musculoskeletal complaints. Method: Muscle activity of right and left upper trapezius and right wrist extensor muscle bundle (extensor carpi radialis longus and brevis) of 24 office workers (performing their usual tasks requiring different ICT at work and away from work) were measured continuously over 10 to 12 hours. Muscle activity variation was quantified using two indices, amplitude probability distribution function and exposure variation analysis. Results: There was a trend for electronics-based New ICT tasks to involve less electromyography (EMG) variation than paper-based Old ICT tasks. Performing Combined ICT tasks (i.e., using paper- and electronics-based ICT simultaneously) resulted in the highest muscle activity levels and least variation; however, these Combined ICT tasks were rarely performed. Tasks involving no ICT (Non-ICT) had the greatest muscle activity variation. Conclusion: Office workers in this study used various ICT during tasks at work and away from work. The high EMG amplitudes and low variation observed when using Combined ICT may present the greatest risk for musculoskeletal complaints, and use of Combined ICT by workers should be kept low in office work. Breaking up combined, New, and Old ICT tasks, for example, by interspersing highly variable Non-ICT tasks into office workers’ daily tasks, could increase overall muscle activity variation and reduce risk for musculoskeletal complaints.

Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors

Abstract Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education. Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learner’s permit, from the perspective of the learner drivers and their driving instructors. Methods: Data were collected from 33 participants with ASD or ADHD, and nine of their driving instructors. Results: Participants with ASD required twice as many driving lessons and more on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to “unfamiliar” driving situations to be the greatest challenges. Conclusion: Obtaining a driving license was associated with stressful training experience.

Should Schools Expect Poor Physical and Mental Health, Social Adjustment, and Participation Outcomes in Students with Disability?

The literature on whether students with disabilities have worse physical and mental health, social adjustment, and participation outcomes when compared to their peers without disabilities is largely inconclusive. While the majority of case control studies showed significantly worse outcomes for students with disabilities; the proportion of variance accounted for is rarely reported. The current study used a population cross-sectional approach to determine the classification ability of commonly used screening and outcome measures in determining the disability status. Furthermore, the study aimed to identify the variables, if any, that best predicted the presence of disability. Results of univariate discriminant function analyses suggest that across the board, the sensitivity of the outcome/screening tools to correctly identify students with a disability was 31.9% higher than the related Positive Predictive Value (PPV). The lower PPV and Positive Likelihood Ratio (LR+) scores suggest that the included measures had limited discriminant ability (17.6% to 40.3%) in accurately identifying students at-risk for further assessment. Results of multivariate analyses suggested that poor health and hyperactivity increased the odds of having a disability about two to three times, while poor close perceived friendship and academic competences predicted disability with roughly the same magnitude. Overall, the findings of the current study highlight the need for researchers and clinicians to familiarize themselves with the psychometric properties of measures, and be cautious in matching the function of the measures with their research and clinical needs.

Why do children think they get discomfort related to daily activities

Children commonly report musculoskeletal discomfort related to different activities such as computer use, playing electronic games, watching TV, reading, and performing physical and hand intensive activities. Discomfort can result in disability and is a strong predictor of future discomfort in adulthood. Adult beliefs regarding discomfort can affect the level of disability and are modifiable. Childrens beliefs regarding discomfort could potentially be modified to minimise disability related to musculoskeletal disorders. The aim of this study was to describe childrens beliefs about why they experience musculoskeletal discomfort, both in general and related to specific activities. Eighty eight school children completed questionnaires on frequency and usual duration of nine activities, whether they had felt discomfort and what they believed was the cause of any discomfort in relation to those activities. The most common activity was TV watching, and most activities were performed for 1 hour or shorter. Bad posture and doing too much of a certain activity were the most common beliefs regarding reasons for discomfort. This study shows that children are developing beliefs that tend to reflect scientific knowledge about risk factors. These beliefs could be incorporated into preventative health interventions.

Is using the strengths and difficulties questionnaire in a community sample the optimal way to assess mental health functioning

An important characteristic of a screening tool is its discriminant ability or the measure’s accuracy to distinguish between those with and without mental health problems. The current study examined the inter-rater agreement and screening concordance of the parent and teacher versions of SDQ at scale, subscale and item-levels, with the view of identifying the items that have the most informant discrepancies; and determining whether the concordance between parent and teacher reports on some items has the potential to influence decision making. Cross-sectional data from parent and teacher reports of the mental health functioning of a community sample of 299 students with and without disabilities from 75 different primary schools in Perth, Western Australia were analysed. The study found that: a) Intraclass correlations between parent and teacher ratings of children’s mental health using the SDQ at person level was fair on individual child level; b) The SDQ only demonstrated clinical utility when there was agreement between teacher and parent reports using the possible or 90% dichotomisation system; and c) Three individual items had positive likelihood ratio scores indicating clinical utility. Of note was the finding that the negative likelihood ratio or likelihood of disregarding the absence of a condition when both parents and teachers rate the item as absent was not significant. Taken together, these findings suggest that the SDQ is not optimised for use in community samples and that further psychometric evaluation of the SDQ in this context is clearly warranted.