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text:
Research article | Open | Open Peer Review | Published: 21 March 2012
Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms
Agneta Lindegård1,
Jens Wahlström2,
Mats Hagberg3,
Rebecka Vilhelmsson4,
Allan Toomingas5 &
Ewa Wigaeus Tornqvist6
BMC Musculoskeletal Disordersvolume 13, Article number: 38 (2012) | Download Citation
The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users.
At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse.
The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.
Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions.
There was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms.
Musculoskeletal pains and aches are prevalent in the general population in many countries [1, 2]. Within the European Union (EU) a 12 month prevalence of 23% has been reported for work related musculoskeletal disorders [3]. In Sweden the prevalence of these disorders has decreased slightly during recent years but it still constitutes one of the major risk factors leading to long term sick leave [4]. Apart from individual suffering and a decrease in the quality of life, these disorders place a heavy economic burden on society due to costs connected to long term sick leave, poorer work performance and reduced productivity [5, 6].
The causes of work related neck and upper extremity symptoms continue to be insufficiently understood. Both cross sectional and longitudinal studies have suggested, however, that factors related to the individual (e.g. age and gender), working technique, working postures, muscular rest and perceived muscle tension as well as factors related to the work place or work organization, such as workplace layout, repetitive and constrained work and psychosocial working conditions, may be potential risk factors [7–12]. Similar risk factors have been found for computer work [13–18]. For instance, poor working technique or work style, as described by Feuerstein and coworkers [13], has been shown to be associated with an increased risk of developing symptoms indicative of neck and upper extremity disorders [19–21]. Over the years, several models have been developed in an attempt to identify and explain possible links between different exposures, early signs of incipient musculoskeletal pain conditions and more manifest musculoskeletal outcome. One of these models is the ecological model of musculoskeletal disorders in office work, presented by Sauter and Swansson in 1996 [22]. A modified version of this model, specifically targeting computer work has been proposed by Wahlström in 2005 [23]. In this model, biomechanical factors, psychosocial factors and mental stress, modified by individual factors, may manifest as different detect sensations (early signs) preceding more manifest neck and upper extremity symptoms. The model underlying the present study is that high perceived exertion and low perceived comfort during computer work, might be such early signs and therefore important to identify in order to target individuals at risk of developing severe and long lasting musculoskeletal symptoms/conditions. Consistent with this hypothesis, an earlier cross-sectional study among call center workers has shown an association between poor work place comfort (including lighting conditions, noise, temperature etc) and a higher prevalence of neck and upper extremity symptoms [24]. Regarding perceived exertion there are indications that high perceived exertion may be a crude general measure of an elevated risk of neck and upper extremity pain among computer workers [25].
Hence, the main aim of this longitudinal cohort study was to investigate:
1. Whether perceived exertion and perceived comfort, respectively, are associated with the incidence of neck and upper extremity symptoms.
2. Whether observed working technique is associated with the incidence of neck and upper extremity symptoms.
The study described herein is a prospective cohort study among professional computer users, with an observation period of 10 months. At baseline a self-administered questionnaire was used to assess work-related exposures, individual factors, and symptoms from the neck and upper extremities.
In addition, observations of working technique were performed by ergonomists using an ergonomic checklist designed for the assessment of computer work exposures [26].
The study was approved by the local ethics committee at the Karolinska Institutet and the regional ethics committee at Gothenburg University.
The participants were recruited by ergonomists employed by different Occupational Health Care Centers. The initial study population included 1529 participants. The baseline questionnaire was answered by 1283 subjects. The study group consisted of 853 participants from 46 different work places, representing a great variety of professionals (librarians, engineers, graphic designers, receptionists, secretaries, journalists, researchers, insurance officers and call center personnel) from both the private and the public sector (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month (Figure 1). The mean age of the men was 42 years and 44 years for the women. The self-reported time spent on computer work was, on average, 3.7 hours/day for the men and 3.8 hours/day for the women (Table 1). During the remaining working time the participants, depending of their professions, performed ordinary office work including reading, writing, sorting, calculating, making telephone calls, attending meetings etc. Thus, there was a great variability in self-reported time with computer work between participants.
Chart showing the study population, participants at baseline, and number of cases affecting the investigated body regions for men and women.
Table 1 Baseline characteristics of participants, presented as mean values with range within brackets
Incidence data were collected by means of 10 postal monthly questionnaires, asking for information on the occurrence of neck and upper extremity symptoms. The questions referred to the time period since completion of the preceding questionnaire, which was approximately one month but could have been longer due to vacations or other reasons for absence. If a follow-up questionnaire was not returned before the next one was available, the time frame used for reporting symptoms covered the whole period since the previous questionnaire was answered, i.e. approximately two months. If two consecutive questionnaires were missing, the calculated person-time connected to that participant was closed when the last questionnaire was answered.
Assessment of symptoms
The monthly questionnaires asked if the participants had experienced symptoms of pain or ache during the preceding month, in any of the following body regions: neck and right and left scapular areas, shoulder joint/upper arms, elbow/forearms, wrists, and hands/fingers (see Figure 2). If they reported any symptoms the duration (number of days) in the respective regions were requested.
Showing the body regions considered for rating of perceived exertion in the present study.
Ratings of perceived exertion
Perceived exertion after a typical work day was rated, in the baseline questionnaire, on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous) for each of the 11 body regions under examination (Figure 2) [27].
Ratings of comfort
Perceived comfort was rated, in the baseline questionnaire, on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse [28].
Observation of working technique
Working technique was observed at baseline by ergonomists (n = 32) according to the checklist. They were trained in using the checklist accurately and in a standardized manner during seminars before the "real life" observations were made. The participants were observed at their work places during ordinary computer work (observation time ranging from 10-15 minutes for each subject). The observations were characterized on the basis of eight variables: 1) use of forearm support during keyboard work; 2) use of forearm support during computer mouse work; 3) elevation of the shoulders during keyboard work; 4) elevation of the shoulders during computer mouse work; 5) sitting in a tense position when using the keyboard; 6) sitting in a tense position when using the computer mouse; 7) range of movement when performing computer mouse work; 8) speed and/or jerkiness of the computer mouse movements.
Data treatment and analysis
Symptoms from the 11 different body regions were combined into symptoms from three major regions: a) the neck and the scapular region (hereafter called the neck region); b) shoulder and upper arms (hereafter called the shoulder region); c) elbows/forearms, wrists and hands/fingers (hereafter called the arm/hand region). A "case" was defined as a participant who reported maximum 2 days with symptoms during the preceding month in all body regions ("symptom free") at baseline and who later, at any follow up occasion, reported symptoms lasting ≥ 3 days during the preceding month in the specific body region, i.e. a, b or c. The incidence rate was calculated as the frequency of "new" cases divided by the total person-time-at risk. Subjects contributed with person-time corresponding to the period between the dates of the baseline questionnaire and the date when they became a case or the date when they completed their last questionnaire (non-cases).
To evaluate perceived exertion, a sum score was calculated for the neck, shoulder, and arm/hand region, respectively. The sum score for each body region was then divided by the number of areas included for each body region in order to obtain a mean value. Subjects were classified into three groups, with 0-4 (less than relatively light exertion) as the reference group, 5-7 (relatively light - somewhat strenuous) as the medium exertion group, and ≥8 (strenuous or very strenuous) as the high exertion group.
For comfort, a sum score for comfort was calculated for the included items and divided by the number of items included in the score in order to obtain a mean value. Subjects were then classified into three groups, where -4 to -1 was classified as poor comfort, 0 to +2 as acceptable or medium comfort and ≥ 3 as good comfort (the reference group).
The working technique scores for each of the eight variables included were combined into an overall score ranging from 1-22 [25]. Subjects scoring ≥14 were classified as having a good working technique, those scoring 12-13 as having an acceptable working technique, and those scoring < 12 as having a poor working technique [29].
Incidence rate ratios (relative risks, RR) with 95% confidence intervals (95% CI) for symptoms in the neck, shoulder, and arm/hand region were calculated using Cox proportional hazard models in the software JMP version 5.0.1 and Proc Phreg (SAS v.9.0) and adjusted for age, sex and time spent undertaking computer work. The rationale behind controlling for the computer use time was partly the great variability in the amount of time spent undertaking computer work in the study population and partly the assumption that computer time might co-vary with both the perceived exertion and comfort and musculoskeletal symptoms and thus a potential confounder as described by Rothman [30].
The median follow up time was 10.3 months (interquartile range 4.1-11.2 months). The incidence rate of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.
Our results showed that higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region (Table 2). Moreover, a dose-response relationship between the level of perceived exertion and the risk of developing symptoms was recorded for all three regions. In addition, participants in the high exertion group reported earlier onset of symptoms than did subjects reporting medium or low exertion in the neck (Figure 3). Regarding perceived comfort, there was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen (Table 2).
Table 2 Relative risks (RR) with 95% confidence intervals (95% CI) for neck and upper extremity symptoms in relation to perceived exertion, working technique score and comfort
Kaplan-Meier survival curve for ratings of perceived exertion in the neck (unadjusted) for low (0-4), medium (5-7) and high (8-14) perceived exertion groups.
Working technique was in this study not associated with the risk of developing symptoms in any of the body regions considered (Table 2).
Perceived exertion and comfort
The main result of this study was that high perceived exertion in the neck, shoulder, and arm/hand during computer work is strongly associated with an increased risk of developing musculoskeletal symptoms in the corresponding body region. The results confirm the model suggesting that high perceived exertion is an early sign preceding musculoskeletal symptoms in the neck and upper extremities. Moreover, low perceived comfort is similarly, an early sign associated with an increased risk of neck pain but not of pain in the shoulder and hand/arm region. The clinical significance of the results from this study is that perceived high exertion and/or low comfort could be used in surveys in order to detect computer users at risk for neck and upper extremity musculoskeletal symptoms. Furthermore, in line with the previously identified association between high perceived muscle tension and neck pain [31] presented in the proposed model for computer work and musculoskeletal disorders by Wahlström [23], high perceived exertion and low perceived comfort should be regarded as independent risk factors for future neck and upper extremity symptoms. Similar to the above mentioned study, the risk estimate for perceived exertion in the current study remained significant when potential confounders such as age, sex and computer use time were controlled for.
To our knowledge most studies performed in this field have focused on the relationship between exposures and exertion and/or comfort [32] or on different exposures and symptoms [16, 33, 34]. However, another publication from the present cohort and a study investigating musculoskeletal symptoms among call-center workers have, congruent with the results from our study, reported a relationship between poor perceived overall comfort and musculoskeletal symptoms [17, 24]. In the study by Tornqvist et al there was a two-fold increased risk of developing neck symptoms among computer workers perceiving low overall comfort [17]. Both the above mentioned studies also found an association between overall perceived comfort and shoulder and arm/hand symptoms, respectively, inconsistent with the lack of association seen in our study. However, this inconsistency might partly be explained by the much broader definition of overall comfort used in the cited studies were also lighting conditions, noise, ventilation and temperature were included.
The validity of subjective ratings has previously been questioned for a number of reasons [35, 36]. However, the modified Borg scale (RPE 0-14) [27] used in this study has been used frequently to investigate perceived exertion during both heavy physical work and under more sedentary working conditions such as office work and computer work [28, 29, 37–39]. With respect to the comfort scale a clear dose-response relationship between ratings of comfort and symptoms in the neck and upper extremities has been found in a cross sectional study of call centre workers, where comfort was recorded in questionnaires similar to those used in this study [24].
Working technique
In this study, working technique was not associated with the incidence of neck/and upper extremity symptoms, although earlier cross-sectional studies among computer users have indicated such an association [20, 21, 40]. Likewise, a study on working technique during text editing tasks on mobile phones has indicated differences in working technique between subjects with and without symptoms [41]. One reason for the inconsistency between these studies and our study could be the way working technique is defined. In this study the definition was solely linked to physical factors (forearm support, computer mouse movements, sitting in a tense position etc), while the studies suggesting a positive relationship used a broader definition of working technique including both physical, psychological and behavioral aspects.
A recent review evaluating the effects of office ergonomic interventions as a secondary preventive action for workers with musculoskeletal disorders concluded that most outcomes were focused on improved comfort among office workers and that the evidence for the effectiveness of these interventions ranged from insufficient to moderate and that more objective measures were needed [42]. Even though perceived exertion and comfort could not be considered as objective measurements, this study provides support for the model that perceived exertion and comfort are feasible markers in surveys targeting individuals at risk of developing neck and upper extremity disorders. Finally, it could be argued that perceived exertion and perceived comfort might just reflect the exposure brought about by for example poor working postures, but this view is contradicted by the fact that another study exploring potential associations between workload and perceived exertion, found that in jobs with high workloads and high ratings for perceived exertion, the two variables are correlated, but such correlations could not be found in jobs with low workloads [43].
A major strength with this study is its longitudinal study design, which allows us to draw conclusions about cause-effect relationships. The high response rate with 76% of those who answered at least one follow-up questionnaire completing all 10 monthly questionnaires is also a major strength in this study.
The fairly high incidence of neck and upper extremity symptoms could of course be debated. However, concerning shoulder and arm/hand symptoms, approximately the same figures have been reported among office workers in other studies [44, 45]. In these studies the incidence rate for neck symptoms was, however, lower than in our study. The case-definition, 3 days or more during the preceding month, in our study could be questioned but we consider this cut-off to be a fairly "conservative" one in comparison with other case-definitions from the same research field and thus a strength in the study. An even more conservative definition (≥ 7 days during the preceding month) might have been appropriate, but the aim of this study to detect "early signs" of neck and upper extremity symptoms justified, in our opinion, the choice of cut-off limit. Moreover, the same cut-off has been used in other published studies from the same cohort [17, 31].
A possible limitation in the study design that may have influenced the results was that the observations of working technique were made on a single occasion and within a relatively short time frame (10-15 min). Consequently, the observation did not entirely mirror the variation in working technique during a full working day. Even though all observers (ergonomists) were trained to the point that their judgments were standardized, the relatively large number of observers involved in the study might have negatively influenced inter-observer reliability, leading to an increased risk of non-dependent misclassification and thus dilution of effects. However, in a study evaluating the reliability of the checklist, using more than one ergonomist in a similar population of professional computer users, the majority of the variables included in this study showed at least fair to good intra- and inter-observer reliability [46].
Another possible limitation is that the investigated variables, perceived exertion and comfort, as well as the outcomes measurements were self-reported. The validity of self-reports has as mentioned before been questioned [34, 35]. In this case when non traditional "exposures" or rather early signs more related to perceptions within the psychological dimension are used the most feasible alternative is to use self ratings. Finally, no data concerning the intensity of the pain or the effects on function due to pain were taken into consideration in this study. This means that the outcome might include participants with both severe and mild symptoms. However, between 16-18% of all cases reported reduced productivity due to neck and upper extremity symptoms according to another study within the same cohort, this, in addition, might be interpreted as a limitation in function/capability due to pain [6].
There was a strong association between perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between perceived comfort during computer work and incident neck symptoms. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms.
Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, Imbernon E, Goldberg M: Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthritis Rheum. 2006, 55 (5): 765-778. 10.1002/art.22222.
Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C: Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum. 2004, 51 (4): 642-651. 10.1002/art.20535.
European Foundation for the improvment of living and working conditions. [http://www.eurofound.europa.eu/pubdocs/2006/98/en/2/ef0698en.pdf]
Arbetsmiljöstatistik rapport. 2010, [http://www.av.se/dokument/statistik/officiell_stat/ARBORS2010.pdf]
Bostrom M, Dellve L, Thomee S, Hagberg M: Risk factors for generally reduced productivity-a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms. Scand J Work Environ Health. 2008, 34 (2): 120-132. 10.5271/sjweh.1218.
Hagberg M, Vilhemsson R, Tornqvist EW, Toomingas A: Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users. Ergonomics. 2007, 50 (11): 1820-1834. 10.1080/00140130701674539.
Andersen JH, Haahr JP, Frost P: Risk factors for more severe regional musculoskeletal symptoms: a two-year prospective study of a general working population. Arthritis Rheum. 2007, 56 (4): 1355-1364. 10.1002/art.22513.
Bongers PM, Ijmker S, van den Heuvel S, Blatter BM: Epidemiology of work related neck and upper limb problems: psychosocial and personal risk factors (part I) and effective interventions from a bio behavioural perspective (part II). J Occup Rehabil. 2006, 16 (3): 279-302.
Hanvold TN, Veiersted KB, Waersted M: A prospective study of neck, shoulder, and upper back pain among technical school students entering working life. J Adolesc Health. 2010, 46 (5): 488-494. 10.1016/j.jadohealth.2009.11.200.
Harrington CB, Siddiqui A, Feuerstein M: Workstyle as a predictor of pain and restricted work associated with upper extremity disorders: a prospective study. J Hand Surg Am. 2009, 34 (4): 724-731. 10.1016/j.jhsa.2008.12.012.
Nordander C, Ohlsson K, Akesson I, Arvidsson I, Balogh I, Hansson GA, Stromberg U, Rittner R, Skerfving S: Risk of musculoskeletal disorders among females and males in repetitive/constrained work. Ergonomics. 2009, 52 (10): 1226-1239. 10.1080/00140130903056071.
Veiersted KB, Westgaard RH: Development of trapezius myalgia among female workers performing light manual work. Scand J Work Environ Health. 1993, 19 (4): 277-283. 10.5271/sjweh.1473.
Feuerstein M: Functional assessment for persons with musculoskeletal pain and impairment. J Occup Rehabil. 2004, 14 (3): 163-164.
Nicholas RA, Feuerstein M, Suchday S: Workstyle and upper-extremity symptoms: a biobehavioral perspective. J Occup Environ Med. 2005, 47 (4): 352-361. 10.1097/01.jom.0000158705.50563.4c.
Rempel D, Barr A, Brafman D, Young E: The effect of six keyboard designs on wrist and forearm postures. Appl Ergon. 2007, 38 (3): 293-298. 10.1016/j.apergo.2006.05.001.
Rempel DM, Krause N, Goldberg R, Benner D, Hudes M, Goldner GU: A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators. Occup Environ Med. 2006, 63 (5): 300-306. 10.1136/oem.2005.022285.
Tornqvist EW, Hagberg M, Hagman M, Risberg EH, Toomingas A: The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users. Int Arch Occup Environ Health. 2009, 82 (6): 689-702. 10.1007/s00420-009-0396-7.
Wahlstrom J, Lindegard A, Ahlborg G, Ekman A, Hagberg M: Perceived muscular tension, emotional stress, psychological demands and physical load during VDU work. Int Arch Occup Environ Health. 2003, 76 (8): 584-590. 10.1007/s00420-003-0454-5.
Juul-Kristensen B, Jensen C: Self-reported workplace related ergonomic conditions as prognostic factors for musculoskeletal symptoms: the "BIT" follow up study on office workers. Occup Environ Med. 2005, 62 (3): 188-194. 10.1136/oem.2004.013920.
Juul-Kristensen B, Sogaard K, Stroyer J, Jensen C: Computer users' risk factors for developing shoulder, elbow and back symptoms. Scand J Work Environ Health. 2004, 30 (5): 390-398. 10.5271/sjweh.827.
Feuerstein M, Nicholas RA: Development of a short form of the Workstyle measure. Occup Med. 2006, 56 (2): 94-99.
Sauter SL, Swanson NG: An ecological model of musculoskeletal disorders in office work. Beyond biomechanics: Psychosocial aspects of musculoskeletal disorders in office work. Edited by: Moon SD, Sauter SL. 1996, 3-21.
Wahlstrom J: Ergonomics, musculoskeletal disorders and computer work. Occupational Medicine. 2005, 55 (3): 168-176. 10.1093/occmed/kqi083.
Norman K, Floderus B, Hagman M, Toomingas A, Tornqvist EW: Musculoskeletal symptoms in relation to work exposures at call centre companies in Sweden. Work. 2008, 30 (2): 201-214.
Lindegård Andersson A: Working technique during computer work. Arbete och Hälsa. 2007, 41: 1-
Ergonomic checklist for computer work. 1997, [http://www.sahlgrenska.se/upload/SU/omrade_6/Arbets-%20och%20Miljömedicin/AMM/fhvmetodik/checklista.pdf]
Borg G: Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health. 1990, 16 (Suppl 1): 55-58.
Karlqvist LK, Bernmark E, Ekenvall L, Hagberg M, Isaksson A, Rostö T: Computer mouse position as a determinant of posture, muscular load and perceived exertion. Scand J Work Environ Health. 1998, 24 (1): 62-73. 10.5271/sjweh.279.
Lindegård A, Wahlström J, Hagberg M, Hansson G-Å, Jonsson P, Wigaeus Tornqvist E: The impact of working technique on physical loads - an exposure profile among newspaper editors. Ergonomics. 2003, 46 (6): 598-615. 10.1080/0014013031000071360.
Rothman KJ, Greenland S, Lash TL: Modern epidemiology. 2008, Philadelphia: Lippincott Williams & Wilkins
Wahlstrom J, Hagberg M, Toomingas A, Wigaeus Tornqvist E: Perceived muscular tension, job strain, physical exposure, and associations with neck pain among VDU users; a prospective cohort study. Occup Environ Med. 2004, 61 (6): 523-528. 10.1136/oem.2003.009563.
Lindegård A, Gustafsson M, Hansson GA: Effects of prismatic glasses including optometric correction on head and neck kinematics, perceived exertion and comfort during dental work in the oral cavity-a randomised controlled intervention. Appl Ergon. 2012, 43 (1): 246-253. 10.1016/j.apergo.2011.05.011.
Arvidsson I, Axmon A, Skerfving S: Follow-up study of musculoskeletal disorders 20 months after the introduction of a mouse-based computer system. Scand J Work Environ Health. 2008, 34 (5): 374-380. 10.5271/sjweh.1277.
Sillanpää J, Huikko S, Nyberg M, Kivi P, Laippala P, Uitti J: Effect of work with visual display units on musculo-skeletal disorders in the office environment. Occup Med. 2003, 53 (7): 443-451. 10.1093/occmed/kqg120.
Hansson GA, Balogh I, Bystrom JU, Ohlsson K, Nordander C, Asterland P, Sjolander S, Rylander L, Winkel J, Skerfving S: Questionnaire versus direct technical measurements in assessing postures and movements of the head, upper back, arms and hands. Scand J Work Environ Health. 2001, 27 (1): 30-40. 10.5271/sjweh.584.
Stock SR, Fernandes R, Delisle A, Vezina N: Reproducibility and validity of workers' self-reports of physical work demands. Scand J Work Environ Health. 2005, 31 (6): 409-437. 10.5271/sjweh.947.
Balogh I, Orbaek P, Ohlsson K, Nordander C, Unge J, Winkel J, Hansson GA: Self-assessed and directly measured occupational physical activities-influence of musculoskeletal complaints, age and gender. Appl Ergon. 2004, 35 (1): 49-56. 10.1016/j.apergo.2003.06.001.
Gustafsson E, Hagberg M: Computer mouse use in two different hand positions: exposure, comfort, exertion and productivity. Appl Ergon. 2003, 34 (2): 107-113. 10.1016/S0003-6870(03)00005-X.
Jang R, Karwowski W, Quesada PM, Rodrick D, Sherehiy B, Cronin SN, Layer JK: Biomechanical evaluation of nursing tasks in a hospital setting. Ergonomics. 2007, 50 (11): 1835-1855. 10.1080/00140130701674661.
Lindegård A, Wahlstrom J, Hagberg M, Hansson GA, Jonsson P, Wigaeus Tornqvist E: The impact of working technique on physical loads - an exposure profile among newspaper editors. Ergonomics. 2003, 46 (6): 598-615. 10.1080/0014013031000071360.
Gustafsson E, Johnson PW, Lindegard A, Hagberg M: Technique, muscle activity and kinematic differences in young adults texting on mobile phones. Ergonomics. 2011, 54 (5): 477-487. 10.1080/00140139.2011.568634.
Leyshon R, Chalova K, Gerson L, Savtchenko A, Zakrzewski R, Howie A, Shaw L: Ergonomic interventions for office workers with musculoskeletal disorders: a systematic review. Work. 2010, 35 (3): 335-348.
Village J, Frazer M, Cohen M, Leyland A, Park I, Yassi A: Electromyography as a measure of peak and cumulative workload in intermediate care and its relationship to musculoskeletal injury: an exploratory ergonomic study. Appl Ergon. 2005, 36 (5): 609-618. 10.1016/j.apergo.2005.01.019.
Eltayeb S, Staal JB, Hassan A, de Bie RA: Work related risk factors for neck, shoulder and arms complaints: a cohort study among Dutch computer office workers. J Occup Rehabil. 2009, 19 (4): 315-322. 10.1007/s10926-009-9196-x.
Eltayeb SM, Staal JB, Khamis AH, de Bie RA: Symptoms of neck, shoulder, forearms, and hands: a cohort study among computer office workers in Sudan. Clin J Pain. 2011, 27 (3): 275-281. 10.1097/AJP.0b013e3181fe94ef.
Norman K, Alm H, Wigaeus Tornqvist E, Toomingas A: Reliability of a questionnaire and an ergonomic checklist for assessing working conditions and health at call centres. Int J Occup Saf Ergon. 2006, 12 (1): 53-68.
This study was supported by the Swedish Council for Working Life and Social Research. We would also like to acknowledge the work places, the ergonomists from the occupational health services participating in the study and the "Epimouse-group" for their skilful work.
Finally, we would like to acknowledge all the participants in the study for letting us use their valuable time, thus making the study possible.
Institute of Stress Medicine, Göteborg, Sweden
Agneta Lindegård
Department of Public Health & Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
Jens Wahlström
Occupational and Environmental Medicine, Sahlgrenska Academy and University hospital, Göteborg, Sweden
Mats Hagberg
Clinical Information Science AstraZeneca R & D, Mölndal, Sweden
Rebecka Vilhelmsson
Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
Allan Toomingas
School of Health Sciences, Jönköping University, Jönköping, Sweden
Ewa Wigaeus Tornqvist
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Correspondence to Agneta Lindegård.
AL was part of the team that collected data for this study, participated in the design of the study, performed the data analyses and drafted the manuscript. JW participated in the design of the study, performed the data analysis and helped to draft the manuscript. RW participated in the data analysis. MH participated in the design of the study and helped to draft the manuscript. AT participated in the design of the study and helped to draft the manuscript. EWT conceived the study, participated in the design of the study and helped to draft the manuscript. All authors read and approved the final manuscript.
Perceived exertion
Perceived comfort
neck and upper extremity disorders

redpajama_set_name: RedPajamaCommonCrawl


THANK YOU FOR YOUR INTEREST BUT ALL WEEKS OF CAMP ARE NOW FULL.
Our summer camp sessions will be from 10:00am until 2:00pm and will include a large lunch prepared during camp each day. Total cost for week of camp is $210 (this $60 deposit plus remaining balance of $150 due by June 1).
A broad range of topics will be taught that include: Kitchen Safety, Basic Kitchen Skills, basic knife skills, menu planning, nutrition, the science of baking, how to understand (and follow) a recipe, and proper dish washing technique.
Camp has a limited number of participants. This non-refundable deposit of $60 will reserve a reserve a space in camp for one child. The balance of $150 per participant for the remaining camp fee and necessary paperwork are due by June 1st. Campers will receive an apron, recipe packet, and certificate of completion, that they will take home at the end of their week.
Tuesday Menu-Mexican Foods: Quesadillas, Salsa, Queso dip, and "Fried" Ice Cream.
Wednesday Menu- French Foods: Herb Roast Chicken, roasted potatoes, salad and lemon crepes.
Thursday Menu- Farmer's Market Fresh Flavor: fresh local produce with- Mashed Potatoes, Green Beans, and Meatloaf.
Friday Menu- Italian Food: Fresh Pasta, Marinara with fresh herbs from our garden, salad with Italian dressing.


Brussels, 23 June 2016. IAB Europe welcomes the Dutch government's confirmation that ad blocking detection is legal, and moreover exempted from any consent rules due to the practice having no or only miniscule effects on user privacy.
"The Dutch government's interpretation is true to the spirit of the ePrivacy Directive", said Townsend Feehan, CEO of IAB Europe, "and will ensure that Dutch publishers can continue educating users about the value of advertising. We are confident that other European countries will share the Dutch view.


text:
IBM to make 'aggressive' run at SMEs
Chris Kanaracus 20 January, 2008 22:00
IBM is developing a new, "one-stop-shop" product offering, Lotus Foundations, aimed at companies with five to 500 employees, it said testerday.
Lotus Foundations will consist of on-premise software servers sold primarily through partners. IBM is also developing a set of accompanying web-hosted services, now available in a beta version.
The company plans to bundle Lotus Domino, file management, directory services, firewall, backup and productivity tools in the initial offering of Lotus Foundations. Customers who need more power will be able to bring on additional servers, according to IBM. The company's partner community will also be able to integrate their own applications into the core platform.
The server software sold under Foundations will be autonomic or "self-healing," and therefore appropriate for small companies without paid IT staffers, IBM said.
Foundations will be the home of technology IBM acquired through its purchase last week of Net Integration Technologies. That deal is set to close later this year.
"Net Integration is a key part of our strategy here. That's why we bought them," said Mike Rhodin, general manager of Lotus, during a press conference on Monday at IBM's Lotusphere show in Orlando, Florida.
IBM did not release pricing information, but Rhodin indicated the company plans to compete vigorously for market share.
"Our intent as we price the Foundations offering, to be blunt, is to be very aggressive," Rhodin said. "The total value we'll put around the solution is going to be pretty big for the customer and we're going to leave some room in there for the partner to make some money."
Also on Monday, IBM and SAP said they are codeveloping a software product under the codename "Atlantic," which will integrate IBM's Lotus Notes collaboration and office productivity software with SAP's Business Suite.
The Atlantic project represents a further deepening of the long-standing relationship between IBM and SAP.
"We think the timing is just right," Rhodin said. "The timing for collaboration and business systems to come together is right now."
The first release of Atlantic is expected to ship in the fourth quarter of this year, and will feature support for SAP workflows, reporting and analytics. It will also include the ability to use roles from within the Lotus Notes client, and tools for expanding these core capabilities, IBM said in a statement.
Tags IBMSAPLotus


Can Our Planet Be Saved?
How Confident is your Faith?
Is SATAN a being who may be WORSHIPPED?
IS SATAN A FALLEN ANGEL?
Is the DEVIL a SUPERNATURAL Being?
Is the TRINITY Biblical teaching?
IS there a SUPERNATURAL SATAN?
Jesus Christ could not have been invented!
MOST Church Teaching is CORRUPTED!
The Da Vinci Code - Fact or Fiction?
The Rapture - True or False?
THE TRINITY - Bible Truth or False Teaching?
Why should I Believe in a God I can't See?
Will the EARTH ever be Destroyed?
A RELIGION THAT MAKES SENSE!
For those of us who have and love our pets, this story my be a familiar one to us.
One Saturday morning I received an urgent call from a friend of mine, who told me her dog was very ill.
As she didn't have a car of her own, she asked me to help her take her dog to the vet.
The dog was lying on the floor on an old sheet and was unable to move his legs because they had stopped working – this was serious. With the help of another neighbour, we managed to carry him to the car and laid him down in the back. Then, with the sick dog settled in the back, my friend and I drove to the vets. When we arrived, the vet and a veterinary nurse lifted him out of the car and took him into the surgery.
The vet told us he didn't know what was wrong, but the dog was obviously very sick. It would cost a lot of money to investigate, which my friend could not afford, and the vet felt there was little likelihood of a recovery. The only other option was to 'put the dog to sleep'.
After a brief discussion, my friend decided on the second option, although it was a painfully sad one.
She was upset, and I was too because I'd known the dog since he was a puppy. The vet gave him the lethal injection; he went from a creature that was obviously alive to a lifeless corpse.
He lay there with his eyes open, a solid unyielding body that had once been a much–loved pet; but now the life had gone from him, he was transformed into a lifeless, dog–shaped lump.
Sad as it was, the experience set me thinking about death and the miracle of life. God the Creator gave life in the beginning – life is very precious; He made life upon earth for a reason.
Genesis chapter 1 tells us that God spoke and created plants and trees, fish and birds and then the land creatures.
Then God said, "Let the earth bring forth the living creature according to its kind: cattle and creeping thing and beast of the earth, each according to its kind"; and it was so (Genesis 1:24).
Finally, God created Adam and Eve who were to be the pinnacle of His creation.
Of every tree of the garden you may freely eat; but of the tree of the knowledge of good and evil you shall not eat, for in the day that you eat of it you shall surely die (Genesis 2:16–17).
"For what happens to the sons of men also happens to animals; one thing befalls them: as one dies, so dies the other. Surely, they all have one breath; man has no advantage over animals, for all is vanity. All go to one place: all are from the dust, and all return to dust" (Ecclesiastes 3:19–20).
"For the living know that they will die; but the dead know nothing, and they have no more reward, for the memory of them is forgotten" (9:5).
"Return, O LORD, deliver me! Oh, save me for Your mercies' sake! For in death there is no remembrance of You; In the grave who will give You thanks?" (Psalm 6:4–5).
"Do not put your trust in princes, nor in a son of man, in whom there is no help. His spirit departs, he returns to his earth; in that very day his plans perish" (Psalm 146:3–4).
However, God did not want this situation to remain – He has a plan which will ultimately result in the Garden of Eden being restored upon earth and the earth being populated by immortal, obedient believers.
This will be in the Kingdom of God.
It was in speaking to the serpent in the story, that God showed there is a way for mankind to come back to Him.
"I will put enmity between you and the woman, and between your seed and her seed; he shall bruise your head, and you shall bruise his heel" (Genesis 3:15).
From that time on, the serpent came to symbolise sin. It was part of God's plan from the very beginning that He was, at some time in the future, going to send someone who would save people from sin, specifically those who showed faith in God. The promised Saviour was to deal a death–blow to sin (bruise the head of the serpent) but it would hurt him temporarily (bruise his heel) in the process.
so through one man's righteous act the free gift came to all men, resulting in justification of life. For as by one man's disobedience many were made sinners, so also by one man's obedience many will be made righteous" (Romans 5:17–19).
When Life is mentioned in the Bible and particularly in the New Testament, it usually means eternal life.
"For God so loved the world that He gave His only begotten Son, that whoever believes in him should not perish but have everlasting life. For God did not send His Son into the world to condemn the world, but that the world through him might be saved" (John 3:16–17).
It is a comforting fact that God does not want anyone to perish. However, if we refuse to listen to His word and His Son, we effectively bring condemnation on ourselves. By ignoring His appeal, we leave ourselves subject to sin and permanent death. It was the same in the time of Jesus.
"And this is the condemnation, that the light has come into the world, and men loved darkness rather than light, because their deeds were evil. For everyone practicing evil hates the light and does not come to the light, lest his deeds should be exposed. But he who does the truth comes to the light, that his deeds may be clearly seen, that they have been done in God" (v19–21).
Jesus came into the world to grant life to any who sincerely believe in him and come to God through him.
This is the hope we can share.
When the Lord Jesus Christ returns to earth, he will raise the dead and judge them. He will decide who has genuinely tried to do the will of God, and should be granted eternal life.
"For as the Father raises the dead and gives life to them, even so the Son gives life to whom he will. For the Father judges no one, but has committed all judgment to the Son… For as the Father has life in Himself, so He has granted the Son to have life in himself, and has given him authority to execute judgment also, because he is the Son of Man. Do not marvel at this; for the hour is coming in which all who are in the graves will hear his voice and come forth — those who have done good, to the resurrection of life, and those who have done evil, to the resurrection of condemnation" (John 5:21–22, 26–29).
We should be excited at the prospect of being found worthy to enter the kingdom of God, and should make the effort now to respond to Him, to be baptised and to do our best to please Him.
"When the Son of Man comes in his glory, and all the holy angels with him, then he will sit on the throne of his glory… Then the King will say to those on his right hand, Come, you blessed of my Father, inherit the kingdom prepared for you from the foundation of the world" (Matthew 25:31, 34).


text:
package com.googlecode.eyesfree.utils;

import android.support.v4.view.accessibility.AccessibilityNodeInfoCompat;

/**
 * A class that simplifies traversal of node trees.
 *
 * This class keeps track of an {@link AccessibilityNodeInfoCompat}
 * object and can traverse to other nodes in the tree, or be reset to
 * other nodes.  The node can be owned, in which case it will be
 * recycled when traversed away from or when a new node is assigned
 * to an object of this class.
 *
 * Any node can be assigned to objects of this class, including nodes that
 * are not visible to the user.  The traversal methods, however, will only
 * traverse to visible nodes.
 *
 * @see AccessibilityNodeInfoUtils#isVisibleOrLegacy(AccessibilityNodeInfoCompat)
 */
public class AccessibilityNodeInfoRef {
    private AccessibilityNodeInfoCompat mNode;
    private boolean mOwned;

    /**
     * Returns the current node.
     */
    public AccessibilityNodeInfoCompat get() {
        return mNode;
    }

    /**
     * Clears this object, recycling the underlying node if owned.
     * This object should not be used after this method is called.
     */
    // TODO(plundblad): Add a pool if proven necessary.
    public void recycle() {
        clear();
    }

    /**
     * Clears this object, recycling the underlying node if owned.
     */
    public void clear() {
        reset((AccessibilityNodeInfoCompat) null);
    }

    /**
     * Resets this object to contain a new node, taking ownership of the
     * new node.
     */
    public void reset(AccessibilityNodeInfoCompat newNode) {
        if (mNode != newNode && mNode != null && mOwned) {
            mNode.recycle();
        }
        mNode = newNode;
        mOwned = true;
    }

    /**
     * Resets this object with the node held by {@code newNode}.
     * if {@code newNode} was owning the node, ownership is
     * transfered to this object.
     */
    public void reset(AccessibilityNodeInfoRef newNode) {
        reset(newNode.get());
        mOwned = newNode.mOwned;
        newNode.mOwned = false;
    }

    /**
     * Creates a new instance of this class containing a new copy of
     * {@code node}.
     */
    public static AccessibilityNodeInfoRef obtain(
        AccessibilityNodeInfoCompat node) {
        return new AccessibilityNodeInfoRef(
            AccessibilityNodeInfoCompat.obtain(node), true);
    }

    /**
     * Creates a new instance of this class without assuming ownership of
     * {@code node}.
     */
    public static AccessibilityNodeInfoRef unOwned(
        AccessibilityNodeInfoCompat node) {
        return node != null ? new AccessibilityNodeInfoRef(node, false) : null;
    }

    /**
     * Creates a new instance of this class taking ownership of {@code node}.
     */
    public static AccessibilityNodeInfoRef owned(
        AccessibilityNodeInfoCompat node) {
        return node != null ? new AccessibilityNodeInfoRef(node, true) : null;
    }

    /**
     * Creates an {@link AccessibilityNodeInfoRef} with a refreshed copy
     * of {@code node}, taking ownership of the copy.
     * If {@code node} is {@code null}, {@code null} is returned.
     */
    public static AccessibilityNodeInfoRef refreshed(
        AccessibilityNodeInfoCompat node) {
        return owned(AccessibilityNodeInfoUtils.refreshNode(node));
    }

    /**
     * Makes sure that this object owns its own copy of the node
     * it holds by creating a new copy of the node if not already
     * owned or doing nothing otherwise.
     */
    public AccessibilityNodeInfoRef makeOwned() {
        if (mNode != null && !mOwned) {
            reset(AccessibilityNodeInfoCompat.obtain(mNode));
        }
        return this;
    }

    public AccessibilityNodeInfoRef() {
    }

    public static boolean isNull(
        AccessibilityNodeInfoRef ref) {
        return ref == null || ref.get() == null;
    }

    private AccessibilityNodeInfoRef(AccessibilityNodeInfoCompat node,
            boolean owned) {
        mNode = node;
        mOwned = owned;
    }

    /**
     * Releases the ownership of the underlying node if it was owned,
     * returning the underlying node.  This is typically chained with
     * {@link #makeOwned} to have a copy that can be put in another
     * container or {@link AccessibilityNodeInfoRef}.
     * After this call, this object still refers to the underlying node
     * so that any of the traversal methods can be used afterwards.
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    public AccessibilityNodeInfoCompat release() {
        mOwned = false;
        return mNode;
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    /**
     * Traverses to the last child of this node, returning {@code true}
     * on success.
     */
    public boolean lastChild() {
        if (mNode == null || mNode.getChildCount() < 1) {
            return false;
        }
        for (int i = mNode.getChildCount() - 1; i >= 0; --i) {
            AccessibilityNodeInfoCompat newNode = mNode.getChild(i);
            if (newNode == null) {
                return false;
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            if (AccessibilityNodeInfoUtils.isVisibleOrLegacy(newNode)) {
                reset(newNode);
                return true;
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            newNode.recycle();
        }
        return false;
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    /**
     * Traverses to the previous sibling of this node within its parent,
     * returning {@code true} on success.
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    public boolean previousSibling() {
        if (mNode == null) {
            return false;
        }
        AccessibilityNodeInfoCompat parent = mNode.getParent();
        if (parent == null) {
            return false;
        }
        try {
            int childNumber = getChildNumber(parent);
            for (int i = childNumber - 1; i >= 0; --i) {
                AccessibilityNodeInfoCompat newNode = parent.getChild(i);
                if (newNode == null) {
                    return false;
                }
                if (AccessibilityNodeInfoUtils.isVisibleOrLegacy(newNode)) {
                    reset(newNode);
                    return true;
                }
                newNode.recycle();
            }
        } finally {
            parent.recycle();
        }
        return false;
    }

    /**
     * Traverses to the first child of this node if any, returning
     * {@code true} on success.
     */
    public boolean firstChild() {
        if (mNode == null) {
            return false;
        }
        int childCount = mNode.getChildCount();
        for (int i = 0; i < childCount; ++i) {
            AccessibilityNodeInfoCompat newNode = mNode.getChild(i);
            if (newNode == null) {
                return false;
            }
            if (AccessibilityNodeInfoUtils.isVisibleOrLegacy(newNode)) {
                reset(newNode);
                return true;
            }
            newNode.recycle();
        }
        return false;
    }

    /**
     * Traverses to the next sibling of this node within its parent, returning
     * {@code true} on success.
     */
    public boolean nextSibling() {
        if (mNode == null) {
            return false;
        }
        AccessibilityNodeInfoCompat parent = mNode.getParent();
        if (parent == null) {
            return false;
        }
        try {
            int childCount = parent.getChildCount();
            int childNumber = getChildNumber(parent);
            if (childNumber < 0) {
                return false;
            }
            for (int i = childNumber + 1; i < childCount; ++i) {
                AccessibilityNodeInfoCompat newNode =
                        parent.getChild(i);
                if (newNode == null) {
                    return false;
                }
                if (AccessibilityNodeInfoUtils.isVisibleOrLegacy(newNode)) {
                    reset(newNode);
                    return true;
                }
                newNode.recycle();
            }
        } finally {
            parent.recycle();
        }
        return false;
    }

    /**
     * Traverses to the parent of this node, returning {@code true} on
     * success. On failure, returns {@code false} and does not move.
     */
    public boolean parent() {
        if (mNode == null) {
            return false;
        }
        AccessibilityNodeInfoCompat parentNode = mNode.getParent();
        while (parentNode != null) {
            if (AccessibilityNodeInfoUtils.isVisibleOrLegacy(parentNode)) {
                reset(parentNode);
                return true;
            }
            AccessibilityNodeInfoCompat tmp = parentNode.getParent();
            parentNode.recycle();
            parentNode = tmp;
        }
        return false;
    }

    private int getChildNumber(AccessibilityNodeInfoCompat parent) {
        int ret = -1;
        int childCount = parent.getChildCount();
        for (int i = 0; i < childCount && ret < 0; ++i) {
            AccessibilityNodeInfoCompat child = parent.getChild(i);
            if (mNode.equals(child)) {
                ret = i;
            }
            if (child != null) {
                child.recycle();
            }
        }
        return ret;
    }

    /**
     * Traverses to the next node in depth-first order, returning {@code true}
     * on success.
     */
    public boolean nextInOrder() {
        if (mNode == null) {
            return false;
        }
        if (firstChild()) {
            return true;
        }
        if (nextSibling()) {
            return true;
        }
        AccessibilityNodeInfoRef tmp = unOwned(mNode);
        while (tmp.parent()) {
            if (tmp.nextSibling()) {
                reset(tmp);
                return true;
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        }
        tmp.clear();
        return false;
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    /**
     * Traverses to the previous node in depth-first order, returning
     * {@code true} on success.
     */
    public boolean previousInOrder() {
        if (mNode == null) {
            return false;
        }
        if (previousSibling()) {
            lastDescendant();
            return true;
        }
        return parent();
    }

    /**
     * Traverses to the last descendant of this node, returning {@code true} on
     * success.
     */
    public boolean lastDescendant() {
        if (!lastChild()) {
            return false;
        }
        while (lastChild()) {
            // Nothing to do.
        }
        return true;
    }
}

redpajama_set_name: RedPajamaGithub


text:
Employment and Recidivism
Tianyin Yu, University of New Haven
According to data from the U.S. Bureau of Justice Statistics (BJS), 67.8% of released state prisoners were arrested for a new crime within three years, and 76.7% were arrested within five years (Durose, Cooper, & Snyder, 2014). Reducing recidivism not only protects society at large, but also improves the life quality of individual ex-prisoners. Employment has long been recognized as having a negative correlation with crime (Uggen, 1999; Uggen et al., 2005). However, ex-prisoners face tremendous difficulties in obtaining employment opportunities post-release. Such a disadvantaged situation may be attributable to multiple reasons. First, most of the offenders may simply lack the necessary job skills for specific positions, keeping them from those usually higher paid and more stable jobs. Second, many employers are reluctant to hire these people due to the stigma imposed by their previous criminal records.
This review aims to explore the general effect of employment on recidivism, the gender effect of employment on recidivism, and the role of job characteristics play in deterring crime, as well as to examine how incarceration may affect ex-prisoners in their pursuit of jobs. Policy implications based on the extant research and future research directions also will be discussed.
Previous Findings
Studies on the association between employment and crime have never been lacking (Lageson & Uggen, 2013). Most of the studies have focused exclusively on men (Laub & Sampson, 2003; Skardhamar & Savolainen, 2014; van der Geest, Bijleveld, & Blokland, 2011). Theories such as social control and rational choice assume employment should have a crime deterrent effect. Many service programs are in place to help offenders to build job skills. However, evaluations of these programs have yielded mixed results. Some have found positive effects on recidivism (e.g., Redcross, Millenky, Rudd, & Levshin, 2012), while others have found little or no effect (e.g., Bushway & Apel, 2012; Cook et al., 2015).
One longitudinal study consisted of a large sample from Norwegian prisons (Skardhamar & Telle, 2012) and used a wide range of individual information (offense type, post-release education, post-release social benefits, drug use/possession, time served, immigrant background, family type, education, parents' education, previous earnings from work, etc.). The researchers found that employment is associated with reduced recidivism, with the association "strongest for those who were sentenced for property and economic offenses and least strong for those who were sentenced for violent and traffic offenses" (Skardhamar & Telle, 2012, p.646-647). Their measure of post-release employment, though, "is based on being registered in the central employee register," which does not include characteristics of the job.
Some studies do incorporate characteristics of the job. One such example is by Uggen (1999). In this study, it was found that job quality had a strong and robust effect on economic and non-economic criminal behavior (Uggen, 1999). Another longitudinal study by van der Geest and colleagues (2011) also considered both job quality and stability. They found a significant relationship between employment and delinquent development among most offender groups.
Others have focused on the timing of the employment (Skardhamar & Savolainen, 2014) and the effect of social ties on employment and recidivism (Berg & Huebner, 2011). Offenders with stronger family ties were more likely to be employed, and those who were employed and had strong ties to family were less likely to recidivate (Berg & Huebner, 2011). In terms of timing, Skardhamar and Savolainen (2014) asked specifically the question of whether employment promotes desistance from crime by testing two contradicting hypotheses – the turning point hypothesis (reductions in offending after job entries) and the hook-for-change hypothesis (desistance occurring before successful transitions to legitimate work). Interestingly, they found that "most offenders had desisted prior to the employment transition and that becoming employed was not associated with further reductions in criminal behavior" (Skardhamar & Savolainen, 2014, p. 263). Nevertheless, there seem to be a tiny portion (less than 2%) of the sample that became employed while engaging in active criminal activity, and subsequently decreased their criminal activity (Skardhamar & Savolainen, 2014).
Contemporary Research and Findings
A study by Ramakers and colleagues (2016) used observational longitudinal Dutch data from the Prison Project to measure ex-prisoners' recidivism risk in relation to employment and its characteristics. Specifically, the researchers investigated whether "job duration, returning to pre-prison employer, working as an employee versus self-employed, hours, and occupational level" have any effect on recidivism outcomes. Because of the design, one cannot rule out the possibility that the recidivism outcomes are due to factors other than employment and its characteristics (education, marital status, offender type, etc.), as people with various recidivism risks may self-select themselves into jobs of different qualities. To address this issue, the authors controlled for a wide range of individual characteristics and life domains in multivariate analyses. Separate propensity score models were used for each of the six independent variables (employed, employee, job retention, full-time job, higher occupational level, return job), with 34 potential confounding factors.
Results from the bivariate analyses indicated that overall, unemployed ex-prisoners were more likely to re-offend than those employed, and that "a higher occupational level seems to be related to a lower risk of reoffending" (Ramakers et al., 2016, p. 15). Meanwhile, it was found that working as an employee or being self-employed and work intensity do not seem to affect recidivism. Multivariate analyses, however, revealed that after controlling for the confounding factors, employment did not seem to affect recidivism, while "type of job remains significantly related to reoffending" (Ramakers et al., 2016, p. 17).
This study advanced our knowledge of the relationship between types of job and recidivism, by incorporating multiple independent variables on job characteristics and careful design to minimize selection bias. Nonetheless, a few aspects are still waiting to be explored by future studies. First, a universal problem in many quasi-experimental studies is that, however many variables are controlled, there will be selection bias to some extent. Second, one important job characteristic, wage, was not included in this study. As one would imagine, being able to pay off monthly bills by using their wages would mean a lot to ex-prisoners. On the other hand, if they could hardly make ends meet, it would likely pull them toward yet another criminal event. Link and Roman (2017) provided some insights into the financial aspects by studying the relationship between child support debt, employment, and recidivism following incarceration. It was found that "higher child support debt significantly reduced employment" in a 15-month follow up period, indicating the strain of financial burden may have an impact on employment, thus further affecting recidivism (Link and Roman, 2017). Third, the authors also acknowledged they used a relatively short follow-up period (6 months). Had the study extended its duration, could it have yielded different outcomes? Finally, as was mentioned earlier, studies in this area tend to focus on male criminals. Although women account for a small portion of the total criminal population, research to date has shown varying (un)employment effects for the two genders (Verbruggen, Blokland, & van der Geest, 2012).
Concerning the gender question, a recent study by Denver and colleagues (2017) advanced our knowledge by focusing on a sample of nursing home and home health-care job applicants, of which the majority (two-thirds) were women with criminal records. Specifically, Denver and colleagues (2017) examined "how a criminal background check affects subsequent criminal justice involvement for individuals with records" (p. 177). In this study, to conquer the selection bias, they used "an instrumental variable (IV) approach" and controlled virtually every aspect (candidate's criminal history, demographic and geographic characteristics, etc.) on which the decision of background clearance is made. Theoretically, as the authors argued, the leftover variation should be "as good as random." In addition to gender, they also examined the age effect on recidivism.
Results show that gender and age do matter. Overall, "older individuals experience smaller treatment effects … on subsequent arrest" (p. 197). Particularly, older women "experienced an almost null effect" of background clearance, whereas men (young and old) "seem to be responsive to the background check decision" (p. 197). It is worth noting that the fact that older women being irresponsive to the background check decision does not necessarily mean they are callous about being able to get a job. As the authors point out, it may simply be that they are less likely to recidivate in the first place. In addition to the background clearance effect on subsequent arrest, the authors went a step further to examine the impact of overall employment on recidivism. In general, results showed that while "women still have a low-to null effect," men "experience a substantial impact," a sizeable portion of which can only be attributable to increased employment opportunities. Such a result is not surprising, given that gender differences in offending have long been recognized by scholars (Daly, 1992; Fagan, 2015; Liu, 2015).
What is worth mentioning is that this sample consists of ex-offenders who are motivated to seek a job, which is different than most of the previous studies examining the employment effect on recidivism. It thus makes it possible to control for motivation and examine precisely the effect of allowing one to work on recidivism. Labeling theory (Becker, 1963) posits that people with criminal records receive negative impressions from others. In other words, given two persons who have everything else equal (age, education, gender, personality, etc.), the one with a criminal record would experience a negative impact of the legal sentencing beyond legal sentencing per se. Employment being a crucial step following releasing, and a good indicator of recidivism, certainly warrants closer examination.
Previous studies have probed the impact of incarceration on employment (Apel & Sweeten, 2010; Raphael, 2007; Fagan and Freeman, 1999; Western, Kling, and Weiman, 2001). In general, results show the effect of incarceration tend to differ across time (Western & Beckett, 1999), and age (Fagan & Freeman, 1999). In an article by van der Geest and colleagues (2016), the authors examined "the effects of incarceration on longitudinal trajectories of employment" by using "observational data on the employment careers from age 23 up to age 32 in 270 high-risk makes" (p. 107). As most of the studies of this kind, random assignment was difficult to implement, so the authors chose to use trajectory models to control for heterogeneity. Four employment trajectories were identified: normative, delayed onset, dropouts, and non-participating. For the non-participating group, after controlling for the characteristics, it was found that incarceration did not affect employment in this category, which is not surprising. As the authors speculated, it may be mainly due to their already poor job skills, social skills, and personality traits, which would have made this group not competent to employment anyway. Meanwhile, a greater negative impact was found among those who were more regularly employed than those who had limited work experience. However, the effect was found to be temporary (van der Geest and colleagues, 2016).
One of the advantages of this study lies in its longitudinal nature (from age 23 to 32), which enables observation of long-term effects of incarceration. The shortcoming, though, is the small sample size (270). As the authors also acknowledged, had the sample size been large enough, it would be possible to control other factors and test exclusively for the effects of incarceration on employment. Also, this study used data from the Netherlands. What would the result look like if it was conducted in the United States? That would leave the need for future research.
Policy Implications and Future Research
Based on the extant research findings, we know that the effect of employment does not apply equally to everyone of different ages, gender, and background. The fact that many of the evaluation studies on employment-oriented reentry programs have failed to yield solid positive results should trigger the question of – why not? As evidence indicates, not every type of job, but jobs of higher quality, will influence recidivism (Ramakers et al., 2016). Therefore, employment-oriented programs should focus on building technical skills and knowledge of the ex-prisoners and help them to get jobs that are of higher quality. Meanwhile, scarce resources need to be focused on those who are most likely to be affected by (un)employment – younger men. As evidence shows, women of older age are the least likely to be influenced by work (Denver et al., 2017). It is possible that their recidivism rates are low in the first place, or (un)employment may simply mean little to them. Either way, programs other than employment training should be utilized for this specific population. Because research in this area is rare, future research should look to verify findings of gender differences.
Meanwhile, there is evidence showing that ex-offenders do face extra obstacles than people who do not have criminal records while seeking for jobs, and that the negative impact is most prominent for those who are regularly employed (van der Geest et al., 2016). One needs to keep in mind that the Netherlands, when compared to the United States, has relatively shorter prison sentences and more lenient laws (van der Geest et al., 2016). Therefore, when it comes to the United States, one would assume that ex-prisoners in the United States may face greater obstacles. The question of how to balance public safety and provide reentry support for individual ex-offenders is always a difficult one. However, a blanket ban on job opportunities by employers certainly is not the best solution. It is encouraging that during the past few years, efforts have been put in place to promote the hiring of people with records (Avery & Hernandez, 2017). Future research should investigate how to best balance public safety and individual ex-offender's wellbeing, by probing into why ex-offenders who hold jobs re-offend and considering their offense types, as well as how to reduce risk factors.
Apel, R., & Sweeten, G. (2010). The Impact of Incarceration on Employment during the Transition to Adulthood. Social Problems, 57(3), 448-479. Retrieved from http://www.jstor.org/stable/10.1525/sp.2010.57.3.448
Avery, B., & Hernandez, P. (2017, August 1). National Employment Law Project. Retrieved November 2017, from BAN THE BOX: U.S. CITIES, COUNTIES, AND STATES ADOPT FAIR HIRING POLICIES: http://www.nelp.org/publication/ban-the-box-fair-chance-hiring-state-and-local-guide/
Becker, H. S. (1963). Outsiders: Studies in the sociology of deviance. NY, New York: The Free Press.
Berg, M. T., & Huebner, B. M. (2011). Reentry and the ties that bind: An examination of social ties, employment, and recidivism. Justice Quarterly, 28(2), 382-410. doi:10.1080/07418825.2010.498383
Bushway, S., & Apel, R. (2012). A signaling perspective on employment-based reentry programming. Criminology & Public Policy, 11, 21-50.
Cook, P. J., Kang, S., Barga, A. A., Ludwig, J., & O'Brien, M. E. (2015). An experimental evaluation of a comprehensive employment-oriented prisoner re-entry program. J Quant Criminol, 31, 355-382. doi:10.1007/s10940-014-9242-5
Daly, K. (1992). Women's pathways to felony court: Feminist theories of lawbreaking and problems of representation. Southern California Review of Law and Women's Studies, 2, 11-52.
Denver, M., Siwach, G., & Bushway, S. D. (2017). A new look at the employment and recidivism relationship through the lens of a criminal background check. Criminology, 174-204. doi:10.1111/1745-9125.12130
Durose, M. R., Cooper, A. D., & Snyder, H. N. (2014). Recidivism of prisoners released in 30 States in 2005: Patterns from 2005 to 2010. U.S. Department of Justice. Bureau of Justice Statistics. Retrieved November 2017, from https://www.bjs.gov/content/pub/pdf/rprts05p0510.pdf
Fagan, A. A. (2015). Sociological Explanations of the Gender Gap in Offending. In K. M. Beaver, J. C. Barnes, & B. B. Boutwell (Eds.), The Nurture Versus Biosocial Debate in Criminology: On the Origins of Criminal Behavior and Criminality. SAGE Publications Inc.
Fagan, J., & Freeman, R. B. (1999). Crime and work. Crime & Justice, 25, 225-290.
Lageson, S., & Uggen, C. (2013). How work affects crime and crime affects work over the life course. In C. L. Gibson, & M. D. Krohm (Eds.), Handbook of life course criminology: Emerging trends and directions for future research (pp. 201-212). New York, NY: Springer.
Laub, J., & Sampson, R. (2003). Shared beginnings, divergent lives: Delinquent boys to age 70. Boston: Harvard University Press.
Link, N. W., & Roman, C. G. (2017). Longitudinal associations among child support debt, employment, and recidivism after prison. The Sociological Quarterly, 140-160. Retrieved from http://dx.doi.org/10.1080/00380253.2016.1246892
Liu, S. (2015). Is the shape of the age-crime curve invariant by sex? Evidence from a national sample with flexible non-parametric modeling. Journal of Quantitative Criminology, 31, 93-123.
Ramakers, A., Nieuwbeerta, P., Wilsem, J. V., & Dirkzwager, A. (2016). Not just any job will do: A study on employment characteristics and recidivism risks after release. International Journal of Offender Therapy and Comparative Criminology, 1-24. doi:10.1177/0306624X16636141
Raphael, S. (2007). The Impact of Incarceration on the Employment Outcomes of Former Inmates: Policy Options for Fostering Self-Sufficiency and an Assessment of the Cost-Effectiveness of Current Corrections Policy. Retrieved from Institute for Research on Poverty Working Conference: http://socrates.berkeley.edu/~raphael/raphael%20july%202007.pdf
Redcross, C., Millenky, M., Rudd, T., & Levshin, V. (2012). More than a job: Final results from the evaluation of the Center for Employment Opportunities (CEO) transitional jobs program. New York: MDRC.
Skardhamar, T., & Savolainen, J. (2014). Changes in criminal offending around the time of job entry: A study of employment and desistance. Criminology, 52(2), 263-291.
Skardhamar, T., & Telle, K. (2012). Post-release employment and recidivism in Norway. J Quant Criminol, 28, 629-649. doi:10.1007/s10940-012-9166-x
Uggen, C. (1999). Ex-Offenders and the Conformist Alternative: A Job Quality Model of Work and Crime. Social Problems, 46(1), 127-151. Retrieved from http://www.jstor.org/stable/3097165
Uggen, C., Wakefield, S., & Western, B. (2005). Work and Family Perspectives on Reentry. In J. Travis, & C. Visher (Eds.), Prisoner Reentry and Crime in America (pp. 209-243). Cambridge: Cambridge University Press. Retrieved from https://doi.org/10.1017/CBO9780511813580.008
van der Geest, V. R., Bijleveld, C. C., & Blokland, A. A. (2011). The effects of employment on longitudinal trajectories of offending: A follow-up of high risk youth from 18 to 32 years of age. Criminology, 49, 1195-234.
van der Geest, V. R., Bijleveld, C. C., Blokland, A. A., & Nagin, D. S. (2016). The effects of incarceration on longitudinal trajectories of employment: A follow-up in high-risk youth from ages 23 to 32. Crime & Delinquency, 62(1), 107-140. doi:10.1177/0011128713519196
Verbruggen, J., Blokland, A. A., & van der Geest, V. R. (2012). Effects of Employment and Unemployment on Serious Offending in a High-Risk Sample of Men and Women from Ages 18 to 32 in the Netherlands. The British Journal of Criminology, 52(5), 845–869.
Western, B., & Beckett, K. (1999). How unregulated is the U.S. labor market? The penal system as a labor market institution. The American Journal of Sociology, 104, 1030-1060.
Western, B., Kling, J. R., & Weiman, D. F. (2001). The Labor Market Consequences of Incarceration . Crime & Delinquency, 47, 410-427.
Created on 30 January 2018 .


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Lerwick Community Council is protesting to NHS Shetland over the lack of available parking spaces for patients at the Gilbert Bain Hospital.
Members are concerned that patients attending appointments cannot find a space in the car park after 9.30am because hospital workers are parking there rather than in designated staff bays at Brevik House.
Only 23 of the 75 spaces at Gilbert Bain are marked for patients, with nine disabled bays and 43 unmarked spaces, while there are a further 76 spaces at the nearby Brevik House and 65 at the health centre.
Community councillors, some of whom have received complaints from constituents on the matter, agreed they were not satisfied with the health board's response to an earlier inquiry and will now write to NHS Shetland chief executive Sandra Laurenson asking her to instruct hospital staff to park at Brevik House.


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text:
Response to 2011 Summer Job Attachment Programme on Nevis overwhelming NIA
Youth Services Coordinator in the Youth Division of the Social Services Department Mrs. Diana Pemberton at the closing ceremony of the 8th Annual Summer Job Attachment Programme (Photo by Luchano Lewis)
CHARLESTOWN NEVIS (August 29, 2011) — A total of 50 placements were found for participants of the 8th Annual Summer Job Placement Programme, 12 of whom were assigned to the Health Services Programme at the Alexandra Hospital and the Charlestown Dental Unit.
According to Youth Services Coordinator in the Youth Division of the Social Services Department Mrs. Diana Pemberton the response was overwhelming but staff at the Division managed to solicit the assistance of 30 businesses and Government Offices on Nevis to participate in this year's programme. She made the disclosure on Friday at the end of the six-week programme at a ceremony at the Red Cross Building in Charlestown.
The Youth Services Coordinator noted that the programme, an initiative of the Youth Division in the Ministry of Social Development in the Nevis Island Administration, commenced in 2003 to provide practical work skills, professional ethics and to learn more about seeking and retaining employment.
"The internship allows students to benefit from a professional mentorship within the organisation they are placed. This mentorship significantly shapes the work values the future employee develops," she noted. Mrs. Pemberton explained further that this year's Programme commenced in March 20011, when an attempt was made to solicit support of over 100 businesses on Nevis and the application process for students of 4-6th form Secondary school students commenced on June 15th. She said a total of 25 students applied on the first day and as the two-week registration period continued, a total of 102 students applied to the programme. "An overwhelming number of 23 applicants applied for jobs within the Ministry of Health to assist with the employment of interns which was graciously accepted.
(L-R) Charlestown Secondary School student Mr. Luchano Lewis one of the 50 interns receives his certificate of completion in the 8th Annual Summer Job Attachment Programme from Health Services Coordinator and Head Nurse at the Alexandra Hospital Mrs. Aldris Pemberton
Interviews were held from July 5th to 8th with the successful selection of 81 students," she said. A two-day training workshop was hosted by a representative of Helping Our People Excel (HOPE) NEVIS INC from July 13-14th and sessions covered topics which included Workplace Ethics and Morals; Productivity and Professionalism; Communications in the Workplace; Budgeting and Saving and a case study and at the end a final selection of interns were made. In conclusion, Mrs. Pemberton told the participants that they should cherish the positive skills and values they had learnt during the six week-programme and they should apply them to their daily lives.
To the employers who agreed to support the programme the Youth Services Coordinator expressed gratitude. "To the employers I say a heartfelt thank you for your support this year and over the years and do hope that we can look forward to your investment in our nation's youth next year God's willing," she said. The Department of Information in the Premier's Ministry was one of the NIA's offices that participated in the Programme. The intern assigned to the Department's Editorial section was Mr. Luchano Lewis a student of the Charlestown Secondary School.


Alright i've been hearing this jam in two or three online life recordings and fan demand for it has been high; so i've chosen to put it out for yáll.
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