A process evaluation of implementing a vocational enablement protocol for employees with hearing difficulties in clinical practice

Objective: A multidisciplinary vocational rehabilitation programme, the Vocational Enablement Protocol (VEP) was developed to address the specific needs of employees with hearing difficulties. In the current study we evaluated the process of implementing the VEP in audiologic care among employees with hearing impairment. Design: In conjunction with a randomized controlled trial, we collected and analysed data on seven process parameters: recruitment, reach, fidelity, dose delivered, dose received and implemented, satisfaction, and perceived benefit. Study sample: Sixty-six employees with hearing impairment participated in the VEP. The multidisciplinary team providing the VEP comprised six professionals. Results: The professionals performed the VEP according to the protocol. Of the recommendations delivered by the professionals, 31% were perceived as implemented by the employees. Compliance rate was highest for hearing-aid uptake (51%). Both employees and professionals were highly satisfied with the VEP. Participants rated good perceived benefit from it. Conclusions: Our results indicate that the VEP could be a useful treatment for employees with hearing difficulties from a process evaluation perspective. Implementation research in the audiological setting should be encouraged in order to further provide insight into parameters facilitating or hindering successful implementation of an intervention and to improve its quality and efficacy.     

The Relationship between College Graduate’s Dual Self-Consciousness and Job Search Clarity: The Mediating Role of Perceived Stress

The aim of the study was to explore the relationship between college graduates’ dual self-consciousness, job search clarity and perceived stress, and reveal the mediating role of perceived stress between dual self-consciousness and job search clarity. In this study, 467 college graduates were investigated using the Dual Self-Consciousness Scale, Job Search Clarity Scale, and Perceived Stress Scale. After controlling for gender, age, and region, the results revealed that: (1) private self-consciousness has a significant positive predictive effect on job search clarity; (2) perceived stress has a significant negative predictive effect on job search clarity; (3) perceived stress plays partial mediation effects between private self-consciousness and job search clarity; (4) perceived stress plays complete mediation effects between public self-consciousness and job search clarity; (5) perceived stress has suppressing effects between public self-consciousness and job search clarity.     

Recognition performance and perceived quality of video enhanced for the visually impaired

Subjects with central field loss (CFL) individually selected enhancement parameters to improve visibility of static video images. The effect of enhancement on performance and on perceived quality of motion video was assessed. Performance, e.g. recognition of visual details, was assessed by having subjects answer questions regarding visual information contained in the video motion segments that were enhanced using the individually-selected parameters. Enhancement did not improve subject performance on questions about video content. This result might be due to a ceiling effect limitation of the performance assessment method. In a second procedure, subjects' continuous perceptions of quality (using an adjective-based rating scale) were made while the enhancement parameters were abruptly switched among multiple values; these included the individually-selected enhancements, as well as unenhanced, over-enhanced, and degraded segments. The results indicate that adaptive enhancement (individually-tuned using a static image) adds significantly to perceived image quality when viewing motion video. Subjects who selected stronger contrast enhancement also perceived the enhancement to provide a larger benefit in image quality.     

Secretory immunoglobulin‐A reactivity following increases in workload intensity using the Defined Intensity Stressor Simulation (DISS)

Previous work suggests that secretory immunoglobulin‐A (S‐IgA) reactivity is inversely related to the perceived demands of the stressor. The Defined Intensity Stressor Simulation (DISS) comprises eight stressor modules, and allows for the manipulation of stress either through increasing the number of modules, or increasing the workload of the modules. The current study assessed the effect of increasing the workload of four modules upon S‐IgA reactivity and perceived demands. Participants (N = 14) attended three sessions on consecutive days where they provided a timed saliva sample immediately before and after 5 min on the DISS at low, medium and high workload. Following each session participants recorded their perceptions of the task with regard to workload and levels of stress and arousal. Perceived workload and stress, but not arousal, increased in accordance with increases in workload, however, differential S‐IgA reactivity was observed. Low workload resulted in a slight increase in S‐IgA secretion; medium workload elicited significant up‐regulation, while down‐regulation of S‐IgA occurred following high workload. As DISS is analogous to a variety of working environments it is suggested that the observed S‐IgA reactivity is indicative of how individuals react to multi‐tasking environments when faced with increases in objective or perceived workload demands. As S‐IgA levels are related to protection from illness, down‐regulation of S‐IgA in those who perceive greater demands may lead to greater vulnerability to ill‐health. Copyright © 2005 John Wiley & Sons, Ltd.     

Sex,stress, and health: Does stress predict health symptoms differently for the two sexes?

Objectives: Previous studies have been inconsistent with regard to the extent to which stress perception, rather than stressor exposure, predicts negative health symptoms. Because sex differences have been observed in all three of these variables, in this study the possibility that sex differences also exist in the relationships between them is investigated. Methods: Self‐report inventories of perceived stress, stressor exposure, and negative health symptoms were given to 107 young‐adult participants (65 females, 42 males). Results: Sex differences were observed in the associations among perceived stress, stressor exposure, and negative health symptom rates. Specifically, while higher perceived stress and higher stressor exposure rates independently predicted higher negative health symptoms rates in females, only higher stressor exposure rates independently predicted higher negative health symptoms in males. Indeed, unexpectedly, after controlling for exposure to stressors there was a trend towards higher perceived stress predicting lower negative health symptoms in males. Conclusions: While exposure to stress was a significant negative predictor of health for both sexes, perception of stress was predictive only for females. One implication of this finding is that different psychological models are needed to predict health symptoms in the two sexes. Copyright © 2005 John Wiley & Sons, Ltd.     

Mothers' Anticipation and Prevention of Unintentional Injury to Young Children in the Home

Investigated anticipation and prevention of children's unintentionalinjuries in the home. 150 mothers of 1-, 2-, and 3-year-oldchildren kept weekly diaries of anticipated injuries and unanticipatedinjuries/near injuries to their child. Mothers anticipated between57 and 67% of all injury events, a majority when the child wasin the same room as the injury-causing agent prior to interactingwith it. Few anticipated injuries led to injury. In these casesno significant differences were found depending on child's ageand sex. In contrast, mothers of younger children most frequentlyreported preventing injury by physically restricting or movingthe child away and by changing the environment, whereas mothersof older children more frequently engaged in teaching.     

Perceived environment and physical activity in youth

The examination of physical environments to explain and promote physical activity is an important yet under-investigated area of research inquiry. This study explored relationships between the perceived availability of physical environmental resources and the perceived importance of these resources in relation to physical activity levels amongst youth. A self-report questionnaire was completed by 610 students (mean age = 15.5 years old; 62% female participants) from four high schools (grades 9-12) in rural Alberta, Canada. Perceived physical environment constructs explained 5% of the variance in physical activity, with home, neighborhood, and school as significant domains. Perceived importance constructs explained 8% of the variance in physical activity with school context showing the only significant relationship with physical activity. A hierarchical regression analysis entered sex, grade, self-efficacy, peer, family and physical education teacher relationships, as the first block and eight environmental constructs as the second block. The first block variables accounted for 22% of the variance and environmental constructs accounted for an added 4% of the variance in physical activity. Perceived importance of the school environment was the only environment variable significantly associated with physical activity (β = .14; p < .05) after taking into account the impact of these traditional predictors. These findings reinforce the need to provide and support school physical environments related to physical activity.     

Does the amount of exercising muscle alter the aerobic demand of dynamic exercise?

The primary purpose of this study was to determine if the aerobic demand for production of specified power outputs is altered by distribution of work between the arms and legs compared with when all the work is performed by the legs. Because of the important exercise training implications, a secondary purpose of this study was to determine if the exercising muscle mass affects the cardiorespiratory demands at specified rating of perceived exertion (RPE) levels and blood lactate concentrations. Nine healthy adults completed leg cycling and combined arm and leg exercise on an Airdyne using a discontinuous protocol. Repeated measures ANOVA revealed that oxygen uptake for the combined arm and leg exercise averaged 0.04 l·min⁻¹ greater (p<0.05) than for leg cycling at the same external power outputs. However, RPE levels at specified power outputs were lower (p<0.05) with combined arm and leg exercise than leg cycling. At specified RPE levels and blood lactate concentrations, oxygen uptake and heart rate values were higher (p<0.05) for combined arm and leg exercise than leg cycling. From these findings we conclude that: (1) the addition of arm exercise to leg cycling results in a reduction in RPE, but a minimal increase in oxygen consumption to perform a given power output, and (2) if training intensity is established by RPE or blood lactate concentration, use of a muscle mass larger than that used in leg cycling should allow a greater cardiorespiratory training effect.     

The Effect of Accuracy of Perceptions of Dietary-Fat Intake on Perceived Risk and Intentions to Change

Consumption of excess fat increases risk for many health problems and diseases. In the present study, 188 undergraduate students were studied to understand self-perceptions of dietary-fat intake and the impact of those perceptions. Findings indicated that the majority of participants had inaccurate perceptions about the amount of fat in their diets. Further, compared to people who overestimated dietary-fat intake, people who underestimated fat intake had lower perceived risk of cancer, had lower intentions to change, and demonstrated less knowledge about the dietary-fat content of many foods. Findings suggest that this unrealistic underestimation of fat intake is a cognitive barrier to dietary change and people who underestimate dietary fat intake may require more intensive intervention to change their diets.     

Validity of heart rate and ratings of perceived exertion as indices of exercise intensity in a group of children while swimming

Summary The purpose of this study was to investigate the validity of heart rate (f _c) and ratings of perceived exertion (RPE) as indices of exercise intensity in a group of children while swimming. Six healthy male swimmers, aged 10–12, swam tethered using the breast-stroke in a flume. The resistance started at 1.0 kg and increased in 1.0 kg steps up to the point of their exhaustion. The subjects swam for 5 min during each period, with a rest of 10–20 min until they had returned to their resting f _c level. The last exercise intensity was with the maximal mass the subjects could support for 2 min. The last min of oxygen consumption (VO₂) and 30 s of f _c were measured during each exercise period. The subjects gave their RPE assessment at the end of exercise.The individual relationships between f _c and VO₂, and percentage maximal oxygen consumption (% VO_2max, were linear with a high correlation r=0.962–0.996 and r=0.962–0.996, respectively. Therefore, it was concluded that f _c was valid as an index of the exercise intensity of children while swimming. Compared to the results found in adults using a similar protocol, the children's f _c were 8.3–26.9 beats·min^–1 higher than those of the adults at the given % VO_2max. The present study showed two different patterns in the relationship between VO₂ and RPE in individuals. In two subjects the RPE increased linearly with VO₂ while in the other four subjects the increase was discontinuous. If f _c and RPE were to be applied to the setting and evaluation of exercise intensity during swimming, it would seem that f _c would be a more useful guide than RPE for some children.