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Houle M, Ducas J, Lardon A, Descarreaux M, Marchand AA, Abboud J. Headache-related clinical features in teleworkers and their association with coping strategies during the COVID-19 pandemic. Front Public Health 2023; 11:1303394. [PMID: 38213645 PMCID: PMC10782858 DOI: 10.3389/fpubh.2023.1303394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024] Open
Abstract
Objectives The objectives were (1) to describe and compare headache-related clinical features between teleworkers with migraine and those with tension-type headache (TTH) and (2) to determine the association between coping strategies and headache frequency, and intensity in the context of the COVID-19 pandemic. Methods This cross-sectional online survey was conducted with 284 teleworkers (127 with migraine and 157 with TTH). Sociodemographic data, information related to work factors, headache clinical features, coping strategies used during the COVID-19 pandemic, and headache-related clinical features were compared between headache profiles. Bivariate logistic regression analyses were used to determine the association between coping strategies and headache frequency, and intensity. Results Results showed that teleworkers with migraine had longer and more painful headache episodes than teleworkers with TTH (ps < 0.001). Higher migraine frequency was associated with the use of the denial coping strategy (p = 0.006) while lower migraine intensity was associated with planning (p = 0.046) and the use of positive reframing (p = 0.025). Higher TTH frequency was associated with the use of venting, self-blame, and behavioral disengagement (ps < 0.007) while higher TTH intensity was associated with substance use and behavioral disengagement (ps < 0.030). All associations remained significant after adjusting for BMI as a covariate. Discussion/conclusion Teleworkers with migraine had more intense and longer headache episodes than teleworkers with TTH. This could be explained by the fact that a greater proportion of individuals suffering from migraine experienced headaches prior to the beginning of the pandemic compared with teleworkers suffering from TTH. Regarding coping strategies, both primary headache profiles were associated with different types of coping strategies. Most of the coping strategies associated with headache frequency or intensity were maladaptive except for planning and positive reframing that were found to be inversely associated with migraine intensity.
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Affiliation(s)
- Mariève Houle
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
| | - Julien Ducas
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Arnaud Lardon
- Institut Franco-Européen de Chiropraxie, Paris, France
| | - Martin Descarreaux
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Andrée-Anne Marchand
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Jacques Abboud
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Cruz-Ausejo L, Copez-Lonzoy A, Vilela-Estrada AL, Valverde JJ, Bohórquez M, Moscoso-Porras M. Can working at home be a hazard? Ergonomic factors associated with musculoskeletal disorders among teleworkers during the COVID-19 pandemic: a scoping review. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:1335-1344. [PMID: 36217607 DOI: 10.1080/10803548.2022.2127246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives. The improvised and massive adoption of remote work in the context of COVID-19 has forced us to adapt homes as workspaces, which could promote development of musculoskeletal disorders (MSDs). This review explores the evidence for ergonomic factors associated with MSDs in teleworkers. Methods. A literature search was conducted in MEDLINE, Embase, Scopus, SciELO and EBSCO. We included observational studies published between March 2020 and October 2021 that included teleworking personnel due to the restrictions of the pandemic. Results. A total of 212 studies were identified, 14 were chosen for complete review. Associated factors were change of work modality (on-site work to telework), use of home environments as workspaces (areas not adapted for work and with low lighting), working furniture (non-ergonomic chairs and desks), use of electronic devices (tablets, cell phones and laptops), organizational factors (working hours, active breaks, sitting time) and individual factors (physical activity practice). Conclusion. Various ergonomic home factors and the characteristics of teleworking - mainly furniture, the environment of work and physical activity - are associated with MSDs. This evidence suggests that the norms and regulation of telework can consider the adaptation of workspace and conditions at home to prevent health problems in the medium and long term.
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Affiliation(s)
- Liliana Cruz-Ausejo
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Tecnólogo Médico, Instituto Nacional de Salud, Perú
| | - Anthony Copez-Lonzoy
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Psicólogo, Instituto Nacional de Salud, Perú
| | - Ana Lucía Vilela-Estrada
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Psicólogo, Instituto Nacional de Salud, Perú
| | - Juan José Valverde
- Tecnólogo Médico, Instituto Nacional de Salud, Perú
- Facultad de Ingeniería Ambiental, Universidad Nacional de Ingeniería, Perú
| | - Melissa Bohórquez
- Facultad de Ingeniería Ambiental, Universidad Nacional de Ingeniería, Perú
- Ingeniera de Higiene y Seguridad Industrial, Universidad Nacional de Ingeniería, Perú
| | - Miguel Moscoso-Porras
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud (CENSOPAS), Instituto Nacional de Salud, Perú
- Tecnólogo Médico, Instituto Nacional de Salud, Perú
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Wells J, Scheibein F, Pais L, Rebelo dos Santos N, Dalluege CA, Czakert JP, Berger R. A Systematic Review of the Impact of Remote Working Referenced to the Concept of Work-Life Flow on Physical and Psychological Health. Workplace Health Saf 2023; 71:507-521. [PMID: 37387511 PMCID: PMC10612377 DOI: 10.1177/21650799231176397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
BACKGROUND COVID-19 accelerated the adoption of remote working in which employers' obligations for employees' health and well-being extended into the home. This paper reports on a systematic review of the health impacts of remote working within the context of COVID-19 and discusses the implications of these impacts for the future role of the occupational health nurse. METHOD The review protocol was registered with PROSPERO (CRD42021258517) and followed the PRISMA guidelines. The review covered 2020-2021 to capture empirical studies of remote working during the COVID-19 pandemic, their physical and psychological impacts and mediating factors. RESULTS Eight hundred and thirty articles were identified. After applying the inclusion criteria, a total of 34 studies were reviewed. Most studies showed low to very low strength of evidence using the GRADE approach. A minority of studies had high strength of evidence. These focused on the reduced risk of infection and negative effects in terms of reduced physical activity, increased sedentary activity, and increased screen time. CONCLUSION/APPLICATION TO PRACTICE The synergy of work and personal well-being with the accelerated expansion of remote working suggests a more active role in the lives of workers within the home setting on the part of occupational health nurses. That role relates to how employees organize their relationship to work and home life, promoting positive lifestyles while mitigating adverse impacts of remote working on personal well-being.
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Affiliation(s)
- John Wells
- School of Health Sciences, South East Technological University
| | | | - Leonor Pais
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra
| | - Nuno Rebelo dos Santos
- Research Centre in Education and Psychology (CIEP-UÉ), School of Social Sciences, Universidade de Évora
| | | | | | - Rita Berger
- Facultat de Psicologia, Universitat de Barcelona
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Milaković M, Koren H, Bradvica-Kelava K, Bubaš M, Nakić J, Jeličić P, Bucić L, Bekavac B, Čvrljak J, Capak M. Telework-related risk factors for musculoskeletal disorders. Front Public Health 2023; 11:1155745. [PMID: 37465175 PMCID: PMC10350503 DOI: 10.3389/fpubh.2023.1155745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/12/2023] [Indexed: 07/20/2023] Open
Abstract
Telework has become considerably more common during the ongoing pandemic. Although working remotely may have numerous advantages, negative impacts on workers' health and safety should also be considered. Telework is a major contributor to the development or aggravation of work-related musculoskeletal disorders where unsuited workstation ergonomics, sedentary behavior, as well as psychosocial and organizational factors play a role. This paper aims to identify telework-related risks and their impact on musculoskeletal health as well as provide recommendations that may be useful in constructing future preventive measures. A comprehensive literature search regarding the topic has been performed. Teleworkers experience musculoskeletal pain and discomfort mostly in low back area, neck, shoulders, arms, and hands. Poor ergonomic solutions when it comes to workstation design resulting in prolonged sitting in non-neutral positions contribute to the development and aggravation of musculoskeletal disorders in teleworkers. Working with inadequately placed screens and laptops and sitting in maladjusted seats without usual functionalities and ergonomic support is associated with musculoskeletal pain and discomfort. Extended working hours with fewer rest periods to meet increased work demands, social isolation, and lack of support from work colleagues and superiors as well as blurred work-home boundaries and omnipresence of work are commonly stated psychosocial and organizational factors associated with musculoskeletal disorders. Environmental factors such as poor lighting and glare, inadequate room temperature, and ventilation or noise, are frequently overlooked remote workstation risk factors. For a certain part of workers, telework will remain a common way of work in the post-pandemic period. Therefore, it is essential to identify telework-related risk factors for musculoskeletal disorders and address them with timely preventive measures tailored to each remote workstation's risks and individual workers' needs.
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Affiliation(s)
- Marina Milaković
- Division for Occupational Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Helena Koren
- Division for Occupational Health, Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Marija Bubaš
- Division for Occupational Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Josipa Nakić
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Pavle Jeličić
- Division for Environmental Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Lovro Bucić
- Division for Environmental Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Barbara Bekavac
- Division for Environmental Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Jelena Čvrljak
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Magdalena Capak
- Department of History, Croatian Catholic University, Zagreb, Croatia
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Fadel M, Bodin J, Cros F, Descatha A, Roquelaure Y. Teleworking and Musculoskeletal Disorders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4973. [PMID: 36981881 PMCID: PMC10049341 DOI: 10.3390/ijerph20064973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Teleworking has spread drastically during the COVID-19 pandemic, but its effect on musculo-skeletal disorders (MSD) remains unclear. We aimed to make a qualitative systematic review on the effect of teleworking on MSD. Following the PRISMA guidelines, several databases were searched using strings based on MSD and teleworking keywords. A two-step selection process was used to select relevant studies and a risk of bias assessment was made. Relevant variables were extracted from the articles included, with a focus on study design, population, definition of MSD, confounding factors, and main results. Of 205 studies identified, 25 were included in the final selection. Most studies used validated questionnaires to assess MSD, six considered confounders extensively, and seven had a control group. The most reported MSD were lower back and neck pain. Some studies found increased prevalence or pain intensity, while others did not. Risk of bias was high, with only 5 studies with low/probably low risk of bias. Conflicting results on the effect of teleworking on MSD were found, though an increase in MSD related to organizational and ergonomic factors seems to emerge. Future studies should focus on longitudinal approaches and consider ergonomic and work organization factors as well as socio-economic status.
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Affiliation(s)
- Marc Fadel
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000 Angers, France
| | - Julie Bodin
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000 Angers, France
| | - Florence Cros
- GRePS UR 4163, Université Lumière Lyon 2, F-69007 Lyon, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000 Angers, France
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine, Hosftra University Northwell Health, New York, NY 11021, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, IRSET-ESTER, SFR ICAT, F-49000 Angers, France
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Social Media Devices' Influence on User Neck Pain during the COVID-19 Pandemic: Collaborating Vertebral-GLCM Extracted Features with a Decision Tree. J Imaging 2023; 9:jimaging9010014. [PMID: 36662112 PMCID: PMC9867361 DOI: 10.3390/jimaging9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/07/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
The prevalence of neck pain, a chronic musculoskeletal disease, has significantly increased due to the uncontrollable use of social media (SM) devices. The use of SM devices by younger generations increased enormously during the COVID-19 pandemic, being-in some cases-the only possibility for maintaining interpersonal, social, and friendship relationships. This study aimed to predict the occurrence of neck pain and its correlation with the intensive use of SM devices. It is based on nine quantitative parameters extracted from the retrospective X-ray images. The three parameters related to angle_1 (i.e., the angle between the global horizontal and the vector pointing from C7 vertebra to the occipito-cervical joint), angle_2 (i.e., the angle between the global horizontal and the vector pointing from C1 vertebra to the occipito-cervical joint), and the area between them were measured from the shape of the neck vertebrae, while the rest of the parameters were extracted from the images using the gray-level co-occurrence matrix (GLCM). In addition, the users' ages and the duration of the SM usage (H.mean) were also considered. The decision tree (DT) machine-learning algorithm was employed to predict the abnormal cases (painful subjects) against the normal ones (no pain). The results showed that angle_1, area, and the image contrast significantly increased statistically with the time of SM-device usage, precisely in the range of 2 to 9 h. The DT showed a promising result demonstrated by classification accuracy and F1-scores of 94% and 0.95, respectively. Our findings confirmed that the objectively detected parameters, which elucidate the negative impacts of SM-device usage on neck pain, can be predicted by DT machine learning.
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Appel-Meulenbroek R, Voulon T, Bergefurt L, Arkesteijn M, Hoekstra B, Jongens-Van der Schaaf P. Perceived health and productivity when working from home during the COVID-19 pandemic. Work 2023; 76:417-435. [PMID: 37092204 DOI: 10.3233/wor-220575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, office workers were obliged to work from home (WFH). Alongside known positive aspects of home-based telework, it is associated with reduced health and productivity impacts. Its success depends on employee and environmental characteristics. OBJECTIVE This paper fills the gap in knowledge on the mediating role of health between personal and environmental factors and employee productivity, when obliged to work from home full-time. It covers health in full (physical, mental, and social) unlike other WFH studies. METHODS Two large survey-based datasets (gathered April 27th - November 20th, 2020) were analysed resp. with a path model and descriptive analyses. The data provide experiences on health and productivity of resp. 25,058 and 18,859 Dutch office workers from different public organisations, who were obliged to work from home during the COVID-19 lockdowns. RESULTS In general, the workers in the sample perceived their health to be quite good. Path analysis revealed that gender, age, education, the at-home workspace, the presence of children in the household, and perceived organisational support were significantly related to self-perceived productivity. However, most of these effects were found to be mediated by physical, mental, and/or social health indicators. Possible explanations for health issues from the descriptive analyses were sedentary behaviour, unsuitable furniture, having to be at home, social isolation and changed content and frequency of contact with colleagues. CONCLUSION Findings imply that specifically engagement and organisational support of teleworkers are most relevant to steer on to ensure productivity while WFH.
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Affiliation(s)
| | - Thijs Voulon
- Urban Systems & Real Estate, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Lisanne Bergefurt
- Urban Systems & Real Estate, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Monique Arkesteijn
- Management of the Built Environment, Delft University of Technology, Delft, The Netherlands
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Ernst MJ, Klaus S, Lüdtke K, Gallina A, Falla D, Barbero M, Brunner B, Cornwall J, Da Cruz Pereira Y, Deforth ME, Distler O, Dratva J, Dressel H, Egli T, Elfering A, Ernst MJ, Etzer-Hofer I, Falla D, Gisler M, Haas M, Johnston V, Klaus S, Kobelt GM, Lüdtke K, Luomajoki H, Melloh M, Nicoletti C, Niggli S, Nüssle A, Richard S, Sax N, Schülke K, Sjøgaard G, Staub L, Volken T, Zweig T. Inter-rater reliability, discriminatory and predictive validity of neck movement control tests in office workers with headache and/or neck pain. Musculoskelet Sci Pract 2022; 62:102685. [PMID: 36370624 DOI: 10.1016/j.msksp.2022.102685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/23/2022] [Accepted: 10/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Movement control tests (MCTs) are clinical tests to evaluate impairment of movement and associated neuromuscular control and are commonly used to evaluate people with neck pain or headache conditions. The aim of this study was to establish inter-rater reliability as well as discriminatory and predictive validity for seven MCTs of the upper (UCS) and lower cervical spine (LCS) in office workers with headache or neck pain. METHODS Seven MCTs of the UCS (3) and LCS (4) were performed at baseline on 140 office workers which were included in a cluster randomized controlled trial. The occurrences of headache and neck pain were established at baseline (discriminatory validity) and at a 15-month follow-up (predictive validity). Inter-rater-reliability was established in a separate cross-sectional study. RESULTS MCTs showed slight to almost perfect inter-rater reliability but limited discriminatory (baseline) and limited to small predictive validity (15-month follow up) for different subgroups of office workers with headache and/or neck pain. MCTs of the UCS showed limited discriminatory validity, especially for rotation in participants with headache and neck pain compared to those with headache only (Negative Likelihood-ratio: 0.82, 95% CI: 0.69-0.98). Participants with neck pain only and ≥1/4 positive MCTs for the sagittal plane had an increased risk for future neck pain (Relative risk: 3.33, 95% CI: 1.05-10.56). DISCUSSION MCTs of the UCS and LCS are reliable but have only limited to small validity to predict future headache events in office workers. Insufficient sagittal plane movement control may predict neck pain relapses in the future.
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Affiliation(s)
- Markus J Ernst
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8400, Winterthur, Switzerland.
| | - Sandro Klaus
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Katharina Sulzer Platz 9, 8400, Winterthur, Switzerland
| | - Kerstin Lüdtke
- Institute of Health Sciences, Department of Physiotherapy, University of Luebeck, Germany
| | - Alessio Gallina
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Music J, Charlebois S, Toole V, Large C. Telecommuting and food E-commerce: Socially sustainable practices during the COVID-19 pandemic in Canada. TRANSPORTATION RESEARCH INTERDISCIPLINARY PERSPECTIVES 2022; 13:100513. [PMID: 35128387 PMCID: PMC8806671 DOI: 10.1016/j.trip.2021.100513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 05/10/2023]
Abstract
Telecommuting has become a dominant professional experience for many Canadian business and workers due to the COVID-19 pandemic. Telecommuting has several benefits that are separate from COVID-19. Two prevalent changes have been in regard to telecommuting and online food buying habits, both of which impact social wellbeing as a dimension of social sustainability. We discuss two exploratory surveys on the perception of telecommuting and food e-commerce. We found that while telecommuting has the potential to increase social wellbeing and the social sustainability of both urban and rural Canadian communities through a variety of mechanisms, food e-commerce does not offer similar returns. Instead, the prevalence of food e-commerce merely adds convenience to the lives of those who already have adequate food access while maintaining the status quo, or even worsening access for disadvantaged Canadians.
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Affiliation(s)
- Janet Music
- Faculty of Agriculture, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sylvain Charlebois
- Faculty of Agriculture, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Virginia Toole
- Faculty of Management, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Charlotte Large
- Faculty of Management, Dalhousie University, Halifax, Nova Scotia, Canada
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