Control charts as an early-warning system for workplace health outcomes

INTRODUCTION

Statistical process control (SPC) charts have not been widely used to monitor workplace health and work environments. This research and effort to develop a more accurate and easy to use management control system for employee health is important from a humanistic, societal and economic standpoint, as well as complying with laws that regulate work environments.

OBJECTIVE

The purpose of the study is to design and discuss control charts as an early warning system for workplace health outcomes to promote workplace health management. Another purpose is to discuss relevant factors in the concept of the out-of-control action plan (OCAP) as a response when a chart warns that the workplace process may be malfunctioning.

PARTICIPANTS

Two Swedish organizations were selected as case study organizations: a department at a university and an elderly care operation in a municipality.

METHODS

This study was explorative and should be seen as a starting point in learning how to use control charts for workplace health management. Self-assessed general health and new sick-cases per employee were selected as indicators for the control charts.

RESULTS

An integrated early warning system with Cumulative Sums- and Shewhart-charts are presented to show a possible method as to how an early warning system can be structured through the use of statistical control charts.

CONCLUSIONS

The conclusion of this study is that control charts, along with well-designed implementation, make up a powerful and useable managerial early-warning system which promotes workplace health and helps to prevent sickness absence.

Control charts as an early-warning system for workplace health outcomes

INTRODUCTION

Statistical process control (SPC) charts have not been widely used to monitor workplace health and work environments. This research and effort to develop a more accurate and easy to use management control system for employee health is important from a humanistic, societal and economic standpoint, as well as complying with laws that regulate work environments.

OBJECTIVE

The purpose of the study is to design and discuss control charts as an early warning system for workplace health outcomes to promote workplace health management. Another purpose is to discuss relevant factors in the concept of the out-of-control action plan (OCAP) as a response when a chart warns that the workplace process may be malfunctioning.

PARTICIPANTS

Two Swedish organizations were selected as case study organizations: a department at a university and an elderly care operation in a municipality.

METHODS

This study was explorative and should be seen as a starting point in learning how to use control charts for workplace health management. Self-assessed general health and new sick-cases per employee were selected as indicators for the control charts.

RESULTS

An integrated early warning system with Cumulative Sums- and Shewhart-charts are presented to show a possible method as to how an early warning system can be structured through the use of statistical control charts.

CONCLUSIONS

The conclusion of this study is that control charts, along with well-designed implementation, make up a powerful and useable managerial early-warning system which promotes workplace health and helps to prevent sickness absence.

Somalis giving birth in Sweden: a challenge to culture and gender specific values and behaviours

OBJECTIVES

Giving birth in a foreign country implies going through a life event with little or no access to your own traditions and social support. The aim of this study was to study the childbirth experiences of Somali women and men in Sweden.

DESIGN

Qualitative. Nine women and seven men were interviewed. Data collection was characterised by an openness to new ideas during the interview and the interviews were analysed according to the grounded theory technique.

FINDINGS

The meeting of Somalis with Swedish antenatal and delivery care was a multicultural event. It revealed social, medical, cultural and gender factors advocating space in the arena of childbirth. The Somalis constituted a homogeneous group with regard to their cultural belonging and motives for exile. The subjects were heterogeneous in that they represented a great variety in social and demographic background as well as in experiences, feelings and modes of expression. One striking finding was the Somali man's dramatic entrance into childbirth, which seemed to have a strong impact on the Somali woman's well-being during delivery. The study showed difficulties in getting used to the Swedish model of parenthood and in finding new role divisions in the couple relationship. Some of the subjects had experienced a strengthening of their marriage and an increased understanding of each other. Others commented that various aspects of traditional womanhood and manhood were lost as a result of the unfamiliar gender structures in Sweden.

CONCLUSION

The Somalis' experiences of childbirth in Sweden can be understood by using the theoretical concept of gender, rather than culture. Our own and other studies show that women and men may have different frames of reference in childbirth, where the women mainly focus on biological circumstances and the men on the social and cultural aspects of birth. The Somali couple were found to be vulnerably positioned, with the professionals having the important role of supporting and empowering Somali parents.

Molecular cloning of rat C4b binding protein alpha- and beta-chains: structural and functional relationships among human, bovine, rabbit, mouse, and rat proteins

The C4b binding protein (C4BP) functions as a regulator of the complement system by interacting with the activated form of the fourth complement component, C4b. Human C4BP also interacts with the anticoagulant protein S and the serum amyloid P component (SAP). It is composed of seven identical 70-kDa alpha-chains and one 45-kDa beta-chain. The alpha-chain contains a binding site for C4b, whereas the beta-chain contains the protein S binding site. Recent studies have shown rabbit and bovine plasma to lack a C4BP-protein S complex, and the mouse beta-chain gene to have evolved into a pseudogene. Using a gel filtration chromatography system in combination with Western blotting, we detected a complex between C4BP and protein S in rat plasma, similar to the complex known in human plasma. Using purified rat C4BP and SAP we were unable to detect any complex between the two proteins, but rat C4BP was able to form a complex with human SAP. Rat cDNA clones encoding the C4BP alpha- and beta-chains were isolated from a rat liver cDNA library. The rat alpha-chain cDNA predicted a mature polypeptide chain of 545 amino acid residues, whereas the beta-chain cDNA predicted a mature polypeptide of 243 amino acid residues. The overall amino acid sequence identities between the rat alpha-chain and the mouse, human, rabbit, and bovine alpha-chains were 64, 60, 59, and 52%, respectively. The identities between the rat beta-chain and the human and bovine beta-chains were 68 and 57%, respectively. The rat represents the first non-primate species in which the C4BP-protein S interaction has been found to be conserved.

Molecular cloning of rat C4b binding protein alpha- and beta-chains: structural and functional relationships among human, bovine, rabbit, mouse, and rat proteins

The C4b binding protein (C4BP) functions as a regulator of the complement system by interacting with the activated form of the fourth complement component, C4b. Human C4BP also interacts with the anticoagulant protein S and the serum amyloid P component (SAP). It is composed of seven identical 70-kDa alpha-chains and one 45-kDa beta-chain. The alpha-chain contains a binding site for C4b, whereas the beta-chain contains the protein S binding site. Recent studies have shown rabbit and bovine plasma to lack a C4BP-protein S complex, and the mouse beta-chain gene to have evolved into a pseudogene. Using a gel filtration chromatography system in combination with Western blotting, we detected a complex between C4BP and protein S in rat plasma, similar to the complex known in human plasma. Using purified rat C4BP and SAP we were unable to detect any complex between the two proteins, but rat C4BP was able to form a complex with human SAP. Rat cDNA clones encoding the C4BP alpha- and beta-chains were isolated from a rat liver cDNA library. The rat alpha-chain cDNA predicted a mature polypeptide chain of 545 amino acid residues, whereas the beta-chain cDNA predicted a mature polypeptide of 243 amino acid residues. The overall amino acid sequence identities between the rat alpha-chain and the mouse, human, rabbit, and bovine alpha-chains were 64, 60, 59, and 52%, respectively. The identities between the rat beta-chain and the human and bovine beta-chains were 68 and 57%, respectively. The rat represents the first non-primate species in which the C4BP-protein S interaction has been found to be conserved.