A Historical Perspective on the Future of Innovation in Social Work

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Okpych, Nathanael J.

2017-01-01

Changing social work from a profession with innovators to a profession that innovates will likely require an innovation movement. This article draws on lessons from a prior movement in social work to suggest implications for a future innovation movement. Empirical clinical practice (ECP), a movement in social work in the 1970-1990s, sought to…

Tasks for the future process and works management

International Nuclear Information System (INIS)

Kinn, T.

1994-01-01

The actions which have been taken according to the company's targets formulated so far, have lead to complex large scale technical plants. The process and works management becomes more and more difficult due to increasing costs and the strict margins, which have been set by the environmental technology. A complex/An integrated approach at the development of process and works control systems can help considerably to solve these problems due to the dependency on information and partly similar tasks. Before the integrated/complex approach is made the structure and nature of the tasks of all company levels must be analysed and put into concrete terms. The resulting demand of data processing must be adjusted within the frame of a data processing development plan and be realised step by step. In this work the structures, the future tasks and the information demand of process and works management are described. (orig.) [de

Professional-applied pedagogical teaching of junior school future teachers to working activity.

Directory of Open Access Journals (Sweden)

Kozhevnikova L.K.

2012-03-01

Full Text Available A purpose of work is determination of maintenance and most meaningful features of activity of teachers of initial classes in the after hours forms of work with students on a section «physical culture». The program is presented professionally-applied preparations and directions of forming professional readiness of students to their future professional activity. 323 students of pedagogical faculty and 253 students - future teachers of initial classes took part in the questionnaire questioning. The most essential sides of preparation of students are selected: motivation, awareness of the future profession as a process of decision of pedagogical tasks, independent participating in the real process of teaching.

INDICATORS AND DIAGNOSTICS OF INDEPENDENT WORK CULTURE FORMATION IN FUTURE MATHEMATICS TEACHERS

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Олена Соя

2015-09-01

Full Text Available The article highlights the results of research of formation the culture of independent work of future mathematics teachers, indicating the effectiveness of selected theoretically grounded and practically implemented pedagogical conditions of its formation. Its semantic components that are interconnected and interdependent unity of cognitive, procedural, technological and motivational components were singled out on the basis of definition of independent work culture of future mathematics teachers. The system of indicators, which assessed the degree of mastering by students the culture of independent work by value-orientation, content-effective, reflective, constructive and operationally-activity criteria is reviewed.

The Future of Digital Working: Knowledge Migration and Learning

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Malcolm, Irene

2014-01-01

Against the backdrop of intensified migration linked to globalisation, this article considers the implications of knowledge migration for future digital workers. It draws empirically on a socio-material analysis of the international software localisation industry. Localisers' work requires linguistic, cultural and software engineering skills to…

Meaning-centered dream work with hospice patients: A pilot study.

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Wright, Scott T; Grant, Pei C; Depner, Rachel M; Donnelly, James P; Kerr, Christopher W

2015-10-01

Hospice patients often struggle with loss of meaning, while many experience meaningful dreams. The purpose of this study was to conduct a preliminary exploration into the process and therapeutic outcomes of meaning-centered dream work with hospice patients. A meaning-centered variation of the cognitive-experiential model of dream work (Hill, 1996; 2004) was tested with participants. This variation was influenced by the tenets of meaning-centered psychotherapy (Breitbart et al., 2012). A total of 12 dream-work sessions were conducted with 7 hospice patients (5 women), and session transcripts were analyzed using the consensual qualitative research (CQR) method (Hill, 2012). Participants also completed measures of gains from dream interpretation in terms of existential well-being and quality of life. Participants' dreams generally featured familiar settings and living family and friends. Reported images from dreams were usually connected to feelings, relationships, and the concerns of waking life. Participants typically interpreted their dreams as meaning that they needed to change their way of thinking, address legacy concerns, or complete unfinished business. Generally, participants developed and implemented action plans based on these interpretations, despite their physical limitations. Participants described dream-work sessions as meaningful, comforting, and helpful. High scores on a measure of gains from dream interpretation were reported, consistent with qualitative findings. No adverse effects were reported or indicated by assessments. Our results provided initial support for the feasibility and helpfulness of dream work in this population. Implications for counseling with the dying and directions for future research were also explored.

Telecommuters: the work force of the future.

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Yancer, D A; Moe, J K

1995-01-01

Telecommuters are the work force of the future. The dawning of the information age, with its explosion of telecommunication technology, presents new opportunities for healthcare agencies to extend their borders far beyond traditional physical boundaries. The virtual workplace can become a reality and position healthcare agencies to be geographically dispersed throughout their community. The authors describe a pioneering effort to use telecommunications to retain a valuable employee and create a healthcare agency's first virtual workplace. Strategies for success in telecommuting also are provided from both the telecommuter's and the manager's viewpoints.

Implementation Science: Why It Matters for the Future of Social Work

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Cabassa, Leopoldo J.

2016-01-01

Bridging the gap between research and practice is a critical frontier for the future of social work. Integrating implementation science into social work can advance our profession's effort to bring research and practice closer together. Implementation science examines the factors, processes, and strategies that influence the uptake, use, and…

The Maker Movement, the Promise of Higher Education, and the Future of Work

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Wigner, Aubrey

The 21st century will be the site of numerous changes in education systems in response to a rapidly evolving technological environment where existing skill sets and career structures may cease to exist or, at the very least, change dramatically. Likewise, the nature of work will also change to become more automated and more technologically intensive across all sectors, from food service to scientific research. Simply having technical expertise or the ability to process and retain facts will in no way guarantee success in higher education or a satisfying career. Instead, the future will value those educated in a way that encourages collaboration with technology, critical thinking, creativity, clear communication skills, and strong lifelong learning strategies. These changes pose a challenge for higher education's promise of employability and success post-graduation. Addressing how to prepare students for a technologically uncertain future is challenging. One possible model for education to prepare students for the future of work can be found within the Maker Movement. However, it is not fully understood what parts of this movement are most meaningful to implement in education more broadly, and higher education in particular. Through the qualitative analysis of nearly 160 interviews of adult makers, young makers and young makers' parents, this dissertation unpacks how makers are learning, what they are learning, and how these qualities are applicable to education goals and the future of work in the 21st century. This research demonstrates that makers are learning valuable skills to prepare them for the future of work in the 21st century. Makers are learning communication skills, technical skills in fabrication and design, and developing lifelong learning strategies that will help prepare them for life in an increasingly technologically integrated future. This work discusses what aspects of the Maker Movement are most important for integration into higher education.

Future time perspective and promotion focus as determinants of intraindividual change in work motivation.

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Kooij, Dorien T A M; Bal, P Matthijs; Kanfer, Ruth

2014-06-01

In the near future, workforces will increasingly consist of older workers. At the same time, research has demonstrated that work-related growth motives decrease with age. Although this finding is consistent with life span theories, such as the selection optimization and compensation (SOC) model, we know relatively little about the process variables that bring about this change in work motivation. Therefore, we use a 4-wave study design to examine the mediating role of future time perspective and promotion focus in the negative association between age and work-related growth motives. Consistent with the SOC model, we found that future time perspective was negatively associated with age, which, in turn, was associated with lower promotion focus, lower work-related growth motive strength, and lower motivation to continue working. These findings have important theoretical implications for the literature on aging and work motivation, and practical implications for how to motivate older workers. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Work-related reproductive, musculoskeletal and mental disorders among working women--history, current issues and future research directions.

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Kishi, Reiko; Kitahara, Teruyo; Masuchi, Ayumi; Kasai, Setsuko

2002-04-01

According to the recent changes of working environments and socio-economical conditions, the proportion of working women are increasing in Japan. Characteristics of occupational workload and stress of Japanese working women are consistent with those in many industrialized countries except man-dominant culture. In this review we describe the history, current issues, and future research directions on occupational health of working women, especially focused on reproductive health, work-related musculo-skeletal disorders (WMSDs), and mental disorders. In the reproductive health survey, traditionally main concern was about pregnancy outcomes, then fecundity studies, such as time to pregnancy, became topics recently. Future research will be shifted to outcomes not only during pregnancy but also disorders of hormonal balance and climacterium or health conditions after menopause. WMSDs are reviewed on mainly gender difference and its causative factors. Historically, mental health of working women in Japan has focused on the job stress of nurses. We compare results with a lot of recent researches in Europe and U.S.A., where interaction between occupational stress and family roles were studied. It is not easy to predict the prospective status of female workers in Japan, but social, workplace and familial supports will enhance their health promotion.

Work ability score and future work ability as predictors of register-based disability pension and long-term sickness absence: A three-year follow-up study.

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Kinnunen, Ulla; Nätti, Jouko

2018-05-01

We investigated two single items of the Work Ability Index - work ability score, and future work ability - as predictors of register-based disability pension and long-term sickness absence over a three-year follow-up. Survey responses of 11,131 Finnish employees were linked to pension and long-term (more than 10 days) sickness absence register data by Statistics Finland. Work ability score was divided into poor (0-5), moderate (6-7) and good/excellent (8-10) and future work ability into poor (1-2) and good (3) work ability at baseline. Cox proportional hazard regressions were used in the analysis of disability pension, and a negative binomial model in the analysis of long-term sickness absence. The results were adjusted for several background, work- and health-related covariates. Compared with those with good/excellent work ability scores, the hazard ratios of disability pension after adjusting for all covariates were 9.84 (95% CI 6.68-14.49) for poor and 2.25 (CI 95% 1.51-3.35) for moderate work ability score. For future work ability, the hazard ratio was 8.19 (95% CI 4.71-14.23) among those with poor future work ability. The incidence rate ratios of accumulated long-term sickness absence days were 3.08 (95% CI 2.19-4.32) and 1.59 (95% CI 1.32-1.92) for poor and moderate work ability scores, and 1.51 (95% CI 0.97-2.36) for poor future work ability. The single items of work ability score and future work ability predicted register-based disability pension equally well, but work ability score was a better predictor of register-based long-term sickness absence days than future work ability in a three-year follow-up. Both items seem to be of use especially when examining the risk of poor work ability for disability but also for long sick leave.

Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment.

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Ashley, Christine; Peters, Kath; Brown, Angela; Halcomb, Elizabeth

2018-02-12

To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care. Most reported positive experiences, valuing work/life balance, role diversity and patient/family interactions. Limited orientation and support, loss of acute skills and inequitable remuneration were reported negatively. Many respondents indicated an intention to stay in primary health care (87.3%) and nursing (92.6%) for the foreseeable future, whilst others indicated they may leave primary health care as soon as convenient (29.6%). Our findings provide guidance to managers in seeking strategies to recruit and retain nurses in primary health care employment. To maximize recruitment and retention, managers must consider factors influencing job satisfaction amongst transitioning nurses, and the impact that nurses' past experiences may have on future career intentions in primary health care. © 2018 John Wiley & Sons Ltd.

Work-family conflict, psychological distress, and sleep deficiency among patient care workers.

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Jacobsen, Henrik B; Reme, Silje Endresen; Sembajwe, Grace; Hopcia, Karen; Stoddard, Anne M; Kenwood, Christopher; Stiles, Tore C; Sorensen, Glorian; Buxton, Orfeu M

2014-07-01

This study examined whether work-family conflict was associated with sleep deficiencies, both cross-sectionally and longitudinally. In this two-phase study, a workplace health survey was completed by a cohort of patient care workers (n = 1,572). Additional data were collected 2 years later from a subsample of the original respondents (n = 102). Self-reported measures included work-family conflict, workplace factors, and sleep outcomes. The participants were 90% women, with a mean age of 41 ± 11.7 years. At baseline, after adjusting for covariates, higher levels of work-family conflict were significantly associated with sleep deficiency. Higher levels of work-family conflict also predicted sleep insufficiency nearly 2 years later. The first study to determine the predictive association between work-family conflict and sleep deficiency suggests that future sleep interventions should include a specific focus on work-family conflict. Copyright 2014, SLACK Incorporated.

Patient-centered medical home cyberinfrastructure current and future landscape.

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Finkelstein, Joseph; Barr, Michael S; Kothari, Pranav P; Nace, David K; Quinn, Matthew

2011-05-01

The patient-centered medical home (PCMH) is an approach that evolved from the understanding that a well-organized, proactive clinical team working in a tandem with well-informed patients is better able to address the preventive and disease management needs in a guideline-concordant manner. This approach represents a fundamental shift from episodic acute care models and has become an integral part of health reform supported on a federal level. The major aspects of PCMH, especially pertinent to its information infrastructure, have been discussed by an expert panel organized by the Agency for Healthcare Research and Quality at the Informatics for Consumer Health Summit. The goal of this article is to summarize the panel discussions along the four major domains presented at the summit: (1) PCMH as an Evolving Model of Healthcare Delivery; (2) Health Information Technology (HIT) Applications to Support the PCMH; (3) Current HIT Landscape of PCMH: Challenges and Opportunities; and (4) Future HIT Landscape of PCMH: Federal Initiatives on Health Informatics, Legislation, and Standardization. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

The Effects of Gender Differences in Patients with Depression on Their Emotional Working Memory and Emotional Experience

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Mi Li

2015-01-01

Full Text Available A large amount of research has been conducted on the effects of sex hormones on gender differences in patients with depression, yet research on cognitive differences between male and female patients with depression is insufficient. This study uses emotion pictures to investigate the differences of the emotional working memory ability and emotional experience in male and female patients with depression. Despite identifying that the working memory of patients with depression is impaired, our study found no significant gender differences in emotional working memory. Moreover, the research results revealed that memory effects of mood congruence are produced in both men and women, which may explain why the depression state can be maintained. Furthermore, female patients have more emotional experiences than male patients, which is particularly significant in terms of negative emotional experiences. This result provides cognitive evidence to explain why women suffer from longer terms of depression, are more susceptible to relapse, and can more easily suffer from major depressive disorder in the future.

[Technology and future ways of thinking related to work from ergonomics points of views in moments of global crisis].

Science.gov (United States)

Puentes-Lagos, David E; García-Acosta, Gabriel

2012-06-01

Is it possible to establish (at short, medium and long term) future work conditions or expected work conditions for Colombian people considering upcoming work technologies? Is it possible to anticipate future work desirable work conditions for Colombian people in order to plan (foresee?) work technologies? These questions guided this research and they point to an action thesis and to a reaction one in this context of work crisis. Even though a work technology establishes where, when, how, who, who with, and using what element work is done, it also establishes certain work conditions. Besides, multiple forms of considering and deconstructing past have been created from many disciplines. However, in order to foresee or construct work technologies requires a different perspective for looking further. This research has been carried out considering other disciplines points of view regarding Future Studies and Future Thinking Studies. This research has the purpose of finding future paths for Future Thinking Studies from ergonomics point of view in this moment of global work crisis we are going through.

Structural maturation and brain activity predict future working memory capacity during childhood development.

Science.gov (United States)

Ullman, Henrik; Almeida, Rita; Klingberg, Torkel

2014-01-29

Human working memory capacity develops during childhood and is a strong predictor of future academic performance, in particular, achievements in mathematics and reading. Predicting working memory development is important for the early identification of children at risk for poor cognitive and academic development. Here we show that structural and functional magnetic resonance imaging data explain variance in children's working memory capacity 2 years later, which was unique variance in addition to that predicted using cognitive tests. While current working memory capacity correlated with frontoparietal cortical activity, the future capacity could be inferred from structure and activity in basal ganglia and thalamus. This gives a novel insight into the neural mechanisms of childhood development and supports the idea that neuroimaging can have a unique role in predicting children's cognitive development.

The Physician-Patient Working Alliance in Hemodialysis Treatment.

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Fuertes, Jairo N; Rubinstein, Sofia; Reyes, Mariela; Iampornpipopchai, Pichet; Mujeeb, Shanza; Smith, Carroll R; Toporovsky, Arielle

2017-01-01

Over the past 20 years, the role of psychological and social factors, including the physician-patient working alliance, have emerged as integral components of medical care for patients with a myriad of health conditions. The current study examines a model comprised of psychological-interpersonal factors and the extent to which it explains patient satisfaction with and adherence to hemodialysis treatment. One hundred and seven adults with end-stage renal disease who were receiving regular outpatient hemodialysis participated in the study. Path analyses show that the physician-patient working alliance indirectly predicts patient adherence through patient satisfaction and patients' outcome expectations. The working alliance directly predicts patients' quality of life. It is concluded that consistent with previous research, the physician-patient working alliance is a significant factor in predicting key patient behaviors in medical care.

Electron emission and work function-Past, present and future

International Nuclear Information System (INIS)

Yamamoto, Shigehiko

2005-01-01

The history of electron emission is reviewed from a standpoint of the work function and the applications. For years, in the field of thermionic emission, a great deal of efforts have been devoted to search for low work function materials with a high melting temperature, while the reduction of the local change in time of the work function rather than the work function itself has been the main issue of field emission investigations. High brightness and long life are the central targets of the emission material investigations for the scientific instrument application, while high current density and low power consumption are the guiding principles for the display application. In both fields, field emission has recently become dominant in research and development. In all above cases, the main issue in the future research works will be to analyze the work function in atomic level and thereby to understand the mechanism of the work function reduction by atom adsorption, the change in time of the local work function leading to the current fluctuation, and the relationship between microscopic and macroscopic work functions. Our attempt is discussed, where the work function in atomic level is measured by utilizing the STM technique and it is made clear how far the work function in atomic level extends its influence over the neighboring sites. As a result, a simple relationship is established between microscopic and macroscopic work functions

Guidelines for children's work in agriculture: implications for the future.

Science.gov (United States)

Marlenga, Barbara; Lee, Barbara C; Pickett, William

2012-01-01

The North American Guidelines for Children's Agricultural Tasks (NAGCAT) were developed to assist parents in assigning developmentally appropriate and safe farm work to their children aged 7-16 years. Since their release in 1999, a growing body of evidence has accumulated regarding the content and application of these guidelines to populations of working children on farms. The purpose of this paper is to review the scientific and programmatic evidence about the content, efficacy, application, and uptake of NAGCAT and propose key recommendations for the future. The methods for this review included a synthesis of the peer-reviewed literature and programmatic evidence gathered from safety professionals. From the review, it is clear that the NAGCAT tractor guidelines and the manual material handling guidelines need to be updated based upon the latest empirical evidence. While NAGCAT do have the potential to prevent serious injuries to working children in the correct age range (7-16 years), the highest incidence of farm related injuries and fatalities occur to children aged 1-6 years and NAGCAT are unlikely to have any direct effect on this leading injury problem. It is also clear that NAGCAT, as a voluntary educational strategy, is not sufficient by itself to protect children working on farms. Uptake of NAGCAT has been sporadic, despite being geographically widespread and has depended, almost solely, on a few interested and committed professionals. Key recommendations for the future are provided based upon this review.

Research on aircraft emissions. Need for future work

Energy Technology Data Exchange (ETDEWEB)

Schmitt, A [German Aerospace Establishment, Cologne (Germany). Transport Research Div.

1998-12-31

Reflecting the present status of the research on aircraft emissions and their impacts upon the atmosphere, task-fields for a work programme for the research on aircraft emissions can be derived. Most important measures are to support the efforts to define adequate reduction measures, and (with highest priority) scenario-writing for the long-term development in aircraft emissions, to be able to include into the decision making process the aspect of in-time-reaction against unwanted future. Besides that, a steady monitoring of global aircraft emissions will be necessary. (author) 5 refs.

Research on aircraft emissions. Need for future work

Energy Technology Data Exchange (ETDEWEB)

Schmitt, A. [German Aerospace Establishment, Cologne (Germany). Transport Research Div.

1997-12-31

Reflecting the present status of the research on aircraft emissions and their impacts upon the atmosphere, task-fields for a work programme for the research on aircraft emissions can be derived. Most important measures are to support the efforts to define adequate reduction measures, and (with highest priority) scenario-writing for the long-term development in aircraft emissions, to be able to include into the decision making process the aspect of in-time-reaction against unwanted future. Besides that, a steady monitoring of global aircraft emissions will be necessary. (author) 5 refs.

Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study.

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Dorland, Heleen F; Abma, Femke I; Roelen, Corné A M; Stewart, Roy E; Amick, Benjamin C; Ranchor, Adelita V; Bültmann, Ute

2017-11-01

More than 60% of cancer patients are able to work after cancer diagnosis. However, little is known about their functioning at work. Therefore, the aims of this study were to (1) identify work functioning trajectories in the year following return to work (RTW) in cancer patients and (2) examine baseline sociodemographic, health-related and work-related variables associated with work functioning trajectories. This longitudinal cohort study included 384 cancer patients who have returned to work after cancer diagnosis. Work functioning was measured at baseline, 3, 6, 9 and 12 months follow-up. Latent class growth modeling (LCGM) was used to identify work functioning trajectories. Associations of baseline variables with work functioning trajectories were examined using univariate and multivariate analyses. LCGM analyses with cancer patients who completed on at least three time points the Work Role Functioning Questionnaire (n = 324) identified three work functioning trajectories: "persistently high" (16% of the sample), "moderate to high" (54%) and "persistently low" work functioning (32%). Cancer patients with persistently high work functioning had less time between diagnosis and RTW and had less often a changed meaning of work, while cancer patients with persistently low work functioning reported more baseline cognitive symptoms compared to cancer patients in the other trajectories. This knowledge has implications for cancer care and guidance of cancer patients at work. © 2017 UICC.

What is the future of work based learning in VET?

DEFF Research Database (Denmark)

Jørgensen, Christian Helms

not to pursue an academic career. Countries with strong apprenticeship systems tend to have less youth unemployment and a smoother transition to the labour market than others. Furthermore, from a learning perspective, the outcomes of work-based training and informal learning are enhanced when they are combined...... that question the future role and organisation of work-based training in VET. The purpose of this paper is to examine these challenges based on a review of research on European VET systems and analyses of the Danish dual system of VET. In the end of the paper, some innovative solutions to these challenges...

PROFESSIONAL PREPAREDNESS OF FUTURE TEACHERS TO WORK WITH DISABLED STUDENTS IN CONDITIONS OF INCLUSIVE PRACTICE

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I. V. Ivenskih

2018-01-01

Full Text Available Introduction: In the article we consider the structure of psychological preparedness of future teachers of the primary education level to work with students in the conditions of inclusive education. The following components are pointed out: motivation and values – the component which presupposes the formation of a new value – transformation of the direct relationship with a child into an indirect sociocultural relationship; activity component, which presupposes that a teacher has an ability not only to analyze their professional activity but also to create new situations of inclusive practice, to be more precise, a teacher should be able to plan the individual trajectory of each student’s development and create new ways of academic communication and new forms of academic interaction at the lesson; reflective-evaluative component, which presupposes that a future teacher has an ability to assess the achievements of each student while mastering an educational program, putting a special emphasis on the student’s individual success and progress in the process of his training, education and development. For this reason, at the stage of training future teachers of the primary education level at university they are to attend lectures aimed at educating them in the field of psychology and pedagogics concerning the peculiarities of the age psychic development and general psychic development of disabled children in primary school taking into consideration the specificity of student integration, the zones of actual and perspective development of a child, specific features of interdisciplinary and collective interaction of the specialists working with these children. Future teachers are also to be engaged in practical work of both types – on the campus and off-campus.Results: The article is devoted to the problem of specific features of professional preparedness of future teachers of the primary education level to work with students in the

Engaging Employees: The Importance of High-Performance Work Systems for Patient Safety.

Science.gov (United States)

Etchegaray, Jason M; Thomas, Eric J

2015-12-01

To develop and test survey items that measure high-performance work systems (HPWSs), report psychometric characteristics of the survey, and examine associations between HPWSs and teamwork culture, safety culture, and overall patient safety grade. We reviewed literature to determine dimensions of HPWSs and then asked executives to tell us which dimensions they viewed as most important for safety and quality. We then created a HPWSs survey to measure the most important HPWSs dimensions. We administered an anonymous, electronic survey to employees with direct patient care working at a large hospital system in the Southern United States and looked for linkages between HPWSs, culture, and outcomes. Similarities existed for the HPWS practices viewed as most important by previous researchers and health-care executives. The HPWSs survey was found to be reliable, distinct from safety culture and teamwork culture based on a confirmatory factor analysis, and was the strongest predictor of the extent to which employees felt comfortable speaking up about patient safety problems as well as patient safety grade. We used information from a literature review and executive input to create a reliable and valid HPWSs survey. Future research needs to examine whether HPWSs is associated with additional safety and quality outcomes.

Are long physician working hours harmful to patient safety?

Science.gov (United States)

Ehara, Akira

2008-04-01

Pediatricians of Japanese hospitals including not only residents but also attending physicians work long hours, and 8% work for >79 h per week. Most of them work consecutively for >or=32 h when they are on call. The aim of the present study was to evaluate the effect of long work hours on patient safety. The electronic databases MEDLINE and EMBASE to searched identify the English- and Japanese-language literature for studies on work hours, medical errors, patient safety, and malpractice for years 1966-2005. Studies that analyzed the relationship between physician work hours and outcomes directly related to patient safety were selected. Seven studies met the criteria. Four studies suggest that reduction of work hours has a favorable effect on patient safety indicators. In the other three studies no significant changes of the indicators were observed, but no report found that shorter work hours were harmful to patient safety. Decrease of physician work hours is not harmful but favorable to patient safety.

Informal mentoring at work: A review and suggestions for future research

NARCIS (Netherlands)

Janssen, Suzanne; van Vuuren, Hubrecht A.; de Jong, Menno D.T.

2016-01-01

This paper reviews the literature on informal mentoring at work. Based on two basic premises of interpersonal relationships, it discusses four promising areas in current mentoring research that could be cultivated further by future research. The first premise that we hold is that relationships never

Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

Science.gov (United States)

Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

2017-03-01

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

SURVEYS ON THE EXPECTATIONS AND ALTERNATIVES FOR THE FUTURE OF THE EXECUTIVE WORK

Directory of Open Access Journals (Sweden)

Daniela Degani

2012-06-01

Full Text Available Many cultural and behavioral changes have occurred in society in recent years, but with little consequence in the corporate labor relations. Despite the great technological evolution, we work mostly in the same way as a century ago. This study conducts surveys about the expectations and alternatives for the future of executive work and aims to assess the benefits and prerequisites for the adoption of differentiated working relationships to reconcile the interests of professionals, organizations and society. The methods used were a quantitative survey with executives and in-depth interviews with experts. The main conclusions were that the executive work will undergo profound changes in the near future, being the main difference the flexibility of times and places to work, creating greater autonomy and demanding from professionals and companies a new level of motivation, discipline, communication skills where there is no physical presence, clarity of purpose and values. This transformation will be gradual and the companies that come forward in the adoption of processes and competences that support differentiated relationships will gain competitive advantage.

Nurses' extended work hours: Patient, nurse and organizational outcomes.

Science.gov (United States)

Kunaviktikul, W; Wichaikhum, O; Nantsupawat, A; Nantsupawat, R; Chontawan, R; Klunklin, A; Roongruangsri, S; Nantachaipan, P; Supamanee, T; Chitpakdee, B; Akkadechanunt, T; Sirakamon, S

2015-09-01

Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems

42 CFR 3.212 - Nonidentification of patient safety work product.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Nonidentification of patient safety work product. 3... PROVISIONS PATIENT SAFETY ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Confidentiality and Privilege Protections of Patient Safety Work Product § 3.212 Nonidentification of patient safety work product. (a...

ICT and the future of health care: aspects of doctor-patient communication.

Science.gov (United States)

Haluza, Daniela; Jungwirth, David

2014-07-01

The current digital revolution is particularly relevant for interactions of healthcare providers with patients and the community as a whole. The growing public acceptance and distribution of new communication tools such as smart mobile phones provide the prerequisite for information and communication technology (ICT) -assisted healthcare applications. The present study aimed at identifying specifications and perceptions of different interest groups regarding future demands of ICT-supported doctor-patient communication in Austria. German-speaking Austrian healthcare experts (n = 73; 74 percent males; mean age, 43.9 years; SD 9.4) representing medical professionals, patient advocates, and administrative personnel participated in a 2-round online Delphi process. Participants evaluated scenario-based benefits and obstacles for possible prospect introduction as well as degree of innovation, desirability, and estimated implementation dates of two medical care-related future set ups. Panelists expected the future ICT-supported doctor-patient dialogue to especially improve the three factors doctors-patient relationship, patients' knowledge, and quality of social health care. However, lack of acceptance by doctors, data security, and monetary aspects were considered as the three most relevant barriers for ICT implementation. Furthermore, inter-group comparison regarding desirability of future scenarios showed that medical professionals tended to be more skeptical about health-related technological innovations (p ICT-supported collaboration and communication between doctors and patients.

42 CFR 3.204 - Privilege of patient safety work product.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Privilege of patient safety work product. 3.204... PROVISIONS PATIENT SAFETY ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Confidentiality and Privilege Protections of Patient Safety Work Product § 3.204 Privilege of patient safety work product. (a) Privilege...

Is it a Case of "Work-Anxiety" When Patients Report Bad Workplace Characteristics and Low Work Ability?

Science.gov (United States)

Muschalla, Beate

2017-03-01

Aims Work-anxiety may produce overly negative views of the workplace that impair provider efforts to assess work ability from patient self-report. This study explores the empirical relationships between patient-reported workplace characteristics, work-anxiety, and subjective and objective work ability measures. Methods 125 patients in medical rehabilitation before vocational reintegration were interviewed concerning their vocational situation, and filled in a questionnaire on work-anxiety, subjective mental work ability and perceived workplace characteristics. Treating physicians gave independent socio-medical judgments concerning the patients' work ability and impairment, and need for supportive means for vocational reintegration. Results Patients with high work-anxiety reported more negative workplace characteristics. Low judgments of work ability were correlated with problematic workplace characteristics. When controlled for work-anxiety, subjective work ability remained related only with social workplace characteristics and with work achievement demands, but independent from situational or task characteristics. Sick leave duration and physicians' judgment of work ability were not significantly related to patient-reported workplace characteristics. Conclusions In socio-medical work ability assessments, patients with high work-anxiety may over-report negative workplace characteristics that can confound provider estimates of work ability. Assessing work-anxiety may be important to assess readiness for returning to work and initiating work-directed treatments.

Re-designing the everyday; The use and perception of time among cancer patients combining work and treatment

DEFF Research Database (Denmark)

Hauge, Bettina

2016-01-01

cancer patients performing their jobs while going through demanding treatment programs found time as their main motive for working while being seriously ill. Actions at work point to a time ahead, so by taking part in the time at the workplace they were inscribed in a future presently under pressure...... by their cancer diagnosis. The article describes how cancer struck women and men perceived time in their different life-worlds, at work, at home on temporary sick leave, and at the hospital, and it shows how these perceptions changed during the process of recovery.To these people time appeared in three forms......: A time beyond control, realizing that they had cancer; taking control of time, discovering that they could go to work; the time of the future, which was their new perception of time as cured. This new perception of time reflected the incidental discovery of the cancer, realizing life as coincidental...

Effects of occupational future time perspective on managing stressful work situations.

Science.gov (United States)

Ho, Henry C Y; Yeung, Dannii Y

2016-08-01

According to the socioemotional selectivity theory (SST; Carstensen, 2006), older adults perceive their future time as increasingly limited, which motivates them to focus more on emotional goals and prefer passive emotion-focused strategies. This study aims to investigate the effect of occupational future time perspective (OFTP) on the use of problem-solving strategies in stressful work situations and to examine the effectiveness of these strategies on psychological well-being. A sample of 199 Chinese clerical workers responded to a structured questionnaire on problem-solving strategy use in relation to hypothetical work scenarios. Results revealed that relative to those with limited OFTP, workers with expansive OFTP preferred problem-focused and proactive strategies in both low- and high-emotionally salient scenarios. Workers with limited OFTP consistently preferred passive strategies irrespective of emotional salience. OFTP moderated the effect of problem-focused strategies on psychological distress. In particular, there was a significant negative relationship between problem-focused strategies and psychological distress among workers with expansive OFTP, but such pattern of relationship was not observed among workers with limited OFTP. Findings of this study inform the training strategies employed by practitioners to fit the developmental goals of workers in order to maximise their strengths at work. © 2015 International Union of Psychological Science.

Reduced ability to work both before and after infectious spondylodiscitis in working-age patients

DEFF Research Database (Denmark)

Kehrer, Michala; Hallas, Jesper; Bælum, Jesper

2017-01-01

BACKGROUND: As little is known about the ability to work in patients with infectious spondylodiscitis, we compared the relation between the workforce before infection with that of a reference population and described the patients' ability to work after infection including predictors of return...... to work (RTW). METHODS: We identified all patients aged 20-57 years treated for infectious spondylodiscitis January 1994-May 2009 at hospitals in Funen County, Denmark. The work status of each week from 2 years before until 2 years after index date was compared with that of a reference population. Time...... before infection compared with a reference population and infection further lowered their ability to RTW....

The OMERACT MRI in Arthritis Working Group - Update on Status and Future Research Priorities.

Science.gov (United States)

Østergaard, Mikkel; Bird, Paul; Gandjbakhch, Frédérique; Eshed, Iris; Haugen, Ida K; Haavardsholm, Espen A; Lillegraven, Siri; Foltz, Violaine; Glinatsi, Daniel; Peterfy, Charles; Ejbjerg, Bo; Bøyesen, Pernille; Mease, Philip J; Hermann, Kay-Geert; Emery, Paul; Genant, Harry K; Conaghan, Philip G

2015-12-01

To provide an update on the status and future research priorities of the Outcome Measures in Rheumatology (OMERACT) magnetic resonance imaging (MRI) in arthritis working group. A summary is provided of the activities of the group within rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA), and its research priorities. The OMERACT RA MRI score (RAMRIS) evaluating bone erosion, bone edema (osteitis), and synovitis is now the standard method of quantifying articular pathology in RA trials. Cartilage loss is another important part of joint damage, and at the OMERACT 12 conference, we provided longitudinal data demonstrating reliability and sensitivity to change of the RAMRIS JSN component score, supporting its use in future clinical trials. The MRI group has previously developed a PsA MRI score (PsAMRIS). At OMERACT 12, PsAMRIS was evaluated in a randomized placebo-controlled trial of patients with PsA, demonstrating the responsiveness and discriminatory ability of applying the PsAMRIS to hands and feet. A hand OA MRI score (HOAMRIS) was introduced at OMERACT 11, and has subsequently been further validated. At OMERACT 12, good cross-sectional interreader reliability, but variable reliability of change scores, were reported. Potential future research areas were identified at the MRI session at OMERACT 12 including assessment of tenosynovitis in RA and enthesitis in PsA and focusing on alternative MRI techniques. MRI has been further developed and validated as an outcome measure in RA, PsA, and OA. The group will continue its efforts to optimize the value of MRI as a robust biomarker in rheumatology clinical trials.

Organizational and pedagogic conditions of maturing the readiness of future pedagogues to work with labour mignrants’ children

Directory of Open Access Journals (Sweden)

Nataliia Sabat

2017-02-01

Full Text Available The article substantiates necessity and suitability of marking out the organizational and pedagogic conditions ensuring efficiency of formation of the future pedagogues for work with labour migrants’ children. The author has singled out and described the following groups: regulatory provisions representing a complex of normative base regulating the process of  formation of the future teachers; interdisciplinary integration of the educational disciplines aiming to ensure the  integrity and the cross-match of preparation of the future teachers for work with labour migrants’ children; Human Resourcing; introduction of the newest teaching technologies within the process of professional formation of the future teachers.Key words: organizational and pedagogic conditions; readiness to professional activity; future pedagogues; labour migrants’ children.

Impact of work place stresses on work ability index in patients with depressive disorders

OpenAIRE

Selmanović Senada; Pranjić Nurka; Brekalo-Lazarević Sanja; Grbović Mensur

2011-01-01

Introduction. Depression seriously affects one’s ability to perform work tasks and function at work. We studied the impact of both the individual and work factors on work ability index in patients suffering from depression. Material and methods. The prospective study, which was conducted by using questionnaires, included 210 patients with depression, who had been on sick leave from 60 to 360 days. The individual factors were evaluated by the standardized abridged form of Occupational St...

Perceived challenges of working in a fertility clinic: a qualitative analysis of work stressors and difficulties working with patients.

Science.gov (United States)

Boivin, Jacky; Bunting, Laura; Koert, Emily; Ieng U, Chin; Verhaak, Christianne

2017-02-01

What are some of the challenges of working in a fertility clinic? The most frequently mentioned challenges were workload (e.g. high time pressure) and patient-related sources (e.g. unrealistic expectations). One study showed a too high workload, worry about handling human material and low success rates were main stressors in fertility clinics. An online open-ended survey inviting participants to respond to seven questions was distributed to 5902 members of the European Society for Human Reproduction and Embryology (ESHRE, October 2010). Questions asked participants to describe the top three factors that made (i) their work stressful (hereafter 'Work stressors') and (ii) working with patients difficult (hereafter 'Perceived sources of difficulties'), and (iii) to choose from these factors which top three issues they would be willing to attend a workshop to resolve (hereafter 'Workshops'). A qualitative content analysis using inductive coding for each question was used to extract meaningful themes from the text replies, at three levels of increasing abstraction (lower and higher categories, general themes). The final sample comprised 526 respondents (8.9% participation rate). Respondents were predominantly clinicians (41.3%, n = 216) or embryologists (35.5%, n = 186) from European countries (73.0%, n = 386). The number of text replies generated for each question was 1421, 1208 and 907 for the 'Work Stressors', 'Perceived sources of difficulties' and 'Workshop' questions, respectively. The most often reported higher-order categories of Work Stressors were 'Time and Workload' (61.6%, e.g. time pressure), 'Organisation, Team and management issues' (60.4%, e.g. team conflicts) and 'Job content and work environment' (50.3%, e.g. burdensome administration). For 'Perceived sources of difficulties' these were 'Patient-related sources' (66.7%, e.g. unrealistic expectations), 'Communication and Counselling with patients' (33.7%, e.g. strained information giving) and

ALARA database value in future outage work planning and dose management

International Nuclear Information System (INIS)

Miller, D.W.; Green, W.H.

1995-01-01

ALARA database encompassing job-specific duration and man-rem plant specific information over three refueling outages represents an invaluable tool for the outage work planner and ALARA engineer. This paper describes dose-management trends emerging based on analysis of three refueling outages at Clinton Power Station. Conclusions reached based on hard data available from a relational database dose-tracking system is a valuable tool for planning of future outage work. The system's ability to identify key problem areas during a refueling outage is improving as more outage comparative data becomes available. Trends over a three outage period are identified in this paper in the categories of number and type of radiation work permits implemented, duration of jobs, projected vs. actual dose rates in work areas, and accuracy of outage person-rem projection. The value of the database in projecting 1 and 5 year station person-rem estimates is discussed

ALARA database value in future outage work planning and dose management

Energy Technology Data Exchange (ETDEWEB)

Miller, D.W.; Green, W.H. [Clinton Power Station Illinois Power Co., IL (United States)

1995-03-01

ALARA database encompassing job-specific duration and man-rem plant specific information over three refueling outages represents an invaluable tool for the outage work planner and ALARA engineer. This paper describes dose-management trends emerging based on analysis of three refueling outages at Clinton Power Station. Conclusions reached based on hard data available from a relational database dose-tracking system is a valuable tool for planning of future outage work. The system`s ability to identify key problem areas during a refueling outage is improving as more outage comparative data becomes available. Trends over a three outage period are identified in this paper in the categories of number and type of radiation work permits implemented, duration of jobs, projected vs. actual dose rates in work areas, and accuracy of outage person-rem projection. The value of the database in projecting 1 and 5 year station person-rem estimates is discussed.

Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care

Directory of Open Access Journals (Sweden)

Tuvesson Hanna

2014-01-01

Full Text Available The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.

42 CFR 3.208 - Continued protection of patient safety work product.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Continued protection of patient safety work product... GENERAL PROVISIONS PATIENT SAFETY ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Confidentiality and Privilege Protections of Patient Safety Work Product § 3.208 Continued protection of patient safety work...

Work ability in rheumatoid arthritis patients

DEFF Research Database (Denmark)

Hansen, Sofie M; Hetland, Merete Lund; Pedersen, Jacob

2017-01-01

Objectives: The aim was to study work ability in patients with RA compared with the general population by investigating the rates and risks of long-term sickness absence, unemployment and disability pension, and the chance of returning to work and the changes in these risks over time (1994-2011)....

Leadership meta-competences for the future world of work: an explorative study in the retail industry

OpenAIRE

2008-01-01

To achieve this purpose a leadership meta-competence model, based on levels of work theory, was developed for the future world of work. This model was firstly validated by senior managers in the retail industry. Subsequently a questionnaire assessing the perceived importance of these competencies currently and in the future was designed. This questionnaire was completed by 101 managers from various South African retail industries. The resultant data was analysed and the results indicated that...

Ameliorating Patient Stigma Amongst Staff Working With Personality Disorder: Randomized Controlled Trial of Self-Management Versus Skills Training.

Science.gov (United States)

Clarke, Sue; Taylor, Georgina; Bolderston, Helen; Lancaster, Joanna; Remington, Bob

2015-11-01

Patients diagnosed with a personality disorder (PD) are often stigmatized by the healthcare staff who treat them. This study aimed to compare the impact on front-line staff of a self-management Acceptance and Commitment Therapy-based training intervention (ACTr) with a knowledge- and skills-based Dialectical Behaviour Training intervention (DBTr). A service-based randomized controlled trial was conducted comparing the effects of 2-day ACTr (N = 53) and DBTr (N = 47) staff workshops over 6 months. Primary outcome measures were staff attitudes towards patients and staff-patient relationships. For both interventions, staff attitudes, therapeutic relationship, and social distancing all improved pre- to postintervention, and these changes were maintained at 6-month follow-up. Although offering different resources to staff, both ACTr and DBTr were associated with an improved disposition towards PD patients. Future research could evaluate a combined approach, both for staff working with PD patients and those working with other stigmatized groups.

Second and third year oral health and dental student perceptions of future professional work.

Science.gov (United States)

Tan, A S; Anderson, V R; Foster Page, L A

2013-11-01

To explore and compare the ways dental and oral health students characterise their future professional work (FPW) at the end of their second and third professional years. Questionnaires were given to a cohort group of 48 dental students and 31 oral health students at the end of their second and third professional years at the University of Otago. Students' characterisations of their FPW were identified using an inductive approach, and the emphasis on each characterisation was confirmed using a 'weighted' table. Dental student response rates were 92% (in 2010) and 85% (in 2011); and oral health student response rates were 100% (in 2011) and 97% (in 2011). Students characterised their FPW in ten broad ways: in reference to treatment-related concerns, patient-related concerns, oral health promotion, oral health education, disease prevention and monitoring, communication, teamwork, maintaining an ideal clinical environment, maintaining a sense of self and improving quality of life. In both years, dental students emphasised treatment-related concerns as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. Oral health students emphasised oral health promotion, oral health education, disease prevention and monitoring and restorative tasks as central to their FPW and dealing with patient-related concerns as a primary source of difficulty. Students' broad perceptions of their FPW changed little as they progressed through their programmes; however, their responses suggested the need for greater attention within their programmes to patient management and teamwork. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Adolescent Future Expectations of Work, Education, Family, and Community: Development of a New Measure

Science.gov (United States)

McWhirter, Ellen Hawley; McWhirter, Benedict T.

2008-01-01

The development and validation of a measure of adolescent future expectations associated with work, education, family, health, and church/community participation is presented. The 25-item measure was administered to a sample of 389 7th- to 12th-grade urban poor and working-class Chilean students. Results of an exploratory principal axis factor…

Work limitations among working persons with rheumatoid arthritis: results, reliability, and validity of the work limitations questionnaire in 836 patients.

Science.gov (United States)

Walker, Nancy; Michaud, Kaleb; Wolfe, Frederick

2005-06-01

To describe workplace limitations and the validity and reliability of the Work Limitations Questionnaire (WLQ) in persons with rheumatoid arthritis (RA). A total of 836 employed persons with RA reported clinical and work related measures and completed the WLQ, a 25 item questionnaire that assesses the impact of chronic health conditions on job performance and productivity. Limitations are categorized into 4 domains: physical demands (PDS), mental demands (MDS), time management demands (TMS), and output demands (ODS), which are then used to calculate the WLQ index. Of the 836 completed WLQ, about 10% (85) could not be scored, as more than half the items in each domain were not applicable to the patient's job. Demographic and clinical variables were associated with missing WLQ scores including older age (OR 1.7, 95% CI 1.3-2.1), male sex (OR 1.9, 95% CI 1.2-3.0), and Health Assessment Questionnaire (HAQ) scores (OR 1.4, 95% CI 1.0-2.0). Work limitations were present in all work domains: PDS (27.5%), MDS (15.7%), ODS (19.4%), and TMS (28.6%), resulting in a mean WLQ index of 5.9 (SD 5.6), which corresponds to a 4.9% decrease in productivity and a 5.1% increase in work hours to compensate for productivity loss. The WLQ index was inversely associated with Medical Outcomes Study Short Form 36 (SF-36) Mental Component Score (MCS; r = -0.60) and Physical Component Score (PCS; r = -0.49). Fatigue (0.5), pain (0.46), and HAQ (0.56) were also significantly associated with the WLQ index. Weaker associations were seen with days unable to perform (0.29), days activities cut down (0.38), and annual income (-0.10). The WLQ is a reliable tool for assessing work productivity. However, persons with RA tend to select jobs that they can do with their RA limitations, with the result that the WLQ does not detect functional limitations as well as the HAQ and SF-36. The WLQ provides special information that is not available using conventional measures of assessment, and can provide helpful

Latent Patient Cluster Discovery for Robust Future Forecasting and New-Patient Generalization.

Directory of Open Access Journals (Sweden)

Ting Qian

Full Text Available Commonly referred to as predictive modeling, the use of machine learning and statistical methods to improve healthcare outcomes has recently gained traction in biomedical informatics research. Given the vast opportunities enabled by large Electronic Health Records (EHR data and powerful resources for conducting predictive modeling, we argue that it is yet crucial to first carefully examine the prediction task and then choose predictive methods accordingly. Specifically, we argue that there are at least three distinct prediction tasks that are often conflated in biomedical research: 1 data imputation, where a model fills in the missing values in a dataset, 2 future forecasting, where a model projects the development of a medical condition for a known patient based on existing observations, and 3 new-patient generalization, where a model transfers the knowledge learned from previously observed patients to newly encountered ones. Importantly, the latter two tasks-future forecasting and new-patient generalizations-tend to be more difficult than data imputation as they require predictions to be made on potentially out-of-sample data (i.e., data following a different predictable pattern from what has been learned by the model. Using hearing loss progression as an example, we investigate three regression models and show that the modeling of latent clusters is a robust method for addressing the more challenging prediction scenarios. Overall, our findings suggest that there exist significant differences between various kinds of prediction tasks and that it is important to evaluate the merits of a predictive model relative to the specific purpose of a prediction task.

Latent Patient Cluster Discovery for Robust Future Forecasting and New-Patient Generalization.

Science.gov (United States)

Qian, Ting; Masino, Aaron J

2016-01-01

Commonly referred to as predictive modeling, the use of machine learning and statistical methods to improve healthcare outcomes has recently gained traction in biomedical informatics research. Given the vast opportunities enabled by large Electronic Health Records (EHR) data and powerful resources for conducting predictive modeling, we argue that it is yet crucial to first carefully examine the prediction task and then choose predictive methods accordingly. Specifically, we argue that there are at least three distinct prediction tasks that are often conflated in biomedical research: 1) data imputation, where a model fills in the missing values in a dataset, 2) future forecasting, where a model projects the development of a medical condition for a known patient based on existing observations, and 3) new-patient generalization, where a model transfers the knowledge learned from previously observed patients to newly encountered ones. Importantly, the latter two tasks-future forecasting and new-patient generalizations-tend to be more difficult than data imputation as they require predictions to be made on potentially out-of-sample data (i.e., data following a different predictable pattern from what has been learned by the model). Using hearing loss progression as an example, we investigate three regression models and show that the modeling of latent clusters is a robust method for addressing the more challenging prediction scenarios. Overall, our findings suggest that there exist significant differences between various kinds of prediction tasks and that it is important to evaluate the merits of a predictive model relative to the specific purpose of a prediction task.

TECHNOLOGY OF TRAINING OF FUTURE TEACHERS WITH NON-TEACHING SPECIALTIES TO TEACHING WORK

Directory of Open Access Journals (Sweden)

T. Modestova

2013-08-01

Full Text Available The ways of information and communication technologies implementation into the process of the future higher school teachers’ readiness formation for pedagogical activities, who are going to get non-pedagogical Master degree are considered in the article. ICT usage expedience at students’ individual work is proved. The proper information resources and communication ways of the educational process participants are found. Technique of informational assets usage during “Theory and Practice of Higher School” course studying is developed. It is based on author’s teaching and learning aids and Internet accessible. It has been proved that supplying educational process with the updated information and communication technologies enables students to perform an effective preparation for the classes independently; supports their skills for individual work and creativity performance; develops motivation for the pedagogical course studying and future teaching activities at higher school.

42 CFR 3.206 - Confidentiality of patient safety work product.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Confidentiality of patient safety work product. 3... individually identifiable health information in such patient safety work product, the direct identifiers listed at 45 CFR 164.514(e)(2) have been removed. (5) Disclosure of nonidentifiable patient safety work...

Patient-reported impact of spondyloarthritis on work disability and working life: the ATLANTIS survey.

Science.gov (United States)

Ramonda, Roberta; Marchesoni, Antonio; Carletto, Antonio; Bianchi, Gerolamo; Cutolo, Maurizio; Ferraccioli, Gianfranco; Fusaro, Enrico; De Vita, Salvatore; Galeazzi, Mauro; Gerli, Roberto; Matucci-Cerinic, Marco; Minisola, Giovanni; Montecucco, Carlomaurizio; Pellerito, Raffaele; Salaffi, Fausto; Paolazzi, Giuseppe; Sarzi-Puttini, Piercarlo; Scarpa, Raffaele; Bagnato, Gianfilippo; Triolo, Giovanni; Valesini, Guido; Punzi, Leonardo; Olivieri, Ignazio

2016-04-01

The aim was to establish how patients experience the impact of spondyloarthritis (SpA) on work disability and working life. The survey was performed in 17/20 regions in Italy (1 January to 31 March 2013). A multiple-choice questionnaire was published on the official website of the sponsor - the National Association of Rheumatic Patients (ANMAR) - and hard-copies were distributed at outpatient clinics for rheumatic patients. Respondents (n = 770) were of both sexes (56 % men), educated (62 % at high school or more), of working age (75 % aged ≤60 years), and affected by SpA. The most common types diagnosed were ankylosing spondylitis (AS) (39 %) and psoriatic arthritis (PsA) (36 %). Respondents were working full-time (45 %), part-time (8 %) or had retired (22 %); 15 % were unemployed (for reasons linked to the disease or for other reasons, students or housewives). Patients reported disability (39 %), were receiving disability benefits (34 %), were experiencing important limitations that were hindering their professional development/career (36 %) and some had to change/leave their job or lost it because of SpA (21 %). Employed respondents (n = 383) had worked on average 32.2 h in the last 7 days. More hours of work were lost over the last 7 days due to SpA (2.39 h vs 1.67 h). The indirect costs of the disease amounted to €106/week for patients reporting well-being/good physical conditions/improvement and €216/week for those reporting permanent impairment. Most patients were in the midst of their productive years and were experiencing considerable difficulties in carrying out their job because of the disease: half of them reported disability and one third were experiencing important limitations in their career perspective.

Faculty of Radiation Oncology 2012 trainee survey: perspectives on choice of specialty training and future work practice preferences.

Science.gov (United States)

Leung, John; Le, Hien; Turner, Sandra; Munro, Philip; Vukolova, Natalia

2014-02-01

This paper reports the key findings of the first Faculty of Radiation Oncology survey of trainees dealing with experiences and perceptions on work practices and choice of specialty. The survey was conducted in mid 2012 using a 37-question instrument. This was distributed by email to 159 current trainees and advertised through the Radiation Oncology Trainees Committee and other channels. There were six email reminders. Respondents were reassured that their responses were anonymous. The overall response rate was 82.8%. Gender was balanced among respondents with 67 (51.5%) being male and 63 (48.5%) being female. The most common age bracket was the 31 to 35 years range. There were similar proportions of trainee responders in each of the five years of training. A substantial number of trainees held other degrees besides medical degrees. The large majority were satisfied with radiation oncology as a career choice and with the Training Network within which they were training. Interest in oncology patients, lifestyle after training and work hours were given as the major reasons for choosing radiation oncology as a career. Nearly half of trainees were interested in undertaking some of their training in a part-time capacity and working part time as a radiation oncologist in the future. Over 70% of trainees stated they were working 36-55 clinical hours per week with additional non-clinical tasks, after-hours work and on-call duties. Nearly half of all trainees reported having one or less hours of protected time per week. Nonetheless, 40% of respondents indicated they had enough time to pursue outside interests. Radiation treatment planning and maintaining currency in general medicine were considered the most difficult aspects of training in radiation oncology. Most respondents were keen on the concept of fostering a research mentor. In terms of views on practice after completion of training, the majority were interested in pursuing a fellowship, and nearly all expressed an

Faculty of Radiation Oncology 2012 trainee survey: perspectives on choice of speciality training and future work practice preference

International Nuclear Information System (INIS)

Leung, John; Le, Hien; Turner, Sandra; Munro, Philip; Vukolova, Natalia

2014-01-01

This paper reports the key findings of the first Faculty of Radiation Oncology survey of trainees dealing with experiences and perceptions on work practices and choice of specialty. The survey was conducted in mid 2012 using a 37-question instrument. This was distributed by email to 159 current trainees and advertised through the Radiation Oncology Trainees Committee and other channels. There were six email reminders. Respondents were reassured that their responses were anonymous. The overall response rate was 82.8%. Gender was balanced among respondents with 67 (51.5%) being male and 63 (48.5%) being female. The most common age bracket was the 31 to 35 years range. There were similar proportions of trainee responders in each of the five years of training. A substantial number of trainees held other degrees besides medical degrees. The large majority were satisfied with radiation oncology as a career choice and with the Training Network within which they were training. Interest in oncology patients, lifestyle after training and work hours were given as the major reasons for choosing radiation oncology as a career. Nearly half of trainees were interested in undertaking some of their training in a part-time capacity and working part time as a radiation oncologist in the future. Over 70% of trainees stated they were working 36–55 clinical hours per week with additional non-clinical tasks, after-hours work and on-call duties. Nearly half of all trainees reported having one or less hours of protected time per week. Nonetheless, 40% of respondents indicated they had enough time to pursue outside interests. Radiation treatment planning and maintaining currency in general medicine were considered the most difficult aspects of training in radiation oncology. Most respondents were keen on the concept of fostering a research mentor. In terms of views on practice after completion of training, the majority were interested in pursuing a fellowship, and nearly all expressed an

Changes of glaciers in the Andes of Chile and priorities for future work.

Science.gov (United States)

Pellicciotti, F; Ragettli, S; Carenzo, M; McPhee, J

2014-09-15

Glaciers in the Andes of Chile seem to be shrinking and possibly loosing mass, but the number and types of studies conducted, constrained mainly by data availability, are not sufficient to provide a synopsis of glacier changes for the past or future or explain in an explicit way causes of the observed changes. In this paper, we provide a systematic review of changes in glaciers for the entire country, followed by a discussion of the studies that have provided evidence of such changes. We identify a missing type of work in distributed, physically-oriented modelling studies that are needed to bridge the gap between the numerous remote sensing studies and the specific, point scale works focused on process understanding. We use an advanced mass balance model applied to one of the best monitored glaciers in the region to investigate four main research issues that should be addressed in modelling studies for a sound assessment of glacier changes: 1) the use of physically-based models of glacier ablation (energy balance models) versus more empirical models (enhanced temperature index approaches); 2) the importance of the correct extrapolation of air temperature forcing on glaciers and in high elevation areas and the large uncertainty in model outputs associated with it; 3) the role played by snow gravitational redistribution; and 4) the uncertainty associated with future climate scenarios. We quantify differences in model outputs associated with each of these choices, and conclude with suggestions for future work directions. © 2013 Elsevier B.V. All rights reserved.

Proteomics Standards Initiative: Fifteen Years of Progress and Future Work.

Science.gov (United States)

Deutsch, Eric W; Orchard, Sandra; Binz, Pierre-Alain; Bittremieux, Wout; Eisenacher, Martin; Hermjakob, Henning; Kawano, Shin; Lam, Henry; Mayer, Gerhard; Menschaert, Gerben; Perez-Riverol, Yasset; Salek, Reza M; Tabb, David L; Tenzer, Stefan; Vizcaíno, Juan Antonio; Walzer, Mathias; Jones, Andrew R

2017-12-01

The Proteomics Standards Initiative (PSI) of the Human Proteome Organization (HUPO) has now been developing and promoting open community standards and software tools in the field of proteomics for 15 years. Under the guidance of the chair, cochairs, and other leadership positions, the PSI working groups are tasked with the development and maintenance of community standards via special workshops and ongoing work. Among the existing ratified standards, the PSI working groups continue to update PSI-MI XML, MITAB, mzML, mzIdentML, mzQuantML, mzTab, and the MIAPE (Minimum Information About a Proteomics Experiment) guidelines with the advance of new technologies and techniques. Furthermore, new standards are currently either in the final stages of completion (proBed and proBAM for proteogenomics results as well as PEFF) or in early stages of design (a spectral library standard format, a universal spectrum identifier, the qcML quality control format, and the Protein Expression Interface (PROXI) web services Application Programming Interface). In this work we review the current status of all of these aspects of the PSI, describe synergies with other efforts such as the ProteomeXchange Consortium, the Human Proteome Project, and the metabolomics community, and provide a look at future directions of the PSI.

Aggression and risk of future violence in forensic psychiatric patients with and without dyslexia.

Science.gov (United States)

Selenius, Heidi; Hellström, Ake; Belfrage, Henrik

2011-05-01

Dyslexia does not cause criminal behaviour, but it may worsen aggressive behaviour tendencies. In this study, aggressive behaviour and risk of future violence were compared between forensic psychiatric patients with and without dyslexia. Dyslexia was assessed using the Swedish phonological processing battery 'The Pigeon'. The patients filled in the Aggression Questionnaire, and trained assessors performed the risk assessments using HCR-20 version 2. Patients with dyslexia self-reported more aggressive behaviour compared with those without dyslexia. There was only a nearly significant tendency (p = 0.06) for the patients with dyslexia to receive higher scores in the HCR-20 compared with the patients without dyslexia, and phonological processing skills did not significantly predict aggression or risk of future violence. However, regression analyses demonstrated that poor phonological processing skills are a significant predictor of anger, which in turn significantly predicts risk of future violence. Copyright © 2011 John Wiley & Sons, Ltd.

USE OF INFORMATION TECHNOLOGY IN RESEARCH WORK OF FUTURE SOFTWARE ENGINEERS

Directory of Open Access Journals (Sweden)

M.O. Vinnik

2014-04-01

Full Text Available The article describes practical cooperation experience of Kherson State University’s lecturers group and students on software creation for automation, selection and processing of information about the universities scientists publication on the Internet. Recently, much attention is paid to scientometric bases by scientific societies of Eastern Europe. Large number of countries creates their own scientometric bases, platforms and other services. Working on familiar projects the future software engineers can be ready to implement similar tasks as for own country and for the world leaders. The result of research group work should be creation of software tools to support the business processes of research activities at the university. The involvement of students in research work allows using their creativity and employment potential for solving urgent problems of university, raising research competence of students’ professional skills in computer science and software engineering, which are involved in design and development of real software product. Participation of students in each stage is essential element of research group work. While creating software, students receive not only theoretical and practical knowledge of research work but also enhance their professional competences, as projects implementation is the closest to the professional software engineer’s work.

The Role of Working Memory in the Probabilistic Inference of Future Sensory Events.

Science.gov (United States)

Cashdollar, Nathan; Ruhnau, Philipp; Weisz, Nathan; Hasson, Uri

2017-05-01

The ability to represent the emerging regularity of sensory information from the external environment has been thought to allow one to probabilistically infer future sensory occurrences and thus optimize behavior. However, the underlying neural implementation of this process is still not comprehensively understood. Through a convergence of behavioral and neurophysiological evidence, we establish that the probabilistic inference of future events is critically linked to people's ability to maintain the recent past in working memory. Magnetoencephalography recordings demonstrated that when visual stimuli occurring over an extended time series had a greater statistical regularity, individuals with higher working-memory capacity (WMC) displayed enhanced slow-wave neural oscillations in the θ frequency band (4-8 Hz.) prior to, but not during stimulus appearance. This prestimulus neural activity was specifically linked to contexts where information could be anticipated and influenced the preferential sensory processing for this visual information after its appearance. A separate behavioral study demonstrated that this process intrinsically emerges during continuous perception and underpins a realistic advantage for efficient behavioral responses. In this way, WMC optimizes the anticipation of higher level semantic concepts expected to occur in the near future. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Interprofessional education in team communication: working together to improve patient safety.

Science.gov (United States)

Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

2013-11-01

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (pteam structure (p=0.002), situation monitoring (pteams (pteam communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Improving of professional training of future primary school teachers by means of independent work

Directory of Open Access Journals (Sweden)

Інна Анатоліївна Нагрибельна

2015-03-01

Full Text Available The issue of independent professional and methodological training of future primary school teachers in the context of higher education reforming in Ukraine is analyzed in the article. The attention is focused on the role of independent work as an important means of students' professional development. The model of the individual work topic in the course "Methods of Teaching Ukrainian Language" is given

Recommendations for the Involvement of Patient Research Partners (PRP) in OMERACT Working Groups. A Report from the OMERACT 2014 Working Group on PRP.

Science.gov (United States)

Cheung, Peter P; de Wit, Maarten; Bingham, Clifton O; Kirwan, John R; Leong, Amye; March, Lyn M; Montie, Pam; Scholte-Voshaar, Marieke; Gossec, Laure

2016-01-01

Patient participation in research is increasing; however, practical guidelines to enhance this participation are lacking. Specifically within the Outcome Measures in Rheumatology (OMERACT) organization, although patients have participated in OMERACT meetings since 2002, consensus about the procedures for involving patients in working groups has not been formalized. The objective is to develop a set of recommendations regarding patient research partner (PRP) involvement in research working groups. We conducted a systematic literature review on recommendations/guidelines of PRP involvement in research; elaborated a structured consensus process involving multiple participants to develop a set of recommendations; and sought endorsement of recommendations by OMERACT. In the 18 articles included in the literature review, there was general agreement on the broad concepts for recommendations covering PRP involvement in research although they were heterogeneous in detail. Most considered PRP involvement in all phases of research with early engagement, training, and support important, but details on the content were scarce. This review informed a larger consensus-building process regarding PRP inclusion in OMERACT research. Three overarching principles and 8 recommendations were developed, discussed, and refined at OMERACT 2014. The guiding principles were endorsed during the OMERACT plenary session. These recommendations for PRP involvement in OMERACT research reinforce the importance of patient participation throughout the research process as integral members. Although the applicability of the recommendations in other research contexts should be assessed, the generalizability is expected to be high. Future research should evaluate their implementation and their effect on outcome development.

Preparing patients with cancer who work and treatment responsiveness.

Science.gov (United States)

Kamau, Caroline

2017-03-01

Many patients with life-limiting illnesses continue to work because of financial reasons and because work provides good psychosocial support. A lack of appropriate advice/support through patient education could, however, make having a job detrimental to well-being (eg, symptom worsening). This study investigated the frequency with which patients received information that empowers their understanding of their condition, treatment, side effects of treatment and the likely impact on occupational functioning. A cross-sectional study. An analysis of survey data from 3457 patients with cancer in employment. Logistic regression showed that patients who received information about the impact of cancer on work life or education are 1.72 times more likely to have a positive treatment outcome. Patients who receive written information about the type of cancer are 1.99 times more likely to have a positive treatment outcome. Also, patients who receive written information before a cancer-related operation are 1.90 times more likely to have a positive treatment outcome. Information about the side effects of cancer treatment produces worse odds of a positive treatment outcome (0.65-1). A stepwise logistic regression analysing the effects irrespective of current employment status in 6710 patients showed that preparing them produces nearly twice better odds of cancer treatment responsiveness. Palliative care teams should consider ways of actively advising patients who work. Whereas the results showed evidence of good practice in cancer care, there is a need to ensure that all working patients with potentially life-limiting illnesses receive similar support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Work-specific cognitive symptoms and the role of work characteristics, fatigue and depressive symptoms in cancer patients during 18 months post return to work.

Science.gov (United States)

Dorland, H F; Abma, F I; Roelen, C A M; Stewart, R; Amick, B C; Bültmann, U; Ranchor, A V

2018-06-19

Cancer patients can experience work-specific cognitive symptoms post return to work (RTW). The study aims to: 1) describe the course of work-specific cognitive symptoms in the first 18 months post RTW, and 2) examine the associations of work characteristics, fatigue and depressive symptoms with work-specific cognitive symptoms over time. This study used data from the 18-months longitudinal "Work Life after Cancer" cohort. The Cognitive Symptom Checklist-Work, Dutch Version (CSC-W DV) was used to measure work-specific cognitive symptoms. Linear mixed models were performed to examine the course of work-specific cognitive symptoms during 18 months follow-up; linear regression analyses with generalised estimating equations (GEE) were used to examine associations over time. Working cancer patients diagnosed with different cancer types were included (n=378). Work-specific cognitive symptoms were stable over 18 months. At baseline, cancer patients reported more working memory symptoms (M=31.9, CI=23.1, 26.4) compared to executive function symptoms (M=19.3; CI=17.6, 20.9). Cancer patients holding a job with both manual and non-manual tasks reported less work-specific cognitive symptoms (unstandardized regression coefficient b=-4.80; CI=-7.76, -1.83) over time, compared to cancer patients with a non-manual job. Over time, higher depressive symptoms were related to experiencing more overall work-specific cognitive symptoms (b=1.27; CI=1.00, 1.55) and a higher fatigue score was related to more working memory symptoms (b=0.13; CI=0.04, 0.23). Job type should be considered when looking at work-specific cognitive symptoms over time in working cancer patients. To reduce work-specific cognitive symptoms, interventions targeted at fatigue and depressive symptoms might be promising. This article is protected by copyright. All rights reserved.

Workaholism vs. work engagement: the two different predictors of future well-being and performance.

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Shimazu, Akihito; Schaufeli, Wilmar B; Kamiyama, Kimika; Kawakami, Norito

2015-02-01

This study investigated the distinctiveness of two types of heavy work investment (i.e., workaholism and work engagement) by examining their 2-year longitudinal relationships with employee well-being and job performance. Based on a previous cross-sectional study by Shimazu and Schaufeli (Ind Health 47:495-502, 2009) and a shorter term longitudinal study by Shimazu et al. (Ind Health 50:316-21, 2012; measurement interval = 7 months), we predicted that workaholism predicts long-term future unwell-being (i.e., high ill-health and low life satisfaction) and poor job performance, whereas work engagement predicts future well-being (i.e., low ill-health and high life satisfaction) and superior job performance. A two-wave survey was conducted among employees from one Japanese company, and valid data from 1,196 employees was analyzed using structural equation modeling. T1-T2 changes in ill-health, life satisfaction, and job performance were measured as residual scores, which were included in the structural equation model. Workaholism and work engagement were weakly and positively related to each other. In addition, and as expected, workaholism was related to an increase in ill-health and to a decrease in life satisfaction. In contrast, and also as expected, work engagement was related to increases in both life satisfaction and job performance and to a decrease in ill-health. Although workaholism and work engagement are weakly positively related, they constitute two different concepts. More specifically, workaholism has negative consequences across an extended period of 2 years, whereas work engagement has positive consequences in terms of well-being and performance. Hence, workaholism should be prevented and work engagement should be stimulated.

QPS/LHC Activities requiring important Tunnel Work During a future long Shutdown

CERN Document Server

Dahlerup-Petersen, K

2011-01-01

The MPE/circuit protection section is presently establishing a road map for its future LHC activities. The tasks comprise essential consolidation work, compulsory upgrades and extensions of existing machine facilities. The results of a first round of engineering exertion were presented and evaluated at a MPE activity review in December 2010. The technical and financial aspects of this program will be detailed in the ‘QPS Medium and Long-Term Improvement Plan’, to be published shortly. The QPS activities in the LHC tunnel during a future, long shutdown are closely related to this improvement chart. A project-package based program for the interventions has been established and will be presented in this report, together with estimates for the associated human and financial resources necessary for its implementation.

Posterior α EEG Dynamics Dissociate Current from Future Goals in Working Memory-Guided Visual Search.

Science.gov (United States)

de Vries, Ingmar E J; van Driel, Joram; Olivers, Christian N L

2017-02-08

Current models of visual search assume that search is guided by an active visual working memory representation of what we are currently looking for. This attentional template for currently relevant stimuli can be dissociated from accessory memory representations that are only needed prospectively, for a future task, and that should be prevented from guiding current attention. However, it remains unclear what electrophysiological mechanisms dissociate currently relevant (serving upcoming selection) from prospectively relevant memories (serving future selection). We measured EEG of 20 human subjects while they performed two consecutive visual search tasks. Before the search tasks, a cue instructed observers which item to look for first (current template) and which second (prospective template). During the delay leading up to the first search display, we found clear suppression of α band (8-14 Hz) activity in regions contralateral to remembered items, comprising both local power and interregional phase synchronization within a posterior parietal network. Importantly, these lateralization effects were stronger when the memory item was currently relevant (i.e., for the first search) compared with when it was prospectively relevant (i.e., for the second search), consistent with current templates being prioritized over future templates. In contrast, event-related potential analysis revealed that the contralateral delay activity was similar for all conditions, suggesting no difference in storage. Together, these findings support the idea that posterior α oscillations represent a state of increased processing or excitability in task-relevant cortical regions, and reflect enhanced cortical prioritization of memory representations that serve as a current selection filter. SIGNIFICANCE STATEMENT Our days are filled with looking for relevant objects while ignoring irrelevant visual information. Such visual search activity is thought to be driven by current goals activated in

The year without pants WordPress.com and the future of work

CERN Document Server

Berkun, Scott

2013-01-01

A behind-the-scenes look at the firm behind WordPress.com and the unique work culture that contributes to its phenomenal success 50 million websites, or twenty percent of the entire web, use WordPress software. The force behind WordPress.com is a convention-defying company called Automattic, Inc., whose 120 employees work from anywhere in the world they wish, barely use email, and launch improvements to their products dozens of times a day. With a fraction of the resources of Google, Amazon, or Facebook, they have a similar impact on the future of the Internet. How is this possible? What's dif

Educating future leaders in patient safety

Science.gov (United States)

Leotsakos, Agnès; Ardolino, Antonella; Cheung, Ronny; Zheng, Hao; Barraclough, Bruce; Walton, Merrilyn

2014-01-01

Education of health care professionals has given little attention to patient safety, resulting in limited understanding of the nature of risk in health care and the importance of strengthening systems. The World Health Organization developed the Patient Safety Curriculum Guide: Multiprofessional Edition to accelerate the incorporation of patient safety teaching into higher educational curricula. The World Health Organization Curriculum Guide uses a health system-focused, team-dependent approach, which impacts all health care professionals and students learning in an integrated way about how to operate within a culture of safety. The guide is pertinent in the context of global educational reforms and growing recognition of the need to introduce patient safety into health care professionals’ curricula. The guide helps to advance patient safety education worldwide in five ways. First, it addresses the variety of opportunities and contexts in which health care educators teach, and provides practical recommendations to learning. Second, it recommends shared learning by students of different professions, thus enhancing student capacity to work together effectively in multidisciplinary teams. Third, it provides guidance on a range of teaching methods and pedagogical activities to ensure that students understand that patient safety is a practical science teaching them to act in evidence-based ways to reduce patient risk. Fourth, it encourages supportive teaching and learning, emphasizing the need to establishing teaching environments in which students feel comfortable to learn and practice patient safety. Finally, it helps educators incorporate patient safety topics across all areas of clinical practice. PMID:25285012

Cochrane Rehabilitation Methodology Committee: an international survey of priorities for future work.

Science.gov (United States)

Levack, William M; Meyer, Thorsten; Negrini, Stefano; Malmivaara, Antti

2017-10-01

Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. We conducted an international online survey via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people's current capabilities to assist with this work. The survey findings indicated strongest interest in work on how reviewers have interpreted and applied Cochrane methods in reviews on rehabilitation topics in the past, and on gathering a collection of existing publications on review methods for undertaking systematic reviews relevant to rehabilitation. Many people are already interested in contributing to the work of the Methodology Committee and there is a large amount of expertise for this work in the extended Cochrane Rehabilitation network already.

Effects of extended work shifts and shift work on patient safety, productivity, and employee health.

Science.gov (United States)

Keller, Simone M

2009-12-01

It is estimated 1.3 million health care errors occur each year and of those errors 48,000 to 98,000 result in the deaths of patients (Barger et al., 2006). Errors occur for a variety of reasons, including the effects of extended work hours and shift work. The need for around-the-clock staff coverage has resulted in creative ways to maintain quality patient care, keep health care errors or adverse events to a minimum, and still meet the needs of the organization. One way organizations have attempted to alleviate staff shortages is to create extended work shifts. Instead of the standard 8-hour shift, workers are now working 10, 12, 16, or more hours to provide continuous patient care. Although literature does support these staffing patterns, it cannot be denied that shifts beyond the traditional 8 hours increase staff fatigue, health care errors, and adverse events and outcomes and decrease alertness and productivity. This article includes a review of current literature on shift work, the definition of shift work, error rates and adverse outcomes related to shift work, health effects on shift workers, shift work effects on older workers, recommended optimal shift length, positive and negative effects of shift work on the shift worker, hazards associated with driving after extended shifts, and implications for occupational health nurses. Copyright 2009, SLACK Incorporated.

[Impact of work place stresses on work ability index in patients with depressive disorders].

Science.gov (United States)

Lazarević, Sanja Brekalo; Pranjić, Nurka; Selmanović, Senada; Grbović, Mensur

2011-01-01

Depression seriously affects one's ability to perform work tasks and function at work. We studied the impact of both the individual and work factors on work ability index in patients suffering from depression. The prospective study, which was conducted by using questionnaires, included 210 patients with depression, who had been on sick leave from 60 to 360 days. The individual factors were evaluated by the standardized abridged form of Occupational Stress Questionnaire, while the work place factors in relation to work ability were evaluated by the work ability index. Poor work ability was observed in 151 (71%) of subjects suffering from depression. All workplace stresses, lack of support by colleagues and supervisors, ergonomically not adjusted work and huge work load are statistically associated with poor work ability index (P=0.001). More than 95% of variables of the evaluated work ability index are the result of varying in the group of stresses at work place (R2=0.95). Perception of bad health condition (Rsq=0.412, P=0.001), low level of life satisfaction (Rsq=0.309, P=0.001), low level of motivation and work knowledge (Rsq=0.309, P=0.001) are predictors for poor work ability. The work ability cannot be related with age and sex. The key activities for maintaining the work ability at the times when epidemic of depression emerges, as it is nowadays, are timely carrying out the psycho-treatments, mental and professional rehabilitation, occupational therapy and adapted work place.

Adapting nurse competence to future patient needs using Checkland's Soft Systems Methodology.

Science.gov (United States)

Železnik, Danica; Kokol, Peter; Blažun Vošner, Helena

2017-01-01

New emerging technologies, health globalization, demographic change, new healthcare paradigms, advances in healthcare delivery and social networking will change the needs of patients in the future and consequently will require that new knowledge, competence and skill sets be acquired by nurses. Checkland's Soft Systems Methodology, focusing on the enriched CATWOE and PQR elements of the root definitions, combined with our own developed "Too much - Too little constraint" approach was used to devise impending knowledge, competence and skill sets. The analysis revealed ten needs among patients of the future, 63 constraints and 18 knowledge, competence and skill sets for the future nurse. The completed study showed that SSM is an appropriate tool for high level structuring of a "messy" real-world problem situation to meet prospective nursing challenges. Copyright © 2016 Elsevier Ltd. All rights reserved.

Expectations from different perspectives on future work outcome of young adults with intellectual and developmental disabilities.

Science.gov (United States)

Holwerda, Anja; Brouwer, Sandra; de Boer, Michiel R; Groothoff, Johan W; van der Klink, Jac J L

2015-03-01

Expectations strongly influence future employment outcomes and social networks seem to mediate employment success of young adults with intellectual and developmental disabilities. The aim of this study is to examine the expectations of young adults with intellectual and developmental disabilities from special needs education, their parents and their school teachers regarding future work and the extent to which these expectations predict work outcome. Data on 341 young adults with intellectual or developmental disabilities, coming from special needs education, aged 17-20 years, and with an ability to work according to the Social Security Institute were examined. The school teacher's expectation was the only perspective that significantly predicted entering competitive employment, with a complementary effect of the expectation of parents and a small additional effect of the expectation of the young adult. Expectations of school teachers and parents are valuable in predicting work outcome. Therefore, it is important for professionals working with the young adult in the transition from school to work to incorporate the knowledge of school teachers and parents regarding the abilities of the young adult to enter competitive employment as a valuable source of information.

ePatient Conference Explores Future of Personalized Medicine | NIH MedlinePlus the Magazine

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... page please turn Javascript on. ePatient Conference Explores Future of Personalized Medicine Past Issues / Spring - Summer 2010 Table of Contents ... your healthcare provider communicate better in the digital future? What is personalized medicine? Some of the nation's top health researchers, computer ...

Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics.

Science.gov (United States)

Kutner, Nancy G; Zhang, Rebecca

2017-08-07

Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated. The ESKD Quality Incentive Program (QIP) initiated in 2012 emphasizes clinical performance indicators, but a newly-added measure requires the monitoring of patient depression-an issue that is important for work ability and employment. We investigated depression scores and four dialysis-specific QIP measures in relation to work ability reported by a multi-clinic cohort of 528 working-age maintenance HD patients. The prevalence of elevated depression scores was substantially higher among patients who said they were not able to work, while only one of the four dialysis-specific clinical measures differed for patients able/not able to work. Ability to work may be among patients' top priorities. As the parameters of quality assessment continue to evolve, increased attention to patient priorities might facilitate work ability and employment outcomes.

The OMERACT MRI in Arthritis Working Group - Update on Status and Future Research Priorities

DEFF Research Database (Denmark)

Østergaard, Mikkel; Bird, Paul; Gandjbakhch, Frédérique

2015-01-01

OBJECTIVE: To provide an update on the status and future research priorities of the Outcome Measures in Rheumatology (OMERACT) magnetic resonance imaging (MRI) in arthritis working group. METHODS: A summary is provided of the activities of the group within rheumatoid arthritis (RA), psoriatic...

Interprofessional education in team communication: working together to improve patient safety.

Science.gov (United States)

Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

2013-05-01

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (pskills included, team structure (p=0.002), situation monitoring (pcommunication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (pcommunicating in interprofessional teams (pcommunication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Telecommuters: the stay-at-home work force of the future

Energy Technology Data Exchange (ETDEWEB)

Eder, P.F.

1983-06-01

The spread of teleworkers who commute via telecommunications from their home offices will depend, despite the energy-saving and tax advantages of self-employment, on how fast the social climate accepts teleworking, whether software can be made friendlier, and whether legal issues of database networks are resolved. The societal changes associated with home offices can be either a positive reemphasis on the home or a negative electronic sweatshop and a way to export office work to low-wage areas. The author, who sees a gradual adoption of teleworking while these technological, societal, and marketing barriers are dealt with, develops a scenario for an information society of the future. (DCK)

Perceived stress, disturbed sleep, and cognitive impairments in patients with work-related stress complaints: a longitudinal study.

Science.gov (United States)

Eskildsen, Anita; Fentz, Hanne Nørr; Andersen, Lars Peter; Pedersen, Anders Degn; Kristensen, Simon Bang; Andersen, Johan Hviid

2017-07-01

Patients on sick leave due to work-related stress often present with cognitive impairments as well as sleep disturbances. The aim of this longitudinal study was to examine the role of perceived stress and sleep disturbances in the longitudinal development in cognitive impairments in a group of patients with prolonged work-related stress (N = 60) during a period of 12 months following initial professional care-seeking. Objective cognitive impairments (neuropsychological tests) were measured on two occasions - at initial professional care-seeking and at 12-month follow-up. Questionnaires on perceived stress, sleep disturbances, and cognitive complaints were completed seven times during the 12 months which facilitated multilevel analysis with segregation of within-person (change) and between-person (baseline level) components of the time-varying predictors (perceived stress and sleep disturbances). Change in perceived stress was associated with concurrent and subsequent change in self-reported cognitive complaints over the period of 12 months and to a lesser extent the change in performance on neuropsychological tests of processing speed from baseline to 12-month follow-up. Change in sleep disturbances was also associated with concurrent and subsequent change in self-reported cognitive complaints over the 12 months but not with change on neuropsychological test performance. Although the mechanism behind the improvement in cognitive impairments in patients with work-related stress should be further explored in future studies, the results could suggest that improvement in cognitive impairments is partly mediated by decreasing levels of perceived stress and, to a lesser extent, decreasing levels of sleep disturbances. Lay summary This study examines the role of perceived stress and sleep disturbances in respect to the development of cognitive impairments (e.g. memory and concentration) in a group of patients with work-related stress. We found that change in

Working with the disabled patient: exploring student nurses views for curriculum development using a SWOT analysis.

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Willis, Diane S; Thurston, Mhairi

2015-02-01

Increased longevity will mean an increase in people presenting with cognitive and physical disabilities, such as sight loss or dementia. The Patient Rights (Scotland) Act 2011 states that health care should be patient-focussed, taking into account patient needs. This will necessitate nursing curricula to reflect the needs of people who have disabilities and equip the future workforce with knowledge and skills to provide appropriate care. This study explores student nurses' strengths and weakness when working with people with disabilities and identifies opportunities and threats to developing their knowledge and skills to meet the needs of this population. As part of a study day, students from the year one Nursing programme were asked to take part in a SWOT analysis and post comments under the categories: strengths, weakness, opportunity and threats on a central wall about working with people with disabilities. Students acknowledged some of the challenges of being disabled especially in a health setting but also believed they were developing their skills to provide holistic care that ensured autonomy. Communication was viewed as both a strength and weakness and was identified as an essential skill to working effectively with people who had a disability. Students acknowledged that clinical staff were not always experts in working with people who were disabled and welcomed the opportunity to work with experts and clients as well as being directed to resources to increase their knowledge. Integration of disability into the nursing curriculum is needed to ensure students have awareness of and the confidence to work effectively with people who have a range of cognitive and physical disabilities alongside other medical problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

Aphysiologic performance on dynamic posturography in work-related patients.

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Larrosa, F; Durà, M J; Menacho, J; González-Sabaté, L; Cordón, A; Hernández, A; García-Ibáñez, L

2013-01-01

It has been suggested that malingering should be suspected in patients suffering from dizziness or imbalance and who had a potential gain associated with insurance and worker's compensation claims. This study aimed to assess and compare the prevalence of aphysiologic performance on computerized dynamic posturography (CDP) in patients with the potential for secondary gain using a retrospective review of two groups of patients: work-related patients referred for dizziness and/or imbalance (Group 1) were compared against a group of patients with complaints of dizziness or imbalance, who had no history of work-related injury, or litigation procedures (Group 2). CDP and videonystagmography (VNG) were carried out in all patients. The Sensory Organization Test summaries were scored as normal, aphysiologic, or vestibular using the scoring method published by Cevette et al. in Otolaryngol Head Neck Surg 112:676-688 (1995). 24 out of 88 (27%) patients had aphysiologic CDP in Group 1 and 9 out of 51 (18%) in Group 2 but these differences were not significant (p > 0.05). Definite signs of vestibular dysfunction were found in 12 out of 24 (50%) of patients with aphysiologic performance in Group 1 although the presence of VNG abnormalities was significantly higher (p = 0.005) in Group 2. The hypothesis that the occupational group could show a significantly higher rate of aphysiologic results than a control group is not confirmed. Furthermore, VNG abnormalities were found in 50% of the work-related cases with non organic sway patterns. These results suggest that patient's complaints should be considered genuine in work-related cases and due caution exercised when evaluating aphysiologic CDP patterns.

Hospital nurses' working conditions in relation to motivation and patient safety.

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Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja

2015-03-01

There is a lack of empirical knowledge about nurses' perceptions of their workplace characteristics and conditions, such as level of autonomy and decision authority, work climate, teamwork, skill exploitation and learning opportunities, and their work motivation in relation to practice outputs such as patient safety. Such knowledge is needed particularly in countries, such as Estonia, where hospital systems for preventing errors and improving patient safety are in the early stages of development. This article reports the findings from a cross-sectional survey of hospital nurses in Estonia that was aimed at determining their perceptions of workplace characteristics, working conditions, work motivation and patient safety, and at exploring the relationship between these. Results suggest that perceptions of personal control over their work can affect nurses' motivation, and that perceptions of work satisfaction might be relevant to patient safety improvement work.

Work values of future teachers

OpenAIRE

Liniauskaitė, Audronė; Zališčevskis, Antanas

2005-01-01

Learning to live under the network conditions, Lithuanian society is forced to change many things, including the approach towards the work values, which describe human work aspirations and reflect person's understanding of what is correct, good, and acceptable, etc. There is such a trend in the network society, that rational work values are being gradually replaced by the personality growth and interrelation-oriented values. The article presents the research, which aims at the examination of ...

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom.

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Sharrock, A E; Gokani, V J; Harries, R L; Pearce, L; Smith, S R; Ali, O; Chu, H; Dubois, A; Ferguson, H; Humm, G; Marsden, M; Nepogodiev, D; Venn, M; Singh, S; Swain, C; Kirkby-Bott, J

2015-01-01

The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general surgical procedures are performed, yet surgical training prioritisation and organisation of NHS institutions is predicated upon elective care. The increasing ratio of emergency general surgery consultant posts compared to traditional sub-specialities has yet to be addressed. How should the capability gap be bridged to equip motivated, skilled surgeons of the future to deliver a high standard of emergency surgical care? The aim was to address both training requirements for the acquisition of necessary emergency general surgery skills, and the formation of job plans for trainee and consultant posts to meet the current and future requirements of the NHS. Twenty nine trainees and a consultant emergency general surgeon convened as a Working Group at The Association of Surgeons in Training Conference, 2015, to generate a united consensus statement to the training requirement and delivery of emergency general surgery provision by future general surgeons. Unscheduled general surgical care provision, emergency general surgery, trauma competence, training to meet NHS requirements, consultant job planning and future training challenges arose as key themes. Recommendations have been made from these themes in light of published evidence. Careful workforce planning, education, training and fellowship opportunities will provide well-trained enthusiastic individuals to meet public and societal need.

The advent of canine performance science: offering a sustainable future for working dogs.

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Cobb, Mia; Branson, Nick; McGreevy, Paul; Lill, Alan; Bennett, Pauleen

2015-01-01

Working and sporting dogs provide an essential contribution to many industries worldwide. The common development, maintenance and disposal of working and sporting dogs can be considered in the same way as other animal production systems. The process of 'production' involves genetic selection, puppy rearing, recruitment and assessment, training, housing and handling, handler education, health and working life end-point management. At present, inefficiencies throughout the production process result in a high failure rate of dogs attaining operational status. This level of wastage would be condemned in other animal production industries for economic reasons and has significant implications for dog welfare, as well as public perceptions of dog-based industries. Standards of acceptable animal use are changing and some historically common uses of animals are no longer publicly acceptable, especially where harm is caused for purposes deemed trivial, or where alternatives exist. Public scrutiny of animal use appears likely to increase and extend to all roles of animals, including working and sporting dogs. Production system processes therefore need to be transparent, traceable and ethically acceptable for animal use to be sustainable into the future. Evidence-based approaches already inform best practice in fields as diverse as agriculture and human athletic performance. This article introduces the nascent discipline of canine performance science, which aims to facilitate optimal product quality and production efficiency, while also assuring evidence-based increments in dog welfare through a process of research and development. Our thesis is that the model of canine performance science offers an objective, transparent and traceable opportunity for industry development in line with community expectations and underpins a sustainable future for working dogs. This article is part of a Special Issue entitled: Canine Behavior. Copyright © 2014 Elsevier B.V. All rights reserved.

Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain.

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Cochrane, Andy; Higgins, Niamh M; Rothwell, Conor; Ashton, Jennifer; Breen, Roisin; Corcoran, Oriel; FitzGerald, Oliver; Gallagher, Pamela; Desmond, Deirdre

2017-12-13

Purpose To assess self-reported work impacts and associations between psychosocial risk factors and work impairment amongst workers seeking care for musculoskeletal pain while continuing to work. Methods Patients were recruited from Musculoskeletal Assessment Clinics at 5 hospitals across Ireland. Participants completed questionnaires including assessments of work impairment (Work Productivity and Activity Impairment Questionnaire), work ability (single item from the Work Ability Index) and work performance (Work Role Functioning Questionnaire; WRFQ). Logistic and hierarchical regressions were conducted to analyse the relation between psychosocial variables and work outcomes. Results 155 participants (53.5% female; mean age = 46.50 years) who were working at the time of assessment completed the questionnaires. Absenteeism was low, yet 62.6% were classified as functioning poorly according to the WRFQ; 52.3% reported having poor work ability. Logistic regression analyses indicated that higher work role functioning was associated with higher pain self-efficacy (OR 1.51); better work ability was associated with older age (OR 1.063) and lower functional restriction (OR 0.93); greater absenteeism was associated with lower pain self-efficacy (OR 0.65) and poorer work expectancy (OR 1.18). Multiple regression analysis indicated that greater presenteeism was associated with higher pain intensity (β = 0.259) and lower pain self-efficacy (β = - 0.385). Conclusions While individuals continue to work with musculoskeletal pain, their work performance can be adversely affected. Interventions that target mutable factors, such as pain self-efficacy, may help reduce the likelihood of work impairment.

Work ability index, absenteeism and depression among patients with burnout syndrome.

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Pranjic, Nurka; Males-Bilic, Ljiljana

2014-08-01

The aim of this study is to estimate the association of burnout syndrome and depression; burnout syndrome and sick leave; and burnout syndrome with Work Ability Index in patients who suffer from stress at work. The control clinical study was conducted in the Teaching Department for Professional Pathology and Toxicology at the Primary Health Care Center Tuzla in the period from 2009 to 2014. The study included 140 patients exposed to different levels of stress at work. Besides conducted interviews and anamnesis with working anamnesis, physical examination, all patients were subjected to diagnostic package of questionnaires for assessing exposure to stress at work and its effects on health and work ability and Hamilton Rating Scale for screening depression. All patients were referred to the Department with suspected distress and burnout syndrome. For this study we used a questionnaire for measuring intensity of burnout (two categories exclude suffering from burnout syndrome: successfully overcome stress at work and sometimes feel stress at work and the other two reveal the initial and very high burn-out syndrome. Studied group was consisted of patients categorized with burnout syndrome (n=88). The questionnaire on the Work Ability Index (WAI) estimated characteristics of sick leave and prognostic factors with current work ability index. Lack of support at work with poor personal relations is the most common factor with the mobbing in burnout syndrome. Significantly more patients with the burnout syndrome suffered very severe depression 49%:37%; more use long sick leaves 53%:21%; several of them have poor WAI 51%:31% compared to those who are only exposed to stress at work (p=0.001). We found that the burn-out syndrome is predictor for developing depression (β=0.312, 95% CI, 0.114-0.353, p=0.001); absenteeism (β=0.285, 95% CI, 0.093-0.334, p=0.001); and a decline in working ability (β=0.413, 95% CI, 0.297-0.648). All the patients in whom it is found burnout

Preparation of future social teachers to work with a patronate family

Directory of Open Access Journals (Sweden)

Volodymyr Kostiv

2018-01-01

Full Text Available The article sets out to establish practicability of special training of future social teachers to work with a patronate family as one of the family types with disturbed structure. It indicates possibilities of establishment of a patronate family institute as an alternative form of family upbringing of orphaned children and children deprived of parental care. It outlines constituents of social teacher readiness for organization social and pedagogical activities with a patronate  family: professional and humanistic orientation, intellectual and cognitive component represented by professional and pedagogical knowledge and skills,  action-oriented practical component which is characterized by availability of personal experience of student’s interaction with the patronate families, with other forms of family establishment of orphaned children and children deprived of parental care, with parents, adopted children, professionals providing social support of these families, representatives of government authorities which promote family forms of upbringing. Key words: orphaned children and children deprived of parental care, patronate family, future social teachers, constituents of social teacher readiness for organization social and pedagogical activities with a patronate family.

Assessing the relationships between nurse working conditions and patient outcomes: systematic literature review.

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Bae, Sung-Heui

2011-09-01

The purpose of the study was to systematically evaluate nurse working conditions and to review the literature dealing with their association with patient outcomes. Improving nurse working conditions is essential to address nursing shortages. Although general reviews of the literature support the positive link between working conditions and patient outcomes, definitive evidence has been lacking. A search of six electronic bibliographic databases was conducted for the primary research published in English, from January 2000 to October 2009. The concepts of working conditions were categorized into 10 groups of working conditions. A total of 69 relationships between working conditions and patient outcomes were examined. Increased attention has been drawn to nurse working conditions resulting from nursing shortages. The findings of this review suggested that the evidence supporting positive relationships between working conditions and patient outcomes is inconclusive. Further studies of a longitudinal and interventional nature in various settings are needed to advance knowledge of the complex contextual and multivariate influences among nurse working conditions and patient outcomes. Efforts to improve working conditions should be made in various health-care work settings to ensure patient safety and improve patient quality of outcomes. 2011 Blackwell Publishing Ltd.

Working hours: Past, present, and future

OpenAIRE

Dolton, Peter

2017-01-01

Working hours across the world are falling, but considerable variation remains. In some countries people work 70% more hours per year, on average, than in other countries. Much of this variation is due to differences in the prevalence of part-time work and patterns of female labor market participation. Looking ahead, the question of how reducing working hours will affect productivity is significant. In addition, how individuals divide up their leisure and work time and what the appropriate wo...

Ethical working relationships in patient care: challenges and possibilities.

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Aroskar, M A

1998-06-01

This article traces the historical concern for building and maintaining effective working relationships between nurses and physicians on behalf of patients. The author takes the position that compassionate patient care requires collegial and collaborative working relationships both within nursing and between nursing and medicine. The development and support of such relationships is obligatory on the part of nursing, medicine, and administration. Selected studies and expert opinion are used to support this position. Practical and visionary models that guide interprofessional relationships are discussed with a goal of creating organizational structures which are supportive of ethical practice and benefit patients and caregivers.

Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

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Wade, Dorothy M; Hankins, Matthew; Smyth, Deborah A; Rhone, Elijah E; Mythen, Michael G; Howell, David C J; Weinman, John A

2014-09-24

The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units. A validation study of IPAT was conducted in the critical care unit of a London hospital. Once un-sedated, orientated and alert, critical care patients were assessed with the IPAT and validated tools for distress, to determine the IPAT's concurrent validity. Fifty six patients took IPAT again to establish test-retest reliability. Finally, patients completed posttraumatic stress disorder (PTSD), depression and anxiety questionnaires at three months, to determine predictive validity of the IPAT. One hundred and sixty six patients completed the IPAT, and 106 completed follow-up questionnaires at 3 months. Scale analysis showed IPAT was a reliable 10-item measure of critical care-related psychological distress. Test-retest reliability was good (r =0.8). There was good concurrent validity with measures of anxiety and depression (r =0.7, P psychological morbidity was good (r =0.4, P psychological morbidity (AUC =0.7). The IPAT was found to have good reliability and validity. Sensitivity and specificity analysis suggest the IPAT could provide a way of allowing staff to assess psychological distress among critical care patients after further replication and validation. Further work is also needed to determine its utility in predicting future psychological morbidity.

Understanding limitations in at-work productivity in patients with active ankylosing spondylitis: the role of work-related contextual factors.

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Boonen, Annelies; Boone, Caroline; Albert, Adelin; Mielants, Herman

2015-01-01

To explore the effect of health-related and contextual factors on presenteeism, absenteeism, and overall work productivity loss in patients with active ankylosing spondylitis (AS). Consecutive patients with AS starting their first tumor necrosis factor inhibitor and in paid employment were eligible. Patients completed the Work Productivity and Activity Impairment (WPAI) questionnaire for AS to assess presenteeism, absenteeism, and overall work productivity loss in the previous 7 days. In addition, they answered questions about work characteristics (type, characteristics of workplace, satisfaction of contacts with colleagues, and importance of work in life) and health status [Bath AS Functional Index (BASFI), AS Disease Activity Score-C-reactive protein (ASDAS-CRP)]. Physicians assessed the Bath Ankylosing Spondylitis Metrology Index, presence of articular and extraarticular manifestations, comorbidities, and laboratory indicators of inflammation. Stepwise regression models were computed to determine which work-related and health-related factors contributed to WPAI outcomes. The study included 80 patients. The WPAI presenteeism, absenteeism, and overall work productivity loss scores were 49.1%, 30.2%, and 53.1%, respectively. Presenteeism was associated with higher BASFI, female sex, and poor quality of contact with colleagues. Absenteeism was associated with increasing age, current smoking status, higher ASDAS-CRP, and low importance of work for life. Overall work productivity loss was associated with female sex, higher BASFI, past adaptation of job because of illness, number of working hours, and manual profession. Both health-related and contextual factors contribute to work limitations in patients with AS and suggest additional opportunities for improvement by addressing the working environment.

Overcoming barriers to work participation for patients with postpoliomyelitis syndrome.

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Ten Katen, Kim; Beelen, Anita; Nollet, Frans; Frings-Dresen, Monique H W; Sluiter, Judith K

2011-01-01

This study aimed to explore the perceived work ability of patients with postpoliomyelitis syndrome (PPS), to identify barriers and factors that are impeding or conducive, respectively, to work participation, and to identify possible interventions. Qualitative cross-sectional interview study with 17 subjects with PPS, 12 women and 5 men, mean age 49 years (SD: 11). Semi-structured interviews were held with the subjects in their homes, with the aid of a topic list. The COREQ criteria list for qualitative research was used as guideline in design and analysis. Thirteen out of 17 subjects rated their work ability six or higher on a scale from 0 to 10. Most subjects worked in an administrative, educational or managerial function. Five subjects stopped working, four worked between 0 and 20 h/week and eight worked between 20 and 40 h/week. Factors conducive to working were physical adaptations in the workplace, accessibility of the workplace and high decision latitude. Barriers to full work ability in PPS patients were high physical job demands, low social support and the symptoms of PPS, especially fatigue and pain. These findings suggest that work-oriented interventions aimed at preventing PPS patients from dropping out of the workforce should primarily focus on reducing physical job demands, arranging adaptations in the workplace and increasing job control.

Evaluation of the current landscape of respiratory nurse specialists in the UK: planning for the future needs of patients.

Science.gov (United States)

Yorke, Janelle; Prigmore, Sam; Hodson, Matt; Stonham, Carol; Long, Hannah; Bellhouse, Sarah; Fletcher, Monica; Edwards, Sheila

2017-01-01

The National Health Service currently faces significant challenges and must optimise effective workforce planning and management. There are increasing concerns regarding poor workforce planning for respiratory medicine; a greater understanding of the role of respiratory nurse specialists will inform better workforce planning and management. This was a survey study. Two surveys were administered: an organisational-level survey and an individual respiratory nurse survey. There were 148 and 457 respondents to the organisational and individual nurse survey, respectively. Four main themes are presented: (1) breadth of service provided; (2) patient care; (3) work environment; and (4) succession planning. The majority of work conducted by respiratory nurse specialists relates to patient care outside the secondary care setting including supporting self-management in the home, supporting patients on home oxygen, providing hospital-at-home services and facilitating early discharge from acute care environments. Yet, most respiratory nursing teams are employed by secondary care trusts and located within acute environments. There was evidence of multidisciplinary working, although integrated care was not prominent in the free-text responses. High workload was reported with one-quarter of nursing teams short-staffed. Respiratory nurses reported working unpaid extra hours and a lack of administrative support that often took them away from providing direct patient care. Nearly half of the present sample either plan to retire or are eligible for retirement within 10 years. This survey report provides a current snapshot of the respiratory nurse specialist workforce in the UK. This workforce is an ageing population; the results from this survey can be used to inform succession planning and to ensure a viable respiratory nurse specialist workforce in future.

Nurse middle managers contributions to patient-centred care: A 'managerial work' analysis.

Science.gov (United States)

Lalleman, Pcb; Smid, Gac; Dikken, J; Lagerwey, M D; Schuurmans, M J

2017-10-01

Nurse middle managers are in an ideal position to facilitate patient-centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient-centred care in hospitals. A combination of time-use analysis and ethnographic work was used to disclose their contribution to patient-centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient-centred care. Others are involved in direct patient care, but this does not result in patient-centred practices. At one hospital, the nurse middle managers did contribute to patient-centred care. Here balancing between "organizing work" and "caring work" is seen as a precondition for their patient-centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both "hands-on" and "heads-on" caring work of nurse middle managers enhances their patient-centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate "doings" of nurse middle managers with regard to patient-centred care through combining time-use analysis with ethnographic work. © 2017 John Wiley & Sons Ltd.

Cognitive bias in back pain patients attending osteopathy: testing the enmeshment model in reference to future thinking.

Science.gov (United States)

Read, Jessica; Pincus, Tamar

2004-12-01

Depressive symptoms are common in chronic pain. Previous research has found differences in information-processing biases in depressed pain patients and depressed people without pain. The schema enmeshment model of pain (SEMP) has been proposed to explain chronic pain patients' information-processing biases. Negative future thinking is common in depression but has not been explored in relation to chronic pain and information-processing models. The study aimed to test the SEMP with reference to future thinking. An information-processing paradigm compared endorsement and recall bias between depressed and non-depressed chronic low back pain patients and control participants. Twenty-five depressed and 35 non-depressed chronic low back pain patients and 25 control participants (student osteopaths) were recruited from an osteopathy practice. Participants were asked to endorse positive and negative ill-health, depression-related, and neutral (control) adjectives, encoded in reference to either current or future time-frame. Incidental recall of the adjectives was then tested. While the expected hypothesis of a recall bias by depressed pain patients towards ill-health stimuli in the current condition was confirmed, the recall bias was not present in the future condition. Additionally, patterns of endorsement and recall bias differed. Results extend understanding of future thinking in chronic pain within the context of the SEMP.

Work productivity in a population-based cohort of patients with spondyloarthritis.

Science.gov (United States)

Haglund, Emma; Bremander, Ann; Bergman, Stefan; Jacobsson, Lennart T H; Petersson, Ingemar F

2013-09-01

To assess work productivity and associated factors in patients with SpA. This cross-sectional postal survey included 1773 patients with SpA identified in a regional health care register. Items on presenteeism (reduced productivity at work, 0-100%, 0 = no reduction) were answered by 1447 individuals. Absenteeism was defined as register-based sick leave using data from a national register. Disease duration, disease activity (BASDAI), physical function (BASFI), health-related quality of life (EQ-5D), anxiety (HAD-a), depression (HAD-d), self-efficacy [Arthritis Self-efficacy Scale (ASES) pain and symptom], physical activity and education were also measured. Forty-five per cent reported reduced productivity at work with a mean reduction of 20% (95% CI 18, 21) and women reported a higher mean reduction than men (mean 23% vs 17%, P productivity (r = 0.52-0.66, P productivity at work in patients with SpA regardless of age, gender and disease subgroup. ASES symptoms, HAD-a and education level productivity but were not significant in all strata for age, gender and disease subgroup. Work productivity was reduced in patients with SpA and more so in women. Worse quality of life, disease activity, physical function, self-efficacy and depression were all associated with reduced productivity at work in patients with SpA.

Return to work after spinal stenosis surgery and the patient's quality of life.

Science.gov (United States)

Truszczyńska, Aleksandra; Rąpała, Kazimierz; Truszczyński, Olaf; Tarnowski, Adam; Łukawski, Stanisław

2013-06-01

The return to work of patients who undergo spinal surgery poses important medical and social challenge. 1) To establish whether patients who undergo spinal stenosis surgery later return to work. 2) To establish the patient's attitude towards employment. 3) To assess the quality of life of the patients and its influence on their attitude to work. The study population consisted of 58 patients aged from 21 to 80 years (the mean age was 52.33±14.12). There were 29 women (50%) and 29 men (50%) in the group. The patients' quality of life was measured by the use of the WHOQOL-BREF instrument. Individual interviews were conducted 3 to 8 months (a mean of 5.72 months ±1.6) after the surgery. 1) Although 13 patients (22.3%) returned to work, 44 (75.9%) did not, these being manual workers of vocational secondary education. 2) Almost half of the patients (27 patients, i.e. 44%) intend to apply for disability pension, 16 patients (27.6%) consider themselves unfit to work, 22 patients (37.9%) do not feel like working again. 3) The quality of life of the patients decreased. Domain scores for the WHOQOL-BREF are transformed to a 0-100 scale. The mean physical health amounted to 60.67 (±16.31), the mean psychological health was 58.78 (±16.01), while the mean social relations with family and friends were 59.91 (±20.69), and the mean environment 59.62 (±12.48). 1) A total of 75% of the patients operated for lumbar spinal stenosis do not return to their preoperative work. Difficulties in returning to work and decreased quality of life are associated with female sex, lower-level education, hard physical work and low income. 2) Physical health, psychological health, social relations and environment decreased to the mean of approximately 60. 3) The quality of life of the patients who did return to work was similar to that of healthy people.

Motivational power of future time perspective: Meta-analyses in education, work, and health.

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Andre, Lucija; van Vianen, Annelies E M; Peetsma, Thea T D; Oort, Frans J

2018-01-01

Future time perspective (FTP) may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of motivation and behavior, we conducted the first systematical synthesis of FTP relationships in three crucial life domains. Our meta-analyses of FTP studies in education (k = 28), work (k = 17), and health (k = 32) involved N = 31,558 participants, and used a conceptual model for grouping FTP constructs. To address different outcome types, we applied the Theory of Planned Behavior when coding the studies. FTP relationships with outcomes were small-to-medium, were generalizable across domains, and were strongest when the FTP construct included a mixture of cognition, behavioral intention, and affect and, in education, when the FTP measure was domain specific rather than general. There were cross-cultural differences in FTP-outcome relationships. The strength of the FTP-outcome types relationship varied for attitudes, perceived behavioral control, behavioral intention, and behaviors. The lowest effect sizes were found for FTP predicting actual behaviors in education, work, and health and between FTP and health attitudes. Theoretical implications of the findings and future research directions are discussed.

Motivational power of future time perspective: Meta-analyses in education, work, and health.

Directory of Open Access Journals (Sweden)

Lucija Andre

Full Text Available Future time perspective (FTP may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of motivation and behavior, we conducted the first systematical synthesis of FTP relationships in three crucial life domains. Our meta-analyses of FTP studies in education (k = 28, work (k = 17, and health (k = 32 involved N = 31,558 participants, and used a conceptual model for grouping FTP constructs. To address different outcome types, we applied the Theory of Planned Behavior when coding the studies. FTP relationships with outcomes were small-to-medium, were generalizable across domains, and were strongest when the FTP construct included a mixture of cognition, behavioral intention, and affect and, in education, when the FTP measure was domain specific rather than general. There were cross-cultural differences in FTP-outcome relationships. The strength of the FTP-outcome types relationship varied for attitudes, perceived behavioral control, behavioral intention, and behaviors. The lowest effect sizes were found for FTP predicting actual behaviors in education, work, and health and between FTP and health attitudes. Theoretical implications of the findings and future research directions are discussed.

Motivational power of future time perspective: Meta-analyses in education, work, and health

Science.gov (United States)

2018-01-01

Future time perspective (FTP) may predict individual attitudes and behaviors. However, FTP research includes different FTP conceptualizations and outcomes which hinder generalizing its findings. To solve the inconsistencies in FTP research and generalize the magnitude of FTP as a driver of motivation and behavior, we conducted the first systematical synthesis of FTP relationships in three crucial life domains. Our meta-analyses of FTP studies in education (k = 28), work (k = 17), and health (k = 32) involved N = 31,558 participants, and used a conceptual model for grouping FTP constructs. To address different outcome types, we applied the Theory of Planned Behavior when coding the studies. FTP relationships with outcomes were small-to-medium, were generalizable across domains, and were strongest when the FTP construct included a mixture of cognition, behavioral intention, and affect and, in education, when the FTP measure was domain specific rather than general. There were cross-cultural differences in FTP-outcome relationships. The strength of the FTP-outcome types relationship varied for attitudes, perceived behavioral control, behavioral intention, and behaviors. The lowest effect sizes were found for FTP predicting actual behaviors in education, work, and health and between FTP and health attitudes. Theoretical implications of the findings and future research directions are discussed. PMID:29364917

Fertility Preservation for Pediatric Patients: Current State and Future Possibilities.

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Johnson, Emilie K; Finlayson, Courtney; Rowell, Erin E; Gosiengfiao, Yasmin; Pavone, Mary Ellen; Lockart, Barbara; Orwig, Kyle E; Brannigan, Robert E; Woodruff, Teresa K

2017-07-01

This review provides an overview of pediatric fertility preservation. Topics covered include the patient populations who could benefit, the current state of fertility preservation options and research, and considerations related to ethics and program development. A broad Embase® and PubMed® search was performed to identify publications discussing investigational, clinical, ethical and health care delivery issues related to pediatric fertility preservation. Relevant publications were reviewed and summarized. Populations who could benefit from fertility preservation in childhood/adolescence include oncology patients, patients with nononcologic conditions requiring gonadotoxic chemotherapy, patients with differences/disorders of sex development and transgender individuals. Peripubertal and postpubertal fertility preservation options are well established and include cryopreservation of oocytes, embryos or sperm. Prepubertal fertility preservation is experimental. Multiple lines of active research aim to develop technologies that will enable immature eggs and sperm to be matured and used to produce a biological child in the future. Ethical challenges include the need for parental proxy decision making and the fact that fertility preservation procedures can be considered not medically necessary. Successful multidisciplinary fertility preservation care teams emphasize partnerships with adult colleagues, prioritize timely consultations and use standardized referral processes. Some aspects of fertility preservation are not covered by insurance and out-of-pocket costs can be prohibitive. Pediatric fertility preservation is an emerging, evolving field. Fertility preservation options for prepubertal patients with fertility altering conditions such as cancer and differences/disorders of sex development are currently limited. However, multiple lines of active research hold promise for the future. Key considerations include establishing a multidisciplinary team to provide

Effects of Live and Educational Music Therapy on Working Alliance and Trust With Patients on Detoxification Unit: A Four-Group Cluster-Randomized Trial.

Science.gov (United States)

Silverman, Michael J

2016-11-09

Lyric analysis is a commonly utilized music therapy intervention for clients in substance abuse rehabilitation wherein participants interpret song lyrics related to their clinical objectives. For these patients, working alliance and trust in the therapist represent consequential factors that may influence outcomes. However, there is a lack of randomized controlled music therapy studies investigating working alliance and trust in the therapist within lyric analysis interventions for patients with addictions. The purpose of this study was to quantitatively differentiate live versus recorded and educational versus recreational music therapy interventions via measures of working alliance and trust with patients on a detoxification unit. Participants (N = 130) were cluster randomized in a single-session posttest-only design to one of four conditions: Live educational music therapy, recorded educational music therapy, education without music, or recreational music therapy. Dependent measures included working alliance and trust in the therapist. Educational music therapy interventions were scripted lyric analyses. There was no statistically significant between-group difference in any of the measures. Although not significant, a greater number of patients and research participants attended live educational music therapy sessions. Between-group descriptive data were consistently similar but attendance trends may have implications for engaging patients and billing. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.

Working memory training and semantic structuring improves remembering future events, not past events.

Science.gov (United States)

Richter, Kim Merle; Mödden, Claudia; Eling, Paul; Hildebrandt, Helmut

2015-01-01

Objectives. Memory training in combination with practice in semantic structuring and word fluency has been shown to improve memory performance. This study investigated the efficacy of a working memory training combined with exercises in semantic structuring and word fluency and examined whether training effects generalize to other cognitive tasks. Methods. In this double-blind randomized control study, 36 patients with memory impairments following brain damage were allocated to either the experimental or the active control condition, with both groups receiving 9 hours of therapy. The experimental group received a computer-based working memory training and exercises in word fluency and semantic structuring. The control group received the standard memory therapy provided in the rehabilitation center. Patients were tested on a neuropsychological test battery before and after therapy, resulting in composite scores for working memory; immediate, delayed, and prospective memory; word fluency; and attention. Results. The experimental group improved significantly in working memory and word fluency. The training effects also generalized to prospective memory tasks. No specific effect on episodic memory could be demonstrated. Conclusion. Combined treatment of working memory training with exercises in semantic structuring is an effective method for cognitive rehabilitation of organic memory impairment. © The Author(s) 2014.

Work ability in patients with polymyositis and dermatomyositis: An explorative and descriptive study.

Science.gov (United States)

Regardt, Malin; Welin Henriksson, Elisabet; Sandqvist, Jan; Lundberg, Ingrid E; Schult, Marie-Louise

2015-01-01

Polymyositis (PM) and dermatomyositis (DM) are rare, chronic inflammatory diseases leading to muscle weakness and low muscle endurance. The muscle weakness may lead to restrictions in daily activities and low health-related quality of life. This study aimed to investigate the work situation, work ability, work-related risk factors, and influence of the physical and psycho-social work environment in patients with PM and DM. Patients with PM/DM were assessed using the Work Ability Index (WAI), and the Work Environment Impact Scale (WEIS). Forty-eight patients (PM n = 25 and DM n = 23) participated (women/men: 29/19) with a mean age of 54 years (range 28-67 years, SD.10) and mean disease duration of nine years (SD.9). Forty-four percent worked full-time, 31% part-time and 25% were on full-time sick leave. More than 50% self-rated work ability as "poor" or "less good". Physically strenuous work components were present "quite to very often" in 23-79% and more in patients on sick leave ≥ 2 years. For those working, the interfering factors in the work environment concerned task and time demands. Supporting factors concerned meaning of work, interactions with co-workers and others. Self-rated work ability correlated moderately-highly positive with percentage of full-time employment, work-related risk factors and opportunities and constraints in the work environment. Poor self-rated work ability is common in patients with PM/DM indicating a need to identify interfering risk factors and support patients to enhance work performance.

Flexible Pedagogies: Employer Engagement and Work-Based Learning. Flexible Pedagogies: Preparing for the Future Series

Science.gov (United States)

Kettle, Jane

2013-01-01

This publication focuses on national and international policy initiatives to develop a better understanding of work-based learners and the types of flexibility that may well enhance their study especially pedagogically. As part of our five-strand research project "Flexible Pedagogies: preparing for the future" it: (1) highlights the…

The concepts of the 'factory of the future' applied to cleanup and dismantling works

International Nuclear Information System (INIS)

Ghiban, A.; Girones, P.; Moitrier, C.; Gouhier, E.; Torreblanca, L.

2016-01-01

The 'factory of the future' relies on the implementation of new concepts and technologies like: connected robots, data analysis, virtual reality or enhanced reality in the fabrication processes. The article describes how these concepts can be used in cleanup or dismantling works. Both activities can be considered as the fabrication of a waste package and the processing plant as a factory. (A.C.)

ESC Working Group on Valvular Heart Disease Position Paper: assessing the risk of interventions in patients with valvular heart disease

Science.gov (United States)

Rosenhek, Raphael; Iung, Bernard; Tornos, Pilar; Antunes, Manuel J.; Prendergast, Bernard D.; Otto, Catherine M.; Kappetein, Arie Pieter; Stepinska, Janina; Kaden, Jens J.; Naber, Christoph K.; Acartürk, Esmeray; Gohlke-Bärwolf, Christa

2012-01-01

Aims Risk scores provide an important contribution to clinical decision-making, but their validity has been questioned in patients with valvular heart disease (VHD), since current scores have been mainly derived and validated in adults undergoing coronary bypass surgery. The Working Group on Valvular Heart Disease of the European Society of Cardiology reviewed the performance of currently available scores when applied to VHD, in order to guide clinical practice and future development of new scores. Methods and results The most widely used risk scores (EuroSCORE, STS, and Ambler score) were reviewed, analysing variables included and their predictive ability when applied to patients with VHD. These scores provide relatively good discrimination, i.e. a gross estimation of risk category, but cannot be used to estimate the exact operative mortality in an individual patient because of unsatisfactory calibration. Conclusion Current risk scores do not provide a reliable estimate of exact operative mortality in an individual patient with VHD. They should therefore be interpreted with caution and only used as part of an integrated approach, which incorporates other patient characteristics, the clinical context, and local outcome data. Future risk scores should include additional variables, such as cognitive and functional capacity and be prospectively validated in high-risk patients. Specific risk models should also be developed for newer interventions, such as transcatheter aortic valve implantation. PMID:21406443

Productivity at work and quality of life in patients with rheumatoid arthritis.

Science.gov (United States)

van Vilsteren, Myrthe; Boot, Cecile R L; Knol, Dirk L; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E; Steenbeek, Romy; Anema, Johannes R

2015-05-06

The aim of this study was to determine which combination of personal, disease-related and environmental factors is best associated with at-work productivity loss in patients with rheumatoid arthritis (RA), and to determine whether at-work productivity loss is associated with the quality of life for these patients. This study is based on cross-sectional data. Patients completed a questionnaire with personal, disease-related and environmental factors (related to the work environment), and clinical characteristics were obtained from patient medical records. At-work productivity loss was measured with the Work Limitations Questionnaire, and quality of life with the RAND 36. Using linear regression analyses, a multivariate model was built containing the combination of factors best associated with at-work productivity loss. This model was cross-validated internally. We furthermore determined whether at-work productivity loss was associated with quality of life using linear regression analyses. We found that at-work productivity loss was associated with workers who had poorer mental health, more physical role limitations, were ever treated with a biological therapeutic medication, were not satisfied with their work, and had more work instability (R(2) = 0.50 and R(2) following cross-validation was 0.32). We found that at-work productivity loss was negatively associated with health-related quality of life, especially with dimensions of mental health, physical role limitations, and pain. We found that at-work productivity loss was associated with personal, work-related, and clinical factors. Although our study results should be interpreted with caution, they provide insight into patients with RA who are at risk for at-work productivity loss.

42 CFR 3.210 - Required disclosure of patient safety work product to the Secretary.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Required disclosure of patient safety work product... HUMAN SERVICES GENERAL PROVISIONS PATIENT SAFETY ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Confidentiality and Privilege Protections of Patient Safety Work Product § 3.210 Required disclosure of patient...

Radioactivity in the aquatic environment. A review of UK research 1994-1997 and recommendations for future work

International Nuclear Information System (INIS)

1998-07-01

The national Radioactivity Research and Environmental Monitoring Committee (RADREM) provides a forum for liaison on UK research and monitoring in the radioactive substances and radioactive waste management fields. The committee aims to ensure that there is no unnecessary overlap between, or significant omission from, the research programmes of the various parts of Government, the regulatory bodies or industry. This report has been produced by the Aquatic Environment Sub-Committee (AESC) of RADREM. AESC is responsible for providing RADREM with scientific advice in the field of research relating to radionuclides in the aquatic environment, for reporting on the progress of research in this field and on future research requirements. The objectives of this report are presented in Section 2, and the membership of AESC given in Section 3. This report describes a review of research undertaken in the field of radioactivity in aquatic systems over the last three years (Section 4). The review updates previous reviews, the most recent of which being in 1993 (AESC, 1994). Future research requirements have been identified by AESC, considering past work and work in progress, and are presented in Section 5. Specific research requirements are discussed in Section 5, whilst Section 6 summarises the main areas where future research is identified as a priority. These areas are as follows: the movement and uptake of 99 Tc and 14 C in aquatic systems and biota; geochemical processes; off-shore sediments; non-equilibrium systems; radiation exposure during civil engineering works; further work on movement of radionuclides in salt marshes; development and validation of models. The specific objectives of this report are as follows: 1. To provide a summary of research undertaken in this field over the last three years. 2. To identify future research requirements. 3. To attach priorities to the future research requirements. It should be noted that the purpose of the report is to identify

Work ability is influenced by kinesiophobia among patients with persistent pain.

Science.gov (United States)

Åkerström, Mona-Lisa; Grimby-Ekman, Anna; Lundberg, Mari

2017-08-01

The purpose of this study was to investigate how kinesiophobia fluctuates in patients over a four weeks multimodal rehabilitation program and to study the relationship between work ability and kinesiophobia. The study included 112 patients (94 women, 18 men). Measurements were made before, directly after, 2 months after, and 12 months after the program. The level of work ability was rated by the patients on a scale from 0% to 100%, and kinesiophobia was measured by the Swedish version of the Tampa Scale for Kinesiophobia (TSK-SV). Kinesiophobia decreased between the start of the multimodal rehabilitation program and the follow-up periods. Work ability increased over time, but not between baseline and the 2-month follow-up. Decreases in the TSK-SV score between baseline and the 2-month follow-up were related to the increased probability of improved work ability at the 12-month follow-up. In conclusion, a decrease in kinesiophobia seems to be related to increased work ability of patients participating in a 4-week multimodal rehabilitation program.

Predicting return to work for lower back pain patients receiving worker's compensation.

Science.gov (United States)

Lancourt, J; Kettelhut, M

1992-06-01

The results of a prospective study of 134 patients with lower back pain suggest that nonorganic factors are better predictors of return to work than organic findings. Patients who returned to work had fewer job, personal, or family related problems. There were no significant differences between patients who returned to work and those who did not when comparing myelograms, computed tomographic scans, or roentgenographs. The only significant difference in physical organic findings was for muscle atrophy. Patients who did not return to work had a statistically higher incidence rate of muscle atrophy. Length of time off from work was significantly related to outcome, but when patients were categorized according to time off the job, different factors predicted failure to return for patients off work for less than 6 months and patients off for more than 6 months. For patients off for less than 6 months, important predictors were a high Oswestry score, history of leg pain, family relocation, short tenure on the job, verbal magnification of pain, reports of moderate to severe pain on superficial palpation, and positive reaction to a "sham" sciatic tension test. None of these was a significant predictor for the group off for more than 6 months. For the group off work for more than 6 months, previous injuries, and stability of family living arrangements were among the significant predictors not significant for the group off less than 6 months. Using 21 factors selected from a larger group of 92 factors, three statistically significant (P less than or equal to 0.001) predictive measures were developed. These measures predicted return to work for the total sample, and for the two subgroups (off more than, or less than 6 months) more accurately than did the total set of 92 factors.

Temporal and subjective work demands in office-based patient care: an exploration of the dimensions of physician work intensity.

Science.gov (United States)

Jacobson, C Jeff; Bolon, Shannon; Elder, Nancy; Schroer, Brian; Matthews, Gerald; Szaflarski, Jerzy P; Raphaelson, Marc; Horner, Ronnie D

2011-01-01

Physician work intensity (WI) during office-based patient care affects quality of care and patient safety as well as physician job-satisfaction and reimbursement. Existing, brief work intensity measures have been used in physician studies, but their validity in clinical settings has not been established. Document and describe subjective and temporal WI dimensions for physicians in office-based clinical settings. Examine these in relation to the measurement procedures and dimensions of the SWAT and NASA-TLX intensity measures. A focused ethnographic study using interviews and direct observations. Five family physicians, 5 general internists, 5 neurologists, and 4 surgeons. Through interviews, each physician was asked to describe low and high intensity work responsibilities, patients, and events. To document time and task allotments, physicians were observed during a routine workday. Notes and transcripts were analyzed using the editing method in which categories are obtained from the data. WI factors identified by physicians matched dimensions assessed by standard, generic instruments of work intensity. Physicians also reported WI factors outside of the direct patient encounter. Across specialties, physician time spent in direct contact with patients averaged 61% for office-based services. Brief work intensity measures such as the SWAT and NASA-TLX can be used to assess WI in the office-based clinical setting. However, because these measures define the physician work "task" in terms of effort in the presence of the patient (ie, intraservice time), substantial physician effort dedicated to pre- and postservice activities is not captured.

Factors Associated With Work Ability in Patients Undergoing Surgery for Cervical Radiculopathy.

Science.gov (United States)

Ng, Eunice; Johnston, Venerina; Wibault, Johanna; Löfgren, Håkan; Dedering, Åsa; Öberg, Birgitta; Zsigmond, Peter; Peolsson, Anneli

2015-08-15

Cross-sectional study. To investigate the factors associated with work ability in patients undergoing surgery for cervical radiculopathy. Surgery is a common treatment of cervical radiculopathy in people of working age. However, few studies have investigated the impact on the work ability of these patients. Patients undergoing surgery for cervical radiculopathy (n = 201) were recruited from spine centers in Sweden to complete a battery of questionnaires and physical measures the day before surgery. The associations between various individual, psychological, and work-related factors and self-reported work ability were investigated by Spearman rank correlation coefficient, multivariate linear regression, and forward stepwise regression analyses. Factors that were significant (P work ability. Work ability was assessed using the Work Ability Index. The mean Work Ability Index score was 28 (SD, 9.0). The forward stepwise regression analysis revealed 6 factors significantly associated with work ability, which explained 62% of the variance in the Work Ability Index. Factors highly correlated with greater work ability included greater self-efficacy in performing self-cares, lower physical load on the neck at work, greater self-reported chance of being able to work in 6 months' time, greater use of active coping strategies, lower frequency of hand weakness, and higher health-related quality of life. Psychological, work-related and individual factors were significantly associated with work ability in patients undergoing surgery for cervical radiculopathy. High self-efficacy was most associated with greater work ability. Consideration of these factors by surgeons preoperatively may provide optimal return to work outcomes after surgery. 3.

Predictors of work disability after start of anti-TNF therapy in a national cohort of Swedish patients with rheumatoid arthritis: does early anti-TNF therapy bring patients back to work?

Science.gov (United States)

Olofsson, T; Petersson, I F; Eriksson, J K; Englund, M; Nilsson, J A; Geborek, P; Jacobsson, L T H; Askling, J; Neovius, M

2017-07-01

To examine predictors of work ability gain and loss after anti-tumour necrosis factor (TNF) start, respectively, in working-age patients with rheumatoid arthritis (RA) with a special focus on disease duration. Patients with RA, aged 19-62 years, starting their first TNF inhibitor 2006-2009 with full work ability (0 sick leave/disability pension days during 3 months before bio-start; n=1048) or no work ability (90 days; n=753) were identified in the Swedish biologics register (Anti-Rheumatic Treatment In Sweden, ARTIS) and sick leave/disability pension days retrieved from the Social Insurance Agency. Outcome was defined as work ability gain ≥50% for patients without work ability at bio-start and work ability loss ≥50% for patients with full work ability, and survival analyses conducted. Baseline predictors including disease duration, age, sex, education level, employment, Health Assessment Questionnaire, Disease Activity Score 28 and relevant comorbidities were estimated using Cox regression. During 3 years after anti-TNF start, the probability of regaining work ability for totally work-disabled patients was 35% for those with disease duration start, disease duration did not predict work ability loss. Baseline disability pension was also a strong predictor of work ability gain after treatment start. A substantial proportion of work-disabled patients with RA who start anti-TNF therapy regain work ability. Those initiating treatment within 5 years of symptom onset have a more than doubled 3-year probability of regaining work ability compared with later treatment starts. This effect seems largely due to the impact of disease duration on disability pension status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Portfolio Diversification with Commodity Futures: Properties of Levered Futures

NARCIS (Netherlands)

Woodard, J.D.; Egelkraut, T.M.; Garcia, P.; Pennings, J.M.E.

2005-01-01

Portfolio Diversification with Commodity Futures: Properties of Levered Futures This study extends previous work on the impact of commodity futures on portfolio performance by explicitly incorporating levered futures into the portfolio optimization problem. Using data on nine individual commodity

USING AUTHENTIC LITERARY WORKS FOR THE FORMATION OF LEXICAL COMPETENCE OF FUTURE GERMAN LANGUAGE TEACHERS

Directory of Open Access Journals (Sweden)

Антоніна Палецька-Юкало

2014-10-01

Full Text Available The article deals with the advantages of use of authentic literary works as the main sphere of learning and improvement of foreign language vocabulary.The definition of lexical competence has been suggested. The possibilities for perceiving and analysis of such language phenomena as synonyms, antonyms, polisemic words, lexical links, linguistic clichés non-equivalent and emotionally colored vocabulary of authentic literary works as the basis of the formation of German lexical competence of future teachers have been grounded. The process of investigation has revealed that lexical contents of authentic literary works contribute to a comprehensive dictionary and learning connected speech structures, provide frequent repetition of lexical items, and create a sense of language.

Impact of psoriasis on patients' work and productivity: a retrospective, matched case-control analysis.

Science.gov (United States)

Wu, Ying; Mills, Douglas; Bala, Mohan

2009-01-01

Psoriasis negatively impacts patient quality of life; however, the impact on work and productivity is not well known. To determine the impact of psoriasis on work and productivity using data from the National Health and Wellness Survey (NHWS). Data collected from 40 730 adults who completed the NHWS between 1 May and 30 June 2004, of whom 1127 had psoriasis, were analyzed. Psoriasis patients and a matched cohort of non-psoriasis patients were identified to assess the impact of psoriasis on work and productivity. Psoriasis patients were more likely to have missed work for health-related reasons (p work productivity impairment (p work impairment (p work (p work productivity.

The Future of Spirituality in Social Work: The Farther Reaches of Human Nurture

Directory of Open Access Journals (Sweden)

Edward R. Canda

2005-05-01

Full Text Available This essay discusses the development of the social work profession in relation to the subject of spirituality and proposes future possibilities and recommendations for innovation. It presents historical trends within four phases leading to the present and beyond. Current trends indicate rapidly increasing quantities of publications and other professional activities about spirituality within a pattern of an ever farther reaching integrative approach that encompasses diverse religious and nonreligious perspectives, academic disciplines, international collaborations, and humanity’s relationship with the Earth.

Memory rehabilitation for the working memory of patients with multiple sclerosis (MS).

Science.gov (United States)

Mousavi, Shokoufeh; Zare, Hossein; Etemadifar, Masoud; Taher Neshatdoost, Hamid

2018-05-01

The main cognitive impairments in multiple sclerosis (MS) affect the working memory, processing speed, and performances that are in close interaction with one another. Cognitive problems in MS are influenced to a lesser degree by disease recovery medications or treatments,but cognitive rehabilitation is considered one of the promising methods for cure. There is evidence regarding the effectiveness of cognitive rehabilitation for MS patients in various stages of the disease. Since the impairment in working memory is one of the main MS deficits, a particular training that affects this cognitive domain can be of a great value. This study aims to determine the effectiveness of memory rehabilitation on the working memory performance of MS patients. Sixty MS patients with cognitive impairment and similar in terms of demographic characteristics, duration of disease, neurological problems, and mental health were randomly assigned to three groups: namely, experimental, placebo, and control. Patients' cognitive evaluation incorporated baseline assessments immediately post-intervention and 5 weeks post-intervention. The experimental group received a cognitive rehabilitation program in one-hour sessions on a weekly basis for 8 weeks. The placebo group received relaxation techniques on a weekly basis; the control group received no intervention. The results of this study showed that the cognitive rehabilitation program had a positive effect on the working memory performance of patients with MS in the experimental group. These results were achieved in immediate evaluation (post-test) and follow-up 5 weeks after intervention. There was no significant difference in working memory performance between the placebo group and the control group. According to the study, there is evidence for the effectiveness of a memory rehabilitation program for the working memory of patients with MS. Cognitive rehabilitation can improve working memory disorders and have a positive effect on the

Prevalence of- and risk factors for work disability in Dutch patients with inflammatory bowel disease.

Science.gov (United States)

Spekhorst, Lieke M; Oldenburg, Bas; van Bodegraven, Ad A; de Jong, Dirk J; Imhann, Floris; van der Meulen-de Jong, Andrea E; Pierik, Marieke J; van der Woude, Janneke C; Dijkstra, Gerard; D'Haens, Geert; Löwenberg, Mark; Weersma, Rinse K; Festen, Eleonora A M

2017-12-14

To determine the prevalence of work disability in inflammatory bowel disease (IBD), and to assess risk factors associated with work disability. For this retrospective cohort study, we retrieved clinical data from the Dutch IBD Biobank on July 2014, containing electronic patient records of 3388 IBD patients treated in the eight University Medical Centers in the Netherlands. Prevalence of work disability was assessed in 2794 IBD patients and compared with the general Dutch population. Multivariate analyses were performed for work disability (sick leave, partial and full disability) and long-term full work disability (> 80% work disability for > 2 years). Prevalence of work disability was higher in Crohn's disease (CD) (29%) and ulcerative colitis (UC) (19%) patients compared to the general Dutch population (7%). In all IBD patients, female sex, a lower education level, and extra-intestinal manifestations, were associated with work disability. In CD patients, an age > 40 years at diagnosis, disease duration > 15 years, smoking, surgical interventions, and anti-TNFα use were associated with work disability. In UC patients, an age > 55 years, and immunomodulator use were associated with work disability. In CD patients, a lower education level (OR = 1.62, 95%CI: 1.02-2.58), and in UC patients, disease complications (OR = 3.39, 95%CI: 1.09-10.58) were associated with long-term full work disability. The prevalence of work disability in IBD patients is higher than in the general Dutch population. Early assessment of risk factors for work disability is necessary, as work disability is substantial among IBD patients.

Informal work and formal plans: articulating the active role of patients in cancer trajectories

Directory of Open Access Journals (Sweden)

Rikke Juul Dalsted

2012-12-01

Full Text Available Introduction: Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories.  Methods and theory: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included.  Results: Patients continuously took initiatives to organize their treatment and care. They initiated processes in the trajectories, and acquired information, which they used to form their trajectories.  Patients presented problems to the healthcare professionals in order to get proper help when needed.  Discussion: Work done by patients was invisible and not perceived as work. The patients' requests were not sufficiently supported in the professional organisation of work or formal planning. Patients' insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients´ active participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed. Introduction: Formal pathway models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories. Methods and theory: An in-depth case study of patient trajectories at a Danish hospital and surrounding municipality using individual interviews with patients. Theory about trajectory and work by Strauss was included. Results: Patients continuously took initiatives to organize their

Working as simulated patient has effects on real patient life – Preliminary insights from a qualitative study

Directory of Open Access Journals (Sweden)

Simmenroth-Nayda, Anne

2016-05-01

Full Text Available Background: Persons who simulate patients during medical education understand the routines and the underlying script of medical consultations better. We aimed to explore how simulated patients (SPs integrated this new understanding into their daily life, how this work affected their private life as patients, and what we can learn from these changes for concepts of empowerment.Design, setting, and participants: A qualitative interview study. All SPs of Göttingen medical school who had been working longer than three semesters (n=14 were invited and agreed to take part in an open interview about their daily experience with real doctors. Documentary method was used to identify the main issues. Several cases were chosen according to maximum contrast and analysed by in-depth analysis to provide vivid examples of how simulations may affect the real life of the SPs as patients.Results: Our analysis revealed three main changes in the behaviour of SPs as real patients. They were more attentive, had a better understanding of the circumstances under which doctors work, and acted more self-confidently. From the selected cases it became apparent that working as a SP may lead to a constant and significant decrease of fear of hospitals and medical procedures or, in other cases, may enable the SPs to develop new abilities for giving feedback, questioning procedures, and explanations for real doctors.Conclusion: working as a simulated patient seems to be well-suited to understand own progression of diseases, to increase self-responsibility and to a confident attitude as patient.

Interventions to enhance return-to-work for cancer patients

NARCIS (Netherlands)

de Boer, Angela G. E. M.; Taskila, Tyna K.; Tamminga, Sietske J.; Feuerstein, Michael; Frings-Dresen, Monique H. W.; Verbeek, Jos H.

2015-01-01

Cancer patients are 1.4 times more likely to be unemployed than healthy people. Therefore it is important to provide cancer patients with programmes to support the return-to-work (RTW) process. This is an update of a Cochrane review first published in 2011. To evaluate the effectiveness of

Prognostic factors for return to work in patients with sciatica.

Science.gov (United States)

Grøvle, Lars; Haugen, Anne J; Keller, Anne; Ntvig, Bård; Brox, Jens I; Grotle, Margreth

2013-12-01

Little is known about the prognostic factors for work-related outcomes of sciatica caused by disc herniation. To identify the prognostic factors for return to work (RTW) during a 2-year follow-up among sciatica patients referred to secondary care. Multicenter prospective cohort study including 466 patients. Administrative data from the National Sickness Benefit Register were accessed for 227 patients. Two samples were used. Sample A comprised patients who at the time of inclusion in the cohort reported being on partial sick leave or complete sick leave or were undergoing rehabilitation because of back pain/sciatica. Sample B comprised patients who, according to the sickness benefit register, at the time of inclusion received sickness benefits or rehabilitation allowances because of back pain/sciatica. In Sample A, the outcome was self-reported return to full-time work at the 2-year follow-up. In Sample B, the outcome was time to first sustained RTW, defined as the first period of more than 60 days without receiving benefits from the register. Significant baseline predictors of self-reported RTW at 2 years (Analysis A) were identified by multivariate logistic regression. Significant predictors of time to sustained RTW (Analysis B) were identified by multivariate Cox proportional hazard modeling. Both analyses included adjustment for age and sex. To assess the effect of surgery on the probability of RTW, analyses similar to A and B were performed, including the variable surgery (yes/no). One-fourth of the patients were still out of work at the 2-year follow-up. In Sample A (n=237), younger age, better general health, lower baseline sciatica bothersomeness, less fear-avoidance work, and a negative straight-leg-raising test result were significantly associated with a higher probability of RTW at the 2-year follow-up. Surgery was not significantly associated with the outcome. In Sample B (n=125), history of sciatica, duration of the current sciatica episode more than 3

Work-family and family-work conflicts amongst African nurses caring for patients with AIDS.

Science.gov (United States)

Makola, Lehlogonolo; Mashegoane, Solomon; Debusho, Legesse K

2015-12-14

South African nursing environments are marked by various incapacitating stressors. This study explores work-family (W-F) and family-work (F-W) conflicts as aspects of stress amongst nurses working with patients who have AIDS. The study sought to determine the value of W-F and F-W conflicts as predictors of work and family satisfaction, as well as turnover intentions and the moderating role of supervisor and significant other support, amongst nurses caring for patients with AIDS in public hospitals within the Capricorn and Mopani districts, Limpopo Province. The study used a cross-sectional design, with data collected at one point only. Ninety-one nursing staff provided the data for the study by completing structured, self-administered surveys. Analysis involved computing correlations of all study variables. Thereafter, associated variables were used as predictors. In each predictive analysis, the nurses' stress served as a control variable, W-F and F-W conflicts were the independent variables and significant others and supervisor supports were moderators. Interaction terms were derived from independent and moderator variables. Although the findings of the study were not generally supportive of the hypotheses advanced, they nevertheless showed, amongst other findings, that F-W conflict predicted work satisfaction whilst W-F conflict predicted turnover intentions. Moreover, significant other support had a direct effect on family satisfaction whilst supervisor support moderated reports of W-F conflict and experiences of work satisfaction. The study showed that inter-role models that appear to be established in the context of developed societies require some further investigations in South Africa.

Job Resources, Physician Work Engagement, and Patient Care Experience in an Academic Medical Setting.

Science.gov (United States)

Scheepers, Renée A; Lases, Lenny S S; Arah, Onyebuchi A; Heineman, Maas Jan; Lombarts, Kiki M J M H

2017-10-01

Physician work engagement is associated with better work performance and fewer medical errors; however, whether work-engaged physicians perform better from the patient perspective is unknown. Although availability of job resources (autonomy, colleague support, participation in decision making, opportunities for learning) bolster work engagement, this relationship is understudied among physicians. This study investigated associations of physician work engagement with patient care experience and job resources in an academic setting. The authors collected patient care experience evaluations, using nine validated items from the Dutch Consumer Quality index in two academic hospitals (April 2014 to April 2015). Physicians reported job resources and work engagement using, respectively, the validated Questionnaire on Experience and Evaluation of Work and the Utrecht Work Engagement Scale. The authors conducted multivariate adjusted mixed linear model and linear regression analyses. Of the 9,802 eligible patients and 238 eligible physicians, respectively, 4,573 (47%) and 185 (78%) participated. Physician work engagement was not associated with patient care experience (B = 0.01; 95% confidence interval [CI] = -0.02 to 0.03; P = .669). However, learning opportunities (B = 0.28; 95% CI = 0.05 to 0.52; P = .019) and autonomy (B = 0.31; 95% CI = 0.10 to 0.51; P = .004) were positively associated with work engagement. Higher physician work engagement did not translate into better patient care experience. Patient experience may benefit from physicians who deliver stable quality under varying levels of work engagement. From the physicians' perspective, autonomy and learning opportunities could safeguard their work engagement.

Work participation in Q-fever patients and patients with Legionnaires' disease: a 12-month cohort study.

NARCIS (Netherlands)

Loenhout, J.A.F. van; Houtvast, J.L.A.; Akkermans, R.P.; Donders, N.C.G.M.; Vercoulen, J.H.; Paget, W.J.; Velden, K. van der

2015-01-01

Aims:The aim of the study was to assess long-term work participation of Q-fever patients and patients with Legionnaires’ disease, and to identify which factors are associated with a reduced ork participation in Q-fever patients. Methods: Q-fever patients participated at four time points until 12

The MS@Work study: a 3-year prospective observational study on factors involved with work participation in patients with relapsing-remitting Multiple Sclerosis.

Science.gov (United States)

van der Hiele, Karin; van Gorp, Dennis A M; Heerings, Marco A P; van Lieshout, Irma; Jongen, Peter J; Reneman, Michiel F; van der Klink, Jac J L; Vosman, Frans; Middelkoop, Huub A M; Visser, Leo H

2015-08-12

Multiple Sclerosis (MS) is the most common cause of neurological disability in young and middle-aged adults. At this stage in life most people are in the midst of their working career. The majority of MS patients are unable to retain employment within 10 years from disease onset. Leading up to unemployment, many may experience a reduction in hours or work responsibilities and increased time missed from work. The MS@Work study examines various factors that may influence work participation in relapsing-remitting MS patients, including disease-related factors, the working environment and personal factors. The MS@Work study is a multicenter, 3-year prospective observational study on work participation in patients with relapsing-remitting MS. We aim to include 350 patients through 15-18 MS outpatient clinics in the Netherlands. Eligible participants are 18 years and older, and either currently employed or within three years since their last employment. At baseline and after 1, 2 and 3 years, the participants are asked to complete online questionnaires (including questions on work participation, work problems and accommodations, cognitive and physical ability, anxiety, depression, psychosocial stress, quality of life, fatigue, empathy, personality traits and coping strategies) and undergo cognitive and neurological examinations. After six months, patients are requested to only complete online questionnaires. Patient perspectives on maintaining and improving work participation and reasons to stop working are gathered through semi-structured interviews in a sub-group of patients. Prospective studies with long-term follow-up on work participation in MS are rare, or take into account a limited number of factors. The MS@Work study provides a 3-year follow-up on various factors that may influence work participation in patients with relapsing-remitting MS. We aim to identify factors that relate to job loss and to provide information about preventative measures for physicians

Longterm Work Productivity Costs Due to Absenteeism and Permanent Work Disability in Patients with Early Rheumatoid Arthritis: A Nationwide Register Study of 7831 Patients.

Science.gov (United States)

Martikainen, Janne A; Kautiainen, Hannu; Rantalaiho, Vappu; Puolakka, Kari T

2016-12-01

To estimate the development and potential disproportional distribution of longterm productivity costs (PC) and their determinants leading to work absenteeism and permanent work disability in working-aged patients with early rheumatoid arthritis (RA). A cohort of subjects with early RA was created by identifying the new cases of RA from the national drug reimbursement register that had been granted a special reimbursement for their antirheumatic medications for RA from 2000-2007. The dataset was enriched by cross-linking with other national registries detailing work absenteeism days and permanent disability pensions. In the base case, the human capital approach was applied to estimate PC based on subjects' annual number of absenteeism days and incomes. Hurdle regression analysis was applied to study the determinants of PC. Among the 7831 subjects with early RA, the mean (bootstrapped 95% CI) annual PC per person-observation year was €4800 (4547-5070). The annual PC declined after the first year of RA diagnosis, but increased significantly in subsequent years. In addition, the PC was heavily disproportionally concentrated in a small fraction of patients with RA, because only around 20% of patients accounted for the majority of total annual PC. The initiation of active drug treatment during the first 3 months after RA diagnosis significantly reduced the cumulative PC when compared with no drug treatment. The longterm PC increased significantly in parallel with years elapsing after RA diagnosis. Further, the majority of these PC are incurred by a small proportion of patients.

Prevalence and Characteristics of Work Anxiety in Medical Rehabilitation Patients: A Cross-Sectional Observation Study.

Science.gov (United States)

Muschalla, Beate; Jöbges, Michael

2018-01-01

To investigate frequency, type, and characteristics of work anxieties in patients with somatic illness. Cross-sectional observation study. Neurology, orthopedic, and cardiology rehabilitation clinics. Patients (N=1610; age, 18-65y) with work anxieties. Not applicable. Patients who scored high on at least 2 of 9 items in the work-anxiety screening questionnaire and who reported impairment were investigated with a differential diagnostic interview on work anxieties and with the Mini-International Neuropsychiatric Interview on non-work-related common mental disorders. Patients also filled out a self-rating questionnaire on their subjective symptom load and sociodemographic data. Approximately 20% to 27% of the investigated inpatients in somatic rehabilitation (altogether n=393) received a work-anxiety diagnosis. Patients with orthopedic illness report highest work anxiety and have previous longest sick leave (20.6wk in the past 12mo). Patients with orthopedic illness suffer from work-related adjustment disorder with anxiety, social anxieties, and workplace phobias, whereas patients with cardiac illness are more often affected by hypochondriac anxieties. Anxieties of insufficiency and worrying occur equally in all indications. About a quarter of patients in somatic rehabilitation are in need of additional diagnostic attention owing to work anxieties. Differential diagnostic of work anxiety is needed for initiating adequate therapeutic action. Somatic rehabilitation physicians should be aware of work anxieties in their patients, especially in patients with orthopedic illness with previous long-term sick leave. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Functional capacity and work ability in patients with chronic musculoskeletal pain

NARCIS (Netherlands)

van der Meer, Suzan

2014-01-01

Patients suffering from chronic low back pain (CLBP) and whiplash associated disorders (WAD) may experience many problems, including in work. Work ability is considered a balance between work demands and personal resources. Functional Capacity Evaluations (FCE) can be used to measure aspects of work

Youth, Work, and Military Service: Findings from Two Decades of Monitoring the Future National Samples of American Youth

National Research Council Canada - National Science Library

Bachman, Jerald

2000-01-01

This report examines the work-related attitudes and experiences of high school seniors and young adults, using questionnaire data from the Monitoring the Future project covering nearly a quarter century...

Sentence processing and verbal working memory in a white-matter-disconnection patient.

Science.gov (United States)

Meyer, Lars; Cunitz, Katrin; Obleser, Jonas; Friederici, Angela D

2014-08-01

The Arcuate Fasciculus/Superior Longitudinal Fasciculus (AF/SLF) is the white-matter bundle that connects posterior superior temporal and inferior frontal cortex. Its causal functional role in sentence processing and verbal working memory is currently under debate. While impairments of sentence processing and verbal working memory often co-occur in patients suffering from AF/SLF damage, it is unclear whether these impairments result from shared white-matter damage to the verbal-working-memory network. The present study sought to specify the behavioral consequences of focal AF/SLF damage for sentence processing and verbal working memory, which were assessed in a single patient suffering from a cleft-like lesion spanning the deep left superior temporal gyrus, sparing most surrounding gray matter. While tractography suggests that the ventral fronto-temporal white-matter bundle is intact in this patient, the AF/SLF was not visible to tractography. In line with the hypothesis that the AF/SLF is causally involved in sentence processing, the patient׳s performance was selectively impaired on sentences that jointly involve both complex word orders and long word-storage intervals. However, the patient was unimpaired on sentences that only involved long word-storage intervals without involving complex word orders. On the contrary, the patient performed generally worse than a control group across standard verbal-working-memory tests. We conclude that the AF/SLF not only plays a causal role in sentence processing, linking regions of the left dorsal inferior frontal gyrus to the temporo-parietal region, but moreover plays a crucial role in verbal working memory, linking regions of the left ventral inferior frontal gyrus to the left temporo-parietal region. Together, the specific sentence-processing impairment and the more general verbal-working-memory impairment may imply that the AF/SLF subserves both sentence processing and verbal working memory, possibly pointing to the AF

Evaluation of self-reported work ability and usefulness of interventions among sick-listed patients.

Science.gov (United States)

Wåhlin, Charlotte; Ekberg, Kerstin; Persson, Jan; Bernfort, Lars; Öberg, Birgitta

2013-03-01

To describe the types of intervention offered, to investigate the relationship between the type of intervention given, patient-reported usefulness of interventions and the effect on self-reported work ability in a cohort of sick-listed patients with musculoskeletal disorders (MSD) or mental disorders (MD). A prospective cohort study was performed including 810 newly sick-listed patients (MSD 62 % and MD 38 %). The baseline questionnaire included sociodemographic characteristics and measures of work ability. The 3-month follow-up questionnaire included measures of work ability, type of intervention received, and judgment of usefulness. Twenty-five percent received medical intervention modalities (MI) only, 45 % received a combination of medical and rehabilitative intervention modalities (CRI) and 31 % received work-related interventions combined with medical or rehabilitative intervention modalities (WI). Behavioural treatments were more common for patients with MD compared with MSD and exercise therapy were more common for patients with MSD. The most prevalent workplace interventions were adjustment of work tasks or the work environment. Among patients with MD, WI was found to be useful and improved work ability significantly more compared with only MI or CRI. For patients with MSD, no significant differences in improved work ability were found between interventions. Patients with MD who received a combination of work-related and clinical interventions reported best usefulness and best improvement in work ability. There was no difference in improvements in work ability between rehabilitation methods in the MSD group. There seems to be a gap between scientific evidence and praxis behaviour in the rehabilitation process. Unimodal rehabilitation was widely applied in the early rehabilitation process, a multimodal treatment approach was rare and only one-third received work-related interventions. It remains a challenge to understand who needs what type of intervention.

Predictors of Functional Improvement and Future Work Status After the Disability Benefit Claim: A Prospective Cohort Study

NARCIS (Netherlands)

Cornelius, L.R.; van der Klink, J.J.L.; de Boer, M.R.; Groothoff, J.W.; Brouwer, S.

2014-01-01

Objective In most industrialized countries, disability benefit rates have increased substantially in the past decade. Few beneficiaries return into employment once disability benefit is awarded. The present study aims to investigate which factors predict functional improvement and future work status

Predicting Future High-Cost Schizophrenia Patients Using High-Dimensional Administrative Data

Directory of Open Access Journals (Sweden)

Yajuan Wang

2017-06-01

Full Text Available BackgroundThe burden of serious and persistent mental illness such as schizophrenia is substantial and requires health-care organizations to have adequate risk adjustment models to effectively allocate their resources to managing patients who are at the greatest risk. Currently available models underestimate health-care costs for those with mental or behavioral health conditions.ObjectivesThe study aimed to develop and evaluate predictive models for identification of future high-cost schizophrenia patients using advanced supervised machine learning methods.MethodsThis was a retrospective study using a payer administrative database. The study cohort consisted of 97,862 patients diagnosed with schizophrenia (ICD9 code 295.* from January 2009 to June 2014. Training (n = 34,510 and study evaluation (n = 30,077 cohorts were derived based on 12-month observation and prediction windows (PWs. The target was average total cost/patient/month in the PW. Three models (baseline, intermediate, final were developed to assess the value of different variable categories for cost prediction (demographics, coverage, cost, health-care utilization, antipsychotic medication usage, and clinical conditions. Scalable orthogonal regression, significant attribute selection in high dimensions method, and random forests regression were used to develop the models. The trained models were assessed in the evaluation cohort using the regression R2, patient classification accuracy (PCA, and cost accuracy (CA. The model performance was compared to the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC model.ResultsAt top 10% cost cutoff, the final model achieved 0.23 R2, 43% PCA, and 63% CA; in contrast, the CMS-HCC model achieved 0.09 R2, 27% PCA with 45% CA. The final model and the CMS-HCC model identified 33 and 22%, respectively, of total cost at the top 10% cost cutoff.ConclusionUsing advanced feature selection leveraging detailed

Survey of attitudes of nurses working with AIDS patients.

Science.gov (United States)

Blumenfield, M; Smith, P J; Milazzo, J; Seropian, S; Wormser, G P

1987-01-01

This article reports the results of a ten-question anonymous survey given to nurses at Westchester County Medical Center in July 1983 and January 1984 concerning attitudes about caring for AIDS patients. Two-thirds of the responding nurses reported that they had friends or family express concern about associating with hospital personnel who have contact with AIDS patients. Other questions showed that between one fourth and one half of nurses have a fear of caring for homosexual men and male prisoners because of their awareness about AIDS. One half of the nurses believe that AIDS can be transmitted to hospital personnel because of contact with patients despite precautions. The fear of caring for patients with AIDS as compared to caring for patients with hepatitis, a more contagious but less serious disease than AIDS, was highest in the intensive care unit staff. Eighty-five percent of the health care personnel responding believed that pregnant nurses should not care for AIDS patients and one half of the nurses responding indicated that they would ask for a transfer if they had to care for AIDS patients on a regular basis. The implication of these findings for future treatment programs, medical and nursing education and psychologic support for staff are discussed.

Work-family and family-work conflicts amongst African nurses caring for patients with AIDS

Directory of Open Access Journals (Sweden)

Lehlogonolo Makola

2015-12-01

Full Text Available Background: South African nursing environments are marked by various incapacitating stressors. This study explores work-family (W-F and family-work (F-W conflicts as aspects of stress amongst nurses working with patients who have AIDS. Objectives: The study sought to determine the value of W-F and F-W conflicts as predictors of work and family satisfaction, as well as turnover intentions and the moderating role of supervisor and significant other support, amongst nurses caring for patients with AIDS in public hospitals within the Capricorn and Mopani districts, Limpopo Province. Methods: The study used a cross-sectional design, with data collected at one point only. Ninety-one nursing staff provided the data for the study by completing structured, self-administered surveys. Analysis involved computing correlations of all study variables. Thereafter, associated variables were used as predictors. In each predictive analysis, the nurses’ stress served as a control variable, W-F and F-W conflicts were the independent variables and significant others and supervisor supports were moderators. Interaction terms were derived from independent and moderator variables. Results: Although the findings of the study were not generally supportive of the hypotheses advanced, they nevertheless showed, amongst other findings, that F-W conflict predicted work satisfaction whilst W-F conflict predicted turnover intentions. Moreover, significant other support had a direct effect on family satisfaction whilst supervisor support moderated reports of W-F conflict and experiences of work satisfaction. Conclusions: The study showed that inter-role models that appear to be established in the context of developed societies require some further investigations in South Africa.

Future In-Space Operations (FISO): A Working Group and Community Engagement

Science.gov (United States)

Thronson, Harley; Lester, Dan

2013-01-01

Long-duration human capabilities beyond low Earth orbit (LEO), either in support of or as an alternative to lunar surface operations, have been assessed at least since the late 1960s. Over the next few months, we will present short histories of concepts for long-duration, free-space human habitation beyond LEO from the end of the Apollo program to the Decadal Planning Team (DPT)/NASA Exploration Team (NExT), which was active in 1999 2000 (see Forging a vision: NASA s Decadal Planning Team and the origins of the Vision for Space Exploration , The Space Review, December 19, 2005). Here we summarize the brief existence of the Future In-Space Operations (FISO) working group in 2005 2006 and its successor, a telecon-based colloquium series, which we co-moderate.

Employment and disability for work in patients with COPD: A cross-sectional study among Dutch patients

NARCIS (Netherlands)

Kremer, A.M.; Pal, T.M.; Keimpema, A.R.J.

2006-01-01

Objectives: The aim was to gain insight into work experiences and problems of subjects with chronic obstructive pulmonary disease (COPD) to develop more effective guidelines for preventing work disability and work loss. Methods: A total of 617 patients aged 45-60, recruited from pulmonary outpatient

Overcoming barriers to work participation for patients with postpoliomyelitis syndrome

NARCIS (Netherlands)

ten Katen, Kim; Beelen, Anita; Nollet, Frans; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

2011-01-01

Purpose. This study aimed to explore the perceived work ability of patients with postpoliomyelitis syndrome (PPS), to identify barriers and factors that are impeding or conducive, respectively, to work participation, and to identify possible interventions. Methods. Qualitative cross-sectional

[Consumerism, patient empowerment and changing clinical work--patient awareness and treatment demands on the rise].

Science.gov (United States)

Toiviainen, Hanna

2011-01-01

Consumerism refers to the accentuation of a patient's status and freedom of choice within the health care. Increasing patient knowledge, empowerment and demands stand out in the medical practice. Patients seek for self-diagnosis before attending the consultation. Regarding the treatment relationship, one doctor out of five experiences the situation positive and two out of five negative. The patients influence prescription decisions. Private doctors have a more positive attitude to patients' consumer role than those working within the public sector.

The patient work system: an analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers.

Science.gov (United States)

Holden, Richard J; Schubert, Christiane C; Mickelson, Robin S

2015-03-01

Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in "patient-engaged human factors," or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. A Patient Work System model was developed to guide the collection and analysis of interviews, surveys, and observations of patients with heart failure (n = 30) and their informal caregivers (n = 14). Iterative analyses revealed the nature and prevalence of self-care barriers across components of the Patient Work System. Person-related barriers were common and stemmed from patients' biomedical conditions, limitations, knowledge deficits, preferences, and perceptions as well as the characteristics of informal caregivers and healthcare professionals. Task barriers were also highly prevalent and included task difficulty, timing, complexity, ambiguity, conflict, and undesirable consequences. Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains-physical-spatial, social-cultural, and organizational-and multiple "spaces" such as "at home," "on the go," and "in the community." Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, contexts, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Employment and disability for work in patients with COPD: a cross-sectional study among Dutch patients

NARCIS (Netherlands)

Kremer, A. M.; Pal, T. M.; van Keimpema, A. R. J.

2006-01-01

The aim was to gain insight into work experiences and problems of subjects with chronic obstructive pulmonary disease (COPD) to develop more effective guidelines for preventing work disability and work loss. A total of 617 patients aged 45-60, recruited from pulmonary outpatient clinics and general

Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care.

Science.gov (United States)

Mousquès, Julien; Bourgueil, Yann; Le Fur, Philippe; Yilmaz, Engin

2010-12-01

To assess the efficacy and the cost of a French team work experiment between nurses and GPs for managing type 2 diabetes patients. Based on a case control study design we compare the evolution of process (standard follow-up procedures) and final (glycemic control) outcomes, and of cost, between two consecutive periods between type 2 diabetes patients followed within the team work experiment (intervention group) or by "standard" GPs (controlled group). After a 11 months of follow-up, patients in the intervention group, compared with those in the controlled group, have more chances to remain or to become: correctly followed-up (with OR comprise between 2.1 and 6.8, p≤5%) and under glycemic control (with OR comprise between 1.8 and 2.7, p≤5%). The latter result is obtained only when a visit for education and counselling has been delivered by a nurse in supplement to systematic electronic patient registry and electronic clinical GPs reminder. All these results are obtained without difference in costs between the intervention and the controlled group. This experimentation of team working can be considered both effective and efficient. Our findings may have implications in the design of future larger primary care team work experiment to be launched by French health authorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The application of patient education in clinical interventional work

International Nuclear Information System (INIS)

Wang Xiuqing; Lv Shukun; Ma Shuxian; Shi Liang

2010-01-01

By introducing patient education into the nursing care of interventional therapy, the medical workers can effectively help and encourage the patients to actively participate in and cooperate with the interventional therapy and related nursing care service. Besides, the relevant education and guidance can greatly help the patients to promote functional restoration and psychological recovery. This article systematically describes the approaches, the principles, the choice of the right moment for health education and the education contents in clinical interventional work. (authors)

Retail food environments research: Promising future with more work to be done.

Science.gov (United States)

Fuller, Daniel; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-06-09

As members of the scientific committee for the Food Environments in Canada conference, we reflect on the current state of food environments research in Canada. We are very encouraged that the field is growing and there have been many collaborative efforts to link researchers in Canada, including the 2015 Food Environments in Canada Symposium and Workshop. We believe there are 5 key challenges the field will need to collectively address: theory and causality; replication and extension; consideration of rural, northern and vulnerable populations; policy analysis; and intervention research. In addressing the challenges, we look forward to working together to conduct more sophisticated, complex and community-driven food environments research in the future.

Working with Bangladeshi patients in Britain: perspectives from Primary Health Care.

Science.gov (United States)

Hawthorne, Kamila; Rahman, Jasmin; Pill, Roisin

2003-04-01

The difficulties of ethnic minority communities in accessing appropriate primary care are well documented, but little is known about the experiences of Primary Health Care Teams (PHCTs) serving these communities, or their strategies to help patients overcome these difficulties. The purpose of the study was to explore the PHCT perspective of working with Bangladeshi patients. Qualitative group discussions with PHCTs were set up by four health centres in the Grangetown area of Cardiff, where a large proportion of the Bangladeshi community lives. Experiences of and attitudes to working with Bangladeshi patients were explored. Discussions were taped and transcribed for independent analysis by two researchers. Comparisons within and between PHCTs were made. PHCTs largely entered into full and frank discussions. Health visitors had made significantly more effort than others to get to know their Bangladeshi patients. This had costs in terms of time and effort, with no reduction in caseload. Cutting across this difference were common themes such as communication and cultural differences, and patients' difficulties in using NHS services appropriately, which caused disruption and frustration. While there was an awareness of the reasons for these difficulties, PHCTs generally were not able to allow for them because of the inflexibility of their workload and systems of working. Group discussions are a useful way to encourage PHCTs to reflect on their practice and share experiences. PHCTs are aware of their patients' needs and keen to explore racial awareness training and new ways of looking at how they work. However, the grind of heavy workloads makes this process unlikely without outside facilitation.

Acuity-adaptable nursing care: exploring its place in designing the future patient room.

Science.gov (United States)

Kwan, Melissa A

2011-01-01

To substantiate the anticipated benefits of the original acuity-adaptable care delivery model as defined by innovator Ann Hendrich. In today's conveyor belt approach to healthcare, upon admission and through discharge, patients are commonly transferred based on changing acuity needs. Wasted time and money and inefficiencies in hospital operations often result-in addition to jeopardizing patient safety. In the last decade, a handful of hospitals pioneered the implementation of the acuity-adaptable care delivery model. Built on the concept of eliminating patient transfers, the projected outcomes of acuity-adaptable units-decreased average lengths of stay, increased patient safety and satisfaction, and increased nurses' satisfaction from reduced walking distances-make a good case for a model patient room. Although some hospitals experienced the projected benefits of the acuity-adaptable care delivery model, sustaining the outcomes proved to be difficult; hence, the original definition of acuity-adaptable units has not fared well. Variations on the original concept demonstrate that eliminating patient transfers has not been completely abandoned in healthcare redesign and construction initiatives. Terms such as flex-up, flex-down, universal room, and single-stay unit have since emerged. These variations convolute the search for empirical evidence to support the anticipated benefits of the original concept. To determine the future of this concept and its variants, a significant amount of outcome data must be generated by piloting the concept in different hospital settings. As further refinements and adjustments to the concept emerge, the acuity-adaptable room may find a place in future hospitals.

Patient and social work factors related to successful placement of ...

African Journals Online (AJOL)

Patient and social work factors related to successful placement of long-term psychiatric in-patients from a specialist psychiatric hospital in South Africa. ... away; a low frequency of behavioural problems (especially of cannabis abuse, verbal or physical aggression, uncontrolled sexual activity), and agitation or restlessness.

Future Remains: Industrial Heritage at the Hanford Plutonium Works

Science.gov (United States)

Freer, Brian

This dissertation argues that U.S. environmental and historic preservation regulations, industrial heritage projects, history, and art only provide partial frameworks for successfully transmitting an informed story into the long range future about nuclear technology and its related environmental legacy. This argument is important because plutonium from nuclear weapons production is toxic to humans in very small amounts, threatens environmental health, has a half-life of 24, 110 years and because the industrial heritage project at Hanford is the first time an entire U.S. Department of Energy weapons production site has been designated a U.S. Historic District. This research is situated within anthropological interest in industrial heritage studies, environmental anthropology, applied visual anthropology, as well as wider discourses on nuclear studies. However, none of these disciplines is really designed or intended to be a completely satisfactory frame of reference for addressing this perplexing challenge of documenting and conveying an informed story about nuclear technology and its related environmental legacy into the long range future. Others have thought about this question and have made important contributions toward a potential solution. Examples here include: future generations movements concerning intergenerational equity as evidenced in scholarship, law, and amongst Native American groups; Nez Perce and Confederated Tribes of the Umatilla Indian Reservation responses to the Hanford End State Vision and Hanford's Canyon Disposition Initiative; as well as the findings of organizational scholars on the advantages realized by organizations that have a long term future perspective. While these ideas inform the main line inquiry of this dissertation, the principal approach put forth by the researcher of how to convey an informed story about nuclear technology and waste into the long range future is implementation of the proposed Future Remains clause, as

Communication Preferences of Pediatric Cancer Patients: Talking about Prognosis and Their Future Life

Science.gov (United States)

Brand, Sarah R; Fasciano, Karen; Mack, Jennifer W

2017-01-01

Purpose The American Academy of Pediatrics recommends that healthcare providers communicate information to patients in a truthful and developmentally appropriate manner. However there is limited guidance about how to translate these recommendations into clinical practice. The aim of this study was to explore how young cancer patients experienced communication around their illness, especially communication about possible outcomes from disease or treatment. Methods Participants included young people ages 8 to under 18 years with cancer (N=16). Semi-structured interviews focused on their expectations about the future, the process of information exchange, and their preferences for communication within the pediatric oncology setting. Results Overall, participants wanted medical information to be provided to them by their healthcare providers and wanted to be direct participants in medical conversations. However, many participants displayed some ambivalence or conveyed conflicting wishes for prognostic information. For example, some participants reported that they were satisfied with what they knew, but later raised lingering questions. While not the focus of the study, almost every participant discussed social concerns as a key concern for their present and future life. Conclusions While most pediatric cancer patients want to be involved in conversations about their cancer care, including conversations about prognosis, this is an individual and sometimes fluctuating decision, and healthcare providers should be encouraged to discuss preferences for involvement with patients and families. This study highlights the importance of understanding the developmental factors that make pediatric patients unique, especially with regards to their patterns of communication. PMID:27747479

The Association Between Self-Assessed Future Work Ability and Long-Term Sickness Absence, Disability Pension and Unemployment in a General Working Population: A 7-Year Follow-Up Study.

Science.gov (United States)

Lundin, A; Kjellberg, K; Leijon, O; Punnett, L; Hemmingsson, T

2016-06-01

Purpose Work ability is commonly measured with self-assessments, in the form of indices or single items. The validity of these assessments lies in their predictive ability. Prospective studies have reported associations between work ability and sickness absence and disability pension, but few examined why these associations exist. Several correlates of work ability have been reported, but their mechanistic role is largely unknown. This study aims to investigate to what extent individual's own prognosis of work ability predicts labor market participation and whether this was due to individual characteristics and/or working conditions. Methods Self-assessed prognosis of work ability, 2 years from "now," in the Stockholm Public Health Questionnaire (2002-2003) was linked to national registers on sickness absence, disability pension and unemployment up to year 2010. Effects were studied with Cox regression models. Results Of a total of 12,064 individuals 1466 reported poor work ability. There were 299 cases of disability pension, 1466 long-term sickness absence cases and 765 long-term unemployed during follow-up. Poor work ability increased the risk of long-term sickness absence (HR 2.25, CI 95 % 1.97-2.56), disability pension (HR 5.19, CI 95 % 4.07-6.62), and long-term unemployment (HR 2.18, CI 95 % 1.83-2.60). These associations were partially explained by baseline health conditions, physical and (less strongly) psychosocial aspects of working conditions. Conclusions Self-assessed poor ability predicted future long-term sickness absence, disability pension and long-term unemployment. Self-assessed poor work ability seems to be an indicator of future labor market exclusion of different kinds, and can be used in public health monitoring.

Work Requirements in Transformation, Competence for the Future: A Critical Look at the Consequences of Current Positions. IAB Labour Market Research Topics No. 45.

Science.gov (United States)

Plath, Hans-Eberhard

In Germany and elsewhere, the literature on current and future work requirements rarely discusses the effects of globalization, internationalization, computerization, and other factors from the point of view of workers. Some have suggested that a blurring of limits will be one of the main changes in work in the future. This blurring will involve…

Loss of ability to work and ability to live independently in Parkinson's disease.

Science.gov (United States)

Jasinska-Myga, Barbara; Heckman, Michael G; Wider, Christian; Putzke, John D; Wszolek, Zbigniew K; Uitti, Ryan J

2012-02-01

Ability to work and live independently is of particular concern for patients with Parkinson's disease (PD). We studied a series of PD patients able to work or live independently at baseline, and evaluated potential risk factors for two separate outcomes: loss of ability to work and loss of ability to live independently. The series comprised 495 PD patients followed prospectively. Ability to work and ability to live independently were based on clinical interview and examination. Cox regression models adjusted for age and disease duration were used to evaluate associations of baseline characteristics with loss of ability to work and loss of ability to live independently. Higher UPDRS dyskinesia score, UPDRS instability score, UPDRS total score, Hoehn and Yahr stage, and presence of intellectual impairment at baseline were all associated with increased risk of future loss of ability to work and loss of ability to live independently (P ≤ 0.0033). Five years after initial visit, for patients ≤70 years of age with a disease duration ≤4 years at initial visit, 88% were still able to work and 90% to live independently. These estimates worsened as age and disease duration at initial visit increased; for patients >70 years of age with a disease duration >4 years, estimates at 5 years were 43% able to work and 57% able to live independently. The information provided in this study can offer useful information for PD patients in preparing for future ability to perform activities of daily living. Copyright © 2011 Elsevier Ltd. All rights reserved.

Factors associated with Danish cancer patients' return to work. A report from the population-based study 'The Cancer Patient's World'

DEFF Research Database (Denmark)

Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

2012-01-01

If patients facing difficulties in the process of returning to work after treatment of cancer could be identified, these patients could be assisted in the transition. This might help some patients to stay in work. We therefore assessed demographic and clinical factors associated with returning to...

Future care planning: a first step to palliative care for all patients with advanced heart disease.

Science.gov (United States)

Denvir, M A; Murray, S A; Boyd, K J

2015-07-01

Palliative care is recommended for patients with end-stage heart failure with several recent, randomised trials showing improvements in symptoms and quality of life and more studies underway. Future care planning provides a framework for discussing a range of palliative care problems with patients and their families. This approach can be introduced at any time during the patient's journey of care and ideally well in advance of end-of-life care. Future care planning is applicable to a wide range of patients with advanced heart disease and could be delivered systematically by cardiology teams at the time of an unplanned hospital admission, akin to cardiac rehabilitation for myocardial infarction. Integrating cardiology care and palliative care can benefit many patients with advanced heart disease at increased risk of death or hospitalisation. Larger, randomised trials are needed to assess the impact on patient outcomes and experiences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Resumption of work after aneurysmal subarachnoid hemorrhage in middle-aged Japanese patients.

Science.gov (United States)

Nishino, A; Sakurai, Y; Tsuji, I; Arai, H; Uenohara, H; Suzuki, S; Li, J H

1999-01-01

Previous reports on the results of treatment for aneurysmal subarachnoid hemorrhage (SAH) have been based only on activities of daily living after discharge, whereas resumption of work has received insufficient attention. Most Japanese work under a lifetime employment system, and it is best for those who have recovered from SAH to return to work for their previous employer. The present study was conducted to determine the extent to which discharged patients who have suffered an SAH resume their former occupations in Japan, focusing on those between 40 and 49 years of age, who usually have a strong desire to return to work. The participants consisted of 193 patients with SAH. Based on the results of telephone interviews or written questionnaires, their work status at 1 year after onset was analyzed. The work resumption rates for patients with Hunt and Kosnik neurological Grades 1 or 2 on admission were higher than for those with Grades 3 or 4 (p = 0.015) and lower for patients with basilar artery aneurysms than for those with aneurysms at other sites (p = 0.028). With regard to premorbid occupation, the work resumption rates were high (80%) for professionals and engineers, many of whom were public servants, or teachers at junior or senior high schools. The resumption rates were also high for primary industry workers (80%), but lowest (20%) for professional drivers (p = 0.04-0.001). The work resumption rate was lower for women than for men (p = 0.01). These findings indicate that resumption of work is determined not only by medical factors, but also by social factors including gender, type of occupation, employment system, and socioeconomic background.

Muscle strength, working capacity and effort in patients with fibromyalgia

DEFF Research Database (Denmark)

Nørregaard, J; Bülow, P M; Lykkegaard, J J

1997-01-01

exercise capacity, work status and psychometric scoring (SCL-90-R) were correlated. The fibromyalgia patients exhibited significant reduction in voluntary muscle strength of the knee and elbow, flexors and extensors in the order of 20-30%. However, the coefficient of variation was higher among patients......, thus indicating lower effort. The physical performance during an ergometer test corresponded to a maximal oxygen consumption of 21 ml/kg-1 x min-1. The maximal increase in heart rate was only 63% (44-90%) of the predicted increase. Degree of effort or physical capacity did not correlate to psychometric...... scores. Work status was related to psychometric scoring, but not to physical capacity or effort. In conclusion, we found a low degree of effort but near normal physical capacity in the fibromyalgia patients....

Elevated Psychosocial Stress at Work in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis.

Science.gov (United States)

Richter, Jutta G; Muth, Thomas; Li, Jian; Brinks, Ralph; Chehab, Gamal; Koch, Tobias; Siegrist, Johannes; Angerer, Peter; Huscher, Dörte; Schneider, Matthias

2018-02-01

Psychosocial stress at work not only affects the healthy working population, but also workers with chronic diseases. We aimed to investigate the psychosocial work stress levels in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). A cross-sectional study applied the Effort-Reward Imbalance (ERI) questionnaire - an internationally established instrument that measures work stress - to patients with SLE and RA who were capable of work and to a group of controls without these diseases. Participants were recruited through rheumatologists in private practices, hospitals, and from self-help groups by personal communication, paper-based flyers, and online advertisements. Because very few studies tested the ERI's applicability in patient groups, with a lack of evidence in patients with inflammatory rheumatic diseases, internal consistency and construct validity of the ERI measure were evaluated. Data came from 270 patients with RA and 247 with SLE, and 178 controls. Patients showed elevated psychosocial stress at work compared to controls. Across the total sample and all groups, satisfactory internal consistencies of the scales effort, reward, and overcommitment were obtained (Cronbach's alpha coefficients > 0.70), and confirmatory factor analysis replicated the theoretical structure of the ERI model (goodness-of-fit index > 0.80). We found elevated psychosocial stress at work in patients with SLE and RA compared to controls by applying the ERI model. Despite some heterogeneity in the sample, we achieved satisfactory psychometric properties of the ERI questionnaire. Our results suggest that the ERI questionnaire is a psychometrically useful tool to be implemented in epidemiological studies of employed patients with SLE and RA.

The work environment and empowerment as predictors of patient safety culture in Turkey.

Science.gov (United States)

Dirik, Hasan Fehmi; Intepeler, Seyda Seren

2017-05-01

As scant research based information is available regarding the work environment, empowerment and patient safety culture, this study from a developing country (Turkey) in which health care institutions are in a state of transition, aimed to investigate further the relationships between these three variables. A cross-sectional descriptive design was employed. The sample comprised 274 nurse participants working in a university hospital located in Izmir (Turkey). In data evaluation, descriptive statistics and hierarchical regression analyses were applied. The work environment and structural empowerment were related to the patient safety culture and explained 55% of the variance in patient safety culture perceptions. 'Support for optimal patient care', 'nurse/physician relationships' and 'staff involvement in organisational affairs' were the significant predictors. An enhancement of the work environment and providing access to empowerment structures may help health care organisations improve the patient safety culture. In light of the findings, the following actions can be recommended to inform health care leaders: providing necessary resources for nursing practise, encouraging nurses' participation in decision-making, strengthening communication within the team and giving nurses the opportunities to cope with challenging work problems to learn and grow. © 2017 John Wiley & Sons Ltd.

Future perspectives

International Nuclear Information System (INIS)

Anon.

1987-01-01

International involvement in particle physics is what the International Committee for Future Accelerators (ICFA) is all about. At the latest Future Perspectives meeting at Brookhaven from 5-10 October (after a keynote speech by doyen Viktor Weisskopf, who regretted the emergence of 'a nationalistic trend'), ICFA reviewed progress and examined its commitments in the light of the evolving world particle physics scene. Particular aims were to review worldwide accelerator achievements and plans, to survey the work of the four panels, and to discuss ICFA's special role in future cooperation in accelerator construction and use, and in research and development work for both accelerators and for detectors

Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting

Science.gov (United States)

Lopez, Karen Dunn; Cary, Michael P; Kanak, Mary F

2010-01-01

Objective To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. Design A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Measurements Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time–motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Results Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive ‘head data’, temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Conclusion Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units. PMID:20442150

Prognostic factors for work ability in women with chronic low back pain consulting primary health care: a 2-year prospective longitudinal cohort study.

Science.gov (United States)

Nordeman, Lena; Gunnarsson, Ronny; Mannerkorpi, Kaisa

2014-05-01

To investigate prognostic factors for future work ability in women with chronic low back pain (CLBP) consulting primary health care. A 2-year prospective longitudinal cohort study of female patients with CLBP within the primary health care was conducted. Patients were assessed at the first assessment and after 2 years. Prognostic factors for work ability (yes/no) were analyzed by multivariate regression. A total of 130 patients were included at first assessment. After 2 years, 123 patients (95%) were followed up. The 6-minute walk test, depression, and earlier work ability predicted work ability at the 2-year follow-up. A nomogram was constructed to assess the probability of future work ability. The 6-minute walk test, work ability, and depression predicted work ability for women with CLBP after 2 years.

Perceived challenges of working in a fertility clinic: a qualitative analysis of work stressors and difficulties working with patients

NARCIS (Netherlands)

Boivin, J.; Bunting, L.; Koert, E.; Ieng, U.C.; Verhaak, C.M.

2017-01-01

STUDY QUESTION: What are some of the challenges of working in a fertility clinic? SUMMARY ANSWER: The most frequently mentioned challenges were workload (e.g. high time pressure) and patient-related sources (e.g. unrealistic expectations). WHAT IS KNOWN ALREADY: One study showed a too high workload,

[Prevalence of aphysiologic performance on dynamic posturography in work-related patients].

Science.gov (United States)

Larrosa, Francisco; Durà, María J; Cordón, Astrid; Hernández, Anabella; García-Ibáñez, Luis

2012-01-01

Medical-legal implications of dizziness and imbalance in work-related patients are important. In these cases, computerized dynamic posturography (CDP) adds information to standard vestibular tests and aphysiologic patterns have been described. The objective is to assess the prevalence of aphysiologic performance on CDP in work-related patients complaining of dizziness/imbalance. Retrospective review of patients referred by the workers' compensation board for assessment of dizziness, imbalance or both. Standard vestibular assessment including CDP was carried out in all patients. The sensory organization test (SOT) summaries were scored as normal, aphysiologic or vestibular using the scoring method published by Cevette et al. in 1995. Aphysiologic performance in SOT, evaluated with the Cevette formula, was found in 31 out of 100 cases. Low composite score results and aphysiologic SOT results had a statistically-significant association (P=.01). Videonystagmography (VNG) was altered in 14 out of 31 cases with aphysiologic SOT. The 31% prevalence of aphysiologic results on CDP among work-related patients complaining of dizziness/imbalance is relatively high in comparison with the 25% published by Longridge and Mallinson in 2005. However, aphysiologic performance should not necessarily be related to malingering or exaggeration and altered vestibular tests are found in some of these cases. Copyright © 2011 Elsevier España, S.L. All rights reserved.

The influence of future time perspective on work engagement and job performance: the role of job crafting.

NARCIS (Netherlands)

Kooij, T.A.M.; Tims,; Akkermans,

2017-01-01

This two-wave study aimed to examine future time perspective (FTP) as an antecedent of job crafting, and in turn job crafting as a mediator in associations between FTP and work outcomes. Based on the lifespan socio-emotional selectivity theory, we expected that open-ended and limited FTP would evoke

Cognitive impairments in former patients with work-related stress complaints - one year later.

Science.gov (United States)

Eskildsen, Anita; Andersen, Lars Peter; Pedersen, Anders Degn; Andersen, Johan Hviid

2016-11-01

Patients on sick leave due to work-related stress often present with cognitive impairments. The aim of this prospective cohort study was to examine the long-term consequences of prolonged work-related stress in terms of cognitive functioning one year after initial professional care seeking. We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions, one year apart. At both time points, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the one-year follow-up. When adjusting for practice effects, patients improved on measures of prospective memory and processing speed. However, patients continued to perform worse than controls on all tests, though only half of the comparisons reached statistical significance. The effect sizes of the differences between the two groups at one-year follow-up were small to medium. In conclusion, former patients with prolonged work-related stress improved, but they continued to perform worse than controls after one year. In the acute phase, the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

Effects of nurse staffing, work environments, and education on patient mortality: an observational study.

Science.gov (United States)

Cho, Eunhee; Sloane, Douglas M; Kim, Eun-Young; Kim, Sera; Choi, Miyoung; Yoo, Il Young; Lee, Hye Sun; Aiken, Linda H

2015-02-01

While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. To examine the effects of nurse staffing, work environment, and education on patient mortality. This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths. Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Training future nurses in providing care for patients who committed criminal acts].

Science.gov (United States)

Corvest, Karina; Royer, Gilles Ripaille-Le; Dugardin, Thierry

2011-01-01

Providing care for patients who have carried out criminal acts is a source of questioning for caregivers, who must position themselves in this specific care relationship. For three years, the nursing training institute (IFSI) in Orthez has offered students an optional module in criminology. Through discussions and critical reflection, its aim is to enable future nurses to be better prepared.

Work Ability Index, Absenteeism and Depression Among Patients with Burnout Syndrome

OpenAIRE

Pranjic, Nurka; Males-Bilic, Ljiljana

2014-01-01

Goal: The aim of this study is to estimate the association of burnout syndrome and depression; burnout syndrome and sick leave; and burnout syndrome with Work Ability Index in patients who suffer from stress at work. Material and methods: The control clinical study was conducted in the Teaching Department for Professional Pathology and Toxicology at the Primary Health Care Center Tuzla in the period from 2009 to 2014. The study included 140 patients exposed to different levels of stress at wo...

Characteristics of the process of culture development project activities (culture of social engineering) at the future bachelors of social work

OpenAIRE

Natalya I. Nikitina; Elena Yu. Romanovaa; Tatyana V. Vasilyeva; Irina N. Nikishina; Veronica M. Grebennikova

2017-01-01

In modern Russia professional activity productivity of social work specialist depends largely on his abilities and skills in the field of social design. University graduate`s (social work bachelor`s) high level of professional-project activity culture can be regarded as one of the necessary conditions of successful labour market adaptation of young specialists in social sphere institutions. The article discusses various aspects of future social work bachelors` vocational project activity cult...

Through Patients' Eyes: Regulation, Technology, Privacy, and the Future.

Science.gov (United States)

Petersen, Carolyn

2018-04-22

Privacy is commonly regarded as a regulatory requirement achieved via technical and organizational management practices. Those working in the field of informatics often play a role in privacy preservation as a result of their expertise in information technology, workflow analysis, implementation science, or related skills. Viewing privacy from the perspective of patients whose protected health information is at risk broadens the considerations to include the perceived duality of privacy; the existence of privacy within a context unique to each patient; the competing needs inherent within privacy management; the need for particular consideration when data are shared; and the need for patients to control health information in a global setting. With precision medicine, artificial intelligence, and other treatment innovations on the horizon, health care professionals need to think more broadly about how to preserve privacy in a health care environment driven by data sharing. Patient-reported privacy preferences, privacy portability, and greater transparency around privacy-preserving functionalities are potential strategies for ensuring that privacy regulations are met and privacy is preserved. Georg Thieme Verlag KG Stuttgart.

White Paper on the Status and Future of Ground-based Gamma-Ray Astronomy - Extragalactic Science Working Group

Science.gov (United States)

Krawczynski, H.; Coppi, P.; Dermer, C.; Dwek, E.; Georganopoulos, M.; Horan, D.; Jones, T.; Krennrich, F.; Mukherjee, R.; Perlman, E.; Vassiliev, V.

2007-04-01

In fall 2006, the Division of Astrophysics of the American Physical Society requested a white paper about the status and future of ground based gamma-ray astronomy. The white paper will largely be written in the year 2007. Interested scientists are invited to join the science working groups. In this contribution, we will report on some preliminary results of the extragalactic science working group. We will discuss the potential of future ground based gamma-ray experiments to elucidate how supermassive black holes accrete matter, form jets, and accelerate particles, and to study in detail the acceleration and propagation of cosmic rays in extragalactic systems like infrared galaxies and galaxy clusters. Furthermore, we discuss avenues to constrain the spectrum of the extragalactic infrared to optical background radiation, and to measure the extragalactic magnetic fields based on gamma-ray observations. Eventually, we discuss the potential of ground based experiments for conducting gamma-ray source surveys. More information about the white paper can be found at: http://cherenkov.physics.iastate.edu/wp/

The effect of work-focused rehabilitation among patients with neck and back pain

DEFF Research Database (Denmark)

Myhre, Kjersti; Marchand, Gunn Hege; Leivseth, Gunnar

2014-01-01

. The median time to RTW was 161 days in the work-focused group and 158 days in the control group. A comparison of the work-focused and control interventions revealed a relative RTW probability (hazard ratio) of 0.94 (95% confidence interval = 0.75-1.17) after adjusting for age, sex, and education. CONCLUSION......STUDY DESIGN: Multicenter randomized trial with patients listed as sick for 1 to 12 months due to neck or back pain and referred to secondary care. OBJECTIVE: To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation. SUMMARY......: A total of 405 patients who were referred to the spine clinics at 2 university hospitals in Norway were randomly assigned into work-focused and control intervention groups. The existing treatments at each hospital were used as the control interventions, which entailed either a comprehensive...

Withdrawal from labour force due to work disability in patients with ankylosing spondylitis

NARCIS (Netherlands)

Boonen, A.; Chorus, A.; Miedema, H.; van der Heijde, D.; Landewé, R.; Schouten, H.; van der Tempel, H.; van der Linden, S.

2001-01-01

To investigate withdrawal from the labour force because of inability to work owing to ankylosing spondylitis (AS) and to determine the characteristics of patients with no job because of work disability attributable to AS. A postal questionnaire was sent to 709 patients with AS aged 16-60 years

The future of work hours--the European view.

Science.gov (United States)

Akerstedt, Torbjörn; Kecklund, Göran

2005-01-01

In Europe the way work hours are handled varies between different countries. However, there are some issues that dominate the discussion in Europe and seem representative for what is happening. One such is the reduction of working hours--which was attempted in several countries but which now seems to be backfiring--probably related to the competition from countries outside Europe. Another area is compressed work hours--the drive towards maximizing the hours per work day in order to increase the number of days off. The health effects are debated--some find clear positive effects. A third area is company oriented flexible work hours, permitting the employer to make moderate changes in work hours when needed. The health impacts have not been evaluated but the loss of individual influence at work is obvious. In some parts of Europe self-determined work hours have been tried with very positive effects. The EU work hour directive is intended to provide uniformity but permits a counterproductive "opting out", creating problems of imbalance.

Professional identity, career choices, and working conditions of future and young dentists in Germany - study design and methods of a nationwide comprehensive survey.

Science.gov (United States)

Kettler, Nele; Frenzel Baudisch, Nicolas; Micheelis, Wolfgang; Klingenberger, David; Jordan, A Rainer

2017-10-18

Little is known regarding young and future dentists' career choices, professional identity, and working conditions in Germany. While the dental healthcare environment and demands in treatment are changing, it remains unclear what job perceptions young dentists have developed at the beginning of their work life and if and how these perceptions change during the subsequent years. The aim of this study was to survey future and young dentists regarding their professional identity, planned career paths, and working conditions and strains to understand career decisions and choices and enable policy makers to include future dentists' views and expectations in their decisions. This study is a longitudinal nationwide survey over a time span of 4 years of dental students and young dentists in Germany and is comprised of three waves. The first wave focuses on dental students in their final year before the state examination and is composed of a qualitative pre-study in the form of focus groups and a quantitative main survey in the form of a questionnaire. The end points were established to analyse (1) the professional identity of the young future dentists; (2) their career paths, preparation for a career, and basic career conditions; and (3) perceived conditions and strains. The aim of the overall survey was to depict the development of these three aspects during the first years of work life. All of the questions were evaluated with a descriptive univariate analysis. The analysed subgroups were grouped according to gender, target working condition (employed/self-employed), and primary socialisation (parents dentists/parents not dentists). To our knowledge, this is the only study which focuses on career choices, professional identity, and working conditions of future and young dentists in Germany. The longitudinal observation provides information that is essential for professional and purposive dental health care planning, and to meet the oral health demands and needs of the

Concordance of opinions between patients and physicians and their relationship with symptomatic control and future risk in patients with moderate-severe asthma.

Science.gov (United States)

Crespo-Lessmann, Astrid; Plaza, Vicente; González-Barcala, Francisco-Javier; Fernández-Sánchez, Toni; Sastre, Joaquín

2017-01-01

Differences between the opinions of patients and physicians on the impact of asthma are common. We hypothesised that patient-physician discordance may negatively affect asthma outcome. A total of 2902 patients (61% women, mean age 47 years) with moderate-severe asthma and 231 physicians participated in a prospective study. At the baseline visit, data on demographics, clinical variables, degree of asthma control according to the Asthma Control Test (ACT), basic spirometry and the Hospital Anxiety and Depression Scale (HADS) were collected and an ad hoc questionnaire was completed that allowed the degree of concordance between doctors and patients to be assessed. A scheduled telephone call after 3 months was used to elicit the ACT score and the future risk of asthma. At the final visit at 6 months, the following data were recorded: ACT score, spirometry, HADS score and an ad hoc questionnaire to assess the agreement between the doctor and the patient. Changes in study variables according to patient-physician concordance or discordance were analysed. The rate of patient-physician discordance was 27.2%, with overestimation of disease impact by the physician in 12.3% and underestimation in 14.9%. Patient-physician opinion discordance, particularly in the case of physicians underestimating the impact of asthma, showed worse results with statistically significant differences in ACT score, a higher percentage of patients with poor asthma control and lower HADS scores. The need for hospital and emergency department admissions was also higher. Patient-physician opinion discordance may be contributing to lower symptomatic control and increased future risk, with a higher impact when physicians underestimate the impact of asthma on their patients.

Interprofessional working: communication, collaboration... perspiration!

Science.gov (United States)

Dawson, Sheila

2007-10-01

Palliative care is rarely delivered by one provider; for most patients their care will be managed by community and one or more hospital teams at the least. This can be problematic for patients, their family and friends, and health professionals. Evidence suggests that, in general, providers work in isolation from each other. Although formal processes are in place for transfer of information between the sectors on discharge between acute and community sectors, there is a de facto lack of communication and therefore a lack of appreciation of the working practices within each environment. This resulting lack of collaboration between teams can lead to disruptive care that detracts from the holistic philosophy purported to be the basis of supportive and palliative care (National Institute for Health and Clinical Excellence (NICE) 2004; Department of Health (DH) 2000). In October 2005, 20% of a clinical nurse specialist's (CNS) full-time post was dedicated to working between the palliative care teams of Central Manchester and Manchester Children's NHS Trust (CMMC) and Central Manchester PCT (CMPCT). The aim was to improve communication and dialogue to promote more effective integrated working between the two sites and develop effective interprofessional working. This article will evaluate the impact of this new post, after 18 months, on collaboration between the teams, their practices and their patients. Finally, it will offer recommendations for future development.

Development of a tailored work-related support intervention for gastrointestinal cancer patients

NARCIS (Netherlands)

Zaman, Anne-Claire G. N. M.; Tytgat, Kristien M. A. J.; Van Hezel, Sanne; Klinkenbijl, Jean H. G.; de Boer, Angela G. E. M.; Frings-Dresen, Monique H. W.

2017-01-01

Aim is the development of a work-related support intervention, tailored to the severity of work-related problems of patients diagnosed with gastrointestinal (GI) cancer treated with curative intent. Two methods were used: (1) Work-related problems were identified from the literature and submitted to

Hospital Patient Room Design: The Issues Facing 23 Occupational Groups Who Work in Medical/Surgical Patient Rooms.

Science.gov (United States)

Lavender, Steven A; Sommerich, Carolyn M; Patterson, Emily S; Sanders, Elizabeth B-N; Evans, Kevin D; Park, Sanghyun; Umar, Radin Zaid Radin; Li, Jing

2015-01-01

The aim of this study was to learn from a wide range of hospital staff members about how the design of the patient room in which they work adversely affects their ergonomics or hinders their job performance. In addition to providing a healing space for patients, hospital patient rooms need to serve as functional workplaces for the people who provide clinical care, to clean, or to maintain room functions. Therefore, from a design perspective, it is important to understand the needs of all the users of hospital patient rooms with regard to room design. One hundred forty-seven people, representing 23 different occupational stakeholder groups, participated in either focus groups or interviews in which they were asked to identify room design issues that affect the performance of their work tasks. Key issues shared across multiple stakeholder groups included an inability to have eye contact with the patient when entering the room, inadequate space around the bed for the equipment used by stakeholders, the physical demands experienced as stakeholders move furnishings to accomplish their activities or access equipment, and a lack of available horizontal surfaces. Unique issues were also identified for a number of stakeholder groups. There are a number of issues that should be addressed in the next generation of hospital patient rooms, or when refurbishing existing facilities, so that all occupational stakeholder groups can work effectively, efficiently, and without undue physical stress. © The Author(s) 2015.

Exploring the Influence of Nurse Work Environment and Patient Safety Culture on Attitudes Toward Incident Reporting.

Science.gov (United States)

Yoo, Moon Sook; Kim, Kyoung Ja

2017-09-01

The aim of this study was to explore the influence of nurse work environments and patient safety culture on attitudes toward incident reporting. Patient safety culture had been known as a factor of incident reporting by nurses. Positive work environment could be an important influencing factor for the safety behavior of nurses. A cross-sectional survey design was used. The structured questionnaire was administered to 191 nurses working at a tertiary university hospital in South Korea. Nurses' perception of work environment and patient safety culture were positively correlated with attitudes toward incident reporting. A regression model with clinical career, work area and nurse work environment, and patient safety culture against attitudes toward incident reporting was statistically significant. The model explained approximately 50.7% of attitudes toward incident reporting. Improving nurses' attitudes toward incident reporting can be achieved with a broad approach that includes improvements in work environment and patient safety culture.

Who among patients with acquired brain injury returned to work after occupational rehabilitation? The rapid-return-to-work-cohort-study.

Science.gov (United States)

Aas, Randi Wågø; Haveraaen, Lise Aasen; Brouwers, Evelien P M; Skarpaas, Lisebet Skeie

2017-07-20

Acquired brain injury (ABI) is known to be severely disabling. On average, 40% of employees return to work (RTW) within two years after injury. There is, however, limited research on what might contribute to successful RTW. To examine factors that might impact the time-to first RTW for patients with ABI, participating in a RTW-program. The study was designed as a cohort study of patients on sick leave due to mild or moderate ABI (n = 137). The mean age of the patients was 51 years, and 58% were men. The most common diagnoses were stroke (75%) and traumatic brain injury (12%). Data were collected through questionnaires, and combined with register data on sickness absence. Survival analyses were used to analyse the effect of different variables on time to first RTW (full or partial), at one- and two-year follow-up. Generally, women (HR = 0.447; CI: 0.239-0.283) had higher RTW-rates than men, and patients with non-comorbid impairments returned to work earlier than patients with multiple impairments. Although not statistically significant, receiving individual consultations and participating in group-sessions were generally associated with a delayed RTW at both follow-up-times. The only service-related factor significantly associated with delayed RTW was meetings with the social insurance office (HR = 0.522; CI: 0.282-0.965), and only at one-year follow-up. Women and patients with non-comorbid impairments returned to work earlier than men and patients with multiple impairments. There seems to be an association between intense and long-lasting participation in the RTW program and prolonged time-to first-RTW, even after controlling for level of cognitive impairments and comorbidity. Implications for Rehabilitation Acquired brain injury (ABI) is known to be severely disabling, and persons with ABI often experience difficulties in regard to returning to work. This study provides information on prognostic factors that might contribute to return to work (RTW

Prescribing a sedative antidepressant for patients at work or on sick leave under conditions of routine care.

Science.gov (United States)

Linden, M; Westram, A

2010-01-01

Sedation can be a beneficial effect of medication, but it can also be an unwanted side-effect, especially in patients who have to work. The aim of this study is to analyze whether physicians prescribe sedative antidepressants differently for patients at work vs. those on sick leave. A drug utilization study of mirtazapine was conducted for 12 weeks on 594 depressed outpatients from 227 general practitioners or psychiatrists. There were 319 patients working and 275 patients on sick leave. The two groups were compared regarding sociodemographic variables, illness characteristics, mode and course of treatment. As expected, patients on sick leave were sicker than working patients; they were treated by specialists more often and received higher dosages of mirtazapine. Work status had no influence on dosage after controlling for severity of illness, patient sex, and physician specialty. The overall improvement of depression was similar in both patient groups. Under treatment with mirtazapine, 64.5% of patients on sick leave returned to work, while 2.6% of the patients initially at work went on sick leave by the end of the 12 weeks. Sedation as an undesired side-effect was reported in less than 1%. The rate of sedative polypharmacy declined during treatment with mirtazapine. The results suggest that in routine treatment physicians do not see a need to adjust prescribing of mirtazapine because of its sedative properties to the working status of the patients. The majority of patients on sick leave returned to work. Mirtazapine can help to reduce sedative polypharmacy. (c) Georg Thieme Verlag KG Stuttgart . New York.

Accounting for the Invisible Work of Hospital Orderlies

DEFF Research Database (Denmark)

Stisen, Allan; Verdezoto, Nervo; Blunck, Henrik

2016-01-01

the coordination changes in orderlies’ work practices in connection to the implementation of a workflow application at the hospital. By applying a mixed methods approach (both qualitative and quantitative studies), this paper calls for attention to the changes in orderlies’ coordination activities while moving......The cooperative, invisible non-clinical work of hospital orderlies is often overlooked. It consists foremost of transferring patients between hospital departments. As the overall efficiency of the hospital is highly dependent on the coordination of the work of orderlies, this study investigates...... coordination. We also present design recommendations for future design of coordination tools to support orderlies’ work practices....

Different types of working memory binding in epilepsy patients with unilateral anterior temporal lobectomy.

Science.gov (United States)

van Geldorp, Bonnie; Bouman, Zita; Hendriks, Marc P H; Kessels, Roy P C

2014-03-01

The medial temporal lobe is an important structure for long-term memory formation, but its role in working memory is less clear. Recent studies have shown hippocampal involvement during working memory tasks requiring binding of information. It is yet unclear whether this is limited to tasks containing spatial features. The present study contrasted three binding conditions and one single-item condition in patients with unilateral anterior temporal lobectomy. A group of 43 patients with temporal lobectomy (23 left; 20 right) and 20 matched controls were examined with a working memory task assessing spatial relational binding (object-location), non-spatial relational binding (object-object), conjunctive binding (object-colour) and working memory for single items. We varied the delay period (3 or 6s), as there is evidence showing that delay length may modulate working memory performance. The results indicate that performance was worse for patients than for controls in both relational binding conditions, whereas patients were unimpaired in conjunctive binding. Single-item memory was found to be marginally impaired, due to a deficit on long-delay trials only. In conclusion, working memory binding deficits are found in patients with unilateral anterior temporal lobectomy. The role of the medial temporal lobe in working memory is not limited to tasks containing spatial features. Rather, it seems to be involved in relational binding, but not in conjunctive binding. The medial temporal lobe gets involved when working memory capacity does not suffice, for example when relations have to be maintained or when the delay period is long. Copyright © 2014 Elsevier Inc. All rights reserved.

Ethical aspects of limiting residents' work hours.

Science.gov (United States)

Wiesing, Urban

2007-09-01

The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. ARGUMENTS AND CONCLUSION: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over-work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians.

The development of future thinking: young children's ability to construct event sequences to achieve future goals.

Science.gov (United States)

Prabhakar, Janani; Hudson, Judith A

2014-11-01

Previous studies suggest that the ability to think about and act on the future emerges between 3 and 5 years of age. However, it is unclear what underlying processes change during the development of early future-oriented behavior. We report three experiments that tested the emergence of future thinking ability through children's ability to explicitly maintain future goals and construct future scenarios. Our main objectives were to examine the effects of goal structure and the effects of working memory demands on children's ability to construct future scenarios and make choices to satisfy future goals. The results indicate that 4-year-olds were able to successfully accomplish two temporally ordered goals even with high working memory demands and a complex goal structure, whereas 3-year-olds were able to accomplish two goals only when the working memory demands were low and the goal structure did not involve additional demands from inferential reasoning and contingencies between the temporally ordered goals. Results are discussed in terms of the development of future thinking in conjunction with working memory, inferential reasoning ability, and goal maintenance abilities. Copyright © 2014. Published by Elsevier Inc.

Aggression and Risk of Future Violence in Forensic Psychiatric Patients with and without Dyslexia

Science.gov (United States)

Selenius, Heidi; Hellstrom, Ake; Belfrage, Henrik

2011-01-01

Dyslexia does not cause criminal behaviour, but it may worsen aggressive behaviour tendencies. In this study, aggressive behaviour and risk of future violence were compared between forensic psychiatric patients with and without dyslexia. Dyslexia was assessed using the Swedish phonological processing battery "The Pigeon". The patients…

Working Paper on the Future of Library Automation at Stanford.

Science.gov (United States)

Weber, David C.

A number of important factors require Stanford University to review the progress and future implications of technological innovations in the library for the community of scholars which it serves. These factors include: The general economic climate of the University in 1971 and in the immediate years ahead; The problem of future funding of the…

The motivational capacity of occupational future time perspective as a moderator of the relationships between job control, work engagement, and personal initiative

NARCIS (Netherlands)

Annet de Lange; Hannes Zacher; Antje Schmitt

2013-01-01

The concept of focus on opportunities describes how many new goals, options, and possibilities employees believe to have in their personal future at work. In this multi-sample, multi-method study, the authors investigated relationships between focus on opportunities and general and daily work

Employment status, difficulties at work and quality of life in inflammatory bowel disease patients.

Science.gov (United States)

De Boer, Angela G E M; Bennebroek Evertsz', Floor; Stokkers, Pieter C; Bockting, Claudia L; Sanderman, Robert; Hommes, Daniel W; Sprangers, Mirjam A G; Frings-Dresen, Monique H W

2016-10-01

To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression. IBD patients attending an IBD outpatients' clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses. In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn's disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates. More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.

The impact of rheumatoid arthritis on work capacity in Chinese patients: a cross-sectional study.

Science.gov (United States)

Zhang, Xiaoying; Mu, Rong; Wang, Xiuru; Xu, Chuanhui; Duan, Tianjiao; An, Yuan; Han, Shuling; Li, Xiaofeng; Wang, Lizhi; Wang, Caihong; Wang, Yongfu; Yang, Rong; Wang, Guochun; Lu, Xin; Zhu, Ping; Chen, Lina; Liu, Jinting; Jin, Hongtao; Liu, Xiangyuan; Sun, Lin; Wei, Ping; Wang, Junxiang; Chen, Haiying; Cui, Liufu; Shu, Rong; Liu, Bailu; Zhang, Zhuoli; Li, Guangtao; Li, Zhenbin; Yang, Jing; Li, Junfang; Jia, Bin; Zhang, Fengxiao; Tao, Jiemei; Lin, Jinying; Wei, Meiqiu; Liu, Xiaomin; Ke, Dan; Hu, Shaoxian; Ye, Cong; Yang, Xiuyan; Li, Hao; Huang, Cibo; Gao, Ming; Lai, Pei; Li, Xingfu; Song, Lijun; Wang, Yi; Wang, Xiaoyuan; Su, Yin; Li, Zhanguo

2015-08-01

To evaluate the impact of RA on work capacity and identify factors related to work capacity impairment in patients with RA. A cross-sectional multicentre study was performed in 21 tertiary care hospitals across China. A consecutive sample of 846 patients with RA was recruited, of which 589 patients of working age at disease onset constituted the study population. Information on the socio-demographic, clinical, working and financial conditions of the patients was collected. Logistic regression analyses were used to identify factors associated with work capacity impairment. The rate of work capacity impairment was 48.0% in RA patients with a mean disease duration of 60 months (interquartile range 14-134 months), including 11.7% leaving the labour force early, 33.6% working reduced hours and 2.7% changing job. Multivariable logistic regression analysis showed that reduced working hours was significantly related to current smoking [odds ratio (OR) 2.07 (95% CI 1.08, 3.97)], no insurance [OR 1.94 (95% CI 1.20, 3.12)], in manual labour [OR 2.66 (95% CI 1.68, 4.20)] and higher HAQ score [OR 2.22 (95% CI 1.36, 3.60)]. There was an association of current smoking [OR 3.75 (95% CI 1.54, 9.15)], in manual labour [OR 2.33 (95% CI 1.17, 4.64)], longer disease duration [OR 1.01 (95% CI 1.00, 1.01)] and lower BMI [OR 0.90 (95% CI 0.82, 0.99)] with leaving the labour force early. There is a substantial impact of RA on the work capacity of patients in China. Social-demographic, disease- and work-related factors are all associated with work capacity impairment. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Employment, work disability and quality of life in patients with ANCA-associated vasculitides. The EXPOVAS study.

Science.gov (United States)

Benarous, Lucas; Terrier, Benjamin; Laborde-Casterot, Hervé; Bérezné, Alice; Dunogué, Bertrand; Cohen, Pascal; Puéchal, Xavier; Mouthon, Luc; Bensefa-Colas, Lynda; Guillevin, Loic

2017-01-01

Improved therapeutic strategies for ANCA-associated vasculitis (AAV) have transformed acute and life-threatening diseases into chronic ones responsible for marked morbidity that could impact employment, work disability and quality of life (QoL). We aimed to analyse work, handicaps and QoL of AAV patients and identify their determinants. Patients with AAV were included in a cross-sectional study assessing employment, work disability and QoL. Specific and non-specific questionnaires, including SF-36, were sent to patients, and clinical-biological data that could affect QoL and their determinants were analysed. Questionnaires were completed by 189 patients. Among 94 working-age (employed; 23% of workers felt that their disease qualitatively limited the nature of their work, while 43% felt it limited the quantity of work they could do; 50% thought their disease had hindered their careers and 43% that it had led to a salary reduction. These results were comparable for the different vasculitides. QoL was significantly impaired for AAV patients compared to the general population (pemployment seemed to be preserved for the majority of the patients.

Working memory and the identification of facial expression in patients with left frontal glioma.

Science.gov (United States)

Mu, Yong-Gao; Huang, Ling-Juan; Li, Shi-Yun; Ke, Chao; Chen, Yu; Jin, Yu; Chen, Zhong-Ping

2012-09-01

Patients with brain tumors may have cognitive dysfunctions including memory deterioration, such as working memory, that affect quality of life. This study was to explore the presence of defects in working memory and the identification of facial expressions in patients with left frontal glioma. This case-control study recruited 11 matched pairs of patients and healthy control subjects (mean age ± standard deviation, 37.00 ± 10.96 years vs 36.73 ± 11.20 years; 7 male and 4 female) from March through December 2011. The psychological tests contained tests that estimate verbal/visual-spatial working memory, executive function, and the identification of facial expressions. According to the paired samples analysis, there were no differences in the anxiety and depression scores or in the intelligence quotients between the 2 groups (P > .05). All indices of the Digit Span Test were significantly worse in patients than in control subjects (P patient and control groups. Of all 7 Wisconsin Card Sorting Test (WCST) indexes, only the Preservative Response was significantly different between patients and control subjects (P Patients were significantly less accurate in detecting angry facial expressions than were control subjects (30.3% vs 57.6%; P identification of other expressions. The backward indexes of the Digit Span Test were associated with emotion scores and tumor size and grade (P Patients with left frontal glioma had deficits in verbal working memory and the ability to identify anger. These may have resulted from damage to functional frontal cortex regions, in which roles in these 2 capabilities have not been confirmed. However, verbal working memory performance might be affected by emotional and tumor-related factors.

Improving working memory performance in brain-injured patients using hypnotic suggestion

DEFF Research Database (Denmark)

Lindeløv, Jonas K.; Overgaard, Rikke; Overgaard, Morten

2017-01-01

be effectively restored by suggesting to hypnotized patients that they have regained their pre-injury level of working memory functioning. Following four 1-h sessions, 27 patients had a medium-sized improvement relative to 22 active controls (Bayes factors of 342 and 37.5 on the two aggregate outcome measures...... group was crossed over to the working memory suggestion and showed superior improvement. By the end of the study, both groups reached a performance level at or above the healthy population mean with standardized mean differences between 1.55 and 2.03 relative to the passive control group. We conclude...... that, if framed correctly, hypnotic suggestion can effectively improve working memory following acquired brain injury. The speed and consistency with which this improvement occurred, indicate that there may be a residual capacity for normal information processing in the injured brain....

ENLIGHT envisions its future

CERN Multimedia

Antonella Del Rosso

2015-01-01

Last week, the European Network for LIGht-ion Hadron Therapy (ENLIGHT) met in Cracow to discuss how to best imagine its future. Over its 13 years of life, the network has succeeded in blending traditionally separate scientific communities with the common goal of more effective treatments against cancer and improving patient outcome.   Group photo of the ENLIGHT members participating in the network's annual meeting, held in Cracow on 18-19 September, 2015. Today, ENLIGHT includes over 300 members from more than 20 countries. Clinicians, physicists, biologists and engineers with experience and interest in particle therapy are working in unison under the network’s umbrella. ENLIGHT has run four EU-funded projects – ULICE, PARTNER, ENVISION and ENTERVISION – and has managed to gather experts from the various fields to design common strategies to fight cancer with particles. “ENLIGHT has worked as an open collaborative network ...

Work impairment in bipolar disorder patients--results from a two-year observational study (EMBLEM).

Science.gov (United States)

Reed, C; Goetz, I; Vieta, E; Bassi, M; Haro, J M

2010-10-01

To explore factors associated with work impairment at 2 years following an acute episode. European Mania in Bipolar disorder Longitudinal Evaluation of Medication (EMBLEM) is a prospective, observational study on the outcomes of patients with a manic/mixed episode. Work impairment was measured using a Longitudinal Interval Follow-up Evaluation (slice of LIFE) item and patients were categorised with either low or high work impairment at each observation. Baseline factors associated with work impairment at 2 years were assessed using multivariate modelling. At baseline (n=2289), 69% of patients had high work impairment. At 2 years (n=1393), high impairment reduced to 41%. Modelling identified rapid cycling as the strongest disease-related factor associated with high work impairment at 2 years, although high work impairment at baseline had the strongest association overall. Lower levels of education, recent admissions, CGI-BP overall severity in the 12 months prior to baseline and CGI-BP mania at baseline all predicted higher work impairment. Living together in a relationship and independent housing were both significantly associated with having low work impairment at 2 years. Work impairment in bipolar disorder is maintained over long periods, and is strongly associated with relationship status, living conditions and various disease-related factors. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Implications of current resident work-hour guidelines on the future practice of surgery in Canada.

Science.gov (United States)

Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L

2012-01-01

Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A clinical return-to-work rule for patients with back pain.

Science.gov (United States)

Dionne, Clermont E; Bourbonnais, Renée; Frémont, Pierre; Rossignol, Michel; Stock, Susan R; Larocque, Isabelle

2005-06-07

Tools for early identification of workers with back pain who are at high risk of adverse occupational outcome would help concentrate clinical attention on the patients who need it most, while helping reduce unnecessary interventions (and costs) among the others. This study was conducted to develop and validate clinical rules to predict the 2-year work disability status of people consulting for nonspecific back pain in primary care settings. This was a 2-year prospective cohort study conducted in 7 primary care settings in the Quebec City area. The study enrolled 1007 workers (participation, 68.4% of potential participants expected to be eligible) aged 18-64 years who consulted for nonspecific back pain associated with at least 1 day's absence from work. The majority (86%) completed 5 telephone interviews documenting a large array of variables. Clinical information was abstracted from the medical files. The outcome measure was "return to work in good health" at 2 years, a variable that combined patients' occupational status, functional limitations and recurrences of work absence. Predictive models of 2-year outcome were developed with a recursive partitioning approach on a 40% random sample of our study subjects, then validated on the rest. The best predictive model included 7 baseline variables (patient's recovery expectations, radiating pain, previous back surgery, pain intensity, frequent change of position because of back pain, irritability and bad temper, and difficulty sleeping) and was particularly efficient at identifying patients with no adverse occupational outcome (negative predictive value 78%- 94%). A clinical prediction rule accurately identified a large proportion of workers with back pain consulting in a primary care setting who were at a low risk of an adverse occupational outcome.

Microalgal Cultivation in Secondary Effluent: Recent Developments and Future Work

Directory of Open Access Journals (Sweden)

Junping Lv

2017-01-01

Full Text Available Eutrophication of water catchments and the greenhouse effect are major challenges in developing the global economy in the near future. Secondary effluents, containing high amounts of nitrogen and phosphorus, need further treatment before being discharged into receiving water bodies. At the same time, new environmentally friendly energy sources need to be developed. Integrating microalgal cultivation for the production of biodiesel feedstock with the treatment of secondary effluent is one way of addressing both issues. This article provides a comprehensive review of the latest progress in microalgal cultivation in secondary effluent to remove pollutants and accumulate lipids. Researchers have discovered that microalgae remove nitrogen and phosphorus effectively from secondary effluent, accumulating biomass and lipids in the process. Immobilization of appropriate microalgae, and establishing a consortium of microalgae and/or bacteria, were both found to be feasible ways to enhance pollutant removal and lipid production. Demonstrations of pilot-scale microalgal cultures in secondary effluent have also taken place. However there is still much work to be done in improving pollutants removal, biomass production, and lipid accumulation in secondary effluent. This includes screening microalgae, constructing the consortium, making use of flue gas and nitrogen, developing technologies related to microalgal harvesting, and using lipid-extracted algal residues (LEA.

Does night-shift work induce apnea events in obstructive sleep apnea patients?

Science.gov (United States)

Laudencka, A; Klawe, J J; Tafil-Klawe, M; Złomańczuk, P

2007-11-01

The aim of the present study was to determine the direct effect of night-work on the occurrence of obstructive apneas during sleep after a night shift in fast-rotating shift workers with sleep-related breathing disorders. Eight obstructive sleep apnea patients were examined with the use of a polysomnograph during sleep under two conditions: after day-shift work and after night-shift work. Both sleep studies were conducted within 2 to 3 weeks of each other. In four of the 8 subjects, during sleep after a night-shift, an increase in apnea/hypopnea index was found. Night work significantly increased several breathing variables: total duration of obstructive apneas during REM sleep, mean duration of obstructive apneas during arousal, and apnea index during arousal. We conclude that in a subpopulation of sleep apnea patients, acute sleep deprivation may worsen obstructive sleep apnea index.

Association between work-family conflict and musculoskeletal pain among hospital patient care workers.

Science.gov (United States)

Kim, Seung-Sup; Okechukwu, Cassandra A; Buxton, Orfeu M; Dennerlein, Jack T; Boden, Leslie I; Hashimoto, Dean M; Sorensen, Glorian

2013-04-01

A growing body of evidence suggests that work-family conflict is an important risk factor for workers' health and well-being. The goal of this study is to examine association between work-family conflict and musculoskeletal pain among hospital patient care workers. We analyzed a cross-sectional survey of 1,119 hospital patient care workers in 105 units in two urban, academic hospitals. Work-family conflict was measured by 5-item Work-Family Conflict Scale questionnaire. Multilevel logistic regression was applied to examine associations between work-family conflict and self-reported musculoskeletal pain in the past 3 months, adjusting for covariates including work-related psychosocial factors and physical work factors. In fully adjusted models, high work-family conflict was strongly associated with neck or shoulder pain (OR: 2.34, 95% CI: 1.64-3.34), arm pain (OR: 2.79, 95% CI: 1.64-4.75), lower extremity pain (OR: 2.20, 95% CI: 1.54-3.15) and any musculoskeletal pain (OR: 2.45, 95% CI: 1.56-3.85), and a number of body areas in pain (OR: 2.47, 95% CI: 1.82-3.36) in the past 3 months. The association with low back pain was attenuated and became non-significant after adjusting for covariates. Given the consistent associations between work-family conflict and self-reported musculoskeletal pains, the results suggest that work-family conflict could be an important domain for health promotion and workplace policy development among hospital patient care workers. Copyright © 2012 Wiley Periodicals, Inc.

Patients' experiences of the impact of chronic back pain on family life and work.

Science.gov (United States)

De Souza, Lorraine; Frank, Andrew Oliver

2011-01-01

The emotional distress caused by pain is one of the most disruptive aspects of living with the condition. This study investigates how individuals experience pain and its consequences for family life and work. Unstructured interviews, using the 'Framework' approach with topic guide, were recorded and transcribed. Patients were sampled for age, sex, ethnicity and occupation from new referrals with spinal pain (SP) to a rheumatology outpatient clinic. Eleven patients (five males and six females) were interviewed in English (n = 9) or their preferred language (n = 2). Interviews were read in depth twice to identify the topics. Data were extracted in phrases and sentences using thematic content analysis. Emergent themes reported were relationships with: spouses and partners (n = 7), children/parents (n = 6), with other family and friends (n = 7) and work-related issues (n = 11). Patients valued support from family but expressed concerns about causing them worry. Work-related issues included physical and emotional efforts to keep working when in pain, fear of losing employment and financial problems. Patients expressed anxiety about how their pain affected other family members, regret at losing full work capacity and worry about financial consequences. The lived experience of chronic SP has ramifications that go beyond the individual, reaching into work and social relationships.

Work Experiences of Patients Receiving Palliative Care at a Comprehensive Cancer Center: Exploratory Analysis.

Science.gov (United States)

Glare, Paul A; Nikolova, Tanya; Alickaj, Alberta; Patil, Sujata; Blinder, Victoria

2017-07-01

Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. To characterize the employment situations of working-age palliative care patients. Cross-sectional survey setting/subjects: Consecutive sample of 112 patients followed in palliative care outpatient clinics at a comprehensive cancer center. Thirty-seven-item self-report questionnaire covering demographics, clinical status, and work experiences since diagnosis. The commonest cancer diagnoses were breast, colorectal, gynecological, and lung. Eighty-one percent had active disease. Seventy-four percent were on treatment. Eighty percent recalled being employed at the time of diagnosis, with 65% working full time. At the time of the survey, 44% were employed and 26% were working full time. Most participants said work was important, made them feel normal, and helped them feel they were "beating the cancer". Factors associated with being employed included male gender, self-employed, and taking less than three months off work. Respondents with pain and/or other symptoms were significantly less likely to be working. On multivariate analysis, only pain (odds ratio [OR] 8.16, p gender (OR 2.07), self-employed (OR 3.07), and current chemotherapy (OR 1.81) were included in the model, but were not statistically significant in this small sample. Work may be an important issue for some palliative care patients. Additional research is needed to facilitate ongoing employment for those who wish or need to continue working.

Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

Science.gov (United States)

Dhukaram, Anandhi Vivekanandan; Baber, Chris

2015-06-01

Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessing the Effects of a Work-Based Antipoverty Program for Parents on Youth's Future Orientation and Employment Experiences

Science.gov (United States)

McLoyd, Vonnie C.; Kaplan, Rachel; Purtell, Kelly M.; Huston, Aletha C.

2011-01-01

The impacts of New Hope, a 3-year work-based antipoverty program to increase parent employment and reduce poverty, on youth ages 9-19 (N = 866) were assessed 5 years after parents left the program. New Hope had positive effects on the future orientation and employment experiences of boys, especially African American boys. Compared to boys in…

Engineering a Cause and Cure to Climate Change; Working a culture change with our Future Engineers.

Science.gov (United States)

Hudier, E. J. J.

2014-12-01

Where scientist unravel the laws of nature giving the human race the means to remodel their environment, engineers are the tools that put together the very technologies that give humans this power. Early on, along our first steps through this industrialization era, development was the key word, nature could digest our waste products no matter what. We have managed to tamper with our atmosphere's gas composition and the climate is slowly remodelling our way of life. Engineers are now expected to be a key part of the solution. Engineering programs have evolved to include new dimensions such as ethics, communication and environment. We want future engineers to put these dimensions first while working on new machine designs, concepts and procedures. As undergraduate students with a deep science background we also want them to be a source of information for their co-workers and more. How well are we getting through? How good teachers our future engineers will be? This work take a look at the teaching/learning successes comparing engineering students with students attending an undergraduate program in biology. Methods emphasizing the acquisition of knowledge through lectures and reading assignments are tested along with activities aiming at unraveling the scientific fundamental behind environmental issues and putting forward original solutions to specific problematic. Concept knowledge scores, communications' quality and activities evaluations by students are discussed.

DOCTOR’S AUTOMATIZED WORK PLACE FOR THE TREATMENT OF PATIENTS WITH GAUCHER DISEASE

Directory of Open Access Journals (Sweden)

N. H. Horovenko

2015-05-01

Full Text Available The program was designed to account the registry of patients with Gaucher disease. During the investigation of object domain a medical documentation and work regime of centre were analyzed including medical forms and questionnaires, medical cards, the order of filling appointment of treatment, report forms. The program provides the creation of automatized work place for interaction with patients with Gaucher disease on a personal computer of doctor. The purpose of development system is to perform a range of functions, which correspond to the full cycle of interaction doctor with patients. General function: introduction and correction of data, analysis and preservation of the history of this treatment, filtration patient records, construction of schedules based on the results of blood tests and examinations which reflect the dynamics of the patient. Special functions: calculation of required quantity of the medicine to the patient, tracing of human health standards depending on the age of the patient, the cost of the medicine.

Physicians' Psychosocial Work Conditions and Quality of Care: A Literature Review

Directory of Open Access Journals (Sweden)

Peter Angerer

2015-05-01

Full Text Available Background: Physician jobs are associated with adverse psychosocial work conditions. We summarize research on the relationship of physicians' psychosocial work conditions and quality of care. Method: A systematic literature search was conducted in MEDLINE and PsycINFO. All studies were classified into three categories of care quality outcomes: Associations between physicians' psychosocial work conditions and (1 the physician-patient-relationship, or (2 the care process and outcomes, or (3 medical errors were examined. Results: 12 publications met the inclusion criteria. Most studies relied on observational cross-sectional and controlled intervention designs. All studies provide at least partial support for physicians’ psychosocial work conditions being related to quality of care. Conclusions: This review found preliminary evidence that detrimental physicians’ psychosocial work conditions adversely influence patient care quality. Future research needs to apply strong designs to disentangle the indirect and direct effects of adverse psychosocial work conditions on physicians as well as on quality of care.Keywords: psychosocial work conditions, physicians, quality of care, physician-patient-relationship, hospital, errors, review, work stress, clinicians

Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients.

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Huang, Bihong; Lai, Bihong; Xu, Ling; Wang, Ying; Cao, Yanpei; Yan, Ping; Chen, Jing

2017-11-01

Returning to society plays an important role in improving the quality of life in maintenance hemodialysis (MHD) patients, and retention of employment is one of the core enablers. The study is to assess the employment status and to determine the variables for unemployment in Chinese MHD patients. Prevalent MHD patients from four dialysis centers in Shanghai China were enrolled. We assessed patients' employment status, current social functioning, hemodialysis modality, annual income and general health condition. Among current unemployed working-age patients, the reasons of quitting jobs and willingness of being reemployed were evaluated. A total of 231 patients were studied, among which 114 patients were unemployed 1 year before hemodialysis. Among 117 employed patients, 16 patients quitted jobs before dialysis inception, while 49 patients quitted jobs at the initiation of HD, and 26 patients followed after a few months' HD. The main reasons for ceasing employment were physical insufficiency, conflict between dialysis and work schedules, lack of support from employers and resistance from family members. Among the 166 patients who were in their working age, 26 patients were employed. The unemployed patients had the characters of elder age, lower education level, higher annual family income, higher female ratio, lower blood flow, lower physical functioning, and social functioning and lower frequency of weekend hemodialysis and HDF/HF. Among the 140 unemployed patients, only 47 patients had the willingness of being reemployed. Their unemployment status was positively associated with elder age ((OR) 3.13, 95% CI, 1.08-9.1), lower education level ((OR) 1.97, 95% CI, 1.05-5.92), and higher family income ((OR) 7.75, 95% CI, 2.49-24.14). Ratio of employment and willingness of being reemployed was low in MHD working-age patients. Lack of social and family's support also hampered patient's returning to society except for the HD treatment quality.

Organization and methodology approach for the safety assessment of the present situation and the future works on Chernobyl-4 and the site

International Nuclear Information System (INIS)

Bachner, D.; Benoist, E.; Duco, J.; Jahns, A.

1995-01-01

This work deals with the organization and methodology approach for the safety assessment of the present situation and the future works on Chernobyl 4 and the site. It presents the results of a common preliminary discussion in order to formulate advices on the basic management of the Chernobyl safety assessment process. (O.L.)

Future orientation and health quality of life in primary care: vitality as a mediator.

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Hirsch, Jameson K; Molnar, Danielle; Chang, Edward C; Sirois, Fuschia M

2015-07-01

Temporal perspective, including views about future goals, may influence motivational processes related to health. An adaptive sense of future orientation is linked to better health, but little research has examined potential underlying factors, such as vitality. In a sample of 101 primary care patients, we examined whether belief in the changeability of the future was related to mental and physical energization and, in turn, to health-related quality of life. Participants were working, uninsured primary care patients, who completed self-report measures of future orientation, vitality, and health-related quality of life. Mediation models, covarying age, sex, and race/ethnicity indicated that vitality significantly mediated the association between future orientation and the outcomes of general health, mental health, social functioning, bodily pain, and role limitations due to emotional and physical reasons. Vitality exerted an indirect-only effect on the relation between future orientation and physical functioning. Our findings suggest that adaptive beliefs about the future may promote, or allow access to, physical and mental energy and, in turn, may result in better mental and physical health functioning. Individual-level and public health interventions designed to promote future orientation and vitality may beneficially influence quality of life and well-being.

Work Productivity and Costs Related to Patients with Ankylosing Spondylitis, Rheumatoid Arthritis, and Psoriasis.

Science.gov (United States)

Kruntorádová, Klára; Klimeš, Jiří; Šedová, Liliana; Štolfa, Jiří; Doležal, Tomáš; Petříková, Alena

2014-09-01

To determine and compare the impact of rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriasis on work productivity, to calculate the productivity costs (PC), and to map out factors that influence (functional status and disease activity) work productivity. The Work Productivity and Activity Impairment questionnaire was used to evaluate productivity losses of patients with RA (n = 77), AS (n = 230), and psoriasis (n = 93). Demographic data, patient-reported outcomes (PROs) (Health Assessment Questionnaire [HAQ] and Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and clinical parameters (Disease Activity Score in 28 joints [DAS28], body surface area [BSA], and Psoriasis Area and Severity Index [PASI]) were collected. The correlations among PROs, clinical parameters, and overall productivity loss were examined, and multiple regression models were used to examine relationships among parameters and productivity loss. PC were calculated using the friction cost approach. Mean patient age and disease duration were 47.1 and 15.7 years, respectively. The mean HAQ and DAS28 in patients with RA were 1.22 and 5.6, respectively. The mean BASDAI score in patients with AS was 4.43. The mean BSA and PASI score in patients with psoriasis were 21.1% and 12.9, respectively. The percentage of patients with psoriatic arthritis (in those with psoriasis) was 24.7%. We did not find significant differences in Work Productivity and Activity Impairment domains among various diagnoses. Patients with AS, RA, and psoriasis reported overall work productivity losses of 40.9%, 42.9%, and 42.8%, respectively. Daily activity impairments were approximately 50.0%. Overall work productivity loss strongly correlated with PROs, whereas correlations with clinical parameters were weak. The HAQ and BASDAI were identified as major predictors of productivity impairment. The greatest loss in productivity was in those with psoriatic arthritis; however, it was not significant. In

“The Record is Our Work Tool!”—Physicians’ Framing of a Patient Portal in Sweden

Science.gov (United States)

2016-01-01

Background Uppsala County in Sweden launched an eHealth patient portal in 2012, which allows patients to access their medical records over the Internet. However, the launch of the portal was critically debated in the media. The professionals were strongly skeptical, and one reason was possible negative effects on their work environment. This study hence investigates the assumptions and perspectives of physicians to understand their framing of the patient portal in relation to their work environment. Objective The study uses the concept of technological frames to examine how physicians in different specialties make sense of the patient portal in relation to their work environment. Methods A total of 12 semistructured interviews were conducted with physicians from different specialties. Interviews were transcribed and translated. A theoretically informed thematic analysis was performed. Results The thematic analysis revealed 4 main themes: work tool, process, workload, and control. Physicians perceive medical records as their work tool, written for communication within health care only. Considering effects on work environment, the physicians held a negative attitude and expected changes, which would affect their work processes in a negative way. Especially the fact that patients might read their test results before the physician was seen as possibly harmful for patients and as an interference with their established work practices. They expected the occurrence of misunderstandings and needs for additional explanations, which would consequently increase their workload. Other perceptions were that the portal would increase controlling and monitoring of physicians and increase or create a feeling of mistrust from patients. Regarding benefits for the patients, most of the physicians believe there is only little value in the patient portal and that patients would mostly be worried and misunderstand the information provided. Conclusions Supported by the study, we conclude

Productivity at work and quality of life in patients with rheumatoid arthritis

NARCIS (Netherlands)

Vilsteren, M. van; Boot, C.R.; Knol, D.L.; Schaardenburg, D. van; Voskuyl, A.E.; Steenbeek, R.; Anema, J.R.

2015-01-01

Background The aim of this study was to determine which combination of personal, disease-related and environmental factors is best associated with at-work productivity loss in patients with rheumatoid arthritis (RA), and to determine whether at-work productivity loss is associated with the quality

Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

Science.gov (United States)

Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

2010-10-01

The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Qualitative analysis of interviews of future non-affective psychotic disorder patients and non-psychiatric controls: preliminary results

Directory of Open Access Journals (Sweden)

Katya Rubinstein

2014-03-01

Conclusions: The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.

The impact of nursing work environments on patient safety outcomes: the mediating role of burnout/engagement.

Science.gov (United States)

Spence Laschinger, Heather K; Leiter, Michael P

2006-05-01

To test a theoretical model of professional nurse work environments linking conditions for professional nursing practice to burnout and, subsequently, patient safety outcomes. The 2004 Institute of Medicine report raised serious concerns about the impact of hospital restructuring on nursing work environments and patient safety outcomes. Few studies have used a theoretical framework to study the nature of the relationships between nursing work environments and patient safety outcomes. Hospital-based nurses in Canada (N = 8,597) completed measures of worklife (Practice Environment Scale of the Nursing Work Index), burnout (Maslach Burnout Inventory-Human Service Scale), and their report of frequency of adverse patient events. Structural equation modeling analysis supported an extension of Leiter and Laschinger's Nursing Worklife Model. Nursing leadership played a fundamental role in the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care (vs medical), and nurse/physician relationships. Staffing adequacy directly affected emotional exhaustion, and use of a nursing model of care had a direct effect on nurses' personal accomplishment. Both directly affected patient safety outcomes. The results suggest that patient safety outcomes are related to the quality of the nursing practice work environment and nursing leadership's role in changing the work environment to decrease nurse burnout.

Productivity at work and quality of life in patients with rheumatoid arthritis

NARCIS (Netherlands)

van Vilsteren, Myrthe; Boot, Cecile R. L.; Knol, Dirk L.; van Schaardenburg, Dirkjan; Voskuyl, Alexandre E.; Steenbeek, Romy; Anema, Johannes R.

2015-01-01

The aim of this study was to determine which combination of personal, disease-related and environmental factors is best associated with at-work productivity loss in patients with rheumatoid arthritis (RA), and to determine whether at-work productivity loss is associated with the quality of life for

Supporting Active Patient and Health Care Collaboration: A Prototype for Future Health Care Information Systems.

Science.gov (United States)

Åhlfeldt, Rose-Mharie; Persson, Anne; Rexhepi, Hanife; Wåhlander, Kalle

2016-12-01

This article presents and illustrates the main features of a proposed process-oriented approach for patient information distribution in future health care information systems, by using a prototype of a process support system. The development of the prototype was based on the Visuera method, which includes five defined steps. The results indicate that a visualized prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in e-Health. The main challenges for developing and implementing a fully functional process support system concern both technical and organizational/management aspects. © The Author(s) 2015.

Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety.

Science.gov (United States)

Estryn-Béhar, Madeleine; Van der Heijden, Beatrice I J M

2012-01-01

12-hour shifts are quickly spreading in Europe. From our multivariate analysis concerning 25,924 European nurses, including twenty explanatory variables simultaneously, we found that work schedule itself is not a major determinant factor. Nurses aim to choose or accept night shifts or 12-hour shift in order to reduce their work/home conflicts, however, at the expense of the patient's safety, as well as their own health and safety. Therefore, it is important to develop measures, such as extended child care, association of nurses to the elaboration of their rota, 9- or 10-hour shifts in the afternoon, allowing naps during night shifts, and reduction of changing shifts with short notice. Work schedules must be organized in order to allow time for shift handover, social support and team building.

[Assessment of Work Engagement in Patients with Hematological Malignancies: Psychometric Properties of the German Version of the Utrecht Work Engagement Scale 9 (UWES-9)].

Science.gov (United States)

Sautier, L P; Scherwath, A; Weis, J; Sarkar, S; Bosbach, M; Schendel, M; Ladehoff, N; Koch, U; Mehnert, A

2015-10-01

Our purpose was the psychometric evaluation of the German version of the Utrecht Work Engagement Scale-9 (UWES-9), a self-assessment tool measuring work-related resources consisting of 9 items. Based on a sample of 179 patients with hematological malignancies in in-patient and rehabilitative oncological settings, we tested the dimensional structure by confirmatory and explorative factor analysis. We further evaluated reliability, item characteristics, and construct validity of the UWES-9. The confirmatory factor analysis showed acceptable fit for both a 1-dimensional factor structure and the original 3-factor model. Based on an explorative principal component analysis, we were able to replicate the 1-dimensional factor accounting for 67% of the total variance and showing very high internal consistency (α=0.94) and high factor loads (0.73-0.88). The construct validity was further supported by significant positive correlations between work engagement and meaning of work, corporate feeling, commitment to the workplace, and job satisfaction. The German version of the UWES-9 shows good psychometric qualities in measuring dedication to work in patients with hematological malignancies in in-patient and rehabilitative oncological settings. © Georg Thieme Verlag KG Stuttgart · New York.

Defining the patient safety attitudes and influencing factors of health professionals working at maternity hospitals.

Science.gov (United States)

Tunçer Ünver, Gamze; Harmanci Seren, Arzu Kader

2018-02-27

To determine patient safety attitudes of midwives, nurses and physicians and to examine the difference or correlation in patient safety attitudes of midwives, nurses and physicians working in maternity hospitals. It has been suggested that it is necessary to define the factors affecting patient safety attitudes of health professionals working in maternity hospitals. A descriptive and correlational design was employed.The sample comprised 58 midwives, 134 nurses and 63 physicians (255) in two maternity hospitals in Istanbul, Turkey. The data were collected using an 'information form' and a 'Patient Safety Attitude Questionnaire'. The safety attitudes of participants were generally found to be negative. However, midwives had more positive patient safety attitudes and the age, unit, adequacy of patient safety training and the importance of patient safety were the most effective variables. As health professionals working in maternity hospitals generally have negative patient safety attitudes and because patient safety training provided better attitudes among the participants, these training programmes should be developed and implemented considering the differences among age groups and units. Health professionals have different views on the patient safety culture; therefore, training needs to involve everyone to create a shared vision for patient safety. © 2018 John Wiley & Sons Ltd.

Health Care Students’ Attitudes Towards Addressing Sexual Health in Their Future Professional Work

DEFF Research Database (Denmark)

Gerbild, H.; Larsen, C. M.; Rolander, B.

2017-01-01

Students’ attitudes and educational needs regarding sexual health are important, since their ability to promote sexual health in their future profession can be challenged by their attitudes and knowledge of sexuality and sexual health. There are no existing Danish instruments able to measure...... students’ attitudes towards working with and communicating about sexual health; thus, to be able to use the Students’ Attitudes Towards Addressing Sexual Health (SA-SH) questionnaire in a Danish context, it is necessary to translate and test the translated questionnaire psychometrically. The aim...... of the SA-SH (SA-SH-D) had a Cronbach’s alpha of 0.67. The content validity index showed high relevance (item context validity index 0.82–1.0), and item scale correlation was satisfactory. The SA-SH-D is a valid and reliable questionnaire, which can be used to measure health care professional students...

The effect of acupuncture on mood and working memory in patients with depression and schizophrenia

NARCIS (Netherlands)

Bosch, M.P.C.; Noort, M.W.M.L. van den; Yeo, S.; Lim, S.; Coenen, A.M.L.; Luijtelaar, E.L.J.M. van

2015-01-01

BACKGROUND: In patients with depression, as well as in patients with schizophrenia, both mood and working memory performance are often impaired. Both issues can only be addressed and improved with medication to some extent. OBJECTIVE: This study investigates the mood and the working memory

Social security work disability and its predictors in patients with fibromyalgia.

Science.gov (United States)

Wolfe, Frederick; Walitt, Brian T; Katz, Robert S; Häuser, Winfried

2014-09-01

To determine prevalence and incidence of US Social Security Disability and Supplemental Security Income (SSD) in patients with fibromyalgia and to investigate prediction of SSD. Over a mean of 4 years (range 1-13 years), we studied 2,321 patients with physician-diagnosed fibromyalgia (prevalent cases) and applied modified American College of Rheumatology (ACR) 2010 research criteria to identify criteria-positive patients. During the study, 34.8% (95% confidence interval [95% CI] 32.9-36.8%) of fibromyalgia patients received SSD. The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (95% CI 3.0-3.9%), and 25% were estimated to be work disabled at 9.0 years of followup. By comparison, the prevalence of SSD in rheumatoid arthritis (RA) patients with concomitant fibromyalgia was 55.6% (95% CI 54.3-57.0%) and was 42.4% in osteoarthritis (OA). By study conclusion, 31.4% of SSD awardees were no longer receiving SSD. In univariate models, incident SSD in patients with fibromyalgia was predicted by sociodemographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability index [HAQ DI]). In multivariable models, the HAQ DI and the Short Form 36-item health survey physical and mental component summary scores, but no other variables, predicted SSD. Fibromyalgia criteria-positive patients had more SSD, but the continuous scale, polysymptomatic distress index derived from the ACR criteria was a substantially better predictor of SSD than a criteria-positive diagnosis. The prevalence of SSD is high in fibromyalgia, but not higher than in RA and OA patients who satisfy fibromyalgia criteria. The best predictors of work disability are functional status variables. Copyright © 2014 by the American College of Rheumatology.

The futures of climate engineering

Science.gov (United States)

Low, Sean

2017-01-01

This piece examines the need to interrogate the role of the conceptions of the future, as embedded in academic papers, policy documents, climate models, and other artifacts that serve as currencies of the science-society interface, in shaping scientific and policy agendas in climate engineering. Growing bodies of work on framings, metaphors, and models in the past decade serve as valuable starting points, but can benefit from integration with science and technology studies work on the sociology of expectations, imaginaries, and visions. Potentially valuable branches of work to come might be the anticipatory use of the future: the design of experimental spaces for exploring the future of an engineered climate in service of responsible research and innovation, and the integration of this work within the unfolding context of the Paris Agreement.

A concept of psychological work capacity demands: First evaluation in rehabilitation patients with and without mental disorders.

Science.gov (United States)

Muschalla, Beate

2018-01-01

Work capacity demands are a concept to describe which psychological capacities are required in a job. Assessing psychological work capacity demands is of specific importance when mental health problems at work endanger work ability. Exploring psychological work capacity demands is the basis for mental hazard analysis or rehabilitative action, e.g. in terms of work adjustmentOBJECTIVE:This is the first study investigating psychological work capacity demands in rehabilitation patients with and without mental disorders. A structured interview on psychological work capacity demands (Mini-ICF-Work; Muschalla, 2015; Linden et al., 2015) was done with 166 rehabilitation patients of working age. All interviews were done by a state-licensed socio-medically trained psychotherapist. Inter-rater-reliability was assessed by determining agreement in independent co-rating in 65 interviews. For discriminant validity purposes, participants filled in the Short Questionnaire for Work Analysis (KFZA, Prümper et al., 1994). In different professional fields, different psychological work capacity demands were of importance. The Mini-ICF-Work capacity dimensions reflect different aspects than the KFZA. Patients with mental disorders were longer on sick leave and had worse work ability prognosis than patients without mental disorders, although both groups reported similar work capacity demands. Psychological work demands - which are highly relevant for work ability prognosis and work adjustment processes - can be explored and differentiated in terms of psychological capacity demands.

Work, family and social environment in patients with Fibromyalgia in Spain: an epidemiological study: EPIFFAC study.

Science.gov (United States)

Collado, Antonio; Gomez, Emili; Coscolla, Rosa; Sunyol, Ruth; Solé, Emília; Rivera, Javier; Altarriba, Emília; Carbonell, Jordi; Castells, Xavier

2014-11-11

Fibromyalgia (FM) is a condition characterized by widespread pain, estimated to affect 2.4% of the Spanish population. Nowadays, there are no consistent epidemiological studies on the actual impact of the disease on work and family of these patients in a representative manner; therefore, the purpose of the study is to analyze the impact on family, employment and social environment in a representative sample of patients with FM attending Primary Public Care Centers in Spain. We carried out an epidemiological study, with a probability sampling procedure, stratified, relative to the municipality size and the number of health centres, seeking territorial representation. The survey was conducted using a self-administered structured questionnaire. A sample of 325 patients with FM was studied in 35 Primary Health Care Centers (PHCCs). The sample is composed of 96.6% of women, 51.9 (8) years of mean (standard deviation- sd) age. Ninety-three percent of the patients have worked throughout their life. Mean (sd) age onset of symptoms was 37 (11) years and diagnosis of FM was established 6.6 (8) years later. Family Environment: Fifty-nine percent of patients have difficulties with their partner. Forty-four percent of the patients report to be fairly or totally dependent on a family member in household chores. The household income decreased a mean (sd) of 708 (504) Euros/month in 65% of the patients. In 81% of the patients, there was an increase in extra expenses related to the disease with a mean (sd) of 230 (192) Euros/month. Working environment: At the moment of the study, 45% of the patients had work activity (34% were working and 11% were at sick leave), 13% were unemployed seeking job and 42% were not in the labor force. Twenty-three percent of patients had some degree of permanent work disability pension. Social Environment: The degree of satisfaction with health care professionals was low and twenty-six percent of the patients were members of specific patients

The Impact of Knowledge of Suicide Prevention and Work Experience among Clinical Staff on Attitudes towards Working with Suicidal Patients and Suicide Prevention.

Science.gov (United States)

Ramberg, Inga-Lill; Di Lucca, Maria Anna; Hadlaczky, Gergö

2016-02-04

Suicide-preventive training has shown to influence attitudes. This study aimed at investigating what impact other factors than knowledge might have on attitudes towards work with suicidal patients and suicide prevention. In 2007, 500 health-care staff working in a psychiatric clinic in Stockholm received a questionnaire with items concerning work with suicidal patients to which 358 (71.6%) responded. A set of attitude items were tested using structural equation modelling (LISREL). Three models were found to be satisfactory valid and reliable: Job clarity, Job confidence and Attitudes towards prevention. These were then used in regression analyses as dependent variables with predictors such as experience of work with suicidal patients, perceived sufficient training, age and gender. Perceived sufficient training was consistently the most important predictor for all three attitude concepts (p prevention). Age was another significant predictor for Job clarity (p suicide for Job confidence (p suicide preventive education is likely to improve attitudes towards the prevention of suicide, clarity and confidence regarding their role in the care for suicidal patients. These improvements may contribute to the prevention of suicide in health care settings.

Psychological impact of working with patients with cystic fibrosis at end-of-life, pre-transplant stage.

Science.gov (United States)

Clisby, Nicola; Shaw, Samantha; Cormack, Maggie

2013-04-01

Multidisciplinary staff who work with end-of-life, pre-transplant patients with cystic fibrosis (CF) have to juggle two seemingly opposing care approaches; active care to maintain their patients' health and condition in anticipation of a transplant, and sensitive palliative care that takes their end-of-life wishes into consideration should they not receive a transplant. Little is known about the psychological impact on staff working within this care dichotomy. The aim of this study is to explore staff's experiences and understand more about the psychological impact of this work on them professionally and personally, and how this affects their ability to provide appropriate care for their patients. A qualitative explorative research design was used. Ten semistructured interviews with multidisciplinary staff working in cystic fibrosis centers and units across the United Kingdom were analyzed using interpretative phenomenological analysis (IPA). Two superordinate themes emerged from the analysis: factors contributing to the "juggle" of active and palliative care, and extent of emotional impact on staff. The study indicates that there is an emotional impact on staff working with patients with CF at end-of-life, pre-transplant stages. Specifically, it reveals the extent of the unpredictability that staff work with, and the range of emotions that staff experience, including uncertainty about professional identity and anxiety about working practices. The depth and intimacy of professional-patient relationships is highlighted, particularly for staff in close contact with and similar in age to their patients. Additionally, the strength of staff's commitment and desire to care for patients within broader humanistic terms that mesh with their own personal values is brought to light. Despite the difficulties with their work, the majority of staff adopted numerous coping strategies to manage their emotions, many of which emphasized the link between their professional and

Identity work and illness careers of patients with medically unexplained symptoms

DEFF Research Database (Denmark)

Rossen, Camilla Blach; Buus, Niels; Stenager, Elsebeth

2018-01-01

often experience being met with mistrust and feel their identity threatened as a consequence of being illegitimately ill. There is a strong tendency in health care towards assessment thorough standardized so-called assessment packages. The study used a case study approach. Ethnographic fieldwork......This article reports a case study of the illness career and identity work of patients who have had medically unexplained symptoms for many years with a particular emphasis on their interactions with a specialized and standardized health care system. Patients with medically unexplained symptoms...... assessment with limited time can lead to a diagnostic limbo and that patients and health care professionals keep on searching for legitimate explanations for the patients' still unexplained symptoms. Consequently the patients were left in a constant identity negotiation....

Shift work in hospitals: what are the effects on patient and employee outcomes?

OpenAIRE

Griffiths, Peter; Dall'ora, Chiara

2017-01-01

The healthcare sector works around the clock and requires the availability of staff 24 hours a day. This means that shift work is an essential aspect of staffing hospital departments. However, concerns have been raised about the consequences of some shift patterns for both patient and staff. Although there is no “ideal” shift system, this brief reports on evidence of the effect of shift characteristics including the length of the shift, rotation and days off on patient and employee outcomes.

Embracing a diversified future for US primary care.

Science.gov (United States)

Hoff, Timothy

2013-01-01

Although less focused upon given the current emphasis on the patient-centered medical home innovation, the future for US primary care is arguably one that will be characterized by diversity in service delivery structures and personnel. The drivers of this diversity include increased patient demand requiring a larger number of primary care access points; the need for lower-cost delivery structures that can flourish in a low-margin business model; greater interest in primary care delivery by retailers and hospitals that see their involvement as a means to enhance their core business goals; the increased desire by non-physician providers to gain work independence; and a growing cadre of younger PCPs whose career and job preferences leave them open to working in a variety of different settings and structures. A key issue to ask of a more diversified primary care system is whether or not it will be characterized by competition or cooperation. While a competitive system would not be unexpected given historical and current trends, such a system would likely stunt the prospects for a full revitalization of US primary care. However, there is reason to believe that a cooperative system is possible and would be advantageous, given the mutual dependencies that already exist among primary care stakeholders, and additional steps that could be taken to enhance such dependencies even more into the future.

Physician burnout, work engagement and the quality of patient care.

Science.gov (United States)

Loerbroks, A; Glaser, J; Vu-Eickmann, P; Angerer, P

2017-07-01

Research suggests that burnout in physicians is associated with poorer patient care, but evidence is inconclusive. More recently, the concept of work engagement has emerged (i.e. the beneficial counterpart of burnout) and has been associated with better care. Evidence remains markedly sparse however. To examine the associations of burnout and work engagement with physicians' self-perceived quality of care. We drew on cross-sectional data from physicians in Germany. We used a six-item version of the Maslach Burnout Inventory measuring exhaustion and depersonalization. We employed the nine-item Utrecht Work Engagement Scale to assess work engagement and its subcomponents: vigour, dedication and absorption. We measured physicians' own perceptions of their quality of care by a six-item instrument covering practices and attitudes. We used continuous and categorized dependent and independent variables in linear and logistic regression analyses. There were 416 participants. In multivariable linear regression analyses, increasing burnout total scores were associated with poorer perceived quality of care [unstandardized regression coefficient (b) = 0.45, 95% confidence interval (CI) 0.37, 0.54]. This association was stronger for depersonalization (b = 0.37, 95% CI 0.29, 0.44) than for exhaustion (b = 0.26, 95% CI 0.18, 0.33). Increasing work engagement was associated with higher perceived quality care (b for the total score = -0.20, 95% CI -0.28, -0.11). This was confirmed for each subcomponent with stronger associations for vigour (b = -0.21, 95% CI -0.29, -0.13) and dedication (b = -0.16, 95% CI -0.24, -0.09) than for absorption (b = -0.12, 95% CI -0.20, -0.04). Logistic regression analyses yielded comparable results. Physician burnout was associated with self-perceived poorer patient care, while work engagement related to self-reported better care. Studies are needed to corroborate these findings, particularly for work engagement. © The Author 2017. Published by Oxford

Effectiveness of work-related medical rehabilitation in cancer patients: study protocol of a cluster-randomized multicenter trial.

Science.gov (United States)

Wienert, Julian; Schwarz, Betje; Bethge, Matthias

2016-07-27

Work is a central resource for cancer survivors as it not only provides income but also impacts health and quality of life. Additionally, work helps survivors to cope with the perceived critical life event. The German Pension Insurance provides medical rehabilitation for working-age patients with chronic diseases to improve and restore their work ability, and support returning to or staying at work, and thus tries to sustainably avoid health-related early retirement. Past research showed that conventional medical rehabilitation programs do not support returning to work sufficiently and that work-related medical rehabilitation programs report higher return-to-work rates across several health conditions, when compared to medical rehabilitation. Therefore, the current study protocol outlines an effectiveness study of such a program for cancer survivors. To evaluate the effectiveness of work-related medical rehabilitation in cancer patients we conduct a cluster-randomized multicenter trial. In total, 504 rehabilitation patients between 18 and 60 years with a Karnofsky Performance Status of ≥70 %, a preliminary positive social-medical prognosis of employability for at least 3 h/day within the next 6 months and an elevated risk of not returning to work will be recruited in four inpatient rehabilitation centers. Patients are randomized to the work-related medical rehabilitation program or the conventional medical rehabilitation program based on their week of arrival at each rehabilitation center. The work-related medical rehabilitation program comprises additional work-related diagnostics, multi-professional team meetings, an introductory session as well as work-related functional capacity training, work-related psychological groups, and social counseling. All additional components are aimed at the adjustment of the patients' capacity in relation to their individual job demands. Role functioning defines the main study outcome and will be assessed with the EORTC

Burnout in Hospital Social Workers Who Work with AIDS Patients.

Science.gov (United States)

Oktay, Julianne S.

1992-01-01

Surveyed 128 hospital social workers who worked with Acquired Immune Deficiency Syndrome (AIDS) patients. Found that hospital AIDS social workers had slightly higher rates of emotional exhaustion and depersonalization on Maslach Burnout Inventory but also felt substantially higher level of personal accomplishment. Age, autonomy, and belonging to…

The future endocrine patient. Reflections on the future of clinical endocrinology

NARCIS (Netherlands)

S.W.J. Lamberts (Steven); J.A. Romijn (Johannes); W.M. Wiersinga (Wilmar)

2003-01-01

textabstractIn recent years the future position of clinical endocrinology has been extensively discussed by Western European endocrine societies. Clinical endocrinology seems to suffer from being too intellectual, generating too little income, and lacking too few spectacular

Supporting cancer patients with work-related problems through an oncological occupational physician: a feasibility study.

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Zaman, A C G N M; Bruinvels, D J; de Boer, A G E M; Frings-Dresen, M H W

2017-09-01

To evaluate the feasibility of an oncological occupational physician (OOP) who is trained in oncological work-related problems, and in providing work-related support to cancer patients within the curative setting. We assessed facilitators and barriers that affect the activities of an OOP, and the satisfaction of the OOPs and patients with this new form of health care. Interviews were held with (1) OOPs (N = 13) to assess facilitators, barriers and their satisfaction with their ability to give supportive care and (2) cancer patients (N = 8) to assess their satisfaction concerning consulting an OOP. The main facilitators were positive feedback from health care providers and patients about the received care and support that the OOP had given, and the additional knowledge of the OOPs about cancer and work-related problems. Major barriers for being active as an OOP were lack of financial support for the OOP and the unfamiliarity of patients and health care providers with the specialised occupational physician. Both OOPs and the specialised knowledge and additional training of the OOPs facilitated providing support to cancer patients and survivors with work-related problems. Familiarity with the specialised occupational physician and financial support should be improved. © 2015 John Wiley & Sons Ltd.

Examining the Matthew effect on the motivation and ability to stay at work after heart disease.

Science.gov (United States)

Meland, Eivind; Grønhaug, Siri; Oystese, Kristin; Mildestvedt, Thomas

2011-07-01

Cardiac rehabilitation should safeguard that socioeconomic factors or other differences that affect people's cardiovascular health are not further aggravated after healthcare treatment. The study examines whether socioeconomic status, emotional problems, or the severity of disease affect people's ability to continue to work after heart disease. We also examined if these effects can be explained by differences in motivational factors. 217 patients (41 women) from the Krokeide Rehabilitation Centre in Bergen participated. Multiple linear regression analysis was used to examine motivational differences, and logistic regression analysis was used to examine whether socioeconomic factors or other differences affected people's ability to continue to work after heart disease. Self-efficacy for future work strongly impacted the likelihood of being incapacitated for work during the 2-year follow-up. The household's total income and emotional problems were statistically significant related to patients dropping out from work in the course of the observation. The association between emotional problems and future work was mediated by motivational problems. The relation between income and future incapacity for work could not be explained by motivational factors. The study shows a clear Matthew effect on people's ability to continue to work after heart disease as low-income groups and people with emotional problems are more at risk of dropping out of work. This Matthew effect was, however, only explained by the motivational difficulties for the association between emotional distress and dropping out of work and not for the impact of household income on the likelihood of leaving work.

The Cognitive Symptom Checklist-Work in cancer patients is related with work functioning, fatigue and depressive symptoms : a validation study

NARCIS (Netherlands)

Dorland, H. F.; Abma, F. I.; Roelen, C. A. M.; Smink, A.; Feuerstein, M.; Amick, B. C.; Ranchor, A. V.; Bultmann, U.

The study objectives are to translate the 21-item Cognitive Symptom Checklist-Work (CSC-W21) to Dutch (CSC-W DV) and to validate the CSC-W DV in working cancer patients. The CSC-W21 was cross-culturally translated and adapted to a Dutch version. In this 19-item version, the dichotomous response

[Which hip articulation bearing for which patient? : Tribology of the future].

Science.gov (United States)

Morlock, M M; Bishop, N; Kaddick, C

2011-12-01

Replacement of the hip joint has become an exceptionally successful procedure since the inauguration of the low friction principle by Charnley. Aseptic osteolysis and joint dislocation have been addressed by the development of wear-optimized materials and the introduction of larger heads. As an increase in head diameter against polyethylene causes wear increase, larger hard-on-hard bearings were introduced, which exhibit reduced wear and reduced dislocation risk with increasing head diameter. These findings were derived from standard simulator testing, not sufficiently considering the risk of fluid film breakdown under adverse conditions, which can cause a dramatic increase in wear and friction proportional to the head diameter. Such adverse conditions can occur clinically in patients due to several factors and have caused the presently observed unexpected problems with these new designs. Standardized preclinical testing has to be viewed as a minimum requirement but certainly not as a guarantee for the clinical success of new materials and designs even if the testing is adapted to the current patient requirements, which is presently not the case. The future of tribology lies in the prevention of adverse conditions in patients, the improvement and optimized use of proven existing materials and not in the use of new materials.

The influence of endometriosis-related symptoms on work life and work ability - a study of Danish endometriosis patients in employment

DEFF Research Database (Denmark)

Hansen, Karina Ejgaard; Kesmodel, Ulrik Schiøler; Baldursson, Einar B

2013-01-01

Abstract Objective Little is known about the implications of endometriosis on women's work life. This study aimed at examining the relation between endometriosis-related symptoms and work ability in employed women with endometriosis. Study design In a cohort study, 610 patients with diagnosed...... ability. The level of statistical significance was set at pwork disturbances due to symptoms, lower work ability and a wide number of other implications on work life in employed women...... endometriosis and 751 reference women completed an electronic survey based on the Endometriosis Health Profile 30-questionnaire and the Work Ability Index (short form). Percentages were reported for all data. Binary and multivariate logistic regression analyses were used to assess risk factors for low work...

The Future of Interprofessional Education and Practice for Dentists and Dental Education.

Science.gov (United States)

Andrews, Elizabeth A

2017-08-01

In the ever-changing landscape of education, health professions programs must be adaptable and forward-thinking. Programs need to understand the services students should be educated to provide over the next 25 years. The movement to increase collaboration among health professionals to improve health care outcomes is a significant priority for all health professions. Complex medical issues frequently seen in patients can best be addressed with interprofessional health care teams. Training future health care providers to work in such teams facilitates collaborative care and can result in improved outcomes for patients. What skills will dental students need in 2040 to practice as part of these interprofessional teams? Important skills needed for success are collaboration, communication, professionalism, and the ability to manage medically complex patients. These abilities are in alignment with the four Interprofessional Education Collaborative (IPEC) core competency domains and will continue to be key skills necessary in the future. Transitioning to a one university approach for preclinical and clinical training along with development of an all-inclusive electronic health record will drive this model forward. Faculty training and continuing education for clinicians, residents, and allied health providers will be necessary for comprehensive adoption of a team-based collaborative care system. With the health care delivery system moving towards more patient-centered, team-based care, interprofessional education helps future clinicians develop into confident team members who will lead health care into the future and produce better patient outcomes. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Work engagement and attitudes toward caring for dying patients and families among home-visiting nurses in Japan.

Science.gov (United States)

Mahiro, Sakai; Takashi, Naruse; Satoko, Nagata

2014-07-01

Nurses with higher levels of work engagement tend to be highly efficient in their work and more willing to keep working and to provide patient-centred care. However, whether more engaged nurses provide end-of-life care more proactively has not been examined in the home-care setting. This study aimed to examine work engagement among home-visiting nurses in Japan and its relationship with their attitudes toward caring for dying patients and their families. A total of 343 nurses working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. The authors performed multiple regression analysis to explore the relationships between home-visiting nurses' work engagement and attitudes. Data from 184 nurses (53.6%) was analysed. Work engagement was significantly positively related to the nurses' attitudes toward caring for dying patients and their families. As more engaged nurses tend to have more positive attitudes toward caring for dying patients and their families, further research is needed to identify the factors that might help nursing managers to enhance their staff's engagement and perhaps thereby improve their attitudes, with the ultimate aim of achieving better outcomes for patients and families.

The future endocrine patient. Reflections on the future of clinical endocrinology

NARCIS (Netherlands)

Lamberts, S. W. J.; Romijn, J. A.; Wiersinga, W. M.

2003-01-01

In recent years the future position of clinical endocrinology has been extensively discussed by Western European endocrine societies. Clinical endocrinology seems to suffer from being too intellectual, generating too little income, and lacking too few spectacular interventions. In this manuscript we

Can patients with asthma feel inhaler therapy working right away? Two clinical trials testing the effect of timing of assessment on patient perception.

Science.gov (United States)

Leidy, Nancy Kline; Gutierrez, Benjamin; Lampl, Kathy; Uryniak, Tom; O'Brien, Christopher D

2009-12-01

Feeling a maintenance therapy work right away may provide positive reinforcement and may offer one way to improve adherence in patients with asthma. Precise measurement is required to accurately compare the presence of this effect across clinical trial treatment groups. Two randomized, controlled studies tested whether timing of assessment (daily vs weekly, study 1; and predose vs postdose, study 2) influenced patients' reports of whether they can feel a medication working right away (perception), and their satisfaction with this perception (satisfaction). These 2-week US-based multicenter double-blind, parallel-group studies included patients > or = 18 years of age with mild to moderate persistent asthma. In each, patients were randomized to one of two drugs with different onset profiles: budesonide/formoterol pressurized metered-dose inhaler (pMDI) 80/4.5 microg x 2 inhalations (160/9 microg) twice daily or budesonide pMDI 80 microg x 2 inhalations (160 microg) twice daily. Patients were further randomized to complete previously validated perception and satisfaction questions in a cross-over fashion, either daily and weekly (N = 123) or predose and postdose (N = 134). Patient surveys also assessed perceptions of the onset of effect of medication and their value of these perceptions. No significant differences were observed in patients' reports of perception, either daily versus weekly or predose versus postdose. A statistically significant difference in satisfaction was found in study 1 only, favoring weekly recall (p away (136 of 157 patients) identified positive airway sensations. Most patients reported that feeling their medication work right away is reassuring and would help them manage their asthma. Assessment timing has no effect on patient response to the perception of feeling a medication working right away. Differences found in satisfaction levels reported with weekly versus daily recall were consistent across treatment groups, indicating that no bias

Making the future palpable: Notes from a major incident Future Laboratory

DEFF Research Database (Denmark)

Büscher, Monika; Kristensen, Margit; Mogensen, Preben Holst

2008-01-01

In this paper we describe experiences from a Future Laboratory. Future laboratories allow users to experiment with prototypes of future technologies in as realistic as possible conditions. We have devised this method because, to realize the potential of advanced ubiquitous computing technologies...... it is essential to anticipate and design for future practices, but for prospective users it is often difficult to imagine and articulate future practices and provide design specifications. However, they readily invent new ways of working in engagement with new technologies and, by facilitating realistic use...... of prototype technologies in Future Laboratories, designers and users can define and study both opportunities and constraints for design. We present 11 scenes from a Major Incidents Future Laboratory held in September 2005. Many raise tough questions rather than provide quick answers. In addition, many also...

The Future of Social Work as a Profession

Directory of Open Access Journals (Sweden)

Leon Ginsberg

2005-05-01

Full Text Available This is an introductory, overview article that summarizes some of the major issues social work will encounter as a profession in the 21st Century. Employment trends are projected. Clinical and other direct services employment appears to be much more pervasive than employment in organization and management services. Professional employment data show that non metropolitan employment will be more prevalent than employment in large cities. Social work in schools will be a major area of growth. So will programs to provide treatment and other alternatives to prison for those involved with illegal drugs. Some of the effects of current political issues and the 2004 elections on social work are also discussed.

Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

Science.gov (United States)

Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

2015-08-01

This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

Impact of hypoglycemia on patients with type 2 diabetes mellitus and their quality of life, work productivity, and medication adherence

Directory of Open Access Journals (Sweden)

Lopez JMS

2014-05-01

Full Text Available Janice MS Lopez,1 Kathy Annunziata,2 Robert A Bailey,1 Marcia FT Rupnow,1 Donald E Morisky31Janssen Scientific Affairs, LLC, Raritan, NJ, 2Kantar Health, Princeton, NJ, 3University of California at Los Angeles Fielding School of Public Health, Los Angeles, CA, USABackground: The purpose of this study was to determine the characteristics of adults with type 2 diabetes mellitus (T2DM that correlate with greater risk of hypoglycemia and determine the impact of hypoglycemia on health-related quality of life, work productivity, and medication adherence from a patient perspective.Methods: Data from a large web-based survey were retrospectively analyzed. Adults with a diagnosis of T2DM taking antihyperglycemic agents were included in the analysis. Participants with knowledge of their hypoglycemic history were divided into three groups: those experiencing recent hypoglycemia (previous 3 months, those experiencing nonrecent hypoglycemia, and those never experiencing hypoglycemia.Results: Of the participants with T2DM taking antihyperglycemic agents who were knowledgeable of their hypoglycemia history, 55.7% had ever experienced hypoglycemia. Of those, 52.7% had recent hypoglycemia. Compared with those who never experienced hypoglycemia, those who experienced hypoglycemia tended to: be younger; be more aware of their glycated hemoglobin (HbA1c levels; have higher HbA1c levels; have a higher body mass index; have higher Charlson Comorbidity Index scores; be on insulin, sulfonylureas, and/or glucagon-like peptide-1 agonists; and be less adherent to their antihyperglycemic agents. Hypoglycemia interfered with social activities, caused more missed work (absenteeism, more impairment while at work (presenteeism, and decreased overall work productivity compared with patients who had never experienced hypoglycemia. Overall health-related quality of life, as determined by the Short Form-36 health questionnaire, was negatively impacted by hypoglycemia. Both

A cohort study of permanently reduced work ability in breast cancer patients.

Science.gov (United States)

Hauglann, Beate; Benth, Jūratė Šaltytė; Fosså, Sophie D; Dahl, Alv A

2012-09-01

The aims of this cohort study were to explore various longitudinal aspects of employment and disability pension due to permanently reduced work ability among women with breast cancer and to investigate the impact of breast cancer on income. In a national register-based controlled cohort study from Norway, 1,548 women diagnosed with breast cancer (all stages) between 1992 and 1996 at the age 45-54 years and 1,548 cancer-free women matched for age, municipality and civil status were followed for up to 14 years. Medical data from the Cancer Registry of Norway were linked with longitudinal data on employment, social security benefits and socio-demography collected from other national official registries. Compared to cancer-free controls, breast cancer patients were significantly more likely to receive disability pension (hazard ratio (HR) 2.7, 95% CI 2.3-3.2) after adjustment for unmatched socio-demographic variables (education, income and children employment rates were higher in non-disabled patients than in non-disabled controls (82% vs. 77%, p = 0.008). Working breast cancer patients experienced a temporary negative effect on employment income. A considerable proportion of women with breast cancer will over time experience permanently reduced work ability and become disability pension holders. In case of reduced work ability in breast cancer survivors, medical personel caring for them should consider and discuss with them rehabilitation and workplace adjustment in order to prevent early disability pension.

Physical inactivity at leisure and work: a 12-month study of cardiac patients.

Science.gov (United States)

Rogerson, Michelle C; Murphy, Barbara M; Le Grande, Michael R; Worcester, Marian U C

2013-01-01

Physical inactivity has been identified as a distinct health risk. However, little is known about how this can vary at leisure and work in cardiac patients. The aim of this study was to examine the prevalence and predictors of inactivity during leisure and work in the 12 months following a cardiac event in Australian cardiac patients. A total of 346 patients consecutively admitted to hospital with acute coronary syndrome or to undergo coronary artery bypass graft surgery were interviewed in hospital, and 4 and 12 months later. Leisure and occupational physical activity was measured using the Stanford Brief Activity Survey. Sociodemographic, psychosocial, and clinical data were also collected. The prevalence of leisure-time physical inactivity declined over time, with 52% inactive preevent and 29% inactive at 12 months. Approximately 50% of participants were physically inactive in their work, regardless of whether this was measured before or after the cardiac event. Logistic regression revealed that the significant predictors of leisure-time physical inactivity at 12 months were non-home ownership (OR = 2.19; P = .007) and physical inactivity in leisure-time prior to the event (OR = 2.44; P = .001). The significant predictors of occupational physical inactivity at 12 months were white-collar occupation (OR = 3.10; P physical inactivity at work prior to the event (OR = 12.99; P physical inactivity, socioeconomic, and clinical factors predicted both leisure and work inactivity after an acute cardiac event. Effective interventions could be designed and implemented to target those most at risk of being physically inactive at work or leisure.

The Smartphone-Based Offline Indoor Location Competition at IPIN 2016: Analysis and Future Work

Directory of Open Access Journals (Sweden)

Joaquín Torres-Sospedra

2017-03-01

Full Text Available This paper presents the analysis and discussion of the off-site localization competition track, which took place during the Seventh International Conference on Indoor Positioning and Indoor Navigation (IPIN 2016. Five international teams proposed different strategies for smartphone-based indoor positioning using the same reference data. The competitors were provided with several smartphone-collected signal datasets, some of which were used for training (known trajectories, and others for evaluating (unknown trajectories. The competition permits a coherent evaluation method of the competitors’ estimations, where inside information to fine-tune their systems is not offered, and thus provides, in our opinion, a good starting point to introduce a fair comparison between the smartphone-based systems found in the literature. The methodology, experience, feedback from competitors and future working lines are described.

The Future Hospital: A Business Architecture View.

Science.gov (United States)

Mokhtar, Ariffin Marzuki

2017-10-01

The future hospital is a resilient, physical learning facility featuring digital enhancement and leveraging an ecosystem of platforms for the Internet of Things (IoT) and analytics, achieving patient-centric care delivery via multidisciplinary healthcare provider teams coordinated to meet patients' medical, psychological, social and economic needs. It exists in a just ecosystem that assimilates the care spectrum from healthy living, the prevention of disease to acute care and the rehabilitation of patients recuperating from illnesses. It will take some time for these future hospitals to be built or for current hospitals to evolve and/or transform, but efforts to spread wisdom among the stakeholders, healthcare providers and patients must start now. The development of the digital components can also begin today, as can competency building for the healthcare providers who will be staffing these future hospitals, ensuring that they are equipped with competent staff employing patient-centric care processes that cater to patients' current and future needs.

Clinical supervision of nurses working with patients with borderline personality disorder.

Science.gov (United States)

Bland, Ann R; Rossen, Eileen K

2005-06-01

Some nurses describe individuals diagnosed with borderline personality disorder (BPD) as among the most challenging and difficult patients encountered in their practice. As a result, the argument has been made for nursing staff to receive clinical supervision to enhance therapeutic effectiveness and treatment outcomes for individuals with BPD. Formal clinical supervision can focus on the stresses of working in a demanding environment within the work place and enable nurses to accept accountability for their own practice and development (Pesut & Herman, 1999). A psychiatric-mental health clinical nurse specialist can provide individual and/or group supervision for the nursing staff, including education about patient dynamics, staff responses, and treatment team decisions. A clinical nurse specialist also can provide emotional support to nursing staff, which enhances job satisfaction, as they struggle to maintain professional therapeutic behavior with these individuals.

Future Climate Analysis

International Nuclear Information System (INIS)

James Houseworth

2001-01-01

This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure 1), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog. Revision 00 of this AMR was prepared in accordance with the ''Work Direction and Planning Document for Future Climate Analysis'' (Peterman 1999) under Interagency Agreement DE-AI08-97NV12033 with the U.S. Department of Energy (DOE). The planning document for the technical scope, content, and management of ICN 01 of this AMR is the ''Technical Work Plan for Unsaturated Zone (UZ) Flow and Transport Process Model Report'' (BSC 2001a). The scope for the TBV resolution actions in this ICN is described in the ''Technical Work Plan for: Integrated Management of Technical Product Input Department''. (BSC 2001b, Addendum B

Future Climate Analysis

Energy Technology Data Exchange (ETDEWEB)

James Houseworth

2001-10-12

This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure 1), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog. Revision 00 of this AMR was prepared in accordance with the ''Work Direction and Planning Document for Future Climate Analysis'' (Peterman 1999) under Interagency Agreement DE-AI08-97NV12033 with the U.S. Department of Energy (DOE). The planning document for the technical scope, content, and management of ICN 01 of this AMR is the ''Technical Work Plan for Unsaturated Zone (UZ) Flow and Transport Process Model Report'' (BSC 2001a). The scope for the TBV resolution actions in this ICN is described in the ''Technical Work Plan for: Integrated Management of Technical

Reducing hospital readmission rates: current strategies and future directions.

Science.gov (United States)

Kripalani, Sunil; Theobald, Cecelia N; Anctil, Beth; Vasilevskis, Eduard E

2014-01-01

New financial penalties for institutions with high readmission rates have intensified efforts to reduce rehospitalization. Several interventions that involve multiple components (e.g., patient needs assessment, medication reconciliation, patient education, arranging timely outpatient appointments, and providing telephone follow-up) have successfully reduced readmission rates for patients discharged to home. The effect of interventions on readmission rates is related to the number of components implemented; single-component interventions are unlikely to reduce readmissions significantly. For patients discharged to postacute care facilities, multicomponent interventions have reduced readmissions through enhanced communication, medication safety, advanced care planning, and enhanced training to manage medical conditions that commonly precipitate readmission. To help hospitals direct resources and services to patients with greater likelihood of readmission, risk-stratification methods are available. Future work should better define the roles of home-based services, information technology, mental health care, caregiver support, community partnerships, and new transitional care personnel.

Challenges and barriers to improving care of the musculoskeletal patient of the future - a debate article and global perspective

Directory of Open Access Journals (Sweden)

Prommersberger Karl J

2011-09-01

Full Text Available Abstract Background With greater technological developments in the care of musculoskeletal patients, we are entering an era of rapid change in our understanding of the pathophysiology of traumatic injury; assessment and treatment of polytrauma and related disorders; and treatment outcomes. In developed countries, it is very likely that we will have algorithms for the approach to many musculoskeletal disorders as we strive for the best approach with which to evaluate treatment success. This debate article is founded on predictions of future health care needs that are solely based on the subjective inputs and opinions of the world's leading orthopedic surgeons. Hence, it functions more as a forum-based rather than a scientific-based presentation. This exposé was designed to stimulate debate about the emerging patients' needs in the future predicted by leading orthopedic surgeons that provide some hint as to the right direction for orthopedic care and outlines the important topics in this area. Discussion The authors aim to provide a general overview of orthopedic care in a typical developed country setting. However, the regional diversity of the United States and every other industrialized nation should be considered as a cofactor that may vary to some extent from our vision of improved orthopedic and trauma care of the musculoskeletal patient on an interregional level. In this forum, we will define the current and future barriers in developed countries related to musculoskeletal trauma, total joint arthroplasty, patient safety and injuries related to military conflicts, all problems that will only increase as populations age, become more mobile, and deal with political crisis. Summary It is very likely that the future will bring a more biological approach to fracture care with less invasive surgical procedures, flexible implants, and more rapid rehabilitation methods. This international consortium challenges the trauma and implants community to

Development of a Streamlined Work Flow for Handling Patients' Genetic Testing Insurance Authorizations.

Science.gov (United States)

Uhlmann, Wendy R; Schwalm, Katie; Raymond, Victoria M

2017-08-01

Obtaining genetic testing insurance authorizations for patients is a complex, time-involved process often requiring genetic counselor (GC) and physician involvement. In an effort to mitigate this complexity and meet the increasing number of genetic testing insurance authorization requests, GCs formed a novel partnership with an industrial engineer (IE) and a patient services associate (PSA) to develop a streamlined work flow. Eight genetics clinics and five specialty clinics at the University of Michigan were surveyed to obtain benchmarking data. Tasks needed for genetic testing insurance authorization were outlined and time-saving work flow changes were introduced including 1) creation of an Excel password-protected shared database between GCs and PSAs, used for initiating insurance authorization requests, tracking and follow-up 2) instituting the PSAs sending GCs a pre-clinic email noting each patients' genetic testing insurance coverage 3) inclusion of test medical necessity documentation in the clinic visit summary note instead of writing a separate insurance letter and 4) PSAs development of a manual with insurance providers and genetic testing laboratories information. These work flow changes made it more efficient to request and track genetic testing insurance authorizations for patients, enhanced GCs and PSAs communication, and reduced tasks done by clinicians.

Enhancing return-to-work in cancer patients, development of an intervention and design of a randomised controlled trial

Directory of Open Access Journals (Sweden)

Taskila Taina

2010-07-01

Full Text Available Abstract Background Compared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large. Therefore, return-to-work of cancer patients needs to be improved by way of an intervention. The objective is to describe the development and content of a work-directed intervention to enhance return-to-work in cancer patients and to explain the study design used for evaluating the effectiveness of the intervention. Development and content of the intervention The work-directed intervention has been developed based on a systematic literature review of work-directed interventions for cancer patients, factors reported by cancer survivors as helping or hindering their return-to-work, focus group and interview data for cancer patients, health care professionals, and supervisors, and vocational rehabilitation literature. The work-directed intervention consists of: 1 4 meetings with a nurse at the treating hospital department to start early vocational rehabilitation, 2 1 meeting with the participant, occupational physician, and supervisor to make a return-to-work plan, and 3 letters from the treating physician to the occupational physician to enhance communication. Study design to evaluate the intervention The treating physician or nurse recruits patients before the start of initial treatment. Patients are eligible when they have a primary diagnosis of cancer, will be treated with curative intent, are employed at the time of diagnosis, are on sick leave, and are between 18 and 60 years old. After the patients have given informed consent and have filled out a baseline questionnaire, they are randomised to either the control group or to the intervention group and receive either care as usual or the work-directed intervention, respectively. Primary outcomes are return-to-work and quality of life. The feasibility of the intervention and direct and indirect costs will be

Association of depressive/anxiety symptoms with quality of life and work ability in patients with systemic lupus erythematosus.

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Mok, Chi Chiu; Chan, Kar Li; Ho, Ling Yin

2016-01-01

To study the association of depressive/anxiety symptoms with health-related quality of life (HRQoL) and work ability in Chinese patients with systemic lupus erythematosus (SLE). Consecutive patients with ≥4 ACR criteria for SLE were recruited. Depressive and anxiety symptoms were assessed by the Hospital Anxiety and Depression scale (HADS). HRQoL was assessed by the Chinese version of MOS-Short Form (SF)-36. Disease activity of SLE was assessed by the SLE disease activity index (SLEDAI) and organ damage was assessed by the ACR/SLICC damage index (SDI). The relationship between HAD scores, work ability and HRQoL was studied. A total of 367 SLE patients were studied (95% women; age 40.2±12.9 years; disease duration 9.3±7.2 years). Fifty-five (15%) patients had HADS-depression score ≥10 and 70 (19%) patients had HADS-anxiety score ≥10. Patients with either score ≥10 had significantly lower SF36 score (physical and mental component) than those with score working in the preceding year (n=190), 30(16%) patients either quitted their job (n=22) or reduced working hours (n=8). Patients with work disability had significantly higher HAD-depression score than those without (6.31±5.51 vs 3.93±3.72; p=0.03). Depressive/anxiety symptoms were fairly common in SLE patients and independently associated with poorer HRQoL. Patients with more depressive symptoms were more likely to experience work disability.

Happy employees lead to loyal patients. Survey of nurses and patients shows a strong link between employee satisfaction and patient loyalty.

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Atkins, P M; Marshall, B S; Javalgi, R G

1996-01-01

A strong relationship exists between employee satisfaction and patients' perceptions of the quality of their care, measured in terms of their intent to return and to recommend the hospital to others. Employee dissatisfaction can negatively affect quality of care and have an adverse effect on patient loyalty and, thus hospital profitability. Therefore, health care marketers should regularly measure employee satisfaction as one way to monitor service quality. Health care marketers must work more closely with their human-resource departments to understand and influence employees' work environment and maintain a high level of job satisfaction. Marketers also should place an increased emphasis on both employee and patient perceptions of satisfaction when developing internal and external strategic marketing plans and formulating future research.

The importance of quality of life for work outcomes in patients with ankylosing spondylitis - a cross-sectional study

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Burcu Taser

2017-10-01

Full Text Available Aims: Work impairment is one of the most important exploration and one of the aims of rheumatologists. We aimed to determine the risk factors for employment state and predictive factors of work outcomes using multi-dimensional measures in patients with ankylosing spondylitis (AS in this comprehensive study. Methods: One hundred patients with AS (31 females and 69 males were included into this study. Demographic properties, local factors, disease activity (BASDAI, functionality (BASFI, spinal mobility (BASMI, radiologic stage (BASRI, quality of life (AS-QoL, cardiopulmonary involvement, exercise stress test and work outcomes were investigated and compared in employed and un-employed patients. The work instability scale (AS-WIS and work productivity activity impairment scale (WPAI:SpA were selected as work outcomes. The predictive factors were analyzed using multiple stepwise linear regressions. Major results: Thirty-two patients (mean age: 42,6±11.7 were unemployed and the risk factors for unemployment state were female sex, lower annual income level, and older age. Work disability was detected only in 5% of patients. Decreased chest mobility (beta: -0.398, p:

Reliability and Validity of the Work and Well-Being Inventory (WBI) for Employees.

Science.gov (United States)

Vendrig, A A; Schaafsma, F G

2018-06-01

Purpose The purpose of this study is to measure the psychometric properties of the Work and Wellbeing Inventory (WBI) (in Dutch: VAR-2), a screening tool that is used within occupational health care and rehabilitation. Our research question focused on the reliability and validity of this inventory. Methods Over the years seven different samples of workers, patients and sick listed workers varying in size between 89 and 912 participants (total: 2514), were used to measure the test-retest reliability, the internal consistency, the construct and concurrent validity, and the criterion and predictive validity. Results The 13 scales displayed good internal consistency and test-retest reliability. The constructive validity of the WBI could clearly be demonstrated in both patients and healthy workers. Confirmative factor analyses revealed a CFI >.90 for all scales. The depression scale predicted future work absenteeism (>6 weeks) because of a common mental disorder in healthy workers. The job strain scale and the illness behavior scale predicted long term absenteeism (>3 months) in workers with short-term absenteeism. The illness behavior scale moderately predicted return to work in rehab patients attending an intensive multidisciplinary program. Conclusions The WBI is a valid and reliable tool for occupational health practitioners to screen for risk factors for prolonged or future sickness absence. With this tool they will have reliable indications for further advice and interventions to restore the work ability.

Work stress and patient safety: observer-rated work stressors as predictors of characteristics of safety-related events reported by young nurses.

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Elfering, A; Semmer, N K; Grebner, S

This study investigates the link between workplace stress and the 'non-singularity' of patient safety-related incidents in the hospital setting. Over a period of 2 working weeks 23 young nurses from 19 hospitals in Switzerland documented 314 daily stressful events using a self-observation method (pocket diaries); 62 events were related to patient safety. Familiarity of safety-related events and probability of recurrence, as indicators of non-singularity, were the dependent variables in multilevel regression analyses. Predictor variables were both situational (self-reported situational control, safety compliance) and chronic variables (job stressors such as time pressure, or concentration demands and job control). Chronic work characteristics were rated by trained observers. The most frequent safety-related stressful events included incomplete or incorrect documentation (40.3%), medication errors (near misses 21%), delays in delivery of patient care (9.7%), and violent patients (9.7%). Familiarity of events and probability of recurrence were significantly predicted by chronic job stressors and low job control in multilevel regression analyses. Job stressors and low job control were shown to be risk factors for patient safety. The results suggest that job redesign to enhance job control and decrease job stressors may be an important intervention to increase patient safety.

Blood genotyping for improved outcomes in chronic transfusion patients: current and future perspectives

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Kutner JM

2014-09-01

Full Text Available Jose Mauro Kutner,1 Mariza Mota,1 Fabiana Conti,1 Lilian Castilho1,2 1Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil; 2Hemocentro Unicamp, Campinas, SP, Brazil Abstract: Blood transfusions are life sustaining in chronically transfused patients. However, certain complications, such as alloimmunization to red blood cells, can create challenges in the management of those patients. Routine phenotyping of blood recipients and the use of phenotype-matched blood units for transfusion have been useful to lower the occurrence of red cell alloantibodies in chronically transfused individuals. Nevertheless, extensive phenotyping is expensive, laborious, and cannot be performed in certain situations. The molecular understanding of blood groups has enabled the design of assays that may be used to better guide matched red blood cell transfusions. This review summarizes key findings related to red cell alloimmunization, the already identified and potential future benefits of blood group genotyping, and how molecular typing is being incorporated in the blood bank's routine to improve clinical and long-term outcomes in chronically transfused patients. Keywords: blood group genotyping, chronically transfused patients, platelet genotyping, RBC alloimmunization

Patient clusters in acute, work-related back pain based on patterns of disability risk factors.

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Shaw, William S; Pransky, Glenn; Patterson, William; Linton, Steven J; Winters, Thomas

2007-02-01

To identify subgroups of patients with work-related back pain based on disability risk factors. Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later. A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group. Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.

Work conditions, mental workload and patient care quality: a multisource study in the emergency department.

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Weigl, Matthias; Müller, Andreas; Holland, Stephan; Wedel, Susanne; Woloshynowych, Maria

2016-07-01

Workflow interruptions, multitasking and workload demands are inherent to emergency departments (ED) work systems. Potential effects of ED providers' work on care quality and patient safety have, however, been rarely addressed. We aimed to investigate the prevalence and associations of ED staff's workflow interruptions, multitasking and workload with patient care quality outcomes. We applied a mixed-methods design in a two-step procedure. First, we conducted a time-motion study to observe the rate of interruptions and multitasking activities. Second, during 20-day shifts we assessed ED staff's reports on workflow interruptions, multitasking activities and mental workload. Additionally, we assessed two care quality indicators with standardised questionnaires: first, ED patients' evaluations of perceived care quality; second, patient intrahospital transfers evaluated by ward staff. The study was conducted in a medium-sized community ED (16 600 annual visits). ED personnel's workflow was disrupted on average 5.63 times per hour. 30% of time was spent on multitasking activities. During 20 observations days, data were gathered from 76 ED professionals, 239 patients and 205 patient transfers. After aggregating daywise data and controlling for staffing levels, prospective associations revealed significant negative associations between ED personnel's mental workload and patients' perceived quality of care. Conversely, workflow interruptions were positively associated with patient-related information on discharge and overall quality of transfer. Our investigation indicated that ED staff's capability to cope with demanding work conditions was associated with patient care quality. Our findings contribute to an improved understanding of the complex effects of interruptions and multitasking in the ED environment for creating safe and efficient ED work and care systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review.

Science.gov (United States)

Kuijer, P P F M; Gouttebarge, V; Brouwer, S; Reneman, M F; Frings-Dresen, M H W

2012-02-01

Assessments of whether patients with musculoskeletal disorders (MSDs) can participate in work mainly consist of case history, physical examinations, and self-reports. Performance-based measures might add value in these assessments. This study answers the question: how well do performance-based measures predict work participation in patients with MSDs? A systematic literature search was performed to obtain longitudinal studies that used reliable performance-based measures to predict work participation in patients with MSDs. The following five sources of information were used to retrieve relevant studies: PubMed, Embase, AMA Guide to the Evaluation of Functional Ability, references of the included papers, and the expertise and personal file of the authors. A quality assessment specific for prognostic studies and an evidence synthesis were performed. Of the 1,230 retrieved studies, eighteen fulfilled the inclusion criteria. The studies included 4,113 patients, and the median follow-up period was 12 months. Twelve studies took possible confounders into account. Five studies were of good quality and thirteen of moderate quality. Two good-quality and all thirteen moderate-quality studies (83%) reported that performance-based measures were predictive of work participation. Two good-quality studies (11%) reported both an association and no association between performance-based measures and work participation. One good-quality study (6%) found no effect. A performance-based lifting test was used in fourteen studies and appeared to be predictive of work participation in thirteen studies. Strong evidence exists that a number of performance-based measures are predictive of work participation in patients with MSDs, especially lifting tests. Overall, the explained variance was modest.

Arthritis symptoms, the work environment, and the future: measuring perceived job strain among employed persons with arthritis.

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Gignac, Monique A M; Sutton, Deborah; Badley, Elizabeth M

2007-06-15

To develop a measure of job strain related to differing aspects of working with arthritis and to examine the demographic, illness, work context, and psychosocial variables associated with it. Study participants were 292 employed individuals with osteoarthritis or inflammatory arthritis. Participants were from wave 3 of a 4-wave longitudinal study examining coping and adaptation efforts used to remain employed. Participants completed an interview-administered structured questionnaire, including a Chronic Illness Job Strain Scale (CIJSS) and questions on demographic (e.g., age, sex), illness and disability (e.g., disease type, pain, activity limitations), work context (e.g., job type, job control), and psychosocial variables (e.g., arthritis-work spillover, coworker/managerial support, job perceptions). Principal component analysis and multiple linear regression were used to analyze the data. A single factor solution emerged for the CIJSS. The scale had an internal reliability of 0.95. Greater job strain was reported for future uncertainty, balancing multiple roles, and difficulties accepting the disease than for current workplace conditions. Participants with inflammatory arthritis, more frequent severe pain, greater workplace activity limitations, fewer hours of work, less coworker support, and greater arthritis-work spillover reported greater job strain. The findings underscore the diverse areas that contribute to perceptions of job strain and suggest that existing models of job strain do not adequately capture the stress experienced by individuals working with chronic illnesses or the factors associated with job strain. Measures similar to the CIJSS can enhance the tools researchers and clinicians have available to examine the impact of arthritis in individuals' lives.

The relationships between nurses' perceptions of the hemodialysis unit work environment and nurse turnover, patient satisfaction, and hospitalizations.

Science.gov (United States)

Gardner, Jane K; Thomas-Hawkins, Charlotte; Fogg, Louis; Latham, Carolyn E

2007-01-01

While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that

Computerized training improves verbal working memory in patients with myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study.

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Maroti, Daniel; Westerberg, Annika Fryxell; Saury, Jean-Michel; Bileviciute-Ljungar, Indre

2015-08-18

Patients with myalgic encephalomyelitis/chronic fatigue syndrome experience cognitive difficulties. The aim of this study was to evaluate the effect of computerized training on working memory in this syndrome. Non-randomized (quasi-experimental) study with no-treatment control group and non-equivalent dependent variable design in a myalgic encephalomyelitis/chronic fatigue syndrome-cohort. Patients with myalgic encephalomyelitis/chronic fatigue syndrome who participated in a 6-month outpatient rehabilitation programme were included in the study. Eleven patients who showed signs of working memory deficit were recruited for additional memory training and 12 patients with no working memory deficit served as controls. Cognitive training with computerized working memory tasks of increasing difficulty was performed 30-45 min/day, 5 days/week over a 5-week period. Short-term and working memory tests (Digit Span - forward, backward, total) were used as primary outcome measures. Nine of the 11 patients were able to complete the training. Cognitive training increased working memory (p = 0.003) and general attention (p = 0.004) to the mean level. Short-term memory was also improved, but the difference was not statistically significant (p = 0.052) vs prior training. The control group did not show any significant improvement in primary outcome measures. Cognitive training may be a new treatment for patients with myalgic encephalomyelitis/chronic fatigue syndrome.

[Current situation of soil-transmitted nematodiasis monitoring in China and working keys in future].

Science.gov (United States)

Chen, Ying-dan; Zang, Wei

2015-04-01

Soil-transmitted nematodiasis is widely epidemic in rural areas in China. It was showed that the infection rate of soil-transmitted nematodes was 19.56% while the overall number of persons infected was 129,000,000, which was supported by the results of the National Survey of Current Situation of Major Human Parasitic Diseases in China in 2005 published by former Ministry of Health. Therefore, soil-transmitted nematodiasis was included in the national infectious diseases and pathogenic media monitoring system by Chinese Center for Disease Control and Prevention in 2006, and subsequently 22 monitoring spots were established nationwide. From 2006 to 2013, the human infection rate of intestinal nematodes in national monitoring spots decreased from 20.88% to 3.12%, which showed a declining trend year by year. Meanwhile, the infection rates of Ascaris lumbricoides, Trichuris trichiura, hookworm, Enterobius vermicularis decreased from 10.10%, 5.88%, 8.88%, 10.00% in 2006 to 0.76%, 0.42%, 2.04%, 6.78% in 2013 respectively. In this paper, the current situation of soil-transmitted nematodiasis is overviewed based on a summary of the 8 years' monitoring work, as well as the experiences, challenges and key of monitoring work in the future.

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

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Kristina D. Wood

2013-01-01

Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology. Setting: Ambulatory care and community practice Practice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers. Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients. Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system. Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.   Type: Idea Paper

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

Directory of Open Access Journals (Sweden)

Cathy H. Ficzere, PharmD, BCPS

2013-01-01

Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology.Setting: Ambulatory care and community practicePractice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers.Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients.Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system.Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.

Professional Learning between Past Experience and Future Work

DEFF Research Database (Denmark)

Weber, Kirsten

2010-01-01

This paper is about learning, qualification and possible professionalization in human service work. With human services we primarily refer to work related to health care, child care, social work, and education. I present empirical findings from different phases of training and workplace experience...... of Danish child care pedagogues. The investigation is part of a human resource centered research program studying the development of welfare institutions and systems in Denmark. Welfare institutions have been developing since World War II as an important aspect of and precondition for the socio...... reality as well as defensive “shyings-away”. It cannot be produced by a formal education alone, neither can it emerge from life experiences alone. In the development of research methodology we explore the interplay of regression and progression, the lifelong and everyday active functions of what was named...

A dark past, a restrained present, and an apocalyptic future: time perspective, personality, and life satisfaction among anorexia nervosa patients.

Science.gov (United States)

Garcia, Danilo; Granjard, Alexandre; Lundblad, Suzanna; Archer, Trevor

2017-01-01

Despite reporting low levels of well-being, anorexia nervosa patients express temperament traits (e.g., extraversion and persistence) necessary for high levels of life satisfaction. Nevertheless, among individuals without eating disorders, a balanced organization of the flow of time, influences life satisfaction beyond temperamental dispositions. A balanced time perspective is defined as: high past positive, low past negative, high present hedonistic, low present fatalistic, and high future. We investigated differences in time perspective dimensions, personality traits, and life satisfaction between anorexia nervosa patients and matched controls. We also investigated if the personality traits and the outlook on time associated to positive levels of life satisfaction among controls also predicted anorexia patients' life satisfaction. Additionally, we investigated if time perspective dimensions predicted life satisfaction beyond personality traits among both patients and controls. A total of 88 anorexia nervosa patients from a clinic in the West of Sweden and 111 gender-age matched controls from a university in the West of Sweden participated in the Study. All participants responded to the Zimbardo Time Perspective Inventory, the Ten Item Personality Inventory, and the Temporal Satisfaction with Life Scale. A t -test showed that patients scored higher in the past negative, the present fatalistic, and the future dimensions, lower in the past positive and the present hedonistic dimensions, higher in conscientiousness, extraversion, and agreeableness, and lower in life satisfaction. Regression analyses showed that life satisfaction was predicted by openness to experience and emotional stability for controls and by emotional stability among patients. When time dimensions were entered in the regression, emotional stability and the past negative and past positive time dimensions predicted life satisfaction among controls, but only the past positive and present hedonistic

Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

Science.gov (United States)

Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

2016-09-01

The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P noise in single-patient rooms (33%) than in multipatient rooms (79%; P pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

TXT@WORK: pediatric hospitalists and text messaging.

Science.gov (United States)

Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Steinberger, Erik

2014-07-01

Many studies assess provider-patient communication through text messaging; however, minimal research has addressed communication among physicians. The purpose of this study was to evaluate the use of text messaging by pediatric hospitalists. A brief, anonymous, electronic survey was distributed through the American Academy of Pediatrics Section on Hospital Medicine Listserv in February 2012. Survey questions assessed work-related text messaging. Of the 106 pediatric hospitalist respondents, 97 met inclusion criteria. Most were female (73%) and had been in practice text messages, some (12%) more than 10 times per shift. More than half (53%) received work-related text messages when not at work. When asked to identify all potential work recipients, most often sent work-related text messages to other pediatric hospitalists (64%), fellows or resident physicians (37%), and subspecialists/consulting physicians (28%). When asked their preferred mode for brief communication, respondents' preferences varied. Many (46%) respondents worried privacy laws can be violated by sending/receiving text messages, and some (30%) reported having received protected health information (PHI) through text messages. However, only 11% reported their institution offered encryption software for text messaging. Physicians were using text messaging as a means of brief, work-related communication. Concerns arose regarding transfer of PHI using unsecure systems and work-life balance. Future research should examine accuracy and effectiveness of text message communication in the hospital, as well as patient privacy issues.

Radionuclide Transport Modelling: Current Status and Future Needs. Synthesis, Work Group Reports and Extended Abstracts

International Nuclear Information System (INIS)

2002-06-01

The workshop identified a set of critical issues for the Swedish Nuclear Power Inspectorate (SKI) and the Swedish Radiation Protection Authority (SSI) to address in preparing for future reviews of license applications, which have subsequently been considered in preparing this synthesis. Structure for organising expert participation: A structure for organising expert participation in future reviews is proposed based on clearinghouses for (1) regulatory application and context, (2) engineered barrier systems, (3) geosphere, (4) biosphere, and (5) performance assessment integration and calculations. As part of their work, these clearinghouses could identify key issues that need to be resolved prior to future reviews. Performance assessment strategy and review context: Future reviews will be conducted in the context of regulations based on risk criteria; this leads to a need to review the methods used in probabilistic risk assessment, as well as the underlying process models. A plan is needed for accomplishing both aims. Despite the probabilistic framework, a need is anticipated for targeted, deterministic calculations to check particular assumptions. Priorities and ambition level for reviews: SKI's and SSI's resources can be more efficiently utilised by an early review of SKB's safety case, so that if necessary the authorities can make an early start on evaluating topics that are of primary significance to the safety case. As a guide to planning for allocation of effort in future reviews, this workshop produced a preliminary ranking of technical issues, on a scale from 'non-controversial' to 'requiring independent modelling,' Analysis of repository system and scenarios: Systems analysis tools including features/events/processes encyclopaedias, process-influence diagrams, and assessment-model flowcharts should be used as review tools, to check the processes and influences considered in SKB's analyses, and to evaluate the comprehensiveness of the scenarios that are

Radionuclide Transport Modelling: Current Status and Future Needs. Synthesis, Work Group Reports and Extended Abstracts

Energy Technology Data Exchange (ETDEWEB)

NONE

2002-06-01

The workshop identified a set of critical issues for the Swedish Nuclear Power Inspectorate (SKI) and the Swedish Radiation Protection Authority (SSI) to address in preparing for future reviews of license applications, which have subsequently been considered in preparing this synthesis. Structure for organising expert participation: A structure for organising expert participation in future reviews is proposed based on clearinghouses for (1) regulatory application and context, (2) engineered barrier systems, (3) geosphere, (4) biosphere, and (5) performance assessment integration and calculations. As part of their work, these clearinghouses could identify key issues that need to be resolved prior to future reviews. Performance assessment strategy and review context: Future reviews will be conducted in the context of regulations based on risk criteria; this leads to a need to review the methods used in probabilistic risk assessment, as well as the underlying process models. A plan is needed for accomplishing both aims. Despite the probabilistic framework, a need is anticipated for targeted, deterministic calculations to check particular assumptions. Priorities and ambition level for reviews: SKI's and SSI's resources can be more efficiently utilised by an early review of SKB's safety case, so that if necessary the authorities can make an early start on evaluating topics that are of primary significance to the safety case. As a guide to planning for allocation of effort in future reviews, this workshop produced a preliminary ranking of technical issues, on a scale from 'non-controversial' to 'requiring independent modelling,' Analysis of repository system and scenarios: Systems analysis tools including features/events/processes encyclopaedias, process-influence diagrams, and assessment-model flowcharts should be used as review tools, to check the processes and influences considered in SKB's analyses, and to evaluate the comprehensiveness of the scenarios that are

European Working Time Directive: implications for surgical training.

LENUS (Irish Health Repository)

Donohoe, C L

2010-02-01

The forthcoming implementation of the European Working Time Directive (EWTD) for non-consultant hospital doctors (NCHDs) poses a number of challenges in the areas of patient care, training, service provision and quality of life for workers. Surgery, as a craft-based speciality, will face a greater impact on training of future surgeons as operating time could be lost to service provision. The EWTD acts a stimulus for reform of current working practices and re-configuration of services. It will necessitate transformation of the way in which surgeons are trained, if current standards are to be maintained.

How Adolescents Construct Their Future: The Effect of Loneliness on Future Orientation

Science.gov (United States)

Seginer, Rachel; Lilach, Efrat

2004-01-01

This study examined the effect of loneliness, gender, and two dimensions of prospective life domains on adolescent future orientation. Future orientation was studied in four prospective domains: social relations, marriage and family, higher education and work and career. These domains are described in terms of two dimensions: theme (relational vs.…

Work life and patient safety culture in Canadian healthcare: connecting the quality dots using national accreditation results.

Science.gov (United States)

Mitchell, Jonathan I

2012-01-01

Fostering quality work life is paramount to building a strong patient safety culture in healthcare organizations. Data from two patient safety culture and work-life questionnaires used for Accreditation Canada's national program were analyzed. Strong team leadership was reported in that units were doing a good job of identifying, assessing and managing risks to patients. Seventy-one percent of respondents gave their unit a positive overall grade on patient safety, and 79% of respondents felt that they could often do their best-quality work in their job. However, healthcare workers felt that they did not have enough time to do their jobs adequately and indicated that co-workers were cutting corners in patient care in order to save time. This article discusses engaging both senior leadership and the entire organization in the change process, ensuring supervisory support, and using performance measures to focus organizational efforts on key priorities all as improvement strategies relevant to these findings. These strategies can be used by organizations across sectors and jurisdictions and by healthcare leaders to positively affect work life and patient safety.

When general practitioners don't feel appreciated by their patients: prospective effects on well-being and work-family conflict in a Swiss longitudinal study.

Science.gov (United States)

Meier, Laurenz L; Tschudi, Peter; Meier, Cornelia A; Dvorak, Charles; Zeller, Andreas

2015-04-01

Impaired well-being and high work-family conflict are critical issues among GPs. This research examined an understudied psychosocial risk factor for these outcomes, namely GPs' perception that they invest more in the relationship with their patients than what they receive in return (i.e. lack of reward in their relationship with patients). To test the effect of lack of reward as a risk factor for poor well-being and work-family conflict among GPs. Longitudinal study (12 months time lag). 272 GPs in Switzerland [mean age 54.5 (SD = 8.3), 73% male] volunteered to participate in the study. 270 participants completed the baseline survey and 252 completed the follow-up survey. Of these, six retired between the baseline and the follow-up survey, resulting in a sample size of 246 participants at t2. Outcome measures were burnout, sleep problems, self-perceived health and work-family conflict. Strength and direction of prospective effects were tested using cross-lagged models. Lack of reward was related to an increase in emotional exhaustion (β = 0.15), sleep problems (β = 0.16) and work-family conflict (β = 0.19) and a decrease in self-perceived health (β = -0.17). Effects on depersonalization and personal accomplishment were not significant. Regarding reversed effects of impaired well-being on lack of reward, emotional exhaustion (β = 0.14) and self-perceived health (β = -0.13) predicted future level of lack of reward. Lack of reward by patients is a risk factor in GPs' mental health. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Exploring the Influence of Nursing Work Environment and Patient Safety Culture on Missed Nursing Care in Korea.

Science.gov (United States)

Kim, Kyoung-Ja; Yoo, Moon Sook; Seo, Eun Ji

2018-04-20

This study aimed to explore the influence of nurse work environment and patient safety culture in hospital on instances of missed nursing care in South Korea. A cross-sectional design was used, in which a structured questionnaire was administered to 186 nurses working at a tertiary university hospital. Data were analyzed using descriptive statistics, t-test or ANOVA, Pearson correlation and multiple regression analysis. Missed nursing care was found to be correlated with clinical career, nursing work environment and patient safety culture. The regression model explained approximately 30.3 % of missed nursing care. Meanwhile, staffing and resource adequacy (β = -.31, p = .001), nurse manager ability, leadership and support of nurses (β = -.26, p = .004), clinical career (β = -.21, p = .004), and perception on patient safety culture within unit (β = -.19, p = .041) were determined to be influencing factors on missed nursing care. This study has significance as it suggested that missed nursing care is affected by work environment factors within unit. This means that missed nursing care is a unit outcome affected by nurse work environment factors and patient safety culture. Therefore, missed nursing care can be managed through the implementation of interventions that promote a positive nursing work environment and patient safety culture. Copyright © 2018. Published by Elsevier B.V.

Job Resources, Physician Work Engagement, and Patient Care Experience in an Academic Medical Setting

NARCIS (Netherlands)

Scheepers, Renée A.; Lases, Lenny S. S.; Arah, Onyebuchi A.; Heineman, Maas Jan; Lombarts, Kiki M. J. M. H.

2017-01-01

Purpose Physician work engagement is associated with better work performance and fewer medical errors; however, whether workengaged physicians perform better from the patient perspective is unknown. Although availability of job resources (autonomy, colleague support, participation in decision

Subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care.

Science.gov (United States)

Barbe, Tammy; Kimble, Laura P; Rubenstein, Cynthia

2018-04-01

The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes. A descriptive correlational design with stratified random sampling. The sample included 96 nurses from the major geographic regions of the United States. Over 9 months in 2016-2017, data were collected using a web-based survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress. © 2017 John Wiley & Sons Ltd.

Effect of Psychosocial Work Environment on Sickness Absence Among Patients Treated for Ischemic Heart Disease

DEFF Research Database (Denmark)

Biering, Karin; Lund, Thomas; Andersen, Johan Hviid

2015-01-01

-force becomes increasingly important. Previous studies among healthy workers suggest that the psychosocial working environment is associated with sickness absence. Whether the psychosocial working environment plays a role for patients with existing cardiovascular disease on return to work and sickness absence...

Psychological and Work Stress Assessment of Patients following Angioplasty or Heart Surgery: Results of 1-year Follow-up Study.

Science.gov (United States)

Fiabane, Elena; Giorgi, Ines; Candura, Stefano M; Argentero, Piergiorgio

2015-12-01

The aim of this study was to explore changes in subjective psychological health and perceived work stress among patients who returned to work (RTW) after a multidisciplinary cardiac rehabilitation (CR) following cardiac interventions. A total of 108 patients were evaluated at the beginning of their CR, at 6 and 12 months after discharge. Self-report questionnaires were used to assess depression, anxiety, illness perception and work stress at each time stage. Results showed reports of depressive symptoms significantly decreased (p work stress after their RTW. Patients' psychological health and work stress need to be assessed during the CR and should be also carefully monitored after the RTW in order to identify patients' psychological and work-related barriers and facilitate a safe and successful work reintegration. Copyright © 2014 John Wiley & Sons, Ltd.

Patient and social work factors related to successful placement of long-term psychiatric in-patients from a specialist psychiatric hospital in South Africa.

Science.gov (United States)

Krüger, C; Lewis, C

2011-05-01

The slow discharge of long-term psychiatry patients from Weskoppies Hospital into the community has not matched the national and international drive towards deinstitutionalisation. This article investigates patient and social work factors related to successful community placement, in the context of limited community care facilities. Thirty-six long-term patients who were successfully placed outside of the hospital during a seven month period were compared to 235 unplaced long-term patients in terms of demographic and clinical variables. Social work services were analysed in terms of which patients received the most interventions, and the most common type of interventions. The most significant patient factors associated with successful placement were: female patients; medium-to-high level of functioning; having involved relatives living far away; a low frequency of behavioural problems (especially of cannabis abuse, verbal or physical aggression, uncontrolled sexual activity), and agitation or restlessness. These patient factors were mirrored in the social work services rendered to the long-term patients during the study period: The recipients were mostly female, in open wards (higher-functioning); and the social services utilised were mostly related to planning for placement and patient support. The lack of community care facilities in the Pretoria area that are able to care for the more difficult long-term psychiatry patients, limits successful placement and increases the burden of hospital based social workers. The problem cannot be resolved at a hospital level and needs to be addressed in the context of provincial and national health departments.

Future trends in health and health care: implications for social work practice in an aging society.

Science.gov (United States)

Spitzer, William J; Davidson, Kay W

2013-01-01

Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

Work-family life balance: future trends and challenges

OpenAIRE

Fagnani, Jeanne

2011-01-01

The aim of this paper is to offer a holistic forward-looking, and multi level analysis of pressing contemporary topics related to work/life balance policies for families with smaller children and to show how they interact with parents' attitudes and practices. The paper is structured as follows: the first chapter presents a brief overview of current trends in the work/family life related areas. Then the main key drivers of change over the last decade are identified and described. Emphasis is ...

The impact of internet-based cognitive behavior therapy on work ability in patients with depression - a randomized controlled study.

Science.gov (United States)

Hange, Dominique; Ariai, Nashmil; Kivi, Marie; Eriksson, Maria Cm; Nejati, Shabnam; Petersson, Eva-Lisa

2017-01-01

The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU. This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013. Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million. A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women. Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale - self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days. Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days. Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression.

Impaired Work Productivity After Aneurysmal Subarachnoid Hemorrhage.

Science.gov (United States)

Crago, Elizabeth A; Price, Thomas J; Bender, Catherine M; Ren, Dianxu; Poloyac, Samuel M; Sherwood, Paula R

2016-10-01

Aneurysmal subarachnoid hemorrhage (aSAH) is a sudden debilitating condition affecting individuals during the most productive times of their lives. Treatment advances have reduced mortality rates but increased the number of survivors facing deficits in physical and neuropsychological function. This study examined associations between neuropsychological function and work productivity after aSAH. Fifty-two patients with aSAH, employed before hemorrhage, were recruited from an ongoing National Institutes of Health study. Work Limitations Questionnaire (WLQ), neuropsychological tests (executive function, psychomotor speed, attention and mental flexibility, memory), and Patient Assessment of Own Function were completed at 3 and 12 months after aSAH. Subjects in this analysis reported some level of difficulty in work productivity at 3 and 12 months (35% and 30%, respectively) after hemorrhage. Lower WLQ scores in time management and mental/interpersonal subscales were associated with poorer performance in psychomotor function (r = .5, p = .04 and r = .42, p = .09). Poorer mental flexibility and working memory correlated with time management difficulty at 3 months (r = -.4, p = .09 and r = .54, p = .02). Patients performing poorly on story recall tests were more likely to report difficulty with job physical performance (r = -.42, p = .09) and completing work effectively (r = .61, p = .009). Poorer working memory performance was associated with lower scores on mental/interpersonal WLQ subscales (r = .45, p = .05) and overall health-related work productivity loss (r = .47, p = .04). WLQ areas also correlated with participants' perception of their neuropsychological function after aSAH. These results suggest that neuropsychological deficits impact work quality after hemorrhage and provide strong impetus for future studies so that domain-specific interventions can be implemented to improve outcomes that affect quality of life including work productivity.

The interaction of working memory performance and episodic memory formation in patients with Korsakoff's amnesia

NARCIS (Netherlands)

Geldorp, B. van; Bergmann, H.C.; Robertson, J.; Wester, A.J.; Kessels, R.P.C.

2012-01-01

Both neuroimaging work and studies investigating amnesic patients have shown involvement of the medial temporal lobe during working memory tasks, especially when multiple items or features have to be associated. However, so far no study has examined the relationship between working memory and

The interaction of working memory performance and episodic memory formation in patients with Korsakoff's amnesia.

NARCIS (Netherlands)

Geldorp, B. van; Bergmann, H.C.; Robertson, J.; Wester, A.J.; Kessels, R.P.C.

2012-01-01

Both neuroimaging work and studies investigating amnesic patients have shown involvement of the medial temporal lobe during working memory tasks, especially when multiple items or features have to be associated. However, so far no study has examined the relationship between working memory and

[Returning to work after an acute coronary syndrome: When waiting is wasting].

Science.gov (United States)

Latil, F; Iliou, M C; Boileau, C; Pietri, J X; Lechien, C; Ha-Vinh, P; Guimond, C

2017-04-01

Return to work (RTW) after acute coronary syndrome (ACS) is an important issue for the patient's future. The study aim was to determine whether RTW practice complies with guidelines or is delayed by failure in patient management. We analysed the factors influencing RTW beyond the 90-day period recommended by guidelines. We conducted a survey of 216 self-employed workers admitted to the hospital for ACS using self-report questionnaires and medical examination. Factors influencing RTW, occupational and cardiac features, and recall and source of medical information were investigated. Ninety-three of 216 patients did not return to work by 90 days, despite good cardiac performance in 30 cases (32 %). The mean sick leave duration was 93.3±103.7 days. Advice concerning return to work was completely missing for 44 % of patients. Cardiac performance was independent of sick leave duration, but was correlated with the likelihood of RTW (Pwork-related information. Recall of work-related information was better among patients admitted to a rehabilitation facility (65 %) compared to those who did not receive rehabilitation (Pperformance within 2 months after ACS. Patient management should also include cardiac rehabilitation or therapeutic education toward improving information recall. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care wards: a systematic review.

Science.gov (United States)

King, Allana; Long, Lesley; Lisy, Karolina

2015-11-01

. There were no statistically significant differences observed in any study in the overall job satisfaction of nurses using a team nursing model compared with a total patient care model. Some differences in job satisfaction were however observed within different subgroups of nurses. There were no statistically significant differences in either stress or job tension. Within the selected studies, the specific outcomes of absenteeism and burnout were not addressed. Due to the limited number of quantitative studies identified for inclusion in this systematic review it is not possible to determine whether organizing nursing work in a team nursing or total patient care model is more effective in terms of staff wellbeing in acute care settings. Neither a team nursing or total patient care model had a significant influence on nurses' overall job satisfaction, stress levels or staff turnover. This review could not ascertain if the type of model of care affects absenteeism or burnout as these were not addressed in any of the identified studies.Caution should be taken when evaluating which model of care is appropriate and the decision needs to incorporate staff experience levels and staff skill mix. There needs to be clear definition of nursing roles.This review demonstrates the need for further quantitative studies of these models of care that are well designed with sufficient sample sizes to allow for attrition of participants, and that explore the impact each model has on nurse's wellbeing, in particular, studies that address burnout and absenteeism. There is a need for consistent terminology to allow for future comparison and research to occur at an international level. Future studies on models of care should include economic analysis to fully inform policy and practice.

Patient-Provider Communication: Experiences of Low-Wage-Earning Breast Cancer Survivors in Managing Cancer and Work.

Science.gov (United States)

Nichols, Helen M; Swanberg, Jennifer E; Vanderpool, Robin C

2018-02-26

In 2017, there will be more than 250,000 new diagnoses of invasive breast cancer; most cases will occur in working-age women. The goal of this qualitative study was to explore low-wage-earning breast cancer survivors' experiences communicating with their oncology team about cancer and employment issues. Twenty-four low-wage-earning breast cancer survivors in the USA were interviewed in 2012 using a structured interview protocol. Sociodemographic data, cancer history, and patient-provider communication experiences regarding the management of cancer and work were collected. Interviews were analyzed using grounded theory strategy of constant comparative analysis. Low-wage-earning breast cancer survivors' experiences communicating with their oncology team about employment and cancer focused on three dimensions of patient-provider communication: extent, quality, and content. Over 70% of respondents reported no communication or only routine communication with their providers regarding work; three quarters of women reported poor or standard communication quality, and content of work-related communication covered scheduling issues, work absences, continuing to work during treatment, and financial concerns. Communication between oncology care teams and low-wage-earning cancer patients is critical to the successful management of treatment and work responsibilities given the vulnerable employment situation of these women. There is a need for education of oncology team members about how cancer and its treatment can impact employment for all workers, but especially for low-wage workers, thereby allowing the care team to address these issues proactively and help patients successfully manage both cancer treatment and work responsibilities.

Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III: A cross-sectional analysis.

Science.gov (United States)

Agnew, Louise; Johnston, Venerina; Landén Ludvigsson, Maria; Peterson, Gunnel; Overmeer, Thomas; Johansson, Gun; Peolsson, Anneli

2015-06-01

To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III. Cross-sectional analysis. A total of 166 working age patients with chronic whiplash-associated disorder. A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability. The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R2 = 0.65, p whiplash-associated disorder.

[Preference Changes Regarding Future Work Area and Intended Position Among German Residents after Four Years of Residency].

Science.gov (United States)

Ziegler, Stine; van den Bussche, Hendrik; Römer, Farina; Krause-Solberg, Lea; Scherer, Martin

2017-06-01

Introduction  We investigated the preferences of medical residents in Germany with regard to future working place (hospital or private practice) and position (employment/self-employment in private practice; resp. specialist/senior or chief physician in the hospital). This is analysed in a gender comparative perspective, including the influence of parenthood. Methods  Annual postal surveys among graduates of seven medical faculties in Germany from their last year ("Practical Year") until after four years of postgraduate training. The return rate at baseline was 48 % and the four surveys after reached rates from 85 % up. In all samples about two thirds were women, which corresponds to the actual gender differentiation in under- and postgraduate training. Descriptive statistics and regression analyses were performed. Results  Compared to private practice the hospital is clearly preferred, although the attraction of hospital jobs decreased over the years. The decision for or against the hospital is connected to the discipline. Working in private practice is seen as possibility for part time work. Men prefer self-employment whereas women prefer to work under an employment contract. In the hospital, male doctors prefer to work in leading positions. Those positions are associated with full-time work. Leadership training especially takes place in university hospitals. Discussion  Three trends are recognized: Reluctance against leading positions, growing interest for part time work and rising popularity of work as an employee in private practice. Those trends can be understood as a rejection of traditional professional role models. The realization of these preferences is easily feasible because of the current labour market situation. Therefore, emerging problems have to be faced in another way. A change of gender-typical role models was rarely detected. © Georg Thieme Verlag KG Stuttgart · New York.

Parents’ Participation in a Work-Based Anti-Poverty Program Can Enhance Their Children's Future Orientation: Understanding Pathways of Influence

Science.gov (United States)

Purtell, Kelly M.; McLoyd, Vonnie C.

2012-01-01

Planning and preparing for life after high school is a central developmental task of American adolescents, and may be even more critical for low-income youth who are less likely to attend a four year college. This study investigates factors that led to the effects of the New Hope Project, a work-based, anti-poverty program directed at parents on youths’ career-related thoughts and planning. The New Hope project was implemented in Milwaukee, WI, during the mid-1990s. 745 families participated (52% male children; 56% African American; 30% Latino, and 15% White non-Hispanic) and half were randomly selected to receive New Hope benefits, which included earnings supplements, job search assistance, and child and health care subsidies for three years. Importantly, effects on youths’ future orientation were found eight years after the program began (five years after benefits ended). The present study investigates what factors sustained these positive impacts over time. Results indicate that parental perceptions of reading performance mediate the effects of New Hope on youths’ cynicism about work. Additionally, parental perceptions of reading performance and youths’ educational expectations mediate the effects of New Hope on boys’ pessimism about future employment. These findings highlight the importance of youths’ educational development to their career-related thoughts and planning. PMID:22878938

Parents' participation in a work-based anti-poverty program can enhance their children's future orientation: understanding pathways of influence.

Science.gov (United States)

Purtell, Kelly M; McLoyd, Vonnie C

2013-06-01

Planning and preparing for life after high school is a central developmental task of American adolescents, and may be even more critical for low-income youth who are less likely to attend a four year college. This study investigates factors that led to the effects of the New Hope Project, a work-based, anti-poverty program directed at parents on youths' career-related thoughts and planning. The New Hope project was implemented in Milwaukee, WI, during the mid-1990s. 745 families participated (52% male children; 56% African American; 30% Latino, and 15% White non-Hispanic) and half were randomly selected to receive New Hope benefits, which included earnings supplements, job search assistance, and child and health care subsidies for 3 years. Importantly, effects on youths' future orientation were found 8 years after the program began (5 years after benefits ended). The present study investigates what factors sustained these positive impacts over time. Results indicate that parental perceptions of reading performance mediate the effects of New Hope on youths' cynicism about work. Additionally, parental perceptions of reading performance and youths' educational expectations mediate the effects of New Hope on boys' pessimism about future employment. These findings highlight the importance of youths' educational development to their career-related thoughts and planning.

Making the Future Palpable

DEFF Research Database (Denmark)

Büscher, Monika; Kristensen, Margit; Mogensen, Preben Holst

2007-01-01

In this paper we describe experiences from a Future Laboratory. Future laboratories allow users to experiment with prototypes of future technologies in as realistic as possible conditions. We have devised this method because, to realize the potential of advanced ubiquitous computing technologies...... it is essential to anticipate and design for future practices, but for prospective users it is often difficult to imagine and articulate future practices and provide design specifications. They readily invent new ways of working in engagement with new technologies, through and, by facilitating as realistic...... as possible use of prototype future technologies in Future Laboratories designers and users can define and study both opportunities and constraints for design. We present 11 scenes from a Major Incidents Future Laboratory held in September 2005. In relation to each scene we point out key results. Many raise...

A dark past, a restrained present, and an apocalyptic future: time perspective, personality, and life satisfaction among anorexia nervosa patients

Directory of Open Access Journals (Sweden)

Danilo Garcia

2017-09-01

Full Text Available Background Despite reporting low levels of well-being, anorexia nervosa patients express temperament traits (e.g., extraversion and persistence necessary for high levels of life satisfaction. Nevertheless, among individuals without eating disorders, a balanced organization of the flow of time, influences life satisfaction beyond temperamental dispositions. A balanced time perspective is defined as: high past positive, low past negative, high present hedonistic, low present fatalistic, and high future. We investigated differences in time perspective dimensions, personality traits, and life satisfaction between anorexia nervosa patients and matched controls. We also investigated if the personality traits and the outlook on time associated to positive levels of life satisfaction among controls also predicted anorexia patients’ life satisfaction. Additionally, we investigated if time perspective dimensions predicted life satisfaction beyond personality traits among both patients and controls. Method A total of 88 anorexia nervosa patients from a clinic in the West of Sweden and 111 gender-age matched controls from a university in the West of Sweden participated in the Study. All participants responded to the Zimbardo Time Perspective Inventory, the Ten Item Personality Inventory, and the Temporal Satisfaction with Life Scale. Results A t-test showed that patients scored higher in the past negative, the present fatalistic, and the future dimensions, lower in the past positive and the present hedonistic dimensions, higher in conscientiousness, extraversion, and agreeableness, and lower in life satisfaction. Regression analyses showed that life satisfaction was predicted by openness to experience and emotional stability for controls and by emotional stability among patients. When time dimensions were entered in the regression, emotional stability and the past negative and past positive time dimensions predicted life satisfaction among controls, but

Into the future with little past: exploring mental time travel in a patient with damage to the mammillary bodies/fornix.

Science.gov (United States)

Tedder, Jacqui; Miller, Laurie; Tu, Sicong; Hornberger, Michael; Lah, Suncica

2016-02-01

Remembering the past and imaging the future are both manifestations of 'mental time travel'. These processes have been found to be impaired in patients with bilateral hippocampal lesions. Here, we examined the question of whether future thinking is affected by other Papez circuit lesions, namely: damage to the mammillary bodies/fornix. Case (SL) was a 43-year-old woman who developed dense anterograde and retrograde amnesia suddenly, as a result of Wernicke-Korsakoff's syndrome. A region of interest volumetric Magnetic resonance imaging (MRI) analysis was performed. We assessed past and future thinking in SL and 11 control subjects of similar age and education with the adapted Autobiographical Interview (AI). Participants also completed a battery of neuropsychological tests. Volumetric MRI analyses revealed severely reduced fornix and mammillary body volumes, but intact hippocampi. SL showed substantial, albeit temporally graded retrograde memory deficits on the adapted AI. Strikingly, whilst SL could not provide any specific details of events from the past two weeks or past two years and had impaired recall of events from her late 30s, her descriptions of potential future events were normal in number of event details and plausibility. This dissociation of past and future events' performance after mammillary body and fornix damage is at odds with the findings of the majority of patients with adult onset hippocampal amnesia. It suggests that these non-hippocampal regions of the Papez circuit are only critical for past event retrieval and not for the generation of possible future events.

Employment status, difficulties at work and quality of life in inflammatory bowel disease patients

NARCIS (Netherlands)

De Boer, Angela G. E. M.; Evertsz', Floor Bennebroek; Stokkers, Pieter C.; Bockting, Claudia L.; Sanderman, Robbert; Hommes, Daniel W.; Sprangers, Mirjam A. G.; Frings-Dresen, Monique H. W.

2016-01-01

ObjectivesTo assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression.Materials and methodsIBD patients attending an IBD outpatients'

How nurses and their work environment affect patient experiences of the quality of care: a qualitative study

Science.gov (United States)

2014-01-01

Background Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what factors within the nursing work environment are of influence. The main focus of this research was to comprehend the views of Dutch nurses on how their work and their work environment contribute to positive patient experiences. Methods A descriptive qualitative research design was used to collect data. Four focus groups were conducted, one each with 6 or 7 registered nurses in mental health care, hospital care, home care and nursing home care. A total of 26 nurses were recruited through purposeful sampling. The interviews were audiotaped, transcribed and subjected to thematic analysis. Results The nurses mentioned essential elements that they believe would improve patient experiences of the quality of nursing care: clinically competent nurses, collaborative working relationships, autonomous nursing practice, adequate staffing, control over nursing practice, managerial support and patient-centred culture. They also mentioned several inhibiting factors, such as cost-effectiveness policy and transparency goals for external accountability. Nurses feel pressured to increase productivity and report a high administrative workload. They stated that these factors will not improve patient experiences of the quality of nursing care. Conclusions According to participants, a diverse range of elements affect patient experiences of the quality of nursing care. They believe that incorporating these elements into daily nursing practice would result in more positive patient experiences. However, nurses work in a healthcare context in which they have to reconcile cost-efficiency and accountability with their desire to provide nursing care that is based on patient needs and preferences, and

Health care costs, work productivity and activity impairment in non-malignant chronic pain patients

DEFF Research Database (Denmark)

Kronborg, Christian; Handberg, Gitte; Axelsen, Flemming

2009-01-01

This study explores the costs of non-malignant chronic pain in patients awaiting treatment in a multidisciplinary pain clinic in a hospital setting. Health care costs due to chronic pain are particular high during the first year after pain onset, and remain high compared with health care costs be...... before pain onset. The majority of chronic pain patients incur the costs of alternative treatments. Chronic pain causes production losses at work, as well as impairment of non-work activities.......This study explores the costs of non-malignant chronic pain in patients awaiting treatment in a multidisciplinary pain clinic in a hospital setting. Health care costs due to chronic pain are particular high during the first year after pain onset, and remain high compared with health care costs...

Working memory dysfunctions predict social problem solving skills in schizophrenia.

Science.gov (United States)

Huang, Jia; Tan, Shu-ping; Walsh, Sarah C; Spriggens, Lauren K; Neumann, David L; Shum, David H K; Chan, Raymond C K

2014-12-15

The current study aimed to examine the contribution of neurocognition and social cognition to components of social problem solving. Sixty-seven inpatients with schizophrenia and 31 healthy controls were administrated batteries of neurocognitive tests, emotion perception tests, and the Chinese Assessment of Interpersonal Problem Solving Skills (CAIPSS). MANOVAs were conducted to investigate the domains in which patients with schizophrenia showed impairments. Correlations were used to determine which impaired domains were associated with social problem solving, and multiple regression analyses were conducted to compare the relative contribution of neurocognitive and social cognitive functioning to components of social problem solving. Compared with healthy controls, patients with schizophrenia performed significantly worse in sustained attention, working memory, negative emotion, intention identification and all components of the CAIPSS. Specifically, sustained attention, working memory and negative emotion identification were found to correlate with social problem solving and 1-back accuracy significantly predicted the poor performance in social problem solving. Among the dysfunctions in schizophrenia, working memory contributed most to deficits in social problem solving in patients with schizophrenia. This finding provides support for targeting working memory in the development of future social problem solving rehabilitation interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Analyzing the attributes of surgeons and working environment required for a successful career path and work-life balance: results of a survey administered to doctors working at Kyoto University Hospital].

Science.gov (United States)

Okoshi, Kae; Tanabe, Tomoko; Hisamoto, Norio; Sakai, Yoshiharu

2012-05-01

We conducted a survey in March 2010 of all physicians at Kyoto University Hospital on working environments, levels of satisfaction, and level of exhaustion. A comparison of surgeons with other physicians showed tendencies among surgeons toward longer working hours and lower income. The findings indicated that surgeons experienced satisfaction from teamwork with fellow physicians, opportunities to manage interesting cases, and patient gratitude. Surgeons tended to have low fatigue level and were satisfied with their working environments, despite their low wages and long working hours. Although surgical treatment is currently built upon the feelings of accomplishment and satisfaction of individual surgeons, there is always a limit to his/her psychological strength. Indeed, the number of young surgeons is not increasing. In the future, efforts must be taken to prevent the departure of currently practicing surgeons. Consideration must also be given to reducing nonsurgical duties by increasing the numbers of medical staff, and making work conditions more appealing to young surgeons by guaranteeing income and prohibiting long working hours, particularly consecutive working hours.

Study on EEG power and coherence in patients with mild cognitive impairment during working memory task

Institute of Scientific and Technical Information of China (English)

JIANG Zheng-yan

2005-01-01

To investigate the features of electroencephalography (EEG) power and coherence at rest and during a working memory task of patients with mild cognitive impairment (MCI). Thirty-five patients (17 males, 18 females; 52～71 years old) and 34 sex- and age-matched controls (17 males, 17 females; 51～63 years old) were recruited in the present study. Mini-Mental State Examination (MMSE) of 35 patients with MCI and 34 normal controls revealed that the scores of MCI patients did not differ significantly from those of normal controls (P＞0.05). Then, EEGs at rest and during working memory task with three levels of working memory load were recorded. The EEG power was computed over 10 channels: right and left frontal (F3, F4), central (C3,C4), parietal (P3, P4), temporal (TS, T6) and occipital (O1, O2); inter-hemispheric coherences were computed from five electrode pairs of F3-F4, C3-C4, P3-P4, T5-T6 and O1-O2 for delta (1.0～3.5 Hz), theta (4.0～7.5 Hz), alpha-1 (8.0～10.0 Hz), alpha-2 (10.5～13.0 Hz), beta-1 (13.5～18.0 Hz) and beta-2 (18.5～30.0 Hz) frequency bands. All values of the EEG power of MCI patients were found to be higher than those of normal controls at rest and during working memory tasks. Furthermore, the values of EEG power in the theta, alpha-1, alpha-2 and beta-1 bands of patients with MCI were significantly high (P＜0.05) in comparison with those of normal controls. Correlation analysis indicated a significant negative correlation between the EEG powers and MMSE scores. In addition, during working memory tasks, the EEG coherences in all bands were significantly higher in the MCI group in comparison with those in the control group (P＜0.05). However, there was no significant difference in EEG coherences between two groups at rest. These findings comprise evidence that MCI patients have higher EEG power at rest, and higher EEG power and coherence during working conditions. It suggests that MCI may be associated with compensatory processes at

How Home Health Nurses Plan Their Work Schedules: A Qualitative Descriptive Study.

Science.gov (United States)

Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H

2018-06-12

To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Qualitative descriptive design. Semi-structured interviews were conducted with 20 registered nurses who had greater than 2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analyzed using conventional content analysis. Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritize visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organizational priorities to facilitate continuity of care and support nurses while alleviating the burnout

Social working memory: Neurocognitive networks and directions for future research

Directory of Open Access Journals (Sweden)

Meghan L Meyer

2012-12-01

Full Text Available Navigating the social world requires the ability to maintain and manipulate information about people’s beliefs, traits, and mental states. We characterize this capacity as social working memory. To date, very little research has explored this phenomenon, in part because of the assumption that general working memory systems would support working memory for social information. Various lines of research, however, suggest that social cognitive processing relies on a neurocognitive network (i.e., the ‘mentalizing network’ that is functionally distinct from, and considered antagonistic with, the canonical working memory network. Here, we review evidence suggesting that demanding social cognition requires social working memory and that both the mentalizing and canonical working memory neurocognitive networks support social working memory. The neural data run counter to the common finding of parametric decreases in mentalizing regions as a function of working memory demand and suggest that the mentalizing network can support demanding cognition, when it is demanding social cognition. Implications for individual differences in social cognition and pathologies of social cognition are discussed.

Factors associated with work productivity among people with COPD: Birmingham COPD Cohort.

Science.gov (United States)

Rai, Kiran K; Adab, Peymané; Ayres, Jon G; Siebert, W Stanley; Sadhra, Steven S; Sitch, Alice J; Fitzmaurice, David A; Jordan, Rachel E

2017-12-01

Patients with chronic obstructive pulmonary disease (COPD) are more likely to take time off work (absenteeism) and report poor performance at work (presenteeism) compared to those without COPD. Little is known about the modifiable factors associated with these work productivity outcomes. To assess the factors associated with work productivity among COPD patients. Cross-sectional analysis of baseline data from a subsample (those in paid employment) of the Birmingham COPD Cohort study. Absenteeism was defined by self-report over the previous 12 months. Presenteeism was assessed using the Stanford Presenteeism Scale. Logistic regression analysis was used to assess the effects of sociodemographic, clinical and occupational characteristics on work productivity. Among 348 included participants, increasing dyspnoea was the only factor associated with both absenteeism and presenteeism (p for trend<0.01). Additionally, increasing history of occupational exposure to vapours, gases, dusts or fumes (VGDF) was independently associated with presenteeism (p for trend<0.01). This is the first study to identify important factors associated with poor work productivity among patients with COPD. Future studies should evaluate interventions aimed at managing breathlessness and reducing occupational exposures to VGDF on work productivity among patients with COPD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Quality of life of patients with asthma related to damp and moldy work environments.

Science.gov (United States)

Karvala, Kirsi; Uitti, Jukka; Luukkonen, Ritva; Nordman, Henrik

2013-01-01

Long-term outcomes of asthma related to exposure to workplace dampness are not well known. The aim of this study was to evaluate the quality of life (QOL) of patients with asthma related to damp and moldy workplaces and characterize factors influencing QOL. Using a questionnaire, we followed 1267 patients previously examined for suspected occupational respiratory disease related to exposure to damp and moldy indoor environments. In addition to demographic and other background data, the questionnaire included sections on current employment status, QOL, anxiety and depression, somatization, hypochondria, and asthma medication. We compared the QOL of patients with occupational asthma (OA) with that of patients with work-exacerbated asthma (WEA) or symptoms without asthma. Impaired QOL was found among patients diagnosed with OA when they were compared with patients in corresponding environments with WEA or symptoms only. Not working and greater use of asthma medication were major determinants of worse QOL. Psychological factors did not explain the differences between the groups. OA induced by exposure to workplace moisture and molds is associated with QOL deterioration. The impairment is related to being unemployed (due to disability, retirement, job loss or other reasons) and the need for medication.

Workplace phobia, workplace problems, and work ability among primary care patients with chronic mental disorders.

Science.gov (United States)

Muschalla, Beate; Linden, Michael

2014-01-01

Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia. A convenience sample of 288 primary care patients with chronic mental disorders (70% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed. Workplace phobia was found in 10% of patients with chronic mental disorders, that is, approximately about 3% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life. Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints. © Copyright 2014 by the American Board of Family Medicine.

Team dynamics, clinical work satisfaction, and patient care coordination between primary care providers: A mixed methods study.

Science.gov (United States)

Song, Hummy; Ryan, Molly; Tendulkar, Shalini; Fisher, Josephine; Martin, Julia; Peters, Antoinette S; Frolkis, Joseph P; Rosenthal, Meredith B; Chien, Alyna T; Singer, Sara J

Team-based care is essential for delivering high-quality, comprehensive, and coordinated care. Despite considerable research about the effects of team-based care on patient outcomes, few studies have examined how team dynamics relate to provider outcomes. The aim of this study was to examine relationships among team dynamics, primary care provider (PCP) clinical work satisfaction, and patient care coordination between PCPs in 18 Harvard-affiliated primary care practices participating in Harvard's Academic Innovations Collaborative. First, we administered a cross-sectional survey to all 548 PCPs (267 attending clinicians, 281 resident physicians) working at participating practices; 65% responded. We assessed the relationship of team dynamics with PCPs' clinical work satisfaction and perception of patient care coordination between PCPs, respectively, and the potential mediating effect of patient care coordination on the relationship between team dynamics and work satisfaction. In addition, we embedded a qualitative evaluation within the quantitative evaluation to achieve a convergent mixed methods design to help us better understand our findings and illuminate relationships among key variables. Better team dynamics were positively associated with clinical work satisfaction and quality of patient care coordination between PCPs. Coordination partially mediated the relationship between team dynamics and satisfaction for attending clinicians, suggesting that higher satisfaction depends, in part, on better teamwork, yielding more coordinated patient care. We found no mediating effects for resident physicians. Qualitative results suggest that sources of satisfaction from positive team dynamics for PCPs may be most relevant to attending clinicians. Improving primary care team dynamics could improve clinical work satisfaction among PCPs and patient care coordination between PCPs. In addition to improving outcomes that directly concern health care providers, efforts to

Impaired Working Memory Updating for Emotional Stimuli in Depressed Patients.

Science.gov (United States)

Zhang, Dandan; Xie, Hui; He, Zhenhong; Wei, Zhaoguo; Gu, Ruolei

2018-01-01

Although two previous studies have demonstrated that depressed individuals showed deficits in working memory (WM) updating of both negative and positive contents, the effects were confounded by shifting dysfunctions and the detailed neural mechanism associated with the failure in N-back task is not clear. Using a 2-back task, the current study examined the WM updating of positive, negative and neutral contents in depressed patients. It is found that depressed patients performed poorer than healthy controls only when updating positive material. Using event-related potential (ERP) technique, the current study also investigated the neural correlates of updating deficits in depression. According to previous studies, the n-back task was divided into three sub-processes, i.e., encoding, matching and maintaining. Our ERP results showed that depressed patients had smaller occipital P1 for positive material compared to healthy controls, indicating their insensitivity to positive items on early encoding stage. Besides, depressed patients had larger frontal P2 and parietal late positive potential (LPP) than healthy controls irrespective of the valence of the words, reflecting that patients are inefficient during matching (P2) and maintaining (LPP) processes. These two mechanisms (insufficient attention to positive stimuli and low efficiency in matching and maintaining) together lead to the deficits of WM updating in depression.

Quality of life and work productivity impairment among psoriasis patients: findings from the National Psoriasis Foundation survey data 2003-2011.

Science.gov (United States)

Armstrong, April W; Schupp, Clayton; Wu, Julie; Bebo, Bruce

2012-01-01

To ascertain impairment in quality of life and work productivity among patients with psoriasis and psoriatic arthritis. From 2003 through 2011, the National Psoriasis Foundation collected survey data from patients with psoriasis and psoriatic arthritis via email and telephone correspondences. Survey data were collected from psoriasis and psoriatic arthritis patients in the general community in the U.S. Quality of life focusing on emotional impact (anger, frustration, helplessness, etc.) and physical impact (pain, pruritus, physical irritation, etc.); employment status. The surveys were performed through random sampling of participants from a database of over 75,000 patients. From 2003 to 2011, 5,604 patients completed the surveys. Psoriasis and psoriatic arthritis affected overall emotional wellbeing in 88% of patients, and they interfered with enjoyment of life in 82%. Most patients reported experiencing anger (89%), frustration (89%), helplessness (87%), embarrassment (87%), and self-consciousness (89%). Many patients also actively concealed physical manifestations of their diseases (83%), and experienced pain (83%) and pruritus (93%) regularly. Of note, 12% of patients were unemployed, and 11% worked part-time. Among unemployed patients, 92% cited psoriasis and/or psoriatic arthritis as the sole reasons for not working. Among working patients, 49% missed work days regularly due to psoriasis. Compared to patients with mild psoriasis, patients with severe psoriasis have 1.8 times greater odds to be unemployed after adjusting for age and gender (Adjusted OR = 1.7, 95% CI 1.4-2.3). Patients with psoriasis and psoriatic arthritis continue to experience significant impairment of quality of life and work productivity.

Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group.

Science.gov (United States)

Collins, Sean; Storrow, Alan B; Albert, Nancy M; Butler, Javed; Ezekowitz, Justin; Felker, G Michael; Fermann, Gregory J; Fonarow, Gregg C; Givertz, Michael M; Hiestand, Brian; Hollander, Judd E; Lanfear, David E; Levy, Phillip D; Pang, Peter S; Peacock, W Frank; Sawyer, Douglas B; Teerlink, John R; Lenihan, Daniel J

2015-01-01

Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures. Copyright © 2015 Elsevier Inc. All rights reserved.

Impairment on a self-ordered working memory task in patients with early-acquired hippocampal atrophy.

Science.gov (United States)

Geva, Sharon; Cooper, Janine M; Gadian, David G; Mishkin, Mortimer; Vargha-Khadem, Faraneh

2016-08-01

One of the features of both adult-onset and developmental forms of amnesia resulting from bilateral medial temporal lobe damage, or even from relatively selective damage to the hippocampus, is the sparing of working memory. Recently, however, a number of studies have reported deficits on working memory tasks in patients with damage to the hippocampus and in macaque monkeys with neonatal hippocampal lesions. These studies suggest that successful performance on working memory tasks with high memory load require the contribution of the hippocampus. Here we compared performance on a working memory task (the Self-ordered Pointing Task), between patients with early onset hippocampal damage and a group of healthy controls. Consistent with the findings in the monkeys with neonatal lesions, we found that the patients were impaired on the task, but only on blocks of trials with intermediate memory load. Importantly, only intermediate to high memory load blocks yielded significant correlations between task performance and hippocampal volume. Additionally, we found no evidence of proactive interference in either group, and no evidence of an effect of time since injury on performance. We discuss the role of the hippocampus and its interactions with the prefrontal cortex in serving working memory. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impairment on a self-ordered working memory task in patients with early-acquired hippocampal atrophy

Directory of Open Access Journals (Sweden)

Sharon Geva

2016-08-01

Full Text Available One of the features of both adult-onset and developmental forms of amnesia resulting from bilateral medial temporal lobe damage, or even from relatively selective damage to the hippocampus, is the sparing of working memory. Recently, however, a number of studies have reported deficits on working memory tasks in patients with damage to the hippocampus and in macaque monkeys with neonatal hippocampal lesions. These studies suggest that successful performance on working memory tasks with high memory load require the contribution of the hippocampus. Here we compared performance on a working memory task (the Self-ordered Pointing Task, between patients with early onset hippocampal damage and a group of healthy controls. Consistent with the findings in the monkeys with neonatal lesions, we found that the patients were impaired on the task, but only on blocks of trials with intermediate memory load. Importantly, only intermediate to high memory load blocks yielded significant correlations between task performance and hippocampal volume. Additionally, we found no evidence of proactive interference in either group, and no evidence of an effect of time since injury on performance. We discuss the role of the hippocampus and its interactions with the prefrontal cortex in serving working memory.

Return to work and quality of life in severely injured patients

NARCIS (Netherlands)

Post, R. B.; Van der Sluis, C. K.; Ten Duis, H. J.

2006-01-01

Background. Little is known about the long-term consequences of severe injuries in terms of return to productivity and quality of life. Methods. In this study we focused on the return to work status and quality of life in 53 severely injured patients (AIS/ISS >= 16, mean ISS 24, range 16 - 54), mean

Return to work and quality of life in severely injured patients

NARCIS (Netherlands)

Post, R. B.; Van der Sluis, C. K.; Ten Duis, H. J.

Background. Little is known about the long-term consequences of severe injuries in terms of return to productivity and quality of life. Methods. In this study we focused on the return to work status and quality of life in 53 severely injured patients (AIS/ISS >= 16, mean ISS 24, range 16 - 54), mean

Factors predicting work outcome in Japanese patients with schizophrenia: role of multiple functioning levels.

Science.gov (United States)

Sumiyoshi, Chika; Harvey, Philip D; Takaki, Manabu; Okahisa, Yuko; Sato, Taku; Sora, Ichiro; Nuechterlein, Keith H; Subotnik, Kenneth L; Sumiyoshi, Tomiki

2015-09-01

Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.

Development of Rasch-based item banks for the assessment of work performance in patients with musculoskeletal diseases.

Science.gov (United States)

Mueller, Evelyn A; Bengel, Juergen; Wirtz, Markus A

2013-12-01

This study aimed to develop a self-description assessment instrument to measure work performance in patients with musculoskeletal diseases. In terms of the International Classification of Functioning, Disability and Health (ICF), work performance is defined as the degree of meeting the work demands (activities) at the actual workplace (environment). To account for the fact that work performance depends on the work demands of the job, we strived to develop item banks that allow a flexible use of item subgroups depending on the specific work demands of the patients' jobs. Item development included the collection of work tasks from literature and content validation through expert surveys and patient interviews. The resulting 122 items were answered by 621 patients with musculoskeletal diseases. Exploratory factor analysis to ascertain dimensionality and Rasch analysis (partial credit model) for each of the resulting dimensions were performed. Exploratory factor analysis resulted in four dimensions, and subsequent Rasch analysis led to the following item banks: 'impaired productivity' (15 items), 'impaired cognitive performance' (18), 'impaired coping with stress' (13) and 'impaired physical performance' (low physical workload 20 items, high physical workload 10 items). The item banks exhibited person separation indices (reliability) between 0.89 and 0.96. The assessment of work performance adds the activities component to the more commonly employed participation component of the ICF-model. The four item banks can be adapted to specific jobs where necessary without losing comparability of person measures, as the item banks are based on Rasch analysis.

Preparation for Future Defuelling and Decommissioning Works on EDF Energy's UK Fleet of Advanced Gas Cooled Reactors

International Nuclear Information System (INIS)

Bryers, John; Ashmead, Simon

2016-01-01

EDF Energy/Nuclear Generation is the owner and operator of 14 Advanced Gas cooled Reactors (AGR) and one Pressurised Water Reactor (PWR), on 8 nuclear stations in the UK. EDF Energy/Nuclear Generation is responsible for all the activities associated with the end of life of its nuclear installations: de-fuelling, decommissioning and waste management. As the first AGR is forecast to cease generation within 10 years, EDF Energy has started planning for the decommissioning. This paper covers: - broad outline of the technical strategy and arrangements for future de-fuelling and decommissioning works on the UK AGR fleet, - high level strategic drivers and alignment with wider UK nuclear policy, - overall programme of preparation and initial works, - technical approaches to be adopted during decommissioning. (authors)

Quality of life of chronic myeloid leukemia patients in Brazil: ability to work as a key factor.

Science.gov (United States)

Hamerschlak, Nelson; de Souza, Carmino; Cornacchioni, Ana Lúcia; Pasquini, Ricardo; Tabak, Daniel; Spector, Nelson; Steagall, Merula

2014-08-01

The purpose of this study was to evaluate the quality of life (QOL) of patients receiving treatment by the public health system in Brazil for chronic myeloid leukemia (CML), a disease requiring daily and strict compliance to oral medication and regular blood and bone marrow controls, which are invasive exams. Between 2008 and 2010, patients with CML were surveyed by telephone. Quality of life was evaluated by the functional assessment of chronic illness therapy (FACIT) tool. The mean QOL among CML patients was 92.53 (out of 124 total points) in the trial outcome index, 78.50 (out of 108) in the general total score, and 130.43 (out of 176) in the leukemia total score. Patients who had the prescriptions recently changed anyway had better QOL general score (p = 0.012) and leukemia-specific score (p = 0.043) than those who remained with the same treatment. Imatinib was not associated with this change in QOL (p > 0.797). The more the patient felt able to work, the higher the scores in all three FACIT scales (p work, while chemotherapy (p = 0.017) and the use of hydroxyurea (p = 0.001) were inversely associated with work capability. A recent change in medication can improve quality of life. The ability to work is an important component of quality of life of patients with CML. Ability to work should be specifically considered in CML treatment.

The relationship among work-family conflict and enhancement, organizational work-family culture, and work outcomes for older working women.

Science.gov (United States)

Gordon, Judith R; Whelan-Berry, Karen S; Hamilton, Elizabeth A

2007-10-01

This article examines the relationship among work-family conflict and enhancement, organizational work-family culture, and four work outcomes for 489 working women over the age of 50. Survey results from two U.S. health care organizations and one U.S. financial services organization indicate that older working women experience differing amounts of work-to-family conflict, family-to-work conflict, work-to-family enhancement, and family-to-work enhancement. Hypotheses relating organizational work-family culture to work-family conflict and enhancement were partially supported, and hypotheses relating conflict and enhancement to four work outcomes were partially supported. Work-to-family conflict and work-to-family enhancement partially mediate the relationship between organizational work-family culture and selected work outcomes. Implications for theory and practice, limitations of this study, and directions for future research are also presented.

The relationship between agreeableness and the development of the working alliance in patients with borderline personality disorder.

Science.gov (United States)