Strategies for Reducing Occupational Stress and Increasing Productivity

Some business leaders lack strategies to reduce occupational stress and increase productivity. Occupational stress can reduce productivity, damage an organization’s image, and incite a toxic work environment. Grounded in social exchange theory, the purpose of this qualitative single case study was to explore strategies leaders of a Texas based land-management service company use to decrease occupational stress and increase productivity. The participants consisted of five senior leaders with a record of reducing occupational stress and maintaining a profitable portfolio of work. Data were collected via a review of existing literature, semistructured interviews, and a review of company resources. Using Yin’s five-step data analysis approach, three themes emerged: providing direct communication, setting boundaries and expectations, and creating a trust or bond. A key recommendation to leaders, managers, and supervisors is to maintain open, transparent communications with subordinates and colleagues to create a trusting professional relationship. Implications for social change include the potential to reduce occupational stress for employees, thus making companies profitable and prosperous providing opportunities for growth and additional employment

Longitudinal, population-based study of racial/ethnic differences in colorectal cancer survival: impact of neighborhood socioeconomic status, treatment and comorbidity

<p>Abstract</p> <p>Background</p> <p>Colorectal cancer, if detected early, has greater than 90% 5-year survival. However, survival has been shown to vary across racial/ethnic groups in the United States, despite the availability of early detection methods.</p> <p>Methods</p> <p>This study evaluated the joint effects of sociodemographic factors, tumor characteristics, census-based socioeconomic status (SES), treatment, and comorbidities on survival after colorectal cancer among and within racial/ethnic groups, using the SEER-Medicare database for patients diagnosed in 1992–1996, and followed through 1999.</p> <p>Results</p> <p>Unadjusted colorectal cancer-specific mortality rates were higher among Blacks and Hispanic males than whites (relative rates (95% confidence intervals) = 1.34 (1.26–1.42) and 1.16 (1.04–1.29), respectively), and lower among Japanese (0.78 (0.70–0.88)). These patterns were evident for all-cause mortality, although the magnitude of the disparity was larger for colorectal cancer mortality. Adjustment for stage accounted for the higher rate among Hispanic males and most of the lower rate among Japanese. Among Blacks, stage and SES accounted for about half of the higher rate relative to Whites, and within stage III colon and stages II/III rectal cancer, SES completely accounted for the small differentials in survival between Blacks and Whites. Comorbidity did not appear to explain the Black-White differentials in colorectal-specific nor all-cause mortality, beyond stage, and treatment (surgery, radiation, chemotherapy) explained a very small proportion of the Black-White difference. The fully-adjusted relative mortality rates comparing Blacks to Whites was 1.14 (1.09–1.20) for all-cause mortality and 1.21 (1.14–1.29) for colorectal cancer specific mortality. The sociodemographic, tumor, and treatment characteristics also had different impacts on mortality within racial/ethnic groups.</p> <p>Conclusion</p> <p>In this comprehensive analysis, race/ethnic-specific models revealed differential effects of covariates on survival after colorectal cancer within each group, suggesting that different strategies may be necessary to improve survival in each group. Among Blacks, half of the differential in survival after colorectal cancer was primarily attributable to stage and SES, but differences in survival between Blacks and Whites remain unexplained with the data available in this comprehensive, population-based, analysis.</p

Up/down impurity density asymmetries in C-Mod plasmas

Brightness profiles of x-ray emission from H-like Ar17+ exhibit a distinct up/down asymmetry under certain operating conditions in C-Mod plasmas, indicating that impurity densities are not constant on flux surfaces with r/a between  ~0.8 and  ~0.95. In L- and I-mode plasmas, there is an x-ray brightness excess, up to a factor of 8, on the side opposite to the ion B  ×   B drift direction. This effect is not observed in H-mode plasmas, presumably due to edge impurity transport being dominated by a strong inward pinch, which is absent in L- and I-mode. The magnitude of the asymmetry in L- and I-mode decreases with increasing plasma current, similar to the observed decrease in radial impurity diffusivity. In I-mode, where the codependence between electron density and temperature can be broken with ICRF heating power, the asymmetry magnitude is found to decrease with increasing density and with increasing edge temperature at fixed density. These measurements exhibit some qualitative features of neo-classical expectations but the observed asymmetry magnitude is much larger than predicted and some scalings with plasma parameters are not seen. The up/down asymmetry appears to be largest when the cross field impurity diffusivity is the highest

Up/down impurity density asymmetries in C-Mod plasmas

Brightness profiles of x-ray emission from H-like Ar17+ exhibit a distinct up/down asymmetry under certain operating conditions in C-Mod plasmas, indicating that impurity densities are not constant on flux surfaces with r/a between  ~0.8 and  ~0.95. In L- and I-mode plasmas, there is an x-ray brightness excess, up to a factor of 8, on the side opposite to the ion B  ×   B drift direction. This effect is not observed in H-mode plasmas, presumably due to edge impurity transport being dominated by a strong inward pinch, which is absent in L- and I-mode. The magnitude of the asymmetry in L- and I-mode decreases with increasing plasma current, similar to the observed decrease in radial impurity diffusivity. In I-mode, where the codependence between electron density and temperature can be broken with ICRF heating power, the asymmetry magnitude is found to decrease with increasing density and with increasing edge temperature at fixed density. These measurements exhibit some qualitative features of neo-classical expectations but the observed asymmetry magnitude is much larger than predicted and some scalings with plasma parameters are not seen. The up/down asymmetry appears to be largest when the cross field impurity diffusivity is the highest

A Picture is Worth a Thousand Words: Practical Use of Videotape in Teaching

Videotapes, through vividly displayed clinical images and teaching interactions, are valuable tools for both learners and teachers. Visual images in combination with verbal instruction have been shown to significantly increase recall and retention. Many clinicians and medical teachers are aware of videotape resources, but have not had a chance to develop their use in medical education. In this paper, we discuss creative applications of videotapes in three major categories: presenting information, triggering discussion, and as a tool for direct self-observation and feedback. Videotapes may be valuable for presenting information in settings of didactic instruction; for triggering discussion during teaching workshops; and for self-observation of patient-doctor interactions and learner-teacher encounters. The article presents learner-centered approaches to review a videotaped clinical encounter in order to enhance value and comfort for the learner and teacher. Sources of tapes include on-site videotaping, published educational tapes and commercial tapes shown in accordance with fair use guidelines, examples of which are referenced. Videotapes add another dimension to traditional sources of physician education

Phase 2 study of bosutinib, a Src inhibitor, in adults with recurrent glioblastoma

BACKGROUND: Tumor cell infiltration is a major mechanism of treatment escape in glioblastoma. Src is an intracellular tyrosine kinase that mediates tumor cell motility and invasiveness. We evaluated the efficacy and safety of bosutinib, a tyrosine kinase inhibitor that potently inhibits Src and Abl, in patients with recurrent glioblastoma. METHODS: In this two-arm study, patients with histologically confirmed recurrent glioblastoma and ≤ 2 relapses, not previously treated with anti-vascular endothelial growth factor therapy, were administered oral bosutinib 400 mg daily. Arm A planned for 6 patients who were candidates for surgical resection to be given bosutinib for 7-9 days prior to resection. Arm B was a two-stage design phase 2 trial targeting 30 patients. The primary endpoint was progression-free survival at 6 months (PFS6) in Arm B. RESULTS: After 9 patients enrolled onto stage 1 of Arm B, 9 (100%) patients progressed within 6 months. Therefore, the study met the pre-specified criteria for early closure and both Arms were closed. In Arm B, Median PFS was 7.71 weeks and median OS was 50 weeks. Best objective response was stable disease in one patient (11.1%). Seven patients (77.8%) had treatment-related AEs of any grade and 2 (22.2%) were grade ≥3. Arm A was closed after 2 patients enrolled. Src activation was evident in all archival tumor samples. CONCLUSION: Bosutinib monotherapy does not appear to be effective in recurrent glioblastoma. However, Src remains a potential target based on its upregulation in tumor samples and role in glioma invasion