Differences in health, productivity and quality of care in younger and older nurses

Aim To determine if younger and older hospital employed nurses have differences in their self-reported health, health related productivity and quality of care.Background An understanding of age cohort differences may assist nurse managers in understanding the health related productivity and potential quality of care concerns of their staff.Method A cross-sectional survey design was utilised. There were 1171 usable surveys returned (47% response rate). Nurses over the age of 50 made up 26% of the respondents.Result Older nurses had a higher body mass index (BMI), higher mental well-being, higher pain scores, a 12% higher prevalence of having health problems, and reported a higher health related productivity loss than younger nurses.Implications for nursing management Nurse managers must determine if their older nurses are being given more difficult, complex patients because of their experience. Perhaps older nurses, especially those with health problems, need assignments that require their assessment and critical thinking skills rather than their strength and physical abilities

Inequality, Social Support and Post Disaster Mental Health in Mexico

Disasters highlight the vulnerability of people who have limited access to resources. However, based on research from Mexico, we seek-in the context of disasters-to qualify the generalization that mental health is associated with social inequality and individual socioeconomic status. We collected data on socioeconomic status, social support, and depression in two storm-impacted cities (n=581) and four control cities (n=2,509) in Mexico. Two years after the storms, depression symptomology remained higher for disaster cities than for the control. Social support returned to better than normal levels in one impacted city, Villahermosa, during that period, but not in the other, Teziutlán-the harder hit city. Socioeconomic status appeared to have a small effect on depression, although co-correlation with perceived support suggests that social support is a stronger and more proximate cause, such that socioeconomic status-in addition to having a minor direct affect-may also work indirectly through availability of social support to affect vulnerability

Nurses’ Presenteeism and Its Effects on Self-Reported Quality of Care and Costs

Objective: Although research has been conducted on how nurse staffing levels affect outcomes, there has been little investigation into how the health-related productivity of nurses is related to quality of care. Two major causes of worker presenteeism (reduced on-the-job productivity as a result of health problems) are musculoskeletal pain and mental health issues, particularly depression. This study sought to investigate the extent to which musculoskeletal pain or depression (or both) in RNs affects their work productivity and self-reported quality of care and considered the associated costs.Methods: Using a cross-sectional survey design, a random sample of 2,500 hospital-employed RNs licensed in North Carolina were surveyed using a survey instrument sent by postal mail. Specific measures included questions on individual and workplace characteristics, self-reported quality of care, and patient safety; a numeric pain rating scale, a depression tool (the Patient Health Questionnaire), and a presenteeism tool (the Work Productivity and Activity Impairment Questionnaire: General Health) were also incorporated. A total of 1,171 completed surveys were returned and used for analysis.Results: Among respondents, the prevalence of musculoskeletal pain was 71%; that of depression was 18%. The majority of respondents (62%) reported a presenteeism score of at least 1 on a 0-to-10 scale, indicating that health problems had affected work productivity at least “a little.” Pain and depression were significantly associated with presenteeism. Presenteeism was significantly associated with a higher number of patient falls, a higher number of medication errors, and lower quality-of-care scores. Baseline cost estimates indicate that the increased falls and medication errors caused by presenteeism are expected to cost $1,346 per North Carolina RN and just under$2 billion for the United States annually. Upper-boundary estimates exceed $9,000 per North Carolina RN and$13 billion for the nation annually.Conclusion: More attention must be paid to the health of the nursing workforce to positively influence the quality of patient care and patient safety and to control costs

Factors Related to the Number of Fast Food Meals Obtained by College Meal Plan Students

Objectives: This study tested whether days on campus, financial access through a meal plan, and health consciousness were associated with number of meals that college students obtained from fast food restaurants. Participants and Methods: In April 2013, all students currently enrolled in a meal plan were invited to participate in an online survey (N= 1,246). Students were asked to report the total number of meals eaten in the past week and where they obtained them. Results: Negative binomial regression was used, and it was found that the number of meals obtained from fast food restaurants was positively associated with financial access and negatively associated with health consciousness. An association between days on campus and the number of meals obtained from fast food restaurants was not found. Conclusions: Increasing levels of health consciousness and reducing access to fast food restaurants through flex plans may reduce college students’ consumption of fast food

Does providing nutrition information at vending machines reduce calories per item sold?

In 2010, the United States (US) enacted a restaurant menu labeling law. The law also applied to vending machine companies selling food. Research suggested that providing nutrition information on menus in restaurants might reduce the number of calories purchased. We tested the effect of providing nutrition information and 'healthy' designations to consumers where vending machines were located in college residence halls. We conducted our study at one university in Southeast US (October-November 2012). We randomly assigned 18 vending machines locations (residence halls) to an intervention or control group. For the intervention we posted nutrition information, interpretive signage, and sent a promotional email to residents of the hall. For the control group we did nothing. We tracked sales over 4 weeks before and 4 weeks after we introduced the intervention. Our intervention did not change what the residents bought. We recommend additional research about providing nutrition information where vending machines are located, including testing formats used to present information

Panel regression formulas for stature and body mass estimation in immature human skeletons

Anthropologists require methods for accurately estimating stature and body mass from the human skeleton. Age-structured, generalized Least Squares (LS) regression formulas have been developed to predict stature from femoral length and to predict body mass in immature human remains using the width of the distal metaphysis, midshaft femoral geometry (J), and femoral head diameter. This paper tests the hypothesis that panel regression is an appropriate statistical method for regression modeling of longitudinal growth data, with longitudinal and cross-sectional effects on variance. Reference data were derived from the Denver Growth Study; panel regression was used to create one formula for estimating stature (for individuals 0.5–11.5 years old); two formulas for estimating body mass from the femur in infants and children (0.5–12.5 years old); and one formula for estimating body mass from the femoral head in older subadults (7–17.5 years old). The formulas were applied to an independent target sample of cadavers from Franklin County, Ohio and a large sample of immature individuals from diverse global populations. Results indicate panel regression formulas accurately estimate stature and body mass in immature skeletons, without reference to an independent estimate for age at death. Thus, using panel regression formulas to estimate stature and body mass in forensic and archaeological specimens may reduce second stage errors associated with inaccurate age estimates

Time for change: dyslipidemia management by internal medicine residents

We evaluate the need for monitoring and reinforcement of inpatient dyslipidemia management throughout Internal Medicine residency training. We reviewed 150 randomly selected chest pain admissions by different levels of Internal Medicine trainees at a tertiary care center and classified their risk factors, lipid panels, and treatment measures according to the National Cholesterol Education Program guidelines. Our sample included 99 patients (66%) with dyslipidemia and mismanagement occurred in 63 cases (42%). Interns handled 94 cases, whereas 56 cases were handled by senior residents. The error rate was 38/94 (40%) among interns and 25/56 (45%) among senior residents. A two-sample comparison of binomial proportions resulted in a P-value of 0.614, indicating statistically similar error rates. In conclusion, inpatient lipid management must be promoted at the beginning of postgraduate training, with re-emphasis and monitoring throughout training to ensure coronary heart disease risk reduction and optimal patient care