Supporting Employee Lactation: Do U.S. Workplace Lactation Benefit Mandates Align with Evidence-Based Practice?

Within the United States, there are governmental benefits and policies in place to support breastfeeding mothers as they return to work. However, the effectiveness and inclusiveness of these policies is not always clear. Because of this, breastfeeding at work, in general, and governmental workplace mandates, specifically, often receive negative press and social media attention as women struggle to reconcile their workplace and lactation demands. To provide evidence-based recommendations for how to best support breastfeeding employees, we use an organizational science perspective to review the existing research for evidence on the (1) effectiveness of the existing legal benefits and supports within the US, and (2) barriers or facilitators that impact benefit success. Through this, we identify areas for improvement and provide suggestions for policy

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial

Background High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains unclear. We investigated whether transdermal glyceryl trinitrate (GTN; also known as nitroglycerin), a nitric oxide donor, might improve outcome when administered very early after stroke onset. Methods We did a multicentre, paramedic-delivered, ambulance-based, prospective, randomised, sham-controlled, blinded-endpoint, phase 3 trial in adults with presumed stroke within 4 h of onset, face-arm-speech-time score of 2 or 3, and systolic blood pressure 120 mm Hg or higher. Participants were randomly assigned (1:1) to receive transdermal GTN (5 mg once daily for 4 days; the GTN group) or a similar sham dressing (the sham group) in UK based ambulances by paramedics, with treatment continued in hospital. Paramedics were unmasked to treatment, whereas participants were masked. The primary outcome was the 7-level modified Rankin Scale (mRS; a measure of functional outcome) at 90 days, assessed by central telephone follow-up with masking to treatment. Analysis was hierarchical, first in participants with a confirmed stroke or transient ischaemic attack (cohort 1), and then in all participants who were randomly assigned (intention to treat, cohort 2) according to the statistical analysis plan. This trial is registered with ISRCTN, number ISRCTN26986053. Findings Between Oct 22, 2015, and May 23, 2018, 516 paramedics from eight UK ambulance services recruited 1149 participants (n=568 in the GTN group, n=581 in the sham group). The median time to randomisation was 71 min (IQR 45–116). 597 (52%) patients had ischaemic stroke, 145 (13%) had intracerebral haemorrhage, 109 (9%) had transient ischaemic attack, and 297 (26%) had a non-stroke mimic at the final diagnosis of the index event. In the GTN group, participants’ systolic blood pressure was lowered by 5·8 mm Hg compared with the sham group (p<0·0001), and diastolic blood pressure was lowered by 2·6 mm Hg (p=0·0026) at hospital admission. We found no difference in mRS between the groups in participants with a final diagnosis of stroke or transient ischaemic stroke (cohort 1): 3 (IQR 2–5; n=420) in the GTN group versus 3 (2–5; n=408) in the sham group, adjusted common odds ratio for poor outcome 1·25 (95% CI 0·97–1·60; p=0·083); we also found no difference in mRS between all patients (cohort 2: 3 [2–5]; n=544, in the GTN group vs 3 [2–5]; n=558, in the sham group; 1·04 [0·84–1·29]; p=0·69). We found no difference in secondary outcomes, death (treatment-related deaths: 36 in the GTN group vs 23 in the sham group [p=0·091]), or serious adverse events (188 in the GTN group vs 170 in the sham group [p=0·16]) between treatment groups. Interpretation Prehospital treatment with transdermal GTN does not seem to improve functional outcome in patients with presumed stroke. It is feasible for UK paramedics to obtain consent and treat patients with stroke in the ultraacute prehospital setting. Funding British Heart Foundation

Big team science initiatives: A catalyst for trustworthy advancements in IO psychology

Keener et al. (2023) raise concerns about the trustworthiness of Industrial/Organizational (IO) Psychology research and related fields due to the low reproducibility and replicability of research findings. The authors provide various solutions to resolve this crisis, such as improving training, realigning incentives, and adopting open science practices. Our commentary elaborates on one solution to which they briefly allude: Big Team Science Initiatives (BTSIs). BTSIs allow scholars to address the trustworthiness of our science by facilitating large sample theory testing, sharing and allocating resources, and selecting appropriate research strategies, all of which support the reproducibility and replication of research. Further, we propose that BTSIs may facilitate researcher training, encourage data sharing and materials, and realign incentives in our field. We discuss how BTSIs could be implemented in IO psychology and related fields, identifying and drawing upon similar BTSIs in related disciplines. Thus, our commentary is an extension of the focal article, encouraging scholars to collaboratively address the “crisis of confidence” facing our field using a big team science approach

ReproducibiliTea Saint Louis Area

Materials from ReproducibiliTea sessions in Saint Louis Area. Templates and presentations are available for others to use and edit. The purpose of this group is to facilitate informal, multidisciplinary discussions around open science, including the current state of psychological science, reproducibility, and open science practices in both research and applied work

A New Measure of Work-Nonwork Boundary Management

Materials for developing a multidimensional measure of work-nonwork boundary management based on prior scales and measures

Big Team Science Initiatives: A Catalyst for Trustworthy Advancements in I/O Psychology

Commentary to Keener et al., 2023: Keener et al. (2023) raise concerns about the trustworthiness of Industrial/Organizational (IO) Psychology research and related fields due to the low reproducibility and replicability of research findings. The authors provide various solutions to resolve this crisis, such as improving training, realigning incentives, and adopting open science practices. Our commentary elaborates on an additional solution: Big Team Science Initiatives (BTSIs). BTSIs allow scholars to address the trustworthiness of our science by facilitating large sample theory testing, sharing and allocating resources, and selecting appropriate research strategies, all of which support the reproducibility and replication of research. Further, we propose BTSIs could help facilitate and promote researcher training, encourage data sharing and materials, and realign incentives in our field. We discuss how BTSIs could be implemented in IO psychology and related fields, identifying and drawing upon similar BTSIs in related disciplines. Thus, our commentary is an extension of the focal article, encouraging scholars to collaboratively address the “crisis of confidence” facing our field

A Review of the LGBTQ+ Work-Family Interface: What Do We Know and Where Do We Go from Here?

Work-family research has blossomed over the past several decades but mostly remains focused on traditional couples and heteronormative individuals. However, research suggests that LGBTQ+ employees face unique challenges, such as discrimination and stigma, that impact their work-family interface in ways that current work-family research may not be fully capturing. We propose a review and synthesis that summarizes current LGBTQ+ and work-family literature with four primary goals: (1) identify predictors and outcomes of the work-family interface for LGBTQ+ employees, (2) integrate empirical findings and current theory into a recently developed framework to delineate our understanding of LGBTQ+ work-family experiences, (3) provide direction for future research, and (4) provide recommendations on translating the current findings into practice. Our results identify k = 74 studies that cover the work-family interface and LGBTQ+ individuals. This comprehensive and integrated review will help inform researchers on how to best address unique research questions for LGBTQ+ employees and provide employers with empirical evidence as they develop inclusive policies, cultures, and workforces

Supporting employee lactation: Do U.S. workplace lactation benefit mandates align with evidence-based practice?

Feeding infants breastmilk (both directly and via pumping) is a pro-health behavior that has well-documented benefits for the mother and child. Although there are many factors that impact a mother’s decision to initiate and continue breastfeeding (e.g., family norms or health constraints), barriers to lactation at work in the postpartum period consistently predict breastfeeding discontinuation. In efforts to support women’s return to work postpartum and their lactation decisions, there are many mandates in the United States across the federal and state levels that provide protection and benefits for working women who are lactating. However, it is currently unclear how these mandates align with best practices of providing support to working mothers identified via organizational research. This Article reviews the federal and state mandates available to understand (1) what benefits/protections are offered, (2) how these benefits align with evidence-based recommendations for supporting lactating women, and (3) where lactating employees are being successfully supported or require additional support

Supporting Employee Lactation: Do U.S. Workplace Lactation Benefit Mandates Align with Evidence-Based Practice?

Within the United States, there are governmental benefits and policies in place to support breastfeeding mothers as they return to work. However, the effectiveness and inclusiveness of these policies is not always clear. Because of this, breastfeeding at work, in general, and governmental workplace mandates, specifically, often receive negative press and social media attention as women struggle to reconcile their workplace and lactation demands. To provide evidence-based recommendations for how to best support breastfeeding employees, we use an organizational science perspective to review the existing research for evidence on the (1) effectiveness of the existing legal benefits and supports within the US, and (2) barriers or facilitators that impact benefit success. Through this, we identify areas for improvement and provide suggestions for policy