The Sad State of Healthcare in New Mexico: Healthcare Worker Suicide in New Mexico 2004-2005

THE SAD STATE OF HEALTH CARE IN NEW MEXICO: HEATHCARE WORKER SUICIDE IN NEW MEXICO 2004-2005. KL Bradley*, KD Martinez*, MB Barry**, S Lathrop**, K Fraser***, and K Peters**** * University of New Mexico School of Medicine, Albuquerque, NM, ** New Mexico Office of the Medical Investigator, Albuquerque, NM, *** University of New Mexico School of Medicine, Department of Psychiatry, Albuquerque, NM, **** New Mexico Bureau of Vital Records and Health Statistics, Santa Fe, NM PURPOSE. To determine if there is a statistically significant relationship between suicide and the healthcare occupations in New Mexico for the years 2004-2005. METHODS. We collected suicide and occupational data from the New Mexico Office of the Medical Investigator and the N.M. Bureau of Vital Records and Health Statistics for the years 2004-2005. Other data collected included race, age, veteran status, county of occurrence and residence, location, method, presence of suicide note, toxicology, and psychiatric, medical and other risk factors. Statistical analysis was performed on the data collected. RESULTS. Our database included 658 suicides, including 34 healthcare worker suicides during this two-year period. The suicide rate for healthcare workers (HCWs) in 2004 was higher than the suicide rate of the New Mexico adult population. The suicide rate for HCWs in 2005 was lower than that of the New Mexico adult population. There were significantly more women among the healthcare workers who committed suicide than among the non-healthcare workers. The most commonly represented healthcare professionals among the HCWs who committed suicide were: Nurses, Home Health Aides, Obstetrician/Gynecologists, Laboratory Technicians, Social Workers, and Medical Assistants. Healthcare workers who committed suicide in New Mexico in 2004 and 2005 were 3.7 times more likely to commit suicide by ingesting or injecting medication than the non-healthcare workers who committed suicide during this time frame. CONCLUSION. This study demonstrates that healthcare workers, particularly females, had a higher rate of suicide that the NM adult population in 2004, but not it 2005. Thus, we cannot comment on a trend at this time. Further investigation would be useful in determining the presence of a trend and guiding prevention efforts

A Review of Controlling Motivational Strategies from a Self-Determination Theory Perspective: Implications for Sports Coaches

The aim of this paper is to present a preliminary taxonomy of six controlling strategies, primarily based on the parental and educational literatures, which we believe are employed by coaches in sport contexts. Research in the sport and physical education literature has primarily focused on coaches’ autonomysupportive behaviours. Surprisingly, there has been very little research on the use of controlling strategies. A brief overview of the research which delineates each proposed strategy is presented, as are examples of the potential manifestation of the behaviours associated with each strategy in the context of sports coaching. In line with self-determination theory (Deci & Ryan, 1985; Ryan & Deci, 2002), we propose that coach behaviours employed to pressure or control athletes have the potential to thwart athletes’ feelings of autonomy, competence,and relatedness, which, in turn, undermine athletes’ self-determined motivation and contribute to the development of controlled motives. When athletes feel pressured to behave in a certain way, a variety of negative consequences are expected to ensue which are to the detriment of the athletes’ well-being. The purpose of this paper is to raise awareness and interest in the darker side of sport participation and to offer suggestions for future research in this area

Action heritage: research, communities, social justice

Societies are unequal and unjust to varying degrees and heritage practitioners unavoidably work with, perpetuate and have the potential to change these inequalities. This article proposes a new framework for undertaking heritage research that can be applied widely and purposefully to achieve social justice, and which we refer to as action heritage. Our primary sources are semi-structured conversations we held with some of the participants in three heritage projects in South Yorkshire, UK: members of a hostel for homeless young people, a primary school, and a local history group. We examine ‘disruptions’ in the projects to understand the repositioning of the participants as researchers. The disruptions include introducing a scrapbook for personal stories in the homeless youth project and giving the school children opportunities to excavate alongside professional archaeologists. These disruptions reveal material and social inequalities through perceptible changes in how the projects were oriented and how the participants thought about the research. We draw on this empirical research and theorisations of social justice to develop a new framework for undertaking co-produced research. Action heritage is ‘undisciplinary’ research that privileges process over outcomes, and which achieves parity of participation between academic and community-based researchers through sustained recognition and redistribution

A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

<p>Abstract</p> <p>Background</p> <p>Shared decision making (SDM) is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP) teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care.</p> <p>Methods/Design</p> <p>We will use a qualitative case study and a quantitative survey to capture the macro, meso and micro levels of stakeholders in home care. The case study will follow the knowledge-to-action process framework to evaluate the work of an IP home care team at a Quebec City health center. Sources of data will include one-on-one interviews with patients, family caregivers or surrogates and significant others, and administrators; a focus group of home care health professionals; organizational documents; and government policies and standards. The interview guide for the interviews and the focus group will explore current practices and clinical problems addressed in home care; factors that could influence the implementation of the proposed IP approach to SDM; the face and content validity of the approach; and interventions to facilitate the implementation and evaluation of the approach. The survey will ask 300 health professionals working in home care at the health center to complete a questionnaire based on the Theory of Planned Behaviour that measures their intentions to engage in an IP approach to SDM. We will use our analysis of the individual interviews, the focus group and the survey to elaborate a toolkit for implementing an IP approach to SDM in home care. Finally, we will conduct a pilot study in Alberta to assess the transferability of our findings.</p> <p>Discussion</p> <p>We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering patient-centered care. This study will contribute to the evaluation of IP SDM delivery models in home care. It will also generate practical, policy-oriented knowledge regarding the barriers and facilitators likely to influence the practice of IP SDM in home care.</p

Hypertensive Disorders of Pregnancy and DNA Methylation in Newborns Findings From the Pregnancy and Childhood Epigenetics Consortium

Hypertensive disorders of pregnancy (HDP) are associated with low birth weight, shorter gestational age, and increased risk of maternal and offspring cardiovascular diseases later in life. The mechanisms involved are poorly understood, but epigenetic regulation of gene expression may play a part. We performed meta-analyses in the Pregnancy and Childhood Epigenetics Consortium to test the association between either maternal HDP (10 cohorts; n=5242 [cases=476]) or preeclampsia (3 cohorts; n=2219 [cases=135]) and epigenome-wide DNA methylation in cord blood using the Illumina HumanMethylation450 BeadChip. In models adjusted for confounders, and with Bonferroni correction, HDP and preeclampsia were associated with DNA methylation at 43 and 26 CpG sites, respectively. HDP was associated with higher methylation at 27 (63%) of the 43 sites, and across all 43 sites, the mean absolute difference in methylation was between 0.6% and 2.6%. Epigenome-wide associations of HDP with offspring DNA methylation were modestly consistent with the equivalent epigenome-wide associations of preeclampsia with offspring DNA methylation (R-2=0.26). In longitudinal analyses conducted in 1 study (n=108 HDP cases; 550 controls), there were similar changes in DNA methylation in offspring of those with and without HDP up to adolescence. Pathway analysis suggested that genes located at/near HDP-associated sites may be involved in developmental, embryogenesis, or neurological pathways. HDP is associated with offspring DNA methylation with potential relevance to development.Peer reviewe

A manually annotated Actinidia chinensis var. chinensis (kiwifruit) genome highlights the challenges associated with draft genomes and gene prediction in plants

Most published genome sequences are drafts, and most are dominated by computational gene prediction. Draft genomes typically incorporate considerable sequence data that are not assigned to chromosomes, and predicted genes without quality confidence measures. The current Actinidia chinensis (kiwifruit) 'Hongyang' draft genome has 164\ua0Mb of sequences unassigned to pseudo-chromosomes, and omissions have been identified in the gene models

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist