Australian work health and safety policy for the regulation of psychosocial risks: perspectives from key informants

The regulation of psychosocial hazards and risks, for the protection of psychological health, is a highly debated issue within work health and safety (WHS). Increasing work-related psychological illness and injury, alongside growing academic evidence and community awareness, has fuelled the need to better prevent and regulate psychosocial hazards and risks. Research must clarify challenges and improvements to policy and practice from stakeholder perspectives. We conduct a qualitative interview-based investigation with 25 informed participants on the effectiveness of Australian WHS policies for the psychosocial risk regulation. Participants are active in diverse roles including policy development, program implementation, industry advice, and psychosocial risk inspection. Inductive analysis revealed divergent viewpoints that are categorised into three broad themes: (1) scant specificity in the current regulatory WHS policy framework, (2) compliance complexities, and (3) the role of regulators in action. Tension points also emerged between these themes and sub-themes, including: (a) how psychosocial risks should be addressed in legislation, (b) how to establish compliance, and (c) the role of the regulator in evaluating compliance, and facilitating education and better practice. Future research must continue to disseminate knowledge from WHS informants to guide better practice. Researchers should investigate organisational barriers that hinder WHS psychosocial risk regulation

Analytical review of the Australian policy context for work-related psychological health and psychosocial risks

Psychosocial hazards and risks are widely acknowledged to be a serious challenge in WHS. WHS regulatory (hard law) and non-regulatory binding (soft law) policies should strive to engage organisations in psychosocial risk management practices and set a standard for good psychological health in the workplace. Therefore, policies should contain key definitions and aspects of good-practice psychosocial risk management principles. However, at present there has been limited review on policy in this area, despite growing evidence of poor work-related psychological health. Using qualitative methods, the current paper reviews relevant regulatory and non-regulatory policy documents and conducts a gap analysis according to criteria identified in models of good psychosocial risk management practice. The paper extends upon European research by Leka et al. (2015) and examines 39 policies (6 regulatory and 33 non-regulatory) in Australia. We found that most policy documents included psychological health in the objective of the policy. Moreover, non-regulatory policies showed sound coverage of exposure factors and preventive actions and, to a slightly lesser degree, risk assessment. Non-regulatory policy documents scored higher than regulatory policies. Within regulatory policies, there is poor inclusion of risk assessment, preventive action and poor coverage of exposure factors and psychological health outcomes. All policies could be strengthened by including greater coverage of work-related psychological health problems/disorders and associated outcomes. This is a novel review, which contributes to a broader program of research on Australian WHS policy. The next research phase seeks detailed information from WHS experts about the effectiveness and/or implementation of these policies in order to ascertain potential improvements

How Psychosocial Safety Climate Helped Alleviate Work Intensification Effects on Presenteeism during the COVID-19 Crisis? A Moderated Mediation Model

Healthcare sector organizations have long been facing the issue of productivity loss due to presenteeism which is affected by psychosocial safety climate (PSC) and work intensification. Presenteeism has visibly increased among nurses during COVID-19 pandemic period. Grounded in COR theory and sensemaking theory, the current study aimed to examine the role PSC plays as driver or moderator to reduce presenteeism by lessening work intensification over time and the impact of work intensification over time on presenteeism during the COVID-19 pandemic. Adopting a time-lagged research design, this study gathered data from randomly selected registered nurses, practicing in Québec, Canada in two phases, i.e., 800 at Time 1 and 344 at Time 2 through email surveys. The study results showed that (1) PSC reduces presenteeism over time by reducing work intensification at time 1; (2) PSC moderates the relationship between work intensification at time 1 and work intensification at time 2; and (3) PSC as moderator also lessens the detrimental effect of work intensification at time 2 on presenteeism at time 2. Presenteeism among nurses affects their health and psychological well-being. We find that PSC is likely an effective organizational tool particularly in crises situations, by providing an organizational mechanism to assist nurses cope (through a resource caravan, management support) with managing intensified work

Are dietary inequalities among Australian adults changing? a nationally representative analysis of dietary change according to socioeconomic position between 1995 and 2011-13

Abstract Background Increasing inequalities in rates of obesity and chronic disease may be partly fuelled by increasing dietary inequalities, however very few nationally representative analyses of socioeconomic trends in dietary inequalities exist. The release of the 2011–13 Australian National Nutrition and Physical Activity Survey data allows investigation of change in dietary intake according to socioeconomic position (SEP) in Australia using a large, nationally representative sample, compared to the previous national survey in 1995. This study examined change in dietary intakes of energy, macronutrients, fiber, fruits and vegetables among Australian adults between 1995 and 2011–13, according to SEP. Methods Cross-sectional data were obtained from the 1995 National Nutrition Survey, and the 2011–13 National Nutrition and Physical Activity Survey. Dietary intake data were collected via a 24-h dietary recall (n = 17,484 adults) and a dietary questionnaire (n = 15,287 adults). SEP was assessed according to educational level, equivalized household income, and area-level disadvantage. Survey-weighted linear and logistic regression models, adjusted for age, sex/gender and smoking status, examined change in dietary intakes over time. Results Dietary intakes remained poor across the SEP spectrum in both surveys, as evidenced by high consumption of saturated fat and total sugars, and low fiber, fruit and vegetable intakes. There was consistent evidence (i.e. according to ≥2 SEP measures) of more favorable changes in dietary intakes of carbohydrate, polyunsaturated and monounsaturated fat in higher, relative to lower SEP groups, particularly in women. Intakes of energy, total fat, saturated fat and fruit differed over time according to a single SEP measure (i.e. educational level, household income, or area-level disadvantage). There were no changes in intake of total sugars, protein, fiber or vegetables according to any SEP measures. Conclusions There were few changes in dietary intakes of energy, most macronutrients, fiber, fruits and vegetables in Australian adults between 1995 and 2011–13 according to SEP. For carbohydrate, polyunsaturated and monounsaturated fat, more favorable changes in intakes occurred in higher SEP groups. Despite the persistence of suboptimal dietary intakes, limited evidence of widening dietary inequalities is positive from a public health perspective. Trial registration Clinical trials registration: ACTRN12617001045303

Assessing a national work health and safety policy intervention using the psychosocial safety climate framework

Despite support for work health and safety (WHS) policy interventions, the evaluation of their effectiveness has been overlooked. As such, many important policy developments have not been assessed for their impact within jurisdictions and organisations. We addressed this research gap by using the Psychosocial Safety Climate (PSC) framework, theory, measurement tool – the PSC-12, and benchmarks - to investigate the impact of a WHS policy intervention, across Australian jurisdictions, that standardised policy approaches (i.e. harmonisation) and legislated the protection of psychological health. PSC refers to a facet of organisational climate that relates to psychological health and safety and is a predictor of job design and employee health. We investigated perceived organisational PSC across jurisdictions, across time, and contrasted effects between those that did (harmonised) and did not (non-harmonised) adopt the policy. Results showed Time X Group effects for the global PSC measure, indicating a significant difference over time between the harmonised and non-harmonised jurisdictions. Specifically, PSC levels significantly decreased in the non-harmonised jurisdiction over time. Analysis of PSC subscales showed that a significant decline in management commitment and priority, and communication (marginally) in relation to employee psychological health, within the non-harmonised group underpinned these effects. We noted no significant overall PSC change across the harmonised jurisdictions, with the exception that participation and consultation in relation to employee psychological health significantly increased. Results imply that without harmonisation the PSC levels reduced. Future research should seek detailed information regarding policy implementation, regulator perspectives and employer data to compliment results from the PSC-12

Identification of outcomes to inform the development of a core outcome set for surgical innovation:a targeted review of case studies of novel surgical devices

OBJECTIVE: Outcome selection and reporting in studies of novel surgical procedures and devices lacks standardisation, hindering safe and effective evaluation. A core outcome set (COS) to measure and report in all studies of surgical innovation is needed. We explored outcomes in a specific sample of innovative surgical device case studies to identify outcome domains specifically relevant to innovation to inform the development of a COS. DESIGN: A targeted review of 11 purposive selected case studies of innovative surgical devices. METHODS: Electronic database searches in PubMed (July 2018) identified publications reporting the introduction and evaluation of each device. Outcomes were extracted and categorised into domains until no new domains were conceptualised. Outcomes specifically relevant to evaluating innovation were further scrutinised. RESULTS: 112 relevant publications were identified, and 5926 outcomes extracted. Heterogeneity in study type, outcome selection and reporting was observed across surgical devices. Categorisation of outcomes was performed for 2689 (45.4%) outcomes into five broad outcome domains. Outcomes considered key to the evaluation of innovation (n=66; 2.5%) were further categorised as surgeon/operator experience (n=40; 1.5%), unanticipated events (n=15, 0.6%) and modifications (n=11; 0.4%). CONCLUSION: Outcome domains unique to evaluating innovative surgical devices have been identified. Findings have been combined with multiple other data sources relevant to the evaluation of surgical innovation to inform the development of a COS to measure and report in all studies evaluating novel surgical procedures/devices

Sprouty2 in the Dorsal Hippocampus Regulates Neurogenesis and Stress Responsiveness in Rats

Both the development and relief of stress-related psychiatric conditions such as major depression (MD) and post-traumatic stress disorder (PTSD) have been linked to neuroplastic changes in the brain. One such change involves the birth of new neurons (neurogenesis), which occurs throughout adulthood within discrete areas of the mammalian brain, including the dorsal hippocampus (HIP). Stress can trigger MD and PTSD in humans, and there is considerable evidence that it can decrease HIP neurogenesis in laboratory animals. In contrast, antidepressant treatments increase HIP neurogenesis, and their efficacy is eliminated by ablation of this process. These findings have led to the working hypothesis that HIP neurogenesis serves as a biomarker of neuroplasticity and stress resistance. Here we report that local alterations in the expression of Sprouty2 (SPRY2), an intracellular inhibitor of growth factor function, produces profound effects on both HIP neurogenesis and behaviors that reflect sensitivity to stressors. Viral vector-mediated disruption of endogenous Sprouty2 function (via a dominant negative construct) within the dorsal HIP of adult rats stimulates neurogenesis and produces signs of stress resilience including enhanced extinction of conditioned fear. Conversely, viral vector-mediated elevation of SPRY2 expression intensifies the behavioral consequences of stress. Studies of these manipulations in HIP primary cultures indicate that SPRY2 negatively regulates fibroblast growth factor-2 (FGF2), which has been previously shown to produce antidepressant- and anxiolytic-like effects via actions in the HIP. Our findings strengthen the relationship between HIP plasticity and stress responsiveness, and identify a specific intracellular pathway that could be targeted to study and treat stress-related disorders

The importance of different frailty domains in a population based sample in England

Background: The aim was to estimate the prevalence of frailty and relative contribution of physical/balance, nutritive, cognitive and sensory frailty to important adverse health states (falls, physical activity levels, outdoor mobility, problems in self-care or usual activities, and lack of energy or accomplishment) in an English cohort by age and sex. Methods: Analysis of baseline data from a cohort of 9803 community-dwelling participants in a clinical trial. The sample was drawn from a random selection of all people aged 70 or more registered with 63 general practices across England. Data were collected by postal questionnaire. Frailty was measured with the Strawbridge questionnaire. We used cross sectional, multivariate logistic regression to estimate the association between frailty domains and known correlates and adjusted for age. Some models were stratified by sex. Results: Mean age of participants was 78 years (sd 5.7), range 70 to 101 and 47.5% (4653/9803) were men. The prevalence of overall frailty was 20.7% (2005/9671) and there was no difference in prevalence by sex (Odds Ratio 0.98; 95% Confidence Interval 0.89 to 1.08). Sensory frailty was the most common and this was reported by more men (1823/4586) than women (1469/5056; Odds Ratio for sensory frailty 0.62, 95% Confidence Interval 0.57 to 0.68). Men were less likely than women to have physical or nutritive frailty. Physical frailty had the strongest independent associations with adverse health states. However, sensory frailty was independently associated with falls, less frequent walking, problems in self-care and usual activities, lack of energy and accomplishment. Conclusions: Physical frailty was more strongly associated with adverse health states, but sensory frailty was much more common. The health gain from intervention for sensory frailty in England is likely to be substantial, particularly for older men. Sensory frailty should be explored further as an important target of intervention to improve health outcomes for older people both at clinical and population level.This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.08/14/41/DH_/Department of Health/United Kingdom Project number 08/14/41/Health Technology Assessment Programmepre-print, post-print, publisher's version/PD