Identifying barriers to implementation of antimicrobial resistance policies: a pilot study in a lower-middle-income country through cross-disciplinary collaboration

For abstract please see attached document

Healthcare workers ‘on the move’: making visible the employment-related geographic mobility of healthcare workers

Many healthcare workers are ‘on the move’ as part of their employment, travelling often great distances to such places as patients’/clients’ homes and community clinics. Healthcare workers’ experiences of this employment-related geographic mobility have been relatively invisible even though mobility is necessary for home and community care. Interviews with professional (e.g. nurses) and paraprofessional (e.g. personal care assistants) healthcare workers in Nova Scotia (Canada) found that mobility includes safety risks, and health and economic costs, although a few professionals had employment contracts that helped to protect them against such risks and costs. Paraprofessionals appear to be most impacted by the economic costs given their lower incomes. Many healthcare workers also experienced travel positively, as time away from fixed sites, and associated this time with freedom. The risks of mobility were understood by some workers as part of a duty to care, but a few suggested that the health and economic costs are an undue burden, pointing to an opening for challenging these conditions. There is a need for regulations to ensure all healthcare workers are safe as they are mobile to and from fixed sites, and do not have to shoulder the health or economic costs of mobility

The Relationship of Safety with Burnout for Mobile Health Employees

Objective: The study examined the relationship of occupational safety with job burnout. Design: The study used a cross-sectional survey design. Setting: The setting was Nova Scotia, Canada. Participants: Mobile health employees (N = 156) completed surveys on road safety, workload, burnout and supervisor incivility. Main outcome measure: The main outcome measure was the Maslach Burnout Inventory. Results: Results found that safety concerns improved the prediction of exhaustion beyond that provided by workload concerns alone. Further, confidence in safety buffered the relationship of exhaustion with cynicism such that the exhaustion/cynicism relationship was stronger for employees who had lower confidence in road safety. Conclusions: Employees’ confidence in occupational safety while addressing work responsibilities on the road has implications for their experience of job burnou

Cover and contents : “Proceedings of the 14th CEReS Symposium on Enviromental Remote Sensing” February 17, 2012

2012年2月17日（金） 於 千葉大学けやき会

Office Space Bacterial Abundance and Diversity in Three Metropolitan Areas

People in developed countries spend approximately 90% of their lives indoors, yet we know little about the source and diversity of microbes in built environments. In this study, we combined culture-based cell counting and multiplexed pyrosequencing of environmental ribosomal RNA (rRNA) gene sequences to investigate office space bacterial diversity in three metropolitan areas. Five surfaces common to all offices were sampled using sterile double-tipped swabs, one tip for culturing and one for DNA extraction, in 30 different offices per city (90 offices, 450 total samples). 16S rRNA gene sequences were PCR amplified using bar-coded “universal” bacterial primers from 54 of the surfaces (18 per city) and pooled for pyrosequencing. A three-factorial Analysis of Variance (ANOVA) found significant differences in viable bacterial abundance between offices inhabited by men or women, among the various surface types, and among cities. Multiplex pyrosequencing identified more than 500 bacterial genera from 20 different bacterial divisions. The most abundant of these genera tended to be common inhabitants of human skin, nasal, oral or intestinal cavities. Other commonly occurring genera appeared to have environmental origins (e.g., soils). There were no significant differences in the bacterial diversity between offices inhabited by men or women or among surfaces, but the bacterial community diversity of the Tucson samples was clearly distinguishable from that of New York and San Francisco, which were indistinguishable. Overall, our comprehensive molecular analysis of office building microbial diversity shows the potential of these methods for studying patterns and origins of indoor bacterial contamination. “[H]umans move through a sea of microbial life that is seldom perceived except in the context of potential disease and decay.” – Feazel et al. (2009)

Admixture Fine-Mapping in African Americans Implicates XAF1 as a Possible Sarcoidosis Risk Gene

Sarcoidosis is a complex, multi-organ granulomatous disease with a likely genetic component. West African ancestry confers a higher risk for sarcoidosis than European ancestry. Admixture mapping provides the most direct method to locate genes that underlie such ethnic variation in disease risk. We sought to identify genetic risk variants within four previously-identified ancestry-associated regions-6p24.3-p12.1, 17p13.3-13.1, 2p13.3-q12.1, and 6q23.3-q25.2-in a sample of 2,727 African Americans. We used logistic regression fit by generalized estimating equations and the MIX score statistic to determine which variants within ancestry-associated regions were associated with risk and responsible for the admixture signal. Fine mapping was performed by imputation, based on a previous genome-wide association study; significant variants were validated by direct genotyping. Within the 6p24.3-p12.1 locus, the most significant ancestry-adjusted SNP was rs74318745 (p = 9.4*10-11), an intronic SNP within the HLA-DRA gene that did not solely explain the admixture signal, indicating the presence of more than a single risk variant within this well-established sarcoidosis risk region. The locus on chromosome 17p13.3-13.1 revealed a novel sarcoidosis risk SNP, rs6502976 (p = 9.5*10-6), within intron 5 of the gene X-linked Inhibitor of Apoptosis Associated Factor 1 (XAF1) that accounted for the majority of the admixture linkage signal. Immunohistochemical expression studies demonstrated lack of expression of XAF1 and a corresponding high level of expression of its downstream target, X-linked Inhibitor of Apoptosis (XIAP) in sarcoidosis granulomas. In conclusion, ancestry and association fine mapping revealed a novel sarcoidosis susceptibility gene, XAF1, which has not been identified by previous genome-wide association studies. Based on the known biology of the XIAP/XAF1 apoptosis pathway and the differential expression patterns of XAF1 and XIAP in sarcoidosis granulomas, we suggest that this pathway may play a role in the maintenance of sarcoidosis granulomas

The Experience of Choosing Nursing as a Career: Narratives from Millennial Nurses

The critical and growing shortage of nurses is a global concern. The growth and sustainability of the nursing profession depends on the ability to recruit and retain the upcoming generation of professionals. Understanding the career choice experiences of Millennial nurses is a critical component of recruitment and retention strategies. An interpretive, narrative methodology, was used to understand how Millennial explain, account for, and make sense of their choice of nursing as a career. Individual, face to face interviews were conducted with 12 Millennial Nursing students (born 1980 or after), for whom nursing was their preferred career choice. Participants were interviewed twice and chronicled their career choice experiences within reflective journals. Data was analyzed using Polkinghorne’s method of narrative configuration and emplotment. The participants’ narratives present a shift from understanding career choice within a virtuous plot to one of social positioning. Career choice was initially emplotted around a traditional and stereotypical understanding of nursing as a virtuous profession: altruistic, noble, caring, and compassionate. The narrative scripts evolved from positioning nursing as virtuous towards understanding the meaning of career choice in relation to one’s position in the social world. The narratives position career choice in relation to the participants’ desire for autonomy, respect and quality of life. Pragmatic considerations such as lifestyle, job security, salary and social status were also emphasized. The narratives represent career choice as a complex consideration of social positioning, fraught with hopes, dreams, doubts and tensions. The participants’ perceptions and expectations in relation to their future nursing careers were influenced by a historical and stereotypical understanding of nursing; an image that remains prevalent in society. Insight gained from this inquiry can inform recruitment, education, socialization and retention strategies for the upcoming and future generations of nurses.Ph

Working behind bars, prison labour and minimum standards protection in Canada

grantor: University of TorontoWhile prison labour is not readily associated with Canada, the fact is that inmates in Canadian penitentiaries do work while incarcerated. Though inmates work in much the same way as unconfined workers, they are not accorded the same work-related benefits as such "employees". This thesis argues that inmate workers should be treated as "employees" for the purposes of minimum standards legislation. When we examine the aims of minimum standards legislation, as well as those of prison industry, we see that the objectives of both are advanced by applying minimum standards to inmate workers. In order to fairly address the question of prisoners' entitlement to minimum standards protection, it is essential to move beyond thinking of prisoner and employee status as mutually exclusive. Such a view is inconsistent with Canada's legal and jurisprudential framework, and threatens the social policy objectives which underlie minimum standards and possibly other employment-related statutes.LL.M

The Importance of Continuing Professional Development to Career Satisfaction and Patient Care: Meeting the Needs of Novice to Mid- to Late-Career Nurses throughout Their Career Span

This paper provides insights into the role of ongoing training and education on nurses’ career satisfaction across different career stages and their ability to provide quality patient care. Eighteen focus groups were conducted over the course of five months in 2015 (January to May) in eight Canadian provinces. There were a total of 185 focus group participants. Each focus group lasted approximately 1.5 h and included 8–15 participants who self-selected in one of three distinct career stages (students, early-career, mid- to late-career). A thematic analysis of the data revealed that ongoing professional development is an expressed need and expectation for nurses across the various career stages. Student and early-career nurses expected sufficient training and education to facilitate workplace transitions, as well as continuing education opportunities throughout their careers for career laddering. For mid- to late-career nurses, the importance of lifelong learning was understood within the context of maintaining competency, providing quality patient care and enhancing future career opportunities. Training and education were directly linked to nurses’ career satisfaction. Healthy work environments were identified by nurses as those that invested in continuing professional development opportunities to ensure continuous growth in their practice and provide optimal quality patient care. Training and education emerged as a cross-cutting theme across all career stages and held implications for patient care, as well as retention and recruitment