Cost Burden of the ‘Presenteeism’ Health Outcome in a Diverse Nurse and Pharmacist Workforce: Practice Models and Health Policy Implications

The complex phenomenon of presenteeism is an undesirable health outcome that occurs when employees remain present on-the-job with lowered work productivity caused by personal health conditions. The cost burden of presenteeism in healthcare professionals has been under-explored and the cost burden of presenteeism across racial and ethnic minority employees has been un-explored. Aims of this research were to describe presenteeism and its cost burden among nurses and pharmacists and to determine distinctness of differences across racial/ethnic groups within these professions. In exploring presenteeism, the focus was on recognizing it, characterizing it, and measuring it. In monetizing presenteeism, its costs burden from the perspective of the employer was determined at the broader workforce level. This analytical study entailed an on-line survey of a cross-sectional, convenience sample of 226 nurses and pharmacist stratified by race and ethnicity (23% minorities and 77% non-minorities). Wellness-at-Work, a patient reported outcomes (PRO) tool that adopted presenteeism scales from two well established presenteeism surveys were administered. Contingency tables using Chi-square tests established association or differences by profession or race. Ordinal logistic regression modeled 12 predictors of presenteeism and the human capital approach determined cost burden. Over half, 52.65%, of the sample (226) reported experiencing presenteeism -- 47.06% nurses and 52.94% pharmacists. Mean rate of reported presenteeism was 13.2%. Presenteeism was the driver of annual lost productivity valued at $12,700 per nurse or pharmacist, a workforce value of$2.6 million loss. The likelihood of presenteeism increased 22.4% if professionals suffered physical health symptoms, increased 22.5% if they suffered mental health conditions, decreased 34% if their physical and mental health conditions were never treated by pharmacotherapy, and decreased 29% if their mental or physical health conditions were previously treated by pharmacotherapy (but not currently treated). Both professions had significant self-reported mental health conditions and physical health symptoms. Physical health symptoms significantly associated with presenteeism were: feeling tired or no energy; back or neck pain; pain in arms, legs, joints; watery eyes, runny nose or stuffy head; trouble sleeping; headaches; muscle soreness; cough or sore throat; fever, chills, or other cold/flu; constipation, loose bowels, or diarrhea; and nausea, gas, or indigestion. Depression and anxiety were more prevalent conditions than the common cold or flu symptoms in these knowledge-based professions and mental health conditions were a significant predictor of presenteeism. Rates of presenteeism between racial and ethnic non-minority and minority groups and rates between nurses and pharmacists were not found to be significantly different (p=.5774 and p=0.4282 respectively). Of note is that rates of presenteeism for racial ethnic minorities were slightly lower than non-minorities, but not statistically significantly so. The imperative for individual health care employers was to address workforce cost burden by being the catalyst for developing creative practice models and changing health policies

On the complex index of refraction of bulk materials

As a part of the investigation of classical reflectance, it is determined that the hemispherical reflectance for a material with a particular pair of optical constants can be approximated by computing the angular reflectance at sixty degrees, using Fresnel\u27s generalized reflectance formulas. Reflection methods for the purpose of determining the optical constants of a variety of materials are discussed. The unpolarized reflectance versus angle of incidence technique is used for determination of the optical constants of bulk solids. Restrictions on the simultaneous solution of the Fresnel equations are determined and a computer program is developed to compute values necessary to plot the isoreflectance curves. Error studies are carried out for the case of the optical constants close to those of aluminum at 0.59µ to determine the effects of small errors in the reflectance values on the resulting values of n and k. The method is applied to the case of an aluminum first surface laboratory mirror and the optical constants are determined to be 1.09 and 6.37 in the wavelength range around 0.55µ --Abstract, page ii

Older Women, Younger Men: Self and Stigma in Age-Discrepant Relationships

This study, based on intensive interviews with married, cohabiting and divorced older women and younger men, explores the impact of this type of age discrepancy on relationships and selves. Both the women and the men were aware of the stigmatizing potential of their relationships, in particular that the woman might be mistaken for the man\u27s mother (which indeed sometimes happened). Although the couples\u27 fear of audience response lessened over time, the impact of stigma on their sense of self remained. For the woman, her embodied self—body and face—was most problematic, and increasingly so as she aged. For the man, it was the cohort self: his lack of shared history with his wife, distance from his age peers, and precipitation into other age-discrepant roles, such as grandfather. Both men and women developed techniques of neutralization to counter stigma, techniques which were challenged only under conditions of divorce or marital problems and clinical intervention

Clinical Research Interviewing in Sociology

This paper explores the interpenetration of clinical and research interviewing processes in research interviews The data are interviews with 17 women diagnosed as schizophrenic, and with their husbands, over the period 1957-1961. The interviews began with the first week of admission to Napa state hospital, and ended up to two years after discharge. The respondents were in a situation of medical uncertainty and marital disruption. They utilized both the form and the content of the research interviews in a therapeutic manner, seeking advice, opinions and information from the interviewers. The interviewers, as they had been trained to do, attempted to resist their respondents\u27 demands, not always successfully

GLASS SHOULDERS

Glass Shoulders is a collection of poems that embody events from my life which have served as catalysts in the process of integrating myself emotionally, psychologically, and spiritually. In the poetry, the speaker searches for spiritual knowledge, and is guided toward meditation of Spirit as an internal reality to find healing. The narrative of the manuscript portrays the speaker’s deep introspection of self, exploring loss and resiliency through challenges surrounding grief, unrecovered abuses, and mood disorders. The inspiration for these poems arose from my contemplations on the incongruities between fate and free will, and how behaviors are influenced by the attitude of each. The poems explore her innermost conflicts as she contemplates whether she is director of her own destiny, or subject to a predestined fate, and seek to illumine how these differences effect her choices, behaviors, and attitude towards Spirit. The speaker is bipolar, and the paradox of the book debates whether the union of her polar selves is the ingredient to healing her phobias and disconnections, granting Spirit integration, or do her fractured selves support greater sensory experience that enhance her perceptions of self and Spirit toward new levels of recognition. The poems contain a variety of humor, tone, and voice. The humor in the poetry is unconscious to the speaker and shields her from her sense of loss and separation from her partner, her family, and divinity. At times she appears sarcastic and flippant, curious and gullible, yet always there is an undercurrent of deep thought. My visions and images for the poems are sourced from the philosophies of metaphysics, and are inspired by both Western and Eastern teachings of mysticism and myth that leads to Self-realization, or God-communion. It is through my studies of these sciences and methodologies that I have sourced my life long aspirations of spiritual knowledge for greater understanding of the human condition. Glass Shoulders is my attempt to show Self-realization as a gnosis of healing. This is a tale of freedom of psyche

Survey of canteens and food services in Victorian schools

Objective: To examine the characteristics of food services in Victorian government primary and secondary schools. Design and methods: A cross-sectional postal survey of all high schools and a random sample of one quarter of primary school respondents in Victoria. A `School Food Services and Canteen\u27 questionnaire was administered by mail to the principal of each school. Subjects: Respondents included principals, canteen managers and home economics teachers from 150 primary and 208 secondary schools representing response rates of 48% and 67%, respectively. Main outcome measures: Responses to closed questions about school canteen operating procedures, staff satisfaction, food policies and desired additional services. Data analyses: Frequency and cross-tabulation analyses and associated &chi;&sup2;-tests. Results: Most schools provided food services at lunchtime and morning recess but one-third provided food before school. Over 40% outsourced their food services, one-third utilised volunteer parents, few involved students in canteen operations. Half of the secondary schools had vending machines; one in five had three or more. Secondary school respondents were more dissatisfied with the nutritional quality of the food service, and expressed more interest in additional services than primary respondents. Schools with food policies wanted more service assistance and used volunteer parents, student and paid canteen managers more than schools without policies. Conclusion: Most schools want to improve the nutritional quality of their food services, especially via school food policies. There is a major opportunity for professional organisations to advocate for the supply of healthier school foods.<br /

The Dangerous Listener: Unforseen Perils in Intensive Interviewing

We suggest that interviewers become dangerous by the simple act of listening. In dangerous listening, there is a looking-glass effect through which the listener deflects the new or repressing self and reveals the old. The heart of danger is the interviewee\u27s self reflected back from the interviewer\u27s relationship to the past self. The data are drawn from two sets of intensive interviews, one with female mental patients-to-expatients in the 1950s in California (see Warren, 1987), and one with ex-Vietnam veterans on a trauma ward at a Veterans\u27 administration hospital (see Karner, 1994). In listening, the narrator and the interviewer become participants in witnessing a violation of a social or personal norm. After such an accounting, the listener is seen as the symbolic repository for the narrator\u27s troubled past, constituting a threat of judgment or exposure. These dangers of listening are not only those special biomedical and social dangers involved in the rhetoric of human subjects regulations, they are dangers of an everyday life world in which selves change, and change again

The Triple P-Positive Parenting Programme: A universal population-level approach to the prevention of child abuse

The Triple P-Positive Parenting Programme is described as an example of an evidence-based universal parenting initiative that provides a tiered continuum of interventions of increasing strength but narrowing reach in an effort to make parenting programmes more accessible to parents. Interventions within the system range from the use of the media and brief messages to intensive family interventions for parents where parenting problems are complicated by multiple additional sources of family adversity. Several issues concerning the role of training and organizational factors that influence the successful uptake and implementation of the programme are discussed

Bajau consciousness in social change : the transformation of a Malaysian minority community

The object of this study is to map out the compl ex processes of contemporary social change in a single community of Baj au laut on the northeast coast of Malaysian Borneo (Sabah) and in particular to explore the role of consciousness in transformation. The Bajau case is a most interesting one because of the rapid and radical nature of change and because of the extraordinary flexibility of preexisting social structure·. The most dramatic changes discussed in this thesis took place in the space of less than one generation, effectively between 1960 and 1975. From a semi-nomadic, materially simple and virtually isolated existence prior to this period, Bajau of Bangau -Bangau village have settled, oriented themselves to a money economy and adopted an achievement ethic in lieu of the egalitarian values and shared subsistence of former times