Outdoor Workers and Sun Protection: Knowledge and Behaviour

Outdoor workers are at high risk of developing skin cancer. Primary prevention can potentiallyreduce the incidence of skin cancer in this group. This study aimed to determine theknowledge and sun protective behaviour of outdoor workers towards skin cancer. A shortquestionnaire was used to collect data from workers on construction sites during workinghours. Despite workers having knowledge of the risks of skin cancer their use of sun protectionwas less than satisfactory, particularly considering their cumulative exposure.Workplace health education programs for outdoor workers addressing sun protection areindicated, as is further research to increase understanding of issues workers have withsun protection in the workplace

Integration or collision? : middle managers\u27 concerns for work-life balance

As increased work demands and longer working hours become the reality for many employees, the concept of work-life balance has received increasing attention. This paper presents findings from an exploratory study of Australian middle managers, which investigated the impact of middle managers&rsquo; daily organisational experiences on their lives both in and beyond the workplace. We focus on respondents&rsquo; concerns for the encroachment of work on their personal lives, both through the advent of new technologies and the introduction of flexibility initiatives in the workplace. The unwelcome effects of frustration, stress and fatigue highlight the need for organisations to gain a better understanding of employees&rsquo; experiences related to work-life balance.<br /

Lesbian women choosing motherhood: the journey to conception

Increasingly, lesbian women are choosing to have children in the context of a same-sex relationship, and their journey to conception and on to motherhood involves a range of decisions that are unique to lesbian couples. While creating a de novo family is burdened with decisions, choosing to be parents was a deliberate and conscious decision made by lesbian women participating in our study. The findings presented in this article focus on choosing which partner would be pregnant, donor decisions, as well as methods of conception used by lesbian women participating in a qualitative study that examined the experiences of lesbian mothers in Australia. This article is not intended to be interpretive, but rather a description of the processes engaged by participants

Friendships under strain : the work-personal life integration of middle managers

Middle managers in today\u27s organisations have reported experiencing longer working hours and intensified work regimes. These increased pressures, in turn, have led to growing difficulty in addressing the integration of their work and personal lives. In an exploratory study of the daily workplace experiences of Australian middle managers and the impacts on their personal lives, one of the key themes to emerge was respondents\u27 concerns about the negative effects on their friendships. This paper discusses middle managers\u27 recognition of the value of friendships for their wellbeing, and the resultant anger and sadness reported at the strain on these relationships due to competing time demands. The significant role that friendships play in alleviating some of the stresses of work demands, while concurrently being impeded by these same demands, is an important issue for organisations to consider. These findings indicate the need for middle managers to truly have an ability to engage in activities - and friendships - which will aid them in their working lives. The study also indicates a need for further investigation into the development and maintenance of friendships for both middle managers and other groups of employees. <br /

Managing in the middle: a review of the mddle management experience in the 21st century

Downsizing and organisational restructuring have impacted both the role and the number of middle managers in organisations. .This paper provides a review of recent research on middle management to seek an understanding of the current situation for middle managers as they face the start of the 2rt century. The literature review is presented in two parts - focusing on the position of middle managers as they emerge from downsizing, and drawing attention to the special circumstances for managers &quot;in the middle&quot;. The research points to some of the challenges middle managers\u27 experience as they work, live, and survive organisational life, as well as highlighting the need for ongoing investigation of their individual experiences.<br /

A randomized controlled trial in non-responders from Newcastle upon Tyne invited to return a self-sample for Human Papillomavirus testing versus repeat invitation for cervical screening.

Background Non-attenders for cervical screening are at increased risk of cervical cancer. Studies offering self-sampling for high-risk Human Papillomavirus (HrHPV) testing have shown greater uptake than sending another invitation for cytology. Objectives To explore whether uptake would increase in a less diverse, more stable population than the previous English study, which demonstrated a lower response rate than other studies. The primary objective was whether non-attenders were more likely to respond to a postal invitation, including kit, to collect a self-sample compared with a further invitation for cytology screening. The secondary objective was whether women with an abnormal result would attend for follow-up. Methods 6000 non-attenders for screening in this pragmatic, randomized (1:1) controlled trial in Newcastle-upon-Tyne were sent an HPV self-sample kit (intervention) or a further invitation for cytology screening (comparator). Results 411(13%) responded to the intervention, returning a self-sample (247(8%)) or attending for cytology (164(5%)), compared with 183(6%) attending for cytology, relative risk 2.25 (95% CI 1.90–2.65) (comparator arm). Of those testing hrHPV positive (32(13%)), 19(59%) subsequently attended cytology screening. Of those in the intervention group who attended for cytology screening without returning an hrHPV self-sample (n = 164), 5% (n = 8) were referred for colposcopy - all attended. In the comparator group eight of the nine referred for colposcopy attended. Conclusion Persistent non-responders to invitations for cervical screening are significantly more likely to respond to a postal invitation to return a self-collected sample for HPV testing than a further invitation for cytology screening. However, just over half followed up on this positive HPV result

Employability Skills in Health Services Management: perceptions of recent graduates

Background: Employer skill requirements of graduates are monitored by Graduate Careers Australia, but health services management (HSM) specific employability skills (ES) perceived by graduates to be important on the job and their perceptions of skills they need to improve are not well reported. Academics need this feedback to improve course employment outcomes by helping current students identify and articulate appropriatecompetencies to potential employers. Also teaching of industry requirements can help improve job matching for employers. Method: Recent graduates working in HSM in New South Wales, Australia were surveyed to rate ES for importance and rate their own skill levels on the same items. The gap between these two ratings was identified for 44 ES. Results: ES important to recent graduates in rank order were: verbal communication skills, integrity and ethical conduct, time management, teamwork, priority setting, ability to work independently, organisational skills, written communication, being flexible and open minded and networking. Highest self-ratings were found for integrity and ethical conduct, ability to&nbsp;work independently, being flexible and open minded, tertiary qualifications, interpersonal skills, written communication skills, time management, life-long learning, priority setting and administration skills. Generally graduates rated their skills lower than their ratings of importance. Conclusions: Recent graduates can provide valuable feedback to universities about ES required for HSM positions and identify their own skill gaps for development at work or through study. Generic skills rather than job-specific skills are what they rate as most important. Closer engagement of universities and employers is recommended especially through placements. Abbreviations: ES – employability skills; GCA – Graduate Careers Australia; HEI – higher education institutions; HRM – human resource management; HSM – health services management; IPC – interpersonal and communication skills

Prospective assessment of the diagnostic accuracy of multi-site photoplethysmography pulse measurements for diagnosis of peripheral artery disease in primary care

Peripheral arterial disease (PAD) is associated with cerebral and coronary artery disease. Symptomatic PAD affects about 5% of people over 55 years; many more have asymptomatic PAD. Early detection enables modification of arterial disease risk factors. Diagnostically, assessment of symptoms or signs can be unreliable; ankle brachial pressure index (ABPI) testing is time-consuming and few healthcare professionals are properly trained. This study assessed the diagnostic accuracy of multi-site photoplethysmography (MPPG), an alternative non-invasive test for PAD, in primary care. PAD patients identified from general practice registers were age- and sex-matched with controls. Participants were assessed using MPPG, ABPI and duplex ultrasound (DUS). Outcome measures were sensitivity and specificity of MPPG and ABPI (relative to DUS) and concordance. MPPG test results were available in 249 of 298 eligible participants from 16 practices between May 2015 and November 2016. DUS detected PAD in 101/249 (40.6%). MPPG sensitivity was 79.8% (95% confidence interval [CI] 69.9-87.6%), with specificity 71.9% (95% CI 63.7-79.2%). ABPI sensitivity was 80.2% (95% CI 70.8-87.6%), with specificity 88.6% (95% CI 82-93.5%). With comparable sensitivity to ABPI, MPPG is quick, automated and simpler to do than ABPI; it offers the potential for rapid and accessible PAD assessments in primary care

The Influence of Behavioral, Social, and Environmental Factors on Reproducibility and Replicability in Aquatic Animal Models

The publication of reproducible, replicable, and translatable data in studies utilizing animal models is a scientific, practical, and ethical necessity. This requires careful planning and execution of experiments and accurate reporting of results. Recognition that numerous developmental, environmental, and test-related factors can affect experimental outcomes is essential for a quality study design. Factors commonly considered when designing studies utilizing aquatic animal species include strain, sex, or age of the animal; water quality; temperature; and acoustic and light conditions. However, in the aquatic environment, it is equally important to consider normal species behavior, group dynamics, stocking density, and environmental complexity, including tank design and structural enrichment. Here, we will outline normal species and social behavior of 2 commonly used aquatic species: zebrafish (Danio rerio) and Xenopus (X. laevis and X. tropicalis). We also provide examples as to how these behaviors and the complexity of the tank environment can influence research results and provide general recommendations to assist with improvement of reproducibility and replicability, particularly as it pertains to behavior and environmental complexity, when utilizing these popular aquatic models. © The Author(s) 2020. Published by Oxford University Press on behalf of the National Academies of Sciences, Engineering, and Medicine. All rights reserved.A.V.K. research was supported by the Russian Science Foundation grant 19-15-00053. He is the Chair of the International Zebrafish Neuroscience Research Consortium (ZNRC). This collaboration was supported, in part, through the NIH/NCI Cancer Center Support Grant P30 CA008748. The authors would like to thank Gregory Paull for sharing his photographs and insight into the natural habitat of zebrafish in Bangladesh

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