Workplace as Community: Influence of Working Conditions on Health Behaviors

Plenary presentation about the influence of working conditions on health behaviors research done by The Center for the Promotion of Health in the New England Workplace (CPH-NEW), a National Institute for Occupational Safety and Health (NIOSH) Center for Excellence. Working conditions link to health outcomes directly, and through health behaviors. The Center evaluates multiple models for integrating health promotion with occupational health interventions, with a strong emphasis on musculoskeletal, cardiovascular, and mental health outcomes; the underlying role of work organization; and the importance of worker involvement in program design and implementation

Estimated and self-reported workloads and lower extremity symptoms for nurses and nursing assistants

Objectives and Significance: In US nursing homes, nursing assistants (NAs) are responsible for direct care and resident handling, while nurses’ roles consist primarily of medication distribution and administrative duties. This study examines differences in observed physical exposures and self-reported knee and ankle symptoms of nurses and NAs. Methods: Observations of clinical staff’s postures and handling were made at fixed time intervals using the PATH Method. An additive physical workload index (PWI) was computed to compare LE workload of NAs and nurses. The PWI combined observed frequencies of postures and handling with their associated forces on the knee and ankle derived from the University of Michigan’s 3D Static Strength Prediction Program. Additionally, surveys on health and working conditions were distributed to employees at 24 nursing homes. Knee and ankle symptoms in the past three months and physical demands were examined by clinical job. Results: Frequencies of postures and handling input into the PWI were based on observations of 275 NAs and 40 nurses. The analysis of PWI for the LE demonstrated higher physical exposures on both the knee and ankle for NAs compared to nurses, especially while NAs were performing resident handling. Among survey participants (n = 1467), NAs reported higher mean physical exertion scores than nurses and also higher frequencies of knee and ankle symptoms (p=0.0076) in the previous three months. Conclusions: In this study, both estimated and self-reported physical workloads were higher among NAs compared to nurses. LE symptoms were also more common among NAs. Safe handling equipment helps reduce some LE exposures for NAs, but interventions for other strenuous tasks should be considered to reduce LE pain symptoms, such as introducing lighter food carts often pushed by NAs and limiting the number of dirty linens bagged before transporting to the soiled linen drop-off

Pediatric Acute Lymphoblastic Leukemia: Recent Advances for a Promising Future

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer and accounts for approximately 75% of all cases of childhood leukemia. Both diagnostic and therapeutic advances have been instrumental in improving the outcomes of once a dreaded disease. Currently, approximately 90% of the children treated according to risk-directed and response-adapted therapy will be long-term survivors. The use of pediatric protocols for the treatment of adolescent and young adults (AYA) has also resulted in significant improvements in their long-term survival. New therapies including tyrosine kinase inhibitors (TKIs), monoclonal antibodies and CAR T-cell therapy are changing the approach to therapy for relapsed or refractory disease. We are approaching a time where therapy for all patients will be personalized with the use of genome-based characterization of disease and incorporation of drugs against actionable targets, ultimately leading to improved clinical outcomes and decreased toxicity of therapy. Still, certain subgroups including patients with relapsed disease, infant ALL, and those with certain cytogenetic/molecular variants, remain challenging to treat. This chapter is an overview of the recent advances in the ALL disease biology, newly identified prognostic factors and an overview of emerging therapeutic options

How Millennials Can Lead Us Out of The Mess We're In: A Jew, a Muslim, and a Christian Share Leadership Lessons from the Life of Moses, By M. Schreiber, I. Case Punnett,

Reviewed by Erin Laurvic

Workplace Predictors of Perceived Quality of Care in Nursing homes

Nursing home quality of care (QOC) is a matter of public concern and public policy. Higher nurse-to-patient ratios have been shown to decrease rates of adverse outcomes. Positive nurse-doctor relationships also have a positive effect, which might translate to other clinical staff, such as nursing aides, who perform the majority of direct care tasks in nursing homes. This cross-sectional study examined whether workplace factors in nursing homes were associated with QOC as evaluated by staff members themselves. Surveys were distributed to personnel in 24 nursing home facilities in the Northeast U.S. A total of 1463 respondents provided ratings of QOC and 14 work environment features. Analyses included correlations, Cronbach’s alpha, and principal components analyses (with rotation) to examine psychometric properties of predictor scales and reduce multicollinearity. A multivariable model of QOC was built using all potential workplace factors to determine which factors contribute to self-reported QOC, with removal of those covariates that were not significant (p\u3e0.05), decreased the model fit, or showed a confounding effect (\u3e15% change in other coefficients). The final model showed that perceived commitment and obstacles to safe-lifting programs, respect and support between coworkers and supervisors, adequacy of staffing, physical exertion, safety climate, and psychological demand, were significant contributors to staff-assessed QOC. Nursing homes should consider cultivating these work environment characteristics for the benefit of both direct-care staff and the residents for whom they provide care

Participating Organizations in Massachusetts Working on Wellness (WoW): Who Are They? What Wellness Programs Have They Put in Place?

Introduction: Most worksite wellness programs are offered by larger employers and accessed by healthier, more educated workers. Massachusetts WoW program is specifically designed to provide guidance in developing wellness programs, with a focus on smaller employers. We examined characteristics of participating organizations and their wellness policies/activity to evaluate the program outreach and delivery. Methods: Organizational and workforce characteristics were collected through an enrollment application. An \u27environmental scan\u27 characterized baseline health-related policies and programs. Wellness intervention activities planned by employers were also collected. Results: The 205 participating organizations are predominantly non-profit (61%) and highly represented by the healthcare and social assistance sector (33%). As a priority of WoW, about one-half of participating organizations have 200 or fewer employees and two-thirds have low-wage workers. At baseline, about half of participating organizations offered no formal wellness program and few policy/environmental supports to encourage wellness activities. The pooled workforce is 63% women, 61% non-Hispanic Whites, and 60% hourly wage workers. About one-quarter have only a high school education/ GED or less, and 17% work evening, night or rotating shifts. WoW has assisted employers to establish program goals, which were predominantly to improve nutrition, increase leisure-time physical activity, and reduce stress. Discussion and Conclusions: The WoW program has successfully reached and delivered services to organizations that previously had no formal wellness program and few wellness policies or supportive environments. In particular, this program has reached a large number of small and moderate-size employer organizations, and a substantial number of low-wage, non-college-educated, and racial/ethnic minority workers

Career decision making in undergraduate medical education

Background: It is unclear how medical students prioritize different factors when selecting a specialty. With rising under and unemployment rates a novel approach to career counselling is becoming increasingly important.  A better understanding of specialty selection could lead to improved career satisfaction amongst graduates while also meeting the health care needs of Canadians.  Methods: Medical students from the University of Toronto participated in a two-phase study looking at factors impacting specialty selection. Phase I consisted of focus groups, conducted independently for each year, and Phase II was a 21-question electronic survey sent to all students.  Results: Twenty-one students participated in the focus group phase and 95 in the survey phase.  Primary themes related to career selection identified in Phase I in order of frequency included personal life factors (36), professional life factors (36), passion/interest (20), changing interests (19) and hidden curriculum (15). The survey phase had similar results with passion (83), lifestyle (79), flexibility (75), employment opportunities (60) and family (50) being ranked as the factors most important in specialty selection. Conclusion: Personal factors, professional factors and passion/interest may be key themes for medical students when deciding which specialty to pursue. Targeting career counselling around these areas may be important.&nbsp

Diamond-Blackfan anemia (DBA)

Review on Diamond-Blackfan anemia (DBA), with data on clinics, and the genes involved