Implementation of a disability management policy in a large healthcare employer: a quasi-experimental, mixed-method evaluation

Objective: This study describes the process and outcomes of the implementation of a strengthened disability management policy in a large Canadian healthcare employer. Key elements of the strengthened policy included an emphasis on early contact, the training of supervisors and the integration of union representatives in return-to-work (RTW) planning. Design: The study applied mixed methods, combining a process evaluation within the employer and a quasi-experimental outcome evaluation between employers for a 3-year period prior to and following policy implementation in January 2012. Participants: Staff in the implementation organisation (n=4000) and staff in a peer group of 29 large hospitals (n=1 19 000). Outcomes: Work disability episode incidence and duration. Results: Both qualitative and quantitative measures of the implementation process were predominantly positive. Over the 6-year observation period, there were 624 work disability episodes in the organisation and 8604 in the comparison group of 29 large hospitals. The annual per cent change in episode incidence in the organisation was −5.6 (95% CI −9.9 to −1.1) comparable to the annual per cent change in the comparison group: −6.2 (-7.2 to –5.3). Disability episode durations also declined in the organisation, from a mean of 19.4 days (16.5, 22.3) in the preintervention period to 10.9 days (8.7, 13.2) in the postintervention period. Reductions in disability durations were also observed in the comparison group: from a mean of 13.5 days (12.9, 14.1) in the 2009–2011 period to 10.5 days (9.9, 11.1) in the 2012–2014 period. Conclusion: The incidence of work disability episodes and the durations of work disability declined strongly in this hospital sector over the 6-year observation period. The implementation of the organisation’s RTW policy was associated with larger reductions in disability durations than observed in the comparison group

Implementation of a disability management policy in a large healthcare employer: a quasi-experimental, mixed-method evaluation

Objective: This study describes the process and outcomes of the implementation of a strengthened disability management policy in a large Canadian healthcare employer. Key elements of the strengthened policy included an emphasis on early contact, the training of supervisors and the integration of union representatives in return-to-work (RTW) planning. Design: The study applied mixed methods, combining a process evaluation within the employer and a quasi-experimental outcome evaluation between employers for a 3-year period prior to and following policy implementation in January 2012. Participants: Staff in the implementation organisation (n=4000) and staff in a peer group of 29 large hospitals (n=1 19 000). Outcomes: Work disability episode incidence and duration. Results: Both qualitative and quantitative measures of the implementation process were predominantly positive. Over the 6-year observation period, there were 624 work disability episodes in the organisation and 8604 in the comparison group of 29 large hospitals. The annual per cent change in episode incidence in the organisation was −5.6 (95% CI −9.9 to −1.1) comparable to the annual per cent change in the comparison group: −6.2 (-7.2 to –5.3). Disability episode durations also declined in the organisation, from a mean of 19.4 days (16.5, 22.3) in the preintervention period to 10.9 days (8.7, 13.2) in the postintervention period. Reductions in disability durations were also observed in the comparison group: from a mean of 13.5 days (12.9, 14.1) in the 2009–2011 period to 10.5 days (9.9, 11.1) in the 2012–2014 period. Conclusion: The incidence of work disability episodes and the durations of work disability declined strongly in this hospital sector over the 6-year observation period. The implementation of the organisation’s RTW policy was associated with larger reductions in disability durations than observed in the comparison group

Training scholars in dissemination and implementation research for cancer prevention and control: A mentored approach

Abstract Background As the field of D&I (dissemination and implementation) science grows to meet the need for more effective and timely applications of research findings in routine practice, the demand for formalized training programs has increased concurrently. The Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) Program aims to build capacity in the cancer control D&I research workforce, especially among early career researchers. This paper outlines the various components of the program and reports results of systematic evaluations to ascertain its effectiveness. Methods Essential features of the program include selection of early career fellows or more experienced investigators with a focus relevant to cancer control transitioning to a D&I research focus, a 5-day intensive training institute, ongoing peer and senior mentoring, mentored planning and work on a D&I research proposal or project, limited pilot funding, and training and ongoing improvement activities for mentors. The core faculty and staff members of the MT-DIRC program gathered baseline and ongoing evaluation data regarding D&I skill acquisition and mentoring competency through participant surveys and analyzed it by iterative collective reflection. Results A majority (79%) of fellows are female, assistant professors (55%); 59% are in allied health disciplines, and 48% focus on cancer prevention research. Forty-three D&I research competencies were assessed; all improved from baseline to 6 and 18 months. These effects were apparent across beginner, intermediate, and advanced initial D&I competency levels and across the competency domains. Mentoring competency was rated very highly by the fellows––higher than rated by the mentors themselves. The importance of different mentoring activities, as rated by the fellows, was generally congruent with their satisfaction with the activities, with the exception of relatively greater satisfaction with the degree of emotional support and relatively lower satisfaction for skill building and opportunity initially. Conclusions These first years of MT-DIRC demonstrated the program’s ability to attract, engage, and improve fellows’ competencies and skills and implement a multicomponent mentoring program that was well received. This account of the program can serve as a basis for potential replication and evolution of this model in training future D&I science researchers

An estimate of the global distribution of radon emissions from the ocean

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 31 (2004): L19104, doi:10.1029/2004GL021051.There is a need for improved estimates of the radon (222Rn) flux density from the ocean for use in the modeling and interpretation of atmospheric radon in global climate and air pollution studies. We use a modification of a frequently used model of gas transfer to generate global predictions of ocean radon flux density for each month of the year (climate averaged) on a 192 by 94 global grid. Compared with the often-used approximation of a constant radon flux from the ocean, the model's predictions indicate large variations over regions of the ocean (a factor of ten is not uncommon). For example, latitude bands near the equator and Southern Ocean are predicted to emit relatively high average radon flux compared with other latitude bands. The predicted annually-averaged flux density from the ocean is 0.0382 mBq m−2 s−1 (0.00182 atoms cm−2 s−1), smaller than some commonly-used estimates

Mentored training and its association with dissemination and implementation research output: A quasi-experimental evaluation

BACKGROUND: There is a continued need to evaluate training programs in dissemination and implementation (D&I) research. Scientific products yielded from trainees are an important and objective measure to understand the capacity growth within the D&I field. This study evaluates our mentored training program in terms of scientific productivity among applicants. METHODS: Post-doctoral and early-career cancer researchers were recruited and applied to the R25 Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) between 2014 and 2017. Using application details and publicly available bibliometric and funding data, we compared selected fellows with unsuccessful applicants (nonfellows). We extracted Scopus citations and US federal grant funding records for all applicants (N = 102). Funding and publication abstracts were de-identified and coded for D&I focus and aggregated to the applicant level for analysis. Logistic regression models were explored separately for the odds of (1) a D&I publication and (2) US federal grant funding post year of application among fellows (N = 55) and nonfellows (N = 47). Additional models were constructed to include independent variables that attenuated the program\u27s association by 5% or more. Only US-based applicants (N = 87) were included in the grant funding analysis. RESULTS: Fellows and nonfellows were similar across several demographic characteristics. Fellows were more than 3 times more likely than nonfellows to have grant funding after MT-DIRC application year (OR 3.2; 95% CI 1.1-11.0) while controlling for time since application year; the association estimate was 3.1 (95% CI 0.98-11.0) after adjusting for both cancer research area and previous grant funding. For publications, fellows were almost 4 times more likely to publish D&I-focused work adjusting for time (OR 3.8; 95% CI 1.7-9.0). This association lessened after adjusting for previous D&I publication and years since undergraduate degree (OR 2.9; 95% CI 1.2-7.5). CONCLUSIONS: We document the association of a mentored training approach with built-in networks of peers to yield productive D&I researchers. Future evaluation efforts could be expanded to include other forms of longer-term productivity such as policy or practice change as additional objective measures. D&I research trainings in the USA and internationally should consider common evaluation measures

The Solar Twin Planet Search. V. Close-in, low-mass planet candidates and evidence of planet accretion in the solar twin HIP 68468

[Methods]. We obtained high-precision radial velocities with HARPS on the ESO 3.6 m telescope and determined precise stellar elemental abundances (~0.01 dex) using MIKE spectra on the Magellan 6.5m telescope. [Results]. Our data indicate the presence of a planet with a minimum mass of 26 Earth masses around the solar twin HIP 68468. The planet is a super-Neptune, but unlike the distant Neptune in our solar system (30 AU), HIP 68468c is close-in, with a semi-major axis of 0.66 AU, similar to that of Venus. The data also suggest the presence of a super-Earth with a minimum mass of 2.9 Earth masses at 0.03 AU; if the planet is confirmed, it will be the fifth least massive radial velocity planet discovery to date and the first super-Earth around a solar twin. Both isochrones (5.9 Gyr) and the abundance ratio [Y/Mg] (6.4 Gyr) indicate an age of about 6 billion years. The star is enhanced in refractory elements when compared to the Sun, and the refractory enrichment is even stronger after corrections for Galactic chemical evolution. We determined a NLTE Li abundance of 1.52 dex, which is four times higher than what would be expected for the age of HIP 68468. The older age is also supported by the low log(R'HK) (-5.05) and low jitter. Engulfment of a rocky planet of 6 Earth masses can explain the enhancement in both lithium and the refractory elements. [Conclusions]. The super-Neptune planet candidate is too massive for in situ formation, and therefore its current location is most likely the result of planet migration that could also have driven other planets towards its host star, enhancing thus the abundance of lithium and refractory elements in HIP 68468. The intriguing evidence of planet accretion warrants further observations to verify the existence of the planets that are indicated by our data and to better constrain the nature of the planetary system around this unique star.Comment: A&A, in pres

Transforming the Untransformable: Application of Direct Transformation To Manipulate Genetically Staphylococcus aureus and Staphylococcus epidermidis

The strong restriction barrier present in Staphylococcus aureus and Staphylococcus epidermidis has limited functional genomic analysis to a small subset of strains that are amenable to genetic manipulation. Recently, a conserved type IV restriction system termed SauUSI (which specifically recognizes cytosine methylated DNA) was identified as the major barrier to transformation with foreign DNA. Here we have independently corroborated these findings in a widely used laboratory strain of S. aureus. Additionally, we have constructed a DNA cytosine methyltransferase mutant in the high-efficiency Escherichia coli cloning strain DH10B (called DC10B). Plasmids isolated from DC10B can be directly transformed into clinical isolates of S. aureus and S. epidermidis. We also show that the loss of restriction (both type I and IV) in an S. aureus USA300 strain does not have an impact on virulence. Circumventing the SauUSI restriction barrier, combined with an improved deletion and transformation protocol, has allowed the genetic manipulation of previously untransformable strains of these important opportunistic pathogens

Antimicrobial Resistance in Enterococcus spp. Isolated from Environmental Samples in an Area of Intensive Poultry Production

Enterococcus spp. from two poultry farms and proximate surface and ground water sites in an area of intensive poultry production were tested for resistance to 16 clinical antibiotics. Resistance patterns were compared to assess trends and possible correlations for specific antimicrobials and levels of resistance. Enterococci were detected at all 12 surface water sites and three of 28 ground water sites. Resistance to lincomycin, tetracycline, penicillin and ciprofloxacin in poultry litter isolates was high (80.3%, 65.3%, 61.1% and 49.6%, respectively). Resistance in the surface water to the same antibiotics was 87.1%, 24.1%, 7.6% and 12.9%, respectively. Overall, 86% of litter isolates, 58% of surface water isolates and 100% of ground water isolates were resistant to more than one antibiotic. Fifty-four different resistance patterns were recognised in isolates obtained from litter and environmental samples and several E. faecium and E. faecalis isolates from litter and environment samples shared the same resistance pattern. Multiple antibiotic resistant (MAR) indices calculated to assess health risks due to the presence of resistant enterococci suggested an increased presence of antibiotics in surface water, likely from poultry sources as no other wastewater contributions in the area were documented

Different Catalytic Mechanisms in Mammalian Selenocysteine- and Cysteine-Containing Methionine-R-Sulfoxide Reductases

Selenocysteine (Sec) is found in active sites of several oxidoreductases in which this residue is essential for catalytic activity. However, many selenoproteins have fully functional orthologs, wherein cysteine (Cys) occupies the position of Sec. The reason why some enzymes evolve into selenoproteins if the Cys versions may be sufficient is not understood. Among three mammalian methionine-R-sulfoxide reductases (MsrBs), MsrB1 is a Sec-containing protein, whereas MsrB2 and MsrB3 contain Cys in the active site, making these enzymes an excellent system for addressing the question of why Sec is used in biological systems. In this study, we found that residues, which are uniquely conserved in Cys-containing MsrBs and which are critical for enzyme activity in MsrB2 and MsrB3, were not required for MsrB1, but increased the activity of its Cys mutant. Conversely, selenoprotein MsrB1 had a unique resolving Cys reversibly engaged in the selenenylsulfide bond. However, this Cys was not necessary for activities of either MsrB2, MsrB3, or the Cys mutant of MsrB1. We prepared Sec-containing forms of MsrB2 and MsrB3 and found that they were more than 100-fold more active than the natural Cys forms. However, these selenoproteins could not be reduced by the physiological electron donor, thioredoxin. Yet, insertion of the resolving Cys, which was conserved in MsrB1, into the selenoprotein form of MsrB3 restored the thioredoxin-dependent activity of this enzyme. These data revealed differences in catalytic mechanisms between selenoprotein MsrB1 and non-selenoproteins MsrB2 and MsrB3, and identified catalytic advantages and disadvantages of Sec- and Cys-containing proteins. The data also suggested that Sec- and Cys-containing oxidoreductases require distinct sets of active-site features that maximize their catalytic efficiencies and provide strategies for protein design with improved catalytic properties