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PubMed1995

Solvent exposure as a risk factor for Alzheimer's disease: a case-control study.

This case-control study investigates whether history of organic solvent exposure is associated with increased risk of Alzheimer's disease. The study base includes about 23,000 persons aged 60 years or more from the local membership of a health maintenance organization in Seattle, Washington, who entered the study between 1987 and 1992. Probable Alzheimer's disease cases (n = 193) who had presented with new dementia symptoms were identified, enrolled, and diagnosed by our Alzheimer's Disease Patient Registry following standardized criteria. Control subjects (n = 243), free of dementia and neurologic disease causing dementia, were selected randomly from the study base and frequency matched to cases for age and sex. Proxy informants provided specific solvent exposure history as well as job descriptions likely to involve solvent use as part of a comprehensive risk factor interview. Kappa statistics indicated substantial agreement for control-control proxy solvent responses. History of exposure to one or more solvent groups (benzene and toluene; phenols and alcohols; ketones; other solvents) yielded an adjusted Alzheimer's disease odds ratio of 2.3 (95 percent confidence interval 1.1-4.7); among males only, it increased to 6.0 (95% confidence interval 2.1-17.2). Thus, past exposure to organic solvents may be associated with onset of Alzheimer's disease.

Age Factors↗
PubMedDate not supplied

A challenge for clinical nurses: a new nursing role.

As a result of difficulties in attracting resident medical officers (RMOs) to the outer western suburbs of Sydney, the intensive care unit at Nepean Hospital created a new nursing position in 1992 called the clinical assistant (CA). This position was trialed and, after a successful period in the intensive care unit, it was expanded to the surgical, pediatric, and mental health divisions. The generic job description of the CA is comprehensive and includes advanced clinical, educational, research, and managerial components. There are a number of variations within the areas of practice. For example, within the clinical component, the intensive care CA is expected to be able to insert central venous and arterial catheters, whereas the mental health CA adopts a full caseload and is responsible for patient assessment and management. A working party was established in 1995 and comprised previous and current CAs, an education manager, a senior nursing administrator, and representatives from personnel and the New South Wales Nursing Association (nursing union). The working party conducted an extensive evaluation of this new nursing role, and the recommendations that followed received a positive response from the hospital management.

Clinical Competence↗
PubMed2005

Working and training as an intern: a national survey of Irish interns.

The Medical Council of Ireland recently introduced some initiatives to enhance the education and training of interns. These include the development of a generic job description, a logbook to monitor training outcomes and a national network of supervisors to plan and oversee intern training. To get feedback on the impact of these reforms, the Medical Council surveyed all interns with Irish addresses in March 2003. Three hundred (65%) of 461 interns responded. The majority provided positive feedback on many aspects of their education and training, their work environment and professional relationships. However, a majority also reported a lack of protected time for education, a lack of formal educational programmes, insufficient feedback on performance and an unnecessarily stressful work environment. Overall, 61% reported being bullied and 4% had experienced sexual harassment. While feedback on the Irish internship experience is generally positive, further work is necessary to address the problems identified.

Agonistic Behavior↗
PubMed2006

Relationships between selected human resource management practices and dairy farm performance.

The objectives were to identify relationships between human resource management (HRM) practices used by dairy farm businesses and the productivity and profitability of the dairies. Explanatory variables were the following practices: training, job descriptions, standard operating procedures, milk quality incentives, and the employment of Spanish-speaking employees. The dependent variables were return on assets, return on equity, rolling herd average, and somatic cell count. The effects of individual HRM practices were analyzed to test for means separation between groups that "used" and those that "did not use" HRM practices. The results did not support expectations that differences exist between the groups. However, a significant positive relationship was found between return on equity and the use of continued training (used = 10.61%; did not use = -62.38%), and a significant negative relationship was found between the use of standard operating procedures for feeding and somatic cell count (used = 263,000; did not use = 214,000). Profitability and productivity did not seem to be major factors in producers' decisions to use or not use HRM practices.

Animals↗
PubMed1992

Designing a respirator fit testing program.

The requirements for adequate respiratory protection for the employees of this agency vary. Therefore, accurate, updated job descriptions are a critical piece of information. Although the agency has made an effort to establish a respiratory protection program, a number of limitations exist when compared to the program components defined in ANSI, NIOSH, and OSHA guidance documents. In response to a request from the agency, the nurse consultant evaluated the existing respiratory protection program and made specific recommendations for improvement. At this time, the agency has signed a formal agreement with the Division of Federal Occupational Health to request continued assistance with "overhauling" their program. Top management has begun assigning responsibilities for the program to specific individuals, and a centralized database is being set up. The agency has implemented two new DFOH developed forms to improve the testing process, and the nurse consultant has revised the educational/training session to more adequately meet the needs of the work force. The Agency and DFOH are collaborating on reassessment of employees to correctly assign them to appropriate respiratory risk categories. This will, in turn, affect the medical monitoring needs as well as the educational needs of each individual.

Consultants↗
PubMed2005

A guide to defining the competence required of a consultant in clinical chemistry and laboratory medicine.

A definition has been agreed for the most senior professional (consultant) in clinical chemistry and laboratory medicine. A model job description for a consultant has been determined, which is intended to act as a toolkit to assist employing authorities and professional bodies to define the role of individual consultant posts. A total of 86 competences for a consultant have been designated and expressed in the form of simple generic proficiency standards. These competences have been allocated to six broad areas: clinical [13]; scientific [15]; technical [12]; communication [12]; management and leadership [20]; professional autonomy and accountability [14]. The competences are intended to be illustrative rather than definitive and to enable the duties of any consultant post to be defined. Assessment of competence is likely to entail consideration of qualifications, registration status, continuing professional development and performance review. The project is intended as a guide to European societies of clinical chemistry and laboratory medicine. The guide should be capable of local interpretation to encourage a greater degree of commonality in the role of the consultant whilst protecting national identity. The guide should stimulate international understanding and collaboration and contribute to an overall improvement in the quality of practice.

Chemistry, Clinical↗
PubMed1999

Beyond the sick role: situating community health nursing practice.

This grounded theory research into the role of the community health nurse in Australia identified that moving from the comfort and structure of an institutional setting to the client's turf results in profound changes to the purpose of nursing practice. Data were collected from 17 'excellent' community health nurses practising in a range of community health settings in three states of Australia. Data included transcripts from in-depth interviews, questionnaires, group discussions with participants, job descriptions, agency documentation, professional organisation documentation and focus groups. Data were analysed using constant comparative techniques. In community health nursing practice, the client's role changes from a sick role to a well role and there is a shift in responsibility for outcomes from the nurse to the client. The central purpose of the community health nursing role is to facilitate Situated Health Competence, which the client achieves within the context of going about their everyday life, including work, recreation, relationships and role responsibilities. Situated Health Competence requires families, groups and communities to address their own illnesses, health problems, health issues and health behaviours; have enough knowledge and power to make their own decisions; question matters that impact on their health; and seek out and access appropriate health resources on an ongoing basis. The findings of this study make the intangible motivations of the community health nurse more explicit. The aim of facilitating Situated Health Competence results in an expanded view of the boundaries of nursing practice. The traditional foci of nursing practice are still present, but are incorporated within a broader 'situated' role.

Attitude of Health Personnel↗
PubMed2006

Health visitor or public health nurse? A Scottish study.

The Scottish Executive and the National Health Service (NHS) have been consistently promoting 'public health nursing' as a new way forward in the community. In addition, since 2001 traditional health visitor and school nurse education programmes have been replaced by a single public health nurse training curriculum. However, many of the roles, responsibilities and job descriptions of clinical health visiting staff have remained unchanged within health board areas. This has led to apparent confusion among staff, both newly qualified and those already in post. This lack of clarity in policy and role prompted this research study, which set out to investigate the perceptions of the public health role of the health visitor within a health board area in Scotland. Initially, a review of the relevant literature was undertaken to provide in-depth background information on the topic, to enable a critical analysis of the current public health role of the health visitor. This analysis was further informed by obtaining qualitative and quantitative data via a questionnaire sent to 89 health visitors, to determine the attitudes and opinions of health visitors currently working within a Scottish health board area. Results from the study indicate that, despite the plethora of public health-related Scottish Executive publications and the changes in educational programmes, many health visitors still carry out what is perceived as a traditional role with mainly the under-five age group. The study also identified the need for clear direction in the public health role for health visitors, with many health visitors expressing a willingness to make changes to their current role.

Attitude of Health Personnel↗
PubMed1989

Concordance of occupational and environmental exposure information elicited from patients with Alzheimer's disease and surrogate respondents.

Identification of risk factors for Alzheimer's disease through the use of well designed case-control studies has been described as a research priority. Increasing recognition of the neurotoxic potential of many industrial chemicals such as organic solvents raises the question of the occupational and environmental contribution to the etiology of this high-priority health problem. The intention of this study was to develop and evaluate a methodology that could be used in a large scale case-control study of the occupational and environmental risk factors for dementia or a population-based surveillance system for neurotoxic disorders. The specific objectives of this study were to investigate: 1) the reliability of exposure-eliciting, interviewer-administered questionnaires given to patients with Alzheimer's disease (SDAT); 2) the reliability of exposure-eliciting interviewer-administered questionnaires given to the family of patients with SDAT and the agreement with the responses of the patient or surrogate respondents; 3) the reliability and agreement of responses of age- and sex-matched control patients and their families selected from geriatric care institutions and the community, with respect to the same exposure-eliciting and interviewer-administered questionnaire; and 4) the reliability of agent-based exposure ascertainment by a single, trained rater. The results of the study demonstrate that occupational and environmental histories from which exposure information can be derived is most reliably elicited from job descriptions of cases and control subjects rather than job titles alone or detailed probes for potential neurotoxic exposures. This will necessitate the use of standardized interviewer-administered instruments to derive this information in case-control studies of Alzheimer's disease or population-based surveillance systems for occupational and environmental neurotoxicity.

Alzheimer Disease↗
PubMed2004

Job satisfaction, stress, and burnout among Canadian gynecologic oncologists.

OBJECTIVES: (1). To provide a job description of Canadian gynecologic oncologists. (2). To assess job satisfaction and job stress, and measure the prevalence of burnout and psychological morbidity. METHODS: A cross-sectional survey was mailed to all Canadian gynecologic oncologists in September 2002. RESULTS: The job profile on Canadian gynecologic oncologists is predominantly clinical with a minor component of administration and to a less extent education or research. Clinically, 80% of the activity is focused on gynecologic cancer care. The majority of physicians (92%) are satisfied with their job, but there are clear concerns raised concerning systems issues in health care delivery. Approximately 26% of physicians are experiencing high stress, and this is strongly associated with emotional exhaustion and high depersonalization. Fourteen percent of Canadian gynecologic oncologists are actively looking for alternative jobs and 45% are trying to decrease the number of hours worked per week. When considering an alternate job, the most important factors are location, colleagues, and potential for personal growth. CONCLUSION: High stress and low personal accomplishment were seen in Canadian gynecologic oncologists. Organizations (i.e., hospitals) and health care funders have the opportunity to incorporate preventative strategies to keep this physician resource healthy.

Adult↗
PubMed1980

Job to career satisfaction spillover among physician's assistants.

From the empirical studies that generalize the individual's job satisfaction to his life satisfaction, a meta-level hypothesis was developed to suggest a positive association between the physician's assistant's satisfaction with his current job and his satisfaction with his broader occupational or career choice. A questionnaire was mailed to 280 graduates of two Physician's Assistant Programs. Data analysis is based on 170 returns. Job satisfaction is measured with an amended version of the Job Description Inventory that includes a patient satisfaction component. Job satisfaction is found to relate positively to a global measure of career satisfaction, with the work satisfaction component explaining most of the variance in career satisfaction.

Career Choice↗
PubMed1996

Job satisfaction and self-esteem of South African nurses.

The overall aim of this study was to investigate job satisfaction and self-esteem among South African nurses. The objectives of the study were to: (1) ascertain South African nurses' satisfaction with their work, pay, promotion, supervision and co-workers; (2) compare job satisfaction of South African nurses with that of North American nurses; (3) determine levels of self-esteem; and (4) test the direct and indirect effects of self-esteem on job satisfaction. A postal survey was conducted on a random sample of 2,000 nurses registered with the South African Nursing Council; 396 persons returned the questionnaires (Group 1). A subsample of 93 nonrespondents was traced and agreed to complete the questionnaire (Group 2). Minimal differences justified combining the groups and conducting subsequent analyses on total sample scores. Nurses were most satisfied with supervision and co-workers and least satisfied with promotion and pay. Reliability coefficients for the five job satisfaction subscales and overall scale ranged between 0.79 (work) and 0.93 (overall scale). South African nurses were significantly less satisfied with all aspects of their jobs than their American counterparts. Coefficient alpha for the self-esteem scale was 0.72, 0.87 for the work-related needs scale and 0.80 for the social approval scale. High self-esteem nurses were more likely to attend to work-related needs in judging their job satisfaction than low self-esteem nurses. The best model for predicting job satisfaction was the linear incorporation of self-esteem and work-related needs. It was concluded that: (1) the Job Descriptive Index (JDI) was a useful measure of job satisfaction; (2) the quality of life in the South African nursing profession was lower than their American counterparts; (3) nurses had high levels of self-esteem; and (4) self-esteem directly and indirectly affected job satisfaction.

Career Mobility↗
PubMedDate not supplied

Selecting the best to be the best: how to gain a competitive edge for your organization, Part II.

This is the second part of a two-part article on finding and hiring the best employees for your organization. Part I discussed costs of poor hiring, benefits of good hiring, elements of an effective hiring process, the job description, hiring from within versus outside the organization, the job application, résumé screening, telephone screening, and salary considerations. Part II will discuss the selection interview, legal issues in hiring, and the orientation process.

Employment↗
PubMed2005

Internal dental school environmental factors promoting faculty survival and success.

A career in dental academics offers ample rewards and challenges. To promote successful careers in dental education, prospective and new dental faculty should possess a realistic view of the dental school work environment, akin to the informed consent so valuable to patients and doctors. Self-assessment of personal strengths and weaknesses provides helpful information in matching faculty applicants with appropriate dental schools. Essential prehiring information also includes a written job description detailing duties and responsibilities, professional development opportunities, and job performance evaluation protocol. Prehiring awareness of what constitutes excellence in job performance will aid new faculty in allotting time to productive venues. New faculty should not rely solely on professional expertise to advance careers. Research and regular peer-reviewed publications are necessary elements in academic career success, along with the ability to secure governmental, private foundation, and corporate grant support. Tactful self-promotion and self-definition to the dental school community are faculty responsibilities, along with substantial peer collaboration. The recruitment period is a singular opportunity to secure job benefits and privileges. It is also the time to gain knowledge of institutional culture and assess administrative and faculty willingness to collaborate on teaching, research, professional development, and attainment of change. Powerful people within dental schools and parent institutions may influence faculty careers and should be identified and carefully treated. The time may come to leave one's position for employment at a different dental school or to step down from full-time academics. Nonetheless, the world of dental and health professional education in 2005 is rapidly expanding and offers unlimited opportunities to dedicated, talented, and informed educators.

Career Choice↗
PubMed1974

Improving job performance of Neighborhood Youth Corps aides in an urban recreation program.

In most federal job training and employment programs, trainees' pay is not contingent on job performance, but upon physical presence. This study sought to increase the job performance of seven Neighborhood Youth Corps workers being paid an hourly wage for serving as aides in an urban recreation program. When thorough job descriptions and threatened termination of employment were insufficient to maintain adequate job performance, an attempt was made to make the hourly wage (required by the Neighborhood Youth Corps program) more contingent on job performance. When the number of hours credited the workers on their payroll sheets was proportional to their rating on a simple checklist of job performance, rather than to the number of hours they were present, their job performance was maintained at near-perfect levels. Although this simple semantic shift in emphasis-from "hours worked" to "hours worked"-was still interpreted as meeting the Neighborhood Youth Corps requirements for hourly pay, its behavioral effects were substantial. This simple procedure might be used in other training programs handicapped by hourly wage requirements.

Adolescent↗
PubMed1989

Factors affecting the job satisfaction of respiratory therapists who work in adult general and critical care: a multivariate study.

UNLABELLED: The development of an expanded understanding of employees' reaction to their job may be important for improvement in the quality of work life and of services rendered. We sought to determine the factors, or rewards, that significantly affect respiratory therapists' job satisfaction. METHOD: Questionnaires designed to elicit responses related to job satisfaction and demographic information were mailed to a random sample of registered respiratory therapists in 9 southeastern states. The Job Descriptive Index (JDI) was used to measure facets of and total job satisfaction. The independent variables used were: Satisfaction with Work on the Job, Supervision, Promotion Opportunities, Pay, and People on the Job. RESULTS: Satisfaction with Work on the Job (p = 0.0001, F = 39.1) and with Supervision (p = 0.005, F = 8.48) were the only variables that significantly affected the job satisfaction scores of respiratory therapists. CONCLUSION: Because satisfaction with work on the job and supervision seem to be rewards therapists consider important, managers need to evaluate those factors in their own organization in relation to their possible impact upon staff members.

Critical Care↗
PubMed1987

Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups.

The aim of the present study was to evaluate the association and impact of occupational exposure and diseases of the shoulder and neck. Prevalence rates, odds ratios, aetiological fractions, and their confidence intervals were computed for pooled and non-pooled data of previous published reports. By comparison with office workers and farmers, dentists had an increased odds ratio for cervical spondylosis (two studies) and for shoulder joint osteoarthrosis. Meat carriers, miners, and "heavy workers" also had significantly higher rates of cervical spondylosis compared with referents. Compared with iron foundry workers, civil servants had a significant odds ratio (4.8) of cervical disc disease and a 0.79 aetiological fraction. Whether this was due to exposure or healthy worker effect was not clear. In four occupational groups with high shoulder-neck load an odds ratio of 4.0 was found for thoracic outlet syndrome with an aetiological fraction of 0.75. Rotator cuff tendinitis in occupational groups with work at shoulder level (two studies) showed an odds ratio of 11 and an aetiological fraction of 0.91. Keyboard operators had an odds ratio of 3.0 for tension neck syndrome (five studies). Unfortunately, owing to the scanty description of the work task, the exposure could be analysed only by job title. Examination of published reports shows clearly that certain job titles are associated with shoulder-neck disorders. High rates and aetiological fractions for rotator cuff tendinitis and tension neck syndrome suggest that preventive measures could be effective. Although job descriptions are brief, the associations noted suggest that highly repetitive shoulder muscle contractions, static contractions, and work at shoulder level are hazardous exposure factors. In reports of cross sectional studies of occupational shoulder-neck disorders presentation of age, exposure, and effect distribution may help for future meta-analysis.

Adult↗
PubMed2002

Note on the relationships among job satisfaction, organizational commitment, and organizational citizenship behavior.

Previous research which has established a relationship between organizational citizenship behavior and job satisfaction has involved primarily white collar workers. This study extends the prior research to a different sample--blue collar workers--and investigates the relations of organizational citizenship behavior to the various facets of job satisfaction as measured by the Job Descriptive Index. We also examine the relative effects of organizational commitment and job satisfaction on citizenship behaviors. Analysis of responses from a sample of 91 machine operators employed by a clothing manufacturer in the southeastern United States indicates that citizenship behaviors of blue collar workers are related to satisfaction with coworkers, satisfaction with supervision, and satisfaction with pay, but not satisfaction with opportunities for advancement, satisfaction with the work itself, or organizational commitment.

Adult↗