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PubMed2003

Predictors of psychological well-being of nurses in Alexandria, Egypt.

As nursing has been previously identified as a stressful occupation, sources of job stress and levels of job satisfaction were extensively investigated. However, studies addressing issues of nurses' mental health are scarce. This work aims to assess psychological well-being of nurses in different job settings in Alexandria and to identify sociodemographic, psychosocial and workplace predictors. A total sample of 412 nurses represented nurses working in five different health organizations in Alexandria. A self-administered questionnaire was used to collect sociodemographic, occupational and health data, and the Standardized Arabic Version of General Health questionnaire (GHQ-30 items), Job Descriptive Index (JDI), and Social Support Scale (SSS) were also used. Results revealed that 21.67% of nurses recorded moderate to severe psychological symptoms on GHQ. Fewer years of experience, negative family and friend support, and negative total work satisfaction were found to be significant predictors of psychological ill health among nurses in a descending rank order. Implications for nursing intervention will be discussed.

Adaptation, Psychological↗
PubMed2003

Polycyclic aromatic hydrocarbon-deoxyribonucleic acid (PAH-DNA) adduct levels and exposure to coke oven emissions among workers in Taiwan.

In this study, the authors evaluated the relationship between polycyclic aromatic hydrocarbon-deoxyribonucleic acid (PAH-DNA) adduct levels in workers' peripheral white blood cells (WBCs) and their occupational exposures to coke oven emissions (measured by air and urinary 1-hydroxypyrene [1-OHP]). Personal exposures to smoking, charbroiled food, changing clothes in the workplace, and respirator use were determined by questionnaire. Eighty-nine coke oven workers were divided into 3 exposure groups on the basis of job description: topside workers, cokeside workers, and plant office staff. Referent subjects comprised 63 individuals from the same company who worked at a site remote from the coking plant. The geometric mean (GM) PAH-DNA adduct levels determined from the WBCs of the exposed groups were 6.86, 1.56, and 0.90 adducts/10(8) nucleotides, respectively (referents = 0.38 adducts/10(8) nucleotides). GM personal benzene soluble fraction (BSF) exposures for the exposed groups were 483.2 microg/m3, 70.1 microg/m3, and 43.2 microg/m3, respectively (referents = 10.7 microg/m3). There was a significant correlation (p < 0.05) between individual BSF and PAH-DNA adduct levels for the exposed groups. The authors also found a significant correlation (p < 0.05) between urinary 1-OHP levels from the day 2 samples of the exposed groups and their PAH-DNA adduct levels. The logistic-regression model revealed that PAH-DNA adduct levels were significantly different between job categories. The results of this study indicate that BSF exposure is the primary contributor to PAH-DNA adduct levels determined from WBCs.

Adult↗
PubMed2006

How to recruit, interview, and retain employees.

Decide how you will recruit new employees and place your advertisements. Screen the resumes and select the applicants to interview. Prepare yourself for the interview by reviewing the job description and determining the qualities you are seeking and the questions required to gain the information you seek. Conduct the interview and followup. Select the final candidate, extend an offer, and establish a start date. Don't forget to notify unsuccessful candidates. Once the employee starts, orient her to the practice and set up a training schedule. Monitor her progress and develop a system of ongoing evaluation of her performance. Make sure you take the necessary steps to retain employees. Remember, hiring and firing employees is an expensive endeavor.

Education, Nursing, Continuing↗
PubMedDate not supplied

Program planning for a community pharmacy residency support service using the nominal group technique.

OBJECTIVE: To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). SETTING: Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. PRACTICE DESCRIPTION: CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. PRACTICE INNOVATION: The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. INTERVENTIONS: Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. MAIN OUTCOME MEASURE: Group consensus on the priority needs of CPRPs was determined through rank order voting. RESULTS: The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. CONCLUSION: The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.

Education, Pharmacy, Continuing↗
PubMed2006

Personal and non-occupational risk factors and occupational injury/illness.

BACKGROUND: The materials handling industry performs is an essential function in the world economy, however, it is plagued with occupationally related injuries and illnesses. Understanding the risk factors may assist this industry in alleviating these injuries and illnesses, as well as their associated costs. METHODS: Forty-eight personal and non-occupational risk factors were measured and evaluated for statistically significant relationships with occupational injury in 442 volunteer manual material handlers who worked for three different companies, at nine US locations, with 15 different job descriptions. OSHA 200 logs were used to ascertain evidence of occupational injury within this population for 1 year after the testing and measurement was completed. RESULTS: Higher occurrences of injury were significantly associated with six risk factors in the univariate model (odds ratios 1.51-4.00). The significantly (P < 0.05) related risk factors in the univariate model were aerobic power, smoking status, perceived fitness level, fishing/hunting as a hobby, speed limit obeyance, and witnessing or being involved in a violent fight. In the multivariate analysis, five risk factors (aerobic power, smoking status, percent body fat, body mass index, and sit-and-reach measured flexibility) were significantly (P < 0.05) associated with occupational injury. Odds ratios in the multivariate analysis varied from 1.42 to 10.11. CONCLUSION: Evidence of an association of occupational injury occurrence with certain risk factors presented in personal and non-occupational univariate and multivariate models is shown. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse.

Adult↗
PubMed1996

Do program directors and their chief residents view the role of chief resident similarly?

BACKGROUND: The chief resident plays an important role in family practice residencies and is positioned at the nexus of the relationship between the faculty and the residents. It is unknown if program directors and their respective chief residents view this position and the role of training and faculty development similarly. METHODS: Parallel surveys were sent to all family practice residency program directors and their respective chief residents to explore their perceptions of the importance of the tasks and roles of the chief resident and the effects that perceived training, feedback, and support have on the chief resident's satisfaction. RESULTS: Fifty-one percent of chief residents and their program directors returned surveys that could be analyzed in parallel. Program directors placed relatively greater importance on the administrative role of chiefs. Mentioned most frequently as problems were balancing administrative duties with other tasks, dealing with personnel issues, and working with the lack of a clear job description. Chiefs who participated in formal training programs and who perceived better burnout prevention were more satisfied with their position. CONCLUSIONS: A large number of chief residents perceived gaps in the preparation for their position, particularly with regard to administrative skills. These deficiencies are particularly ironic in light of program directors' perceptions that administrative duties are of the highest importance among the tasks assigned to chief residents. Faculty development strategies and a program of burnout prevention for chief residents should be incorporated into each residency.

Adult↗
PubMed2006

Surveying the RHIO landscape. A description of current RHIO models, with a focus on patient identification.

Across the country, new RHIOs are being formed every day. The 21 RHIOs studied by the work group illustrate the variety of purposes, funding, and record linking methods RHIOs may adopt. As this trend continues to evolve and improve, RHIOs may prove to be a valuable stepping stone on the road to a national system in which a patient's medical data will be available anywhere, anytime. Accurate patient identification and linking are the foundation of health technology that is implemented in a RHIO or any similar network that shares patient information. Without accurate patient identification, patient safety and quality of care are compromised. When high percentages of duplication or overlaying of records occurs in electronic health record databases, physician trust in the system is lost. As HIM professionals, we must be involved in addressing the security and confidentiality of RHIO databases and in defining the record linking method appropriate to the RHIO. As professionals skilled in patient identification methods and possessing significant organizational skills and personnel management experience, HIM professionals should become involved in this process at the earliest opportunity in the RHIO formation. HIM professionals can participate in long-term planning, business plan development, and organizational structure definition. Future articles will address how HIM professionals can become involved, what particular attributes and skills they can bring to the table, and job descriptions appropriate to HIM professionals in the healthcare information sharing industry. The work group urges all HIM professionals to become involved personally in this exciting new field.

Humans↗
PubMed2004

How sedentary are people in "sedentary" occupations? The physical activity of teachers in urban South India.

AIMS: The aim of this study was to assess the total and occupational physical activity status of school and college teachers in Bangalore, South India and to evaluate the use of "job description" as an indicator of occupational physical activity. METHOD: A self-administered questionnaire was given to a convenience sample of 198 (25 males and 173 females) school and college teachers. RESULTS: Despite the categorization of "teacher" in India as "sedentary", our data indicate that the overall physical activity status of teachers varies considerably and is dependent on non-occupational physical activity, such as household chores and discretionary exercise. Thus, only 12% of teachers were truly sedentary, based on computations of the contributions of all measured physical activity domains, while 10% were heavily active. The contribution of other physical activity domains to the overall physical activity status in our data set was dependent on gender; in women, the energy expenditure related to household chores was 4-fold higher than in men (P < 0.01), while in men, energy expenditure related to discretionary exercise was 3-fold higher than in women (P < 0.01). CONCLUSIONS: This study highlights the problems associated with extrapolating occupational activity using job descriptors to overall physical activity status. The findings have implications in epidemiological studies which use occupational activity as a surrogate for overall physical activity status. However, the impact of potential misclassifications will need to be assessed within a socio-cultural context.

Adult↗
PubMed2000

Does computerizing paper-and-pencil job attitude scales make a difference? New IRT analyses offer insight.

The measurement equivalence of 2 scales of the Job Descriptive Index (JDI; P. C. Smith, L. M. Kendall, & C. L. Hulin, 1969), the Supervisor Satisfaction scale and the Coworker Satisfaction scale, was examined across computerized and paper-and-pencil administrations. In this study, employees in 2 organizations (N = 1,777) were administered paper-and-pencil versions of the scales, and employees in a third organization (N = 509) were administered a computerized version. A newly developed item response theory (IRT) technique for examining differential test functioning (N. S. Raju, W. J. van der Linden, & P. F. Fleer, 1995) was used to examine measurement equivalence across media. Results support the measurement equivalence of the JDI Supervisor and Coworker scales across administration media. The implications of these findings for both practitioners and organizational researchers are discussed.

Attitude↗
PubMed1980

Some characteristics of participants in an industrial fitness programme.

A controlled study has allowed an investigation of several hypotheses relating to initial recruitment and continued participation in an employee fitness programme. Following initial physiological and psychological testing, attendance records show that the staff of the experimental company sorted themselves into four categories (non-participants, drop-outs, low adherents, and high adherents). Parallel observations were made at a second, comparable company where there was no employee fitness programme. Exercise classes met three times per week for 30 minutes of rhythmic calisthenics and endurance-type activities. Continued participation was favoured by a short stature, but perhaps because of gentle progression of intensity, there was no selective loss of obese subjects. A below average strength in high adherent men was related to their short stature. Participation was favoured by an interest in activity as the release of tension on the scale of Kenyon (women). Negative factors were a low score for personal and social factors on the scale of Holmes & Rahe (men), a recent health change (women), dissatisfaction with pay on the Job Description Index of Smith et al. (male non-participants, female drop-outs), and an interest in activity as Games of Chance (women). In the men, "Type A" score on the questionnaire of Friedman and Rosenman was highest in those with infrequent participation, but not in drop-outs; this possibly reflects a real time conflict among upper executives. Body image (Kenyon and McPherson scales), manifest anxiety (Taylor Scale) and reported health (Cornell Medical Index) were unrelated to participation in the programme. Lessons for future programming include (i) matching of prescribed activity to body build, (ii) gentle progression (to avoid discouragement of the obese), (iii) attention to the desired rewards of the individual, and (iv) flexibility of class schedules to accommodate subjects with real or perceived time conflicts.

Anxiety↗
PubMed1993

Comparing the status of women and men in academic medicine.

OBJECTIVE: To explore the status and academic productivity of women compared with men in academic internal medicine. DESIGN: Mail survey done in 1986. SETTING: A total of 107 major teaching hospitals in the United States. PARTICIPANTS: Full-time (1693 of 2510) faculty in cardiology, rheumatology, and general internal medicine; 67% of eligible men and 70% of eligible women. MEASUREMENTS: Academic productivity defined as research grants awarded, abstracts accepted, and papers published in refereed journals; academic advancement as determined by academic rank and tenure status; and monetary compensation. RESULTS: Women entered academic medicine with shorter periods of fellowship training and were less likely to be members in the Alpha Omega Alpha honor society, but they had job descriptions similar to those of men, with similar allocation of work between research, clinical, and teaching activities. After adjustment, women and men were similar in the numbers of research grants funded as principal investigator (1.9 compared with 2.0), abstracts accepted (6.8 compared with 6.1), and papers published in refereed journals (28.8 compared with 29.2; all with P > 0.20). Women were as likely as men to have tenure, but they had lower academic rank (full or associate professor; 33% compared with 47%, P < 0.001) and received less compensation ($72,000 compared with $79,600 annually; P < 0.001). CONCLUSION: Although women do similar professional tasks and achieve similar levels of academic productivity, they receive fewer rewards for their work, both in academic rank and monetary compensation.

Achievement↗
PubMedDate not supplied

The psychological contract: enhancing productivity and its implications for long-term care.

When hired, a new employee is usually given a job description and an explanation of benefits. In addition, the employee will also have a psychological contract with the organization. This contract, often unstated, reflects the main source of the employee's motivation to work hard. This is true of all groups of employees, including long-term care staff. Common examples of psychological contracts for long-term care administrative staff include autonomy, social acceptance, and being in the forefront of cutting-edge research. An awareness of these psychological contracts can result in better "fits" between employee aspirations and relevant long-term care organization tasks so that productivity is enhanced. This article outlines the steps necessary to create these good fits in ways that benefit both the organization and its employees. These recommendations are of particular relevance to administrators and supervisors in long-term carefacilities.

Efficiency↗
PubMed1989

A follow-up report of occupational stress in urban EMT-paramedics.

A survey completed by 280 nonvolunteer, urban emergency medicine technician (EMT)-paramedics revealed high levels of occupational stress. We used a four-component model of occupational stress in medical environments to show indications that much variation in the manifestation of stress was accounted for by the rank and job description of the EMT-paramedic, the district served by the EMT-paramedic, and the patient population served by the EMT-paramedic. Stress exhibited by field EMT-paramedics tended to manifest in more negative attitudes toward patients, whereas administrative-level paramedics exhibited more organizational stress. We noted that the age of the EMT-paramedic and the length of time employed as an EMT-paramedic correlated with the level of occupational stress (P less than .05). The recent occurrence of significant life events also was significantly related to the level of stress (P less than .05). An EMT-paramedic's gender, marital status, and number of calls per shift had no significant correlation to the level of occupational stress. Based on these results, we recommend tailoring occupational stress programs to meet the needs of individual EMT-paramedics. Special attempts should be made to identify and counsel EMT-paramedics who are undergoing stressful life events. Finally, we suggest that rotating EMT-paramedics through various districts on a regular basis may help alleviate the negative impact on patient care in areas that have been identified as particularly stressful. Further studies are needed to verify our hypothesis.

Administrative Personnel↗
PubMed1975

Utilization of medical services by transferred employees. Differential effect of life change on health.

Some of the health consequences of being transferred to a new job and a new community were examined. The medical records of transferred employees for one year following transfer were compared to the records of a matched control group of more permanently located employees. Because of the authors' clinical observation that an employee's job description was related to the medical response to transfer, the professional and nonprofessional (production and clerical) employees were examined as separate groups. The results demonstrated a greater utilization of health services by transferred nonprofessional, but not by transferred professional employees. The results are discussed in the light of current research in life changes and their relationship to illness.

Adaptation, Psychological↗
PubMedDate not supplied

What is an academic general internist? Career options and training pathways.

Academic divisions of general internal medicine have developed and flourished in the last 2 decades. Young faculty can join these divisions in 1 of 3 possible career paths: clinical educator, clinical researcher, and, most recently, the "hospitalist." This article describes the typical job description, training pathway, and rewards and challenges for each path for students and residents considering a career in academic general internal medicine.

Academic Medical Centers↗
PubMed1996

Dioxins and dioxin-like chemicals in blood and semen of American Vietnam veterans from the state of Michigan.

This exposure assessment pilot study tested the hypothesis that elevated blood levels of the dioxin congener 2,3,7,8-TCDD ("TCDD"), due to Agent Orange exposure, in American Vietnam veterans could be demonstrated two to three decades after Vietnam service. A second objective was to determine if dioxins, including TCDD, are present in the semen of adult males. In the early 1990s, blood samples from 50 Vietnam veterans and three pooled semen samples from 17 of them were analyzed by high-resolution gas chromatography-mass spectroscopy for dioxins, dibenzofurans, and the dioxin-like PCBs. Fifty volunteers from the Michigan Vietnam veteran bonus list, which documented Vietnam service, were invited to participate based on their self-reported exposure to Agent Orange in Vietnam. Screening of military and medical records was performed by an epidemiologist and a physician to assure that Agent Orange exposure was possible based on job description, location of service in Vietnam, and military Agent Orange spray records. Elevated 2,3,7,8-TCDD levels, over 20 ppt on a lipid basis, could still be detected in six of the 50 veterans in this nonrandomly selected group. The dioxin and dibenzofuran congeners commonly found in the U.S. population, including TCDD, were also detected in the three pooled semen samples. Quantification and comparison on a lipid basis were not possible due to low lipid concentrations where levels were below the detection limit. Therefore, semen samples were measured and reported on a wet-weight basis. Elevated blood TCDD levels, probably related to Agent Orange exposure, can be detected between two and three decades after potential exposure in some American veterans. Original levels were estimated to be 35-1,500-fold greater that that of the general population (4 ppt, lipid) at the time of exposure. In addition, the detection of dioxins in semen suggests a possible mechanism for male-mediated adverse reproductive outcomes following Agent Orange or other dioxin exposure.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1999

State-of-the-art challenges for mental health services research.

BACKGROUND: Research-based, state-of-the-art services for people with serious mental disorders would consist of demonstrably effective treatments, organized synergistically, and financed in ways that create incentives to provide such treatment. While research exists in these domains of treatment, organization and financing, this research base contains significant gaps, and what is known frequently neither informs policy making nor enters practice. REVIEW: The NIMH services-research portfolio has identified successful patient-level and system-level interventions for people with serious mental disorders, but much of this research has yet to make its way into practice. Similarly, while we have made progress in asking "what is good care?", we have much less information about the answers to "what constitutes an adequate try?". Writing a prescription for an efficacious medication does not constitute an adequate trial of that medication. Similarly, offering people boring psychosocial rehabilitation programs does not constitute an adequate try of promoting recovery via rehabilitation services, but what does? Defining what constitutes an adequate try can be a way of allocating scarce resources or it can be a polite way of defining when a system gets to give up on someone. As state governments move to contract with managed care entities for services for Medicaid beneficiaries, one of the great contracting challenges is defining and monitoring the provision of what constitutes an adequate try. DISCUSSION: To obtain better value for our health care expenditures, we need to find ways to get what we know works into practice, whether we are contracting for services or deciding which clinical therapies to pursue. For example, problem-oriented family therapy has been shown to improve clinical outcomes for people with schizophrenia, yet such interventions are rare in practice. We also need to pay more attention to the quality of the clinical care actually being delivered - not what was prescribed, nor what the clinician was trained in, nor what the job description was, but what actually is occurring. Figuring out how to contract for and disseminate efficacious treatments so that they occur and are effective in real-world settings is critically important yet is a largely unexplored area of services research. We need to answer both "what is good care?" and "how do we get it to happen?".

Journal Article↗
PubMed1992

Clinicians and research: recurring obstacles and some possible solutions.

We surveyed clinicians in residential treatment centers (RTCs) to explore their perceptions of barriers to and resources for accomplishing research and scholarly pursuits. A nationwide sampling of RTCs generated a sample of 273 respondents, which consisted of 95 psychologists, 27 psychiatrists, and 151 social workers. Our sample of clinicians expressed very favorable attitudes toward research and the scientist-practitioner model. However, the great majority are not combining the roles of clinician and researcher/scholar. The most frequently cited barriers to scholarly activity were insufficient time, research not part of the job description, and lack of funding. Recommendations are offered.

Attitude of Health Personnel↗