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PubMed2002

Balancing breastfeeding and paid employment: a project targeting employers, women and workplaces.

Since breastfeeding is acknowledged as the best nutrition for young babies, it needs to be protected, supported and promoted. This includes enabling mothers to continue breastfeeding even when they return to work. This paper describes a project that promotes balancing breastfeeding and paid work through the development, distribution, promotion and evaluation of suitable materials to workplaces, employers and women in Australia. Information provided in a workplace kit was based on previous successful strategies from published works in refereed journals and in consultation with employers, employees and other key people. Information for employees was further summarized and translated into Arabic, Chinese, Turkish, Spanish and Vietnamese. Over 50,000 information kits were distributed Australia-wide using a database that comprised contact details of medium to large workplaces plus employee and employer organizations, with preference given to workplaces that employed women of childbearing age and women from diverse cultural backgrounds. The translated material was also distributed to migrant resource centres and working women's centres around Australia. Promotion of the project was extensive, resulting in 20 newspaper articles, 17 radio interviews or news items, and articles in 18 newsletters and professional journals and three magazines. The project was also promoted at three conferences and one seminar. Evaluation (directed at employers) focused primarily on the distribution and content of the information kit, since the evaluation was conducted soon after distribution. The evaluation survey was sent to 1571 valid contacts (808 e-mail addresses, 1360 fax numbers). The response rate was 12.8% (n = 202). Seventy per cent of responding businesses rated the information kit as excellent. Over half anticipated the kit would be useful in their organization, while over two-thirds agreed that the kit provided sufficient information and suitable solutions to support balancing breastfeeding and work in their organization. While this project has achieved its objectives, further work is required to assist organizations to develop and implement policies and procedures for balancing breastfeeding and work, so that breastfeeding mothers who are returning to work can continue to breastfeed as long as they and their baby require it.

Attitude to Health↗
PubMedDate not supplied

A comparison of breastfeeding rates in an urban birth cohort among women delivering infants at hospitals that employ and do not employ lactation consultants.

OBJECTIVE: To compare rates of breastfeeding at hospital discharge between facilities that employ and do not employ International Board Certified Lactation Consultants (IBCLCs). METHODS: This study used a cross-sectional design. Data from 11,525 birth certificates of Philadelphia residents who delivered in 2003 were used. Breastfeeding was assessed using a question included on the Pennsylvania birth record, "Is the infant being breastfed at discharge?" The Philadelphia Department of Public Health's lactation consultants collected information on number of hours worked annually by IBCLCs by facility. RESULTS: After adjusting for race/ethnicity, education, insurance status, age, marital status, route of delivery, birth weight, and gestational age, delivering in a hospital that employed an IBCLC was associated with a 2.28 (95% confidence interval [CI] =1.98,2.62) times increase in the odds of breastfeeding at hospital discharge. Among women receiving Medicaid, delivering at a hospital that employed IBCLCs was associated with a 4.13 (95% CI =3.22,4.80) times increase in the odds of breastfeeding at hospital discharge. CONCLUSIONS: The findings presented here identify an association between delivering at a facility that employs IBCLCs and breastfeeding at hospital discharge. As the strength of this association is not negligible, particularly for women on Medicaid, these findings may be used to encourage widespread use of IBCLCs.

Breast Feeding↗
PubMed2004

Tax incidence and net benefits in the market for employment-related health insurance: sensitivity of estimates to the incidence of employer costs.

The market for employment-related coverage contains public transfers through the tax system and private transfers across workers with predictably different risks. We examine both transfers across a wide range of employee characteristics, including age, race, ethnicity, family size, poverty level, and health risk. To resolve longstanding questions regarding the incidence of employer contributions, we simulate a range of alternative incidence scenarios in which (i) all employees offered coverage in a firm share equally in the employer's costs, (ii) burdens are narrowly targeted according to employee-specific health risks, and (iii) intermediate cases with burdens targeted by job characteristics, age, sex, race, ethnicity, and family size. Our results provide evidence regarding the distribution of tax subsidies and net benefits under a range of scenarios that we believe bound the true incidence of employer premium contributions.

Employer Health Costs↗
PubMed2000

Renewing the model employer. Changing employment relations and "partnership" in the health and private sectors.

Drawing from original empirical data this paper compares the changing nature of employment relations in the health and private sectors. A key concern is to assess the extent to which the emergence of partnership-type arrangements between employers and trade unions lays the basis for the "renewal" of the traditional public sector concept of the model employer. Empirically, the paper draws on a survey of trade union representatives from 238 workplaces and a case study of a hospital trust. The data reveal that employment relations in the NHS are more collectivist when compared with the private sector. However, the development of partnership in the NHS is hamstrung by ongoing training and involvement gaps and widespread work intensification.

Employment↗
PubMed1996

A comparison of patients attending general dental practices employing or not employing dental hygienists.

Previous studies have shown that dental practices employing dental hygienists provide a more periodontally oriented mix of dental services. Little is known about differences in the characteristics of patients who attend these practices, and whether these reflect the orientation of service delivery. In this study, a comparison was made between patients attending private general dental practices employing hygienists and patients attending practices without hygienists in Adelaide, South Australia. A questionnaire was mailed to 2391 patients, and valid responses were received from 632 patients attending 12 practices employing hygienists, and 1052 patients attending 22 practices not employing hygienists. Bivariate analysis of the responses comparing the two groups of patients was conducted using ANOVA for continuous variables and chi-square statistics for categorical variables. A multiple logistic regression model was developed to identify characteristics of patients attending practices with hygienists. Examination of significant (p < 0.05) findings revealed that patients attending practices with hygienists had a higher socio-economic status, had a more preventive pattern of use of services, had better knowledge of periodontally related topics and it was more likely that the dental profession was their main source of information of these topics. These findings indicate that patient profiles do reflect the orientation of service delivery within dental practices and raise the question of whether the dental practice alters the patient's knowledge and behaviour or whether certain patients selectively seek care from practices with hygienists.

Adult↗
PubMed2000

Direct support in supported employment and its relation to job typicalness, coworker involvement, and employment outcomes.

Supported employment is a comprehensive package of strategies continually evolving and designed to successfully employ people with disabilities. The emerging nature of natural support is receiving extensive attention. Understanding and improving natural support strategies is a means to provide uniquely distinctive personalized supports. It is this underlying theme that has driven four previous research reports regarding typical employment features and their relation to employment outcomes for people with disabilities. In this report we investigate the previously raised issue that high levels of direct support are associated with less typicalness, integration, and wages. This study shows that wage and integration outcomes can be increased, even if there is a high level of direct support, if there is coworker training.

Adolescent↗
PubMed2004

Facilitators and barriers to employment: the perspectives of people with psychiatric disabilities and employment service providers.

This study examined the perspectives of people with psychiatric disabilities and employment service providers regarding factors that most directly help or hinder consumer efforts to obtain and maintain employment. Forty-four adults with serious mental illness (SMI) (consumers) and 30 providers participated in 12 focus groups across Massachusetts. We began both consumer and provider groups by posing two broad questions: 1) what factors most help people with SMI get and keep jobs (facilitators), and 2) what factors most prevent people with SMI from getting and keeping jobs (barriers)? Data were analyzed qualitatively and both person and environmental factors were highlighted. Among facilitators, participants agreed that quality consumer-provider relationships and individualized employment services are most instrumental in helping consumers achieve employment goals. Participants identified a range of environmental barriers, including issues related to the service system, entitlement programs, non-human resources, and social stigma. Implications for services are discussed.

Adult↗
PubMed2004

What do employers think about employing people with experience of mental illness in New Zealand workplaces?

The researchers investigated employers' experiences with individuals with a mental illness and in their workplaces. Seventy-two business owners or human resource managers were interviewed. Most knew the prospective employee's health background prior to deciding to employ them. The majority of the reported experiences with employed individuals were very positive. Key strategies the employers or managers reported using to support employees were: to create trustworthy relationships, to work through issues and to seek external support.

Employment↗
PubMed1995

Parent caregivers: a comparison of employed and not employed daughters.

A major task for social workers is sorting out the kinds of assistance needed by families who care for an elderly parent. In particular, information is needed about the differential effects of employment on daughters who care for their elderly parent. This study describes parental caregiving among three groups: daughters who were employed, daughters who were never employed while caregivers, and daughters who ended their employment to continue caregiving. The effects of caregiving on these three groups, as well as the daughters' involvement with care tasks and use of formal and informal assistance, are examined.

Adult↗
PubMed1994

Discrepancies in employer-sponsored health insurance among Hispanics, blacks, and whites: the effects of sociodemographic and employment factors.

Using a nationally representative sample of employed adults from the 1987 National Medical Expenditure Survey (NMES), this research explores differences in the incidence and predictors of employer-sponsored health insurance among Hispanics, blacks, and whites. The data suggest that: 1) whites are most likely, and Hispanics are least likely, to have employer-sponsored medical insurance in their own name, or in the name of another individual; 2) Hispanics are most likely, and whites are least likely, to be completely uninsured; and 3) the factors which increase the odds of receiving employer-sponsored coverage in one's own name are relatively similar across racial groups, though they differ substantially in magnitude.

Adult↗
PubMed1998

Employers' attitudes towards employment of people with mental illnesses in Mzuzu, Malawi.

In Mzuzu as elsewhere, people with mental health problems have trouble finding and keeping jobs, and one aim of psychiatric rehabilitation is to assist them in this. This requires an understanding of the factors which lead to under-employment in this group, including the stigmatising attitudes of potential employers. Our survey explored this with hand delivered questionnaire administered to 58 of the main employers in Mzuzu, of whom 46 (79%) responded. Despite an often assumed negative attitude towards the mentally ill, we did not find high levels of stigmatisation or discrimination against this group. Fifty two per cent of respondents stated that they would consider offering work to recovered psychiatric patients and might even adapt working practices or provide extra training to accommodate them. As well as guiding our community education programmes on mental health the findings have implications for psychiatric rehabilitation services in the region, which as well as attending to daily living skills and rural crafts should be focused to maximise clients' employment opportunities on the open job market.

Attitude to Health↗
PubMed2006

Social inclusion in workplaces where people with intellectual disabilities are employed: implications for supported employment professionals.

This research investigated elements of workplace culture across eight New Zealand workplaces where people with intellectual disability were employed. Using a semi-structured interview format, eight employers were surveyed, and variations in job entry procedures, orientation and training, company policies, job design, customs and practice, and social opportunities were examined. Factors influencing inclusion in the workplace culture of a total of 16 employees, eight supported employees and eight co-workers without disabilities, were identified and compared. The findings indicated that supported workers had a lower level of inclusion than co-workers. Several factors influencing inclusion of employees in the workplace culture were identified; full-time vs. part-time, level of employment support, limiting expectations and employer/co-worker attitudes. The use of a workplace culture survey by supported employment professionals has several benefits, including the identification of potentially inclusive workplaces, the facilitation of a good person and workplace environment match, the possibility of monitoring inclusion levels, encouragement of full work shift placements, and the provision of effective support on the job.

Humans↗
PubMedDate not supplied

Employment outcomes of persons following traumatic brain injury: pre-injury, post-injury, and supported employment.

This paper provides a prospective analysis of the pre-injury, post-injury and supported employment work histories of 20 persons who survived a severe head injury. All persons had a very limited or inconsistent work history post-injury, due to the severity of the injury. Data are presented on the placement outcomes and include factors such as wages, hours worked, months of employment and type of occupation. The supported employment model is described and the job coach approach is presented in some detail. The most significant finding of this preliminary report is that, as an aggregate group, supported employment was able to facilitate restoration of vocational capacity from pre-injury levels based on total months worked.

Activities of Daily Living↗
PubMed1985

Medicare program; limitation on payment for services furnished to employed aged and aged spouses of employed individuals--HCFA. Final rule.

These regulations amend and respond to comments on the final Medicare rules published on April 13, 1983 which set forth policies and procedures under which Medicare is secondary paper for health care items and services furnished to employed individuals age 65 through 69 and their spouses age 65 through 69, who are covered under employer group health plans of employers which employ 20 or more employees. The April 1983 regulations implemented section 116(b) of the Tax Equity and Fiscal Responsibility Act of 1982 (Pub. L. 97-248). These regulations also have been changed to include provisions of the Deficit Reduction Act of 1984 (Pub. L. 98-369), enacted July 18, 1984, which modified application of these rules to employees' spouses age 65 through 69 and changed the age limit for individuals subject to the secondary payer provisions to the month before the month the individual attains age 70. Previously the age limit was the month in which the individual attained age 70.

Aged↗
PubMed2006

Reexamining the arthritis-employment interface: perceptions of arthritis-work spillover among employed adults.

OBJECTIVE: To examine employed individuals' perceptions of arthritis-work spillover (AWS), the reciprocal influence of arthritis on work and work on arthritis, and the demographic, illness, and work context factors associated with AWS. METHODS: The study group comprised 492 employed individuals with osteoarthritis or inflammatory arthritis. Participants completed an interview-administered, structured questionnaire assessing AWS, demographic (e.g., age, sex), illness (e.g., disease type, pain, activity limitations), and work context (e.g., workplace control, hours of work) variables. Principal components analysis, reliability analysis, and multiple linear regression were used to analyze the data. RESULTS: A single factor solution emerged for AWS. The scale had an internal reliability of 0.88. Respondents were more likely to report that work interfered with caring for their arthritis than they were to report that their disease affected their work performance. Younger respondents, those with more fatigue and workplace activity limitations, and those working in trades and transportation reported more AWS. Individuals with more control over their work schedules reported less AWS. CONCLUSION: The results of this study extend research on arthritis by reexamining the interface between arthritis and employment. This study introduces a new measure of AWS that enhances the range of tools available to researchers and clinicians examining the impact of arthritis in individuals' lives.

Arthritis↗
PubMedDate not supplied

Relation of the pre-employment drug testing result to employment status: a one-year follow-up.

All employees hired over a six-month period at a large hospital underwent pre-employment urinary toxicology screening. Results of the screening were kept confidential. After a year of employment, the personnel folders of all employees studied were reviewed. Twenty-two of 180 employees (12%) had tested positive for drug use. Employees in clerical/aide positions were significantly more likely to test positive than were employees in professional positions (17% vs. 6%). Drug-positive employees were also more likely to be young and male. Comparison of job performance variables, job retention, supervisor evaluations, and reasons for termination showed no difference between drug-positive and drug-negative employees. Eleven drug-negative employees were fired during the study; no drug-positive employee was fired. There was a strongly significant difference between clerical and professional employees on each of these variables. This study did not find a relation between drug use and job performance. The widespread use of drug screening prior to employment makes further studies of this issue important.

Adult↗
PubMed1998

The process of vocational rehabilitation for employed and unemployed people on sick-leave: employed people vs unemployed people in Stockholm compared with circumstances in rural Jämtland, Sweden.

The likelihood that a period of sick-leave will result in a temporary disability pension is about three times greater for unemployed people than for those with jobs. The aim of this study was 1) to compare the vocational rehabilitation of the employed with the rehabilitation of the unemployed in the city of Stockholm and 2) to compare the results with previous results from rural Jämtland. The study was based on 156 matched cases on long-term sick-leave (90 days or more) initiated during 1992 and 1993. Two inclusion criteria were that the diagnoses should indicate low-back pain or problems in the neck/shoulders, and that the patients should be below 58 years of age. Our hypothesis was that the unemployed were disregarded in vocational rehabilitation. The results confirm this in that rehabilitation plans are not established to the same extent for the unemployed as for the employed. Against our hypothesis, however, no difference exists in rehabilitation impulse, rehabilitation investigation or rehabilitation measures received. The major finding of the study is, instead, that rehabilitation in general seems beset with problems. Rehabilitation activities seem far too few and initiated unnecessarily late. Neither the employers nor the social insurance offices seem to be fulfilling their statutory duties. The results of the study correspond well with the results previously found in rural Jämtland.

Adult↗
PubMed1998

The changing context of employment in the NHS: some legal implications of changes to employment contracts.

The NHS has undergone and continues to undergo rapid change. As a result of this, the duties and responsibilities of employees will also change. Managers within the NHS have a responsibility to ensure that appropriate contracts of employment are held by employees and that, where required, variations in these contracts are documented. This paper uses the example of the changing role of the Executive Nurse Director to highlight the importance of this need. It concludes by warning that failure to consider both the legal duties placed on employers when implementing contractual variations and the legal implications of adopting an unlawful method of variation, might lead to large legal bills and a demand on managerial time dealing with any legal claim against the employer.

Contract Services↗