For several months, nurses completed ratings of the degree to which certain events relevant to absence were present during each of their scheduled workdays. The event ratings for days when the nurses decided to be absent were then compared with those for days when the nurses attended. As expected, certain events, such as ill health and tiredness, tended to covary and proved to be consistently related to absenteeism across nurses. Also as expected, some events that were not especially relevant for the nurses as a whole, like having a sick family member or friend and concerns about previous poor attendance, nonetheless emerged as being relevant to the absence behavior of certain individuals. Finally, some events were consistently related to the nurses' expressed desire to be absent but not to actual absences. We discuss these differences from two perspectives, one emphasizing the role of attribution bias and the other, a two-stage process in which such bias has no major role.
Early recognition and treatment of pediatric rheumatic diseases is associated with improved outcome. We documented access to pediatric rheumatology subspecialty care for children in British Columbia (BC), Canada, referred to the pediatric rheumatology clinic at BC Children's Hospital, Vancouver.
An audit of new patients attending the outpatient clinic from May 2006 to February 2007 was conducted. Parents completed a questionnaire through a guided interview at the initial clinic assessment. Referral dates were obtained from the referral letters. Patients were classified as having rheumatic disease, nonrheumatic disease, or a pain syndrome based on final diagnosis by a pediatric rheumatologist.
Data were collected from 124 of 203 eligible new patients. Before pediatric rheumatology assessment, a median of 3 healthcare providers were seen (range 1-11) for a median of 5 visits (range 1-39). Overall, the median time interval from symptom onset to pediatric rheumatology assessment was 268 days (range 13-4989), and the median time interval from symptom onset to referral to pediatric rheumatology was 179 days (range 3-4970). Among patients ultimately diagnosed with rheumatic diseases (n = 53), there was a median of 119 days (range 3-4970) from symptom onset to referral, and 169 days (range 31-4989) from onset to pediatric rheumatology assessment.
Children and adolescents with rheumatic complaints see multiple care providers for multiple visits before referral to pediatric rheumatology, and there is often a long interval between symptom onset and this referral.
Differential risks of occupational injuries by gender have been examined across various industries. With the number of employees in healthcare rising and an overwhelming proportion of this workforce being female, it is important to address this issue in this growing sector.
To determine whether compensated work-related injuries among females are higher than their male colleagues in the British Columbia healthcare sector.
Incidents of occupational injury resulting in compensated days lost from work over a 1-year period for all healthcare workers were extracted from a standardized operational database and the numbers of productive hours were obtained from payroll data. Injuries were grouped into all injuries and musculoskeletal injuries (MSIs). Detailed analysis was conducted using Poisson regression modelling.
A total of 42 332 employees were included in the study of whom 11% were male and 89% female. When adjusted for age, occupation, sub-sector, employment category, health region and facility, female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24-2.01)] and MSIs [1.43 (1.11-1.85)] compared to their male colleagues.
Occupational health and safety initiatives should be gender sensitive and developed accordingly.
Comment In: Occup Med (Lond). 2009 May;59(3):13719396939
To increase our understanding of patterns of change in physical activity and sleep complaints and to test whether intra-individual changes in physical activity are correlated with intra-individual changes in sleep complaints across four measurement time-points over six years, adopting both a between-person and within-person perspective.
Data from a longitudinal cohort study were used in this research. At baseline, 3187 participants took part in the study (86% women, Mage = 46.9 years). The response rate was 84% (n = 3136) after two years, 60% (n = 2232) after four years, and 40% (n = 1498) after six years. Physical activity was assessed with the  widely used 4-level physical activity scale (SGPALS), and sleep complaints with three items from the Karolinska Sleep Questionnaire (KSQ). Patterns and correlations of change between physical activity and sleep complaints were examined with latent growth curve modeling.
Changes in physical activity were associated with changes in sleep complaints across the six years. More specifically, significant associations occurred between baseline levels, correlated (between-person) change, and coupled (within-person change). These associations indicate that higher physical activity levels are not only cross-sectionally linked with fewer sleep complaints, but that increases in physical activity over time (either in comparison to others or to oneself) are paralleled by decreases in sleep complaints.
Given that changes in physical activity and sleep are correlated, our findings indicate that it is worthwhile to initiate more physically active lifestyles in physically inactive individuals; and to ensure that those who are already physically active maintain their physical activity levels over longer periods.
Collaborative, interdisciplinary care models have the potential to improve maternity care. Differing attitudes of maternity care providers may impede this process. We sought to examine the attitudes of Canadian maternity care practitioners towards labour and birth.
We performed a cross-sectional web- and paper-based survey of 549 obstetricians, 897 family physicians (400 antepartum only, 497 intrapartum), 545 nurses, 400 midwives, and 192 doulas.
Participants responded to 43 Likert-type attitudinal questions. Nine themes were identified: electronic fetal monitoring, epidural analgesia, episiotomy, doula roles, Caesarean section benefits, factors decreasing Caesarean section rates, maternal choice, fear of vaginal birth, and safety of birth mode and place. Obstetrician scores reflected positive attitudes towards use of technology, in contrast to midwives' and doulas' scores. Family physicians providing only antenatal care had attitudinal scores similar to obstetricians; family physicians practising intrapartum care and nurses had intermediate scores on technology. Obstetricians' scores indicated that they had the least positive attitudes towards home birth, women's roles in their own births, and doula care, and they were the most concerned about the consequences of vaginal birth. Midwives' and doulas' scores reflected opposing views on these issues. Although 71% of obstetricians supported regulated midwifery, 88.9% were against home birth. Substantial numbers of each group held attitudes similar to dominant attitudes from other disciplines.
To develop effective team practice, efforts to reconcile differing attitudes towards labour and birth are needed. However, the overlap in attitudes between disciplines holds promise for a basis upon which to begin shared problem solving and collaboration.
Republic of Sakha (Yakutia) is a hyperendemic region of Russian Federation for spreading of parenteral viral hepatitis B, C and D. In risk groups of these diseases are firstly medical personnel, who contacting with infection carriers including latent infections family and members of families of chronic viral hepatitis carriers.
To reveal the breadth of spreading of viral hepatitis markers in the risk groups.
The level of HBV- and HC- infection were determined in medical staff of large multi specialty hospital and family members of people with viral hepatitis B and C. Epidemiological, clinical, serological and molecular biology methods of viral hepatitis diagnostics were applied in this study.
Results of this study showed that the staff at surgery and hematology departments and all nursing staff belong to the high-risk of HBV-infection groups. Therefore, they are a priority for active immunization. Attention is paid on the fact that infectivity of medical staff is not equally distributed in dependence on type of department and position of medical staff. Rate HBV-marker detecting in "family hearths" was dependent on degree of interrelationship with infection source. According received information, in families of patientwith chronic hepatitis B spreading of infection was higher (77.6%) then in families of patients with acute hepatitis B (39.7%). At primary examination of families an anti-HCV was detected in 9.3 ? 1.8% cases, i.e. the spreading of HCV was at low-activity.
Results of our study on spreading of hepatitis B and C in Yakutia showed the high rate of appearance of HCV and HBV markers in the risk groups.
Healthcare workers are exposed to a variety of work-related hazards including biological, chemical, physical, ergonomic, psychological hazards; and workplace violence. The Occupational Health and Safety Agency for Healthcare in British Columbia (OHSAH), in conjunction with British Columbia (BC) health regions, developed and implemented a comprehensive surveillance system that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of healthcare workers.
Workplace Health Indicator Tracking and Evaluation (WHITE) is a secure operational database, used for data entry and transaction reporting. It has five modules: Incident Investigation, Case Management, Employee Health, Health and Safety, and Early Intervention/Return to Work.
Since the WHITE database was first introduced into BC in 2004, it has tracked the health of 84,318 healthcare workers (120,244 jobs), representing 35,927 recorded incidents, resulting in 18,322 workers' compensation claims. Currently, four of BC's six healthcare regions are tracking and analyzing incidents and the health of healthcare workers using WHITE, providing OHSAH and healthcare stakeholders with comparative performance indicators on workplace health and safety. A number of scientific manuscripts have also been published in peer-reviewed journals.
The WHITE database has been very useful for descriptive epidemiological studies, monitoring health risk factors, benchmarking, and evaluating interventions.
Comment In: Can J Public Health. 2009 Mar-Apr;100(2):157; author reply 157-819839296
Erratum In: Can J Public Health. 2009 Sep-Oct;100(5):397
We report on the anesthesia subsection of a comprehensive nationwide survey (Canadian Electroconvulsive Therapy Survey/Enquête canadienne sur les electrochocs) on the practice of electroconvulsive therapy (ECT) in Canada.
This comprehensive survey was sent to the 175 Canadian institutions identified as providers of ECT in 2007. Among other topics, 9 anesthesia-related questions were administered regarding anesthesiology consultation; high-risk patients; credentials of the anesthesia provider; monitoring, airway, and resuscitation equipment; anesthetic induction, muscle relaxant, vasoactive, and other perianesthetic drugs and practices; and postanesthetic discharge.
Sixty-one percent (107/175) of the institutions returned completed survey questionnaires. More than 70% of the sites reported pre-ECT anesthesiology consultation for all (61%) or most (11%) patients. In more than 90%, a Canadian Royal College-certified anesthesiologist, or equivalent, provided anesthetic care. Routine use of oximetry, electrocardiography, and blood pressure monitoring were reported by all but 2 sites; use of bite block was reported by all but 4 sites; and preoxygenation was reported by all but 7 sites. Dantrolene and capnography were not reported as readily available by 35% and 40%, respectively, with comparatively less frequent availability at non-operating room and lower-volume sites.
These results suggest safe practices of anesthesia for ECT in Canada. Further attention needs to be paid to ready availability of dantrolene and capnography, particularly at non-operating room ECT sites. Improvements in anesthetic care of patients undergoing ECT may be realized through continued knowledge translation efforts and by expanding access to currently unavailable anesthetic induction agents and, in some settings, limited clinical anesthesiology resources.
Cancer Care Ontario's Systemic Therapy Task Force recently reviewed the medical oncology system in the province. There has been growing concern about anecdotal reports of burnout, high levels of stress and staff leaving or decreasing their work hours. However, no research has systematically determined whether there is evidence to support or refute these reports. To this end, a confidential survey was undertaken.
A questionnaire was mailed to all 1016 personnel of the major providers of medical oncology services in Ontario. The questionnaire consisted of the Maslach Burnout Inventory, the 12-item General Health Questionnaire, a questionnaire to determine job satisfaction and stress, and questions to obtain demographic characteristics and to measure the staff's consideration of alternative work situations.
The overall response rate was 70.9% (681 of 961 eligible subjects): by group it was 63.3% (131/207) for physicians, 80.9% (314/388) for allied health professionals and 64.5% (236/366) for support staff. The prevalence of emotional exhaustion were significantly higher among the physicians (53.3%) than among the allied health professionals (37.1%) and the support staff (30.5%) (p
In 2008, many Western countries faced a great economic recession, the result of which was increased unemployment and reduced public expenditure.
This article focuses on changes in the self-reported mental and physical health and health symptoms of the remaining employees of Icelandic municipalities who worked within the educational system and the care service during the economic recession. We examine gender differences in health and differences between downsized workplaces and workplaces where no downsizing occurred and differences between workplaces with heavy workload and light workload.
The study is based on a balanced panel online survey and focus groups.
The main finding is that both the mental and physical health of employees deteriorated year by year between 2010, 2011 and 2013 in all workplaces although the downsized workplaces and workplaces with heavy workloads fared worse. At the same time, public expenditure on the health care system was reduced.
We hope that our results encourage further studies in the field and that they will be taken into account when dealing with prevention and rehabilitation initiatives.