Journey to work:exploring difficulties, solutions and the impact of aging

A study was conducted in the UK, as part of the New Dynamics of Ageing Working Late project, of the journey to work among 1215 older workers (age groups 45-49, 50-55, 56-60 and 60 + ). The aim was to identify problems or concerns that they might have with their commute, strategies that have been adopted to address them, and the role that employers can play to assist them. Follow-up interviews with 36 employees identified many strategies for assisting with the problems of journeys to work, ranging from car share and using public transport to flexible working and working some days from home. Further interviews with a sample of 12 mainly larger companies showed that employers feel a responsibility for their workers’ commute, with some offering schemes to assist them, such as adjusting work shift timings to facilitate easier parking. The research suggests that the journey to work presents difficulties for a significant minority of those aged over 45, including issues with cost, stress, health, fatigue and journey time. It may be possible to reduce the impact of these difficulties on employee decisions to change jobs or retire by assisting them to adopt mitigating strategies. It does not appear that the likelihood of experiencing a problem with the journey to work increases as the employee approaches retirement; therefore, any mitigating strategy is likely to help employees of all ages. These strategies have been disseminated to a wider audience through an online resource at www.workinglate.org.

Methotrexate polyglutamates as a potential marker of adherence to long-term therapy in children with juvenile idiopathic arthritis and juvenile dermatomyositis:an observational, cross-sectional study

Introduction: Methotrexate (MTX) is a cornerstone of treatment in a wide variety of inflammatory conditions, including juvenile idiopathic arthritis (JIA) and juvenile dermatomyositis (JDM). However, owing to its narrow therapeutic index and the considerable interpatient variability in clinical response, monitoring of adherence to MTX is important. The present study demonstrates the feasibility of using methotrexate polyglutamates (MTXPGs) as a biomarker to measure adherence to MTX treatment in children with JIA and JDM. Methods: Data were collected prospectively from a cohort of 48 children (median age 11.5 years) who received oral or subcutaneous (SC) MTX therapy for JIA or JDM. Dried blood spot samples were obtained from children by finger pick at the clinic or via self- or parent-led sampling at home, and they were analysed to determine the variability in MTXPG concentrations and assess adherence to MTX therapy. Results: Wide fluctuations in MTXPG total concentrations (>2.0-fold variations) were found in 17 patients receiving stable weekly doses of MTX, which is indicative of nonadherence or partial adherence to MTX therapy. Age (P = 0.026) and route of administration (P = 0.005) were the most important predictors of nonadherence to MTX treatment. In addition, the study showed that MTX dose and route of administration were significantly associated with variations in the distribution of MTXPG subtypes. Higher doses and SC administration of MTX produced higher levels of total MTXPGs and selective accumulation of longer-chain MTXPGs (P < 0.001 and P < 0.0001, respectively). Conclusions: Nonadherence to MTX therapy is a significant problem in children with JIA and JDM. The present study suggests that patients with inadequate adherence and/or intolerance to oral MTX may benefit from SC administration of the drug. The clinical utility of MTXPG levels to monitor and optimise adherence to MTX in children has been demonstrated. Trial registration: ISRCTN Registry identifier: ISRCTN93945409. Registered 2 December 2011.

'Taking a sickie':Job satisfaction and job involvement as interactive predictors of absenteeism in a public organization

Correlations between absenteeism and work attitudes such as job satisfaction have often been found to be disappointingly weak. As prior work reveals, this might be due to ignoring interactive effects of attitudes with different attitude targets (e.g. job involvement and organizational commitment). Drawing on basic principles in personality research and insights about the situational variability of job satisfaction judgments, we proposed that similar interactions should be present also for attitudes with the same target. More specifically, it was predicted that job involvement affects absenteeism more if job satisfaction is low as this indicates a situation with weak constraints. Both attitudes were assessed in a sample of 436 employees working in a large civil service organization, and two indexes of absence data (frequency and time lost) were drawn from personnel records covering a 12-month period following the survey. Whereas simple correlations were not significant, a moderated regression documented that the hypothesized interaction was significant for both indicators of absence behaviour. As a range of controls (e.g. age, gender, job level) were accounted for, these findings lend strong support to the importance of this new, specific form of attitude interaction. Thus, we encourage researchers not only to consider interactions of attitudes with a different focus (e.g. job vs. organization) but also interactions between job involvement and job satisfaction as this will yield new insights into the complex function of attitudes in influencing absenteeism. © 2007 The British Psychological Society.

The effect of age, gender and driver status on pedestrians' intentions to cross the road in risky situations

The theory of planned behaviour (TPB) has been used successfully in the past to account for pedestrians' intentions to cross the road in risky situations. However, accident statistics show age and gender differences in the likelihood of adult pedestrian accidents. This study extends earlier work by examining the relative importance of the model components as predictors of intention to cross for four different adult age groups, men, women, drivers and nondrivers. The groups did not differ in the extent to which they differentiated between two situations of varying perceived risk. The model fit was good, but accounted for less of the variance in intention for the youngest group (17-24) than for other age groups. Differences between the age groups in intention to cross seemed to be due to differences in perceived value of crossing rather than differences in perceived risk. Women were less likely to intend to cross than men and perceived more risk, and there were important age, gender and driver status differences in the importance of the TPB variables as predictors of intention. A key implication of these findings is that road safety interventions need to be designed differently for different groups. © 2006 Elsevier Ltd. All rights reserved.

Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma

BACKGROUND: Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. OBJECTIVE: To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. METHODS: Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. RESULTS: A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. CONCLUSIONS: A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.

Use of social media to enable medical teams to work virtually (and better)

Refers to: Sophie Scott The researcher of the future…makes the most of social media The Lancet, Volume 381, Supplement 1, 27 February 2013, Pages S5-S6

Career development and careerist orientation to work:it's a question of trust, isn't it?

Presentation

Deficient inhibition of return in subclinical OCD only when attention is directed to the threatening aspects of a stimulus

Background - Inhibition of return (IOR) is thought to reflect inhibition of previously attended but irrelevant stimuli. Deficient IOR would increase the likelihood of revisiting previously searched locations or objects, thus leading to unproductive perseverations. Method - Therefore, using a novel IOR task, we investigated whether high scoring checkers attentional biases to threat would result in dysfunctional inhibitory functioning compared to low checkers. In two tasks, we compared 53 subclinical high and 49 low checkers regarding IOR effects for stimuli that were concordant with the concerns of high but not of low checkers (electrical kitchen appliances: e.g., toaster, kettle). The difference between the two tasks was the cueing procedure. In one task, an appliance was switched “ON” and “OFF” as an unpredictive cue, drawing attention to the functionality of the stimulus. Results - In this task, IOR was specifically attenuated in high checkers. In the other task, however, the cue was more abstract in form of a yellow outline that appeared around one of two appliances. Although the appliance was either “ON” or “OFF,” this did not seem to matter and high checkers revealed a typical IOR pattern similar to low checkers. Conclusions - We conclude that IOR mechanisms might not be generally deficient in high checkers; rather only when attention is drawn to the threatening aspects of ecologically valid stimuli, then disengagement of attention is deficient in high checkers. We make suggestions on how our task-specific findings may inform cognitive interventions that target attentional control in the treatment of checking/obsessive–compulsive disorder.

Performance enhancement of asymmetric filtered 40 Gb/s carrier suppressed return to zero-differential phase shift keying receiver in a 50 GHz grid

The authors present the impact of asymmetric filtering of strong (e.g. 35 GHz) optical filters on the performance of 42.7 Gb/s 67% (carrier suppressed return to zero)-differential phase shift keying systems. The performance is examined (in an amplified spontaneous emission (ASE) noise-limited regime and in the presence of chromatic dispersion) when offsetting the filter at the receiver by substantial amounts via balanced, constructive and destructive single-ended detections. It is found that with a slight offset (vestigial side band) or an offset of almost half of the modulation frequency (single-side band), there is a significant improvement in the calculated 'Q'. © The Institution of Engineering and Technology 2013.

Predictors of household hardship in a resource constrained environment:the case of sub-Saharan Africa

Using data from the 2004 wave of the Afrobarometer survey, this study examines correlates of household hardship in three countries of sub-Saharan Africa: Tanzania, Zambia, and Zimbabwe. Findings provide partial support for the hypothesized relationship. Specifically, poverty reduction initiatives and informal assistance are associated with reduced hardship while civic engagement is related to an increase in household hardship. We also note that certain demographic characteristics are linked to hardship. Policy and practice implications are suggested. © The Author(s) 2011.

Double jeopardy:subordinates' worldviews and poor performance as predictors of abusive supervision

Purpose - To test a moderated mediation model where a positive relationship between subordinates’ perceptions of a dangerous world—the extent to which an individual views the world as a dangerous place—and supervisory abuse is mediated by their submission to authority figures, and that this relationship is heightened for more poorly performing employees. Design/Methodology/Approach - Data were obtained from 173 subordinates and 45 supervisors working in different private sector organizations in Pakistan. Findings - Our model was supported. It appears that subordinates’ dangerous worldviews are positively associated with their perceptions of abusive supervision and that this is because such views are likely to lead to greater submission to authority figures. But this is only for those employees who are performing more poorly. Implications - We highlight the possibility that individual differences (worldviews, attitudes to authority figures, and performance levels) may lead employees to become victims of abusive supervision. As such, our research informs organizations on how they may better support supervisors in managing effectively their subordinate relationships and, in particular, subordinate poor performance. Originality/Value - We add to recent work exploring subordinate-focused antecedents of abusive supervision, finding support for the salience of the previously untested constructs of individual worldviews, authoritarian submission, and individual job performance. In so doing we also extend research on dangerous worldviews into a new organizational setting. Finally, our research takes place within a new Pakistani context, adding to the burgeoning non-US based body of empirical work into the antecedents and consequences of abusive supervision.

Serum procalcitonin, interleukin-6, soluble intercellular adhesin molecule-1 and IgG to short-chain exocellular lipoteichoic acid as predictors of infection in total joint prosthesis revision

The diagnosis of prosthetic joint infection and its differentiation from aseptic loosening remains problematic. The definitive laboratory diagnostic test is the recovery of identical infectious agents from multiple intraoperative tissue samples; however, interpretation of positive cultures is often complex as infection is frequently associated with low numbers of commensal microorganisms, in particular the coagulase-negative staphylococci (CNS). In this investigation, the value of serum procalcitonin (PCT), interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sICAM-1) as predictors of infection in revision hip replacement surgery is assessed. Furthermore, the diagnostic value of serum IgG to short-chain exocellular lipoteichoic acid (sce-LTA) is assessed in patients with infection due to CNS. Presurgical levels of conventional serum markers of infection including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) is also established. Forty-six patients undergoing revision hip surgery were recruited with a presumptive clinical diagnosis of either septic (16 patients) or aseptic loosening (30 patients). The diagnosis was confirmed microbiologically and levels of serum markers were determined. Serum levels of IL-6 and sICAM-1 were significantly raised in patients with septic loosening (P=0.001 and P=0.0002, respectively). Serum IgG to sce-LTA was elevated in three out of four patients with infection due to CNS. In contrast, PCT was not found to be of value in differentiating septic and aseptic loosening. Furthermore, CRP, ESR and WBC were significantly higher (P=0.0001, P=0.0001 and P=0.003, respectively) in patients with septic loosening. Serum levels of IL-6, sICAM-1 and IgG to sce-LTA may provide additional information to facilitate the diagnosis of prosthetic joint infection.

A retrospective study examining the nature, contributory factors and predictors of dispensing errors in community pharmacy

Introduction: Since 2005, the workload of community pharmacists in England has increased with a concomitant increase in stress and work pressure. However, it is unclear how these factors are impacting on the ability of community pharmacists to ensure accuracy during the dispensing process. This research seeks to extend our understanding of the nature, outcome, and predictors of dispensing errors. Methodology: A retrospective analysis of a purposive sample of incident report forms (IRFs) from the database of a pharmacist indemnity insurance provider was conducted. Data collected included; type of error, degree of harm caused, pharmacy and pharmacist demographics, and possible contributory factors. Results: In total, 339 files from UK community pharmacies were retrieved from the database. The files dated from June 2006 to November 2011. Incorrect item (45.1%, n = 153/339) followed by incorrect strength (24.5%, n = 83/339) were the most common forms of error. Almost half (41.6%, n = 147/339) of the patients suffered some form of harm ranging from minor harm (26.7%, n = 87/339) to death (0.3%, n = 1/339). Insufficient staff (51.6%, n = 175/339), similar packaging (40.7%, n = 138/339) and the pharmacy being busier than normal (39.5%, n = 134/339) were identified as key contributory factors. Cross-tabular analysis against the final accuracy check variable revealed significant association between the pharmacy location (P < 0.024), dispensary layout (P < 0.025), insufficient staff (P < 0.019), and busier than normal (P < 0.005) variables. Conclusion: The results provide an overview of some of the individual, organisational and technical factors at play at the time of a dispensing error and highlight the need to examine further the relationships between these factors and dispensing error occurrence.