Leadership and organisational outcomes in healthcare

This research examined to what extent and how leadership is related to organisational outcomes in healthcare. Based on the Job Demands-Resource model, a set of hypotheses was developed, which predicted that the effect of leadership on healthcare outcomes would be mediated by job design, employee engagement, work pressure, opportunity for involvement, and work-life balance. The research focused on the National Health Service (NHS) in England, and examined the relationships between senior leadership, first line supervisory leadership and outcomes. Three years of data (2008 ��� 2010) were gathered from four data sources: the NHS National Staff Survey, the NHS Inpatient Survey, the NHS Electronic Record, and the NHS Information Centre. The data were drawn from 390 healthcare organisations and over 285,000 staff annually for each of the three years. Parallel mediation regressions modelled both cross sectional and longitudinal designs. The findings revealed strong relationships between senior leadership and supervisor support respectively and job design, engagement, opportunity for involvement, and work-life balance, while senior leadership was also associated with work pressure. Except for job design, there were significant relationships between the mediating variables and the outcomes of patient satisfaction, employee job satisfaction, absenteeism, and turnover. Relative importance analysis showed that senior leadership accounted for significantly more variance in relationships with outcomes than supervisor support in the majority of models tested. Results are discussed in relation to theoretical and practical contributions. They suggest that leadership plays a significant role in organisational outcomes in healthcare and that previous research may have underestimated how influential senior leaders may be in relation to these outcomes. Moreover, the research suggests that leaders in healthcare may influence outcomes by the way they manage the work pressure, engagement, opportunity for involvement and work-life balance of those they lead.

Labor Cost Analysis for the Food Service Industry

There are many factors which can assist in controlling the cost of labor in the food service industry. The author discusses a number of these, including scheduling, establishing production standards, forecasting workloads, analyzing employee turnover, combating absenteeism, and controlling overtime.

Condi����es de trabalho e sa��de ps��quica de servidores t��cnico-administrativos da UFRN

Unfavorable working conditions constitute one of the factors that may contribute to cause psychic suffering and behavioral disorders in workers. This research aimed to characterize the working conditions public servant technical- administrative , specifically the auxiliaries and assistants in administration of the Federal University of Rio Grande do Norte ��� UFRN, Natal, Brasil, as well to identify the incidence of psychic suffering in this group of public servants. As a strategy, we chose a case study of multi-method type, descriptive with quantitative and qualitative sequential steps. For this, it initially performed desk research by surveying epidemiological data for these public servants working in central campus, to identify the major diseases presented in the period from January 2011 to June 2014. Then, we proceeded to diagnostic step of the aspects related to work, by applying online and in loco of Working Conditions Survey (already validated by Borges et al., 2013a) in 11 sectors selected according to the following criteria: high number of workers public servants and major and minor percentage of absences for health care for ICD-F (according to records of Sector of Workers Health Care - DAS). In the treatment of the data the spreadsheet editor software Microsoft Office Excel and statistical SPSS Statistical Package for Social Sciences were used and made qualifying type of content analysis of open questions. Applied to this study 174 public servants and the results show a predominance of absenteeism due to mental or behavioral disorders (ICD F), musculoskeletal diseases (ICD M) and respiratory system (ICD J). Among the factors that were significant are the working hours (contractual and legal); Physical Effort (M = 2.59) and workspace (M = 2.58) - physical and material conditions; encouraging collaboration (M = 3.5) - processes and characteristics of the work; and participation (M = 1.78) - social-management environment. Therefore, it infers the existence of a relationship between these factors and some of the reasons for absenteeism reported by participants. It is suggested the expansion of this research with studies involving other professionals (including scholarship workers and contractors) and specific sectors.

Can a Broader Education Narrow the Gap? Evidence on Non-Academic Features of Schooling

<p>Empirical studies of education programs and systems, by nature, rely upon use of student outcomes that are measurable. Often, these come in the form of test scores. However, in light of growing evidence about the long-run importance of other student skills and behaviors, the time has come for a broader approach to evaluating education. This dissertation undertakes experimental, quasi-experimental, and descriptive analyses to examine social, behavioral, and health-related mechanisms of the educational process. My overarching research question is simply, which inside- and outside-the-classroom features of schools and educational interventions are most beneficial to students in the long term? Furthermore, how can we apply this evidence toward informing policy that could effectively reduce stark social, educational, and economic inequalities?</p><p>The first study of three assesses mechanisms by which the Fast Track project, a randomized intervention in the early 1990s for high-risk children in four communities (Durham, NC; Nashville, TN; rural PA; and Seattle, WA), reduced delinquency, arrests, and health and mental health service utilization in adolescence through young adulthood (ages 12-20). A decomposition of treatment effects indicates that about a third of Fast Track���s impact on later crime outcomes can be accounted for by improvements in social and self-regulation skills during childhood (ages 6-11), such as prosocial behavior, emotion regulation and problem solving. These skills proved less valuable for the prevention of mental and physical health problems.</p><p>The second study contributes new evidence on how non-instructional investments ��� such as increased spending on school social workers, guidance counselors, and health services ��� affect multiple aspects of student performance and well-being. Merging several administrative data sources spanning the 1996-2013 school years in North Carolina, I use an instrumental variables approach to estimate the extent to which local expenditure shifts affect students��� academic and behavioral outcomes. My findings indicate that exogenous increases in spending on non-instructional services not only reduce student absenteeism and disciplinary problems (important predictors of long-term outcomes) but also significantly raise student achievement, in similar magnitude to corresponding increases in instructional spending. Furthermore, subgroup analyses suggest that investments in student support personnel such as social workers, health services, and guidance counselors, in schools with concentrated low-income student populations could go a long way toward closing socioeconomic achievement gaps.</p><p>The third study examines individual pathways that lead to high school graduation or dropout. It employs a variety of machine learning techniques, including decision trees, random forests with bagging and boosting, and support vector machines, to predict student dropout using longitudinal administrative data from North Carolina. I consider a large set of predictor measures from grades three through eight including academic achievement, behavioral indicators, and background characteristics. My findings indicate that the most important predictors include eighth grade absences, math scores, and age-for-grade as well as early reading scores. Support vector classification (with a high cost parameter and low gamma parameter) predicts high school dropout with the highest overall validity in the testing dataset at 90.1 percent followed by decision trees with boosting and interaction terms at 89.5 percent.</p>

Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children's school performance.

This study examined the intergenerational effects of parental conviction of a substance-related charge on children's academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. State administrative data from North Carolina courts, birth records, and school records were linked for 2005-2012. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics; for example, mother's educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. While the children of convicted parents fared worse on average, much--but not all--of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children.

Effectiveness and cost-effectiveness of a physical activity loyalty scheme for behaviour change maintenance: a cluster randomised controlled trial

Background<br/>Increasing physical activity in the workplace can provide employee physical and mental health benefits, and employer economic benefits through reduced absenteeism and increased productivity. The workplace is an opportune setting to encourage habitual activity. However, there is limited evidence on effective behaviour change interventions that lead to maintained physical activity. This study aims to address this gap and help build the necessary evidence base for effective, and cost-effective, workplace interventions<br/><br/>Methods/design<br/>This cluster randomised control trial will recruit 776 office-based employees from public sector organisations in Belfast and Lisburn city centres, Northern Ireland. Participants will be randomly allocated by cluster to either the Intervention Group or Control Group (waiting list control). The 6-month intervention consists of rewards (retail vouchers, based on similar principles to high street loyalty cards), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of participating workplaces will promote and monitor minutes of physical activity undertaken by participants. Both groups will complete all outcome measures. The primary outcome is steps per day recorded using a pedometer (Yamax Digiwalker CW-701) for 7 consecutive days at baseline, 6, 12 and 18 months. Secondary outcomes include health, mental wellbeing, quality of life, work absenteeism and presenteeism, and use of healthcare resources. Process measures will assess intervention ���dose���, website usage, and intervention fidelity. An economic evaluation will be conducted from the National Health Service, employer and retailer perspective using both a cost-utility and cost-effectiveness framework. The inclusion of a discrete choice experiment will further generate values for a cost-benefit analysis. Participant focus groups will explore who the intervention worked for and why, and interviews with retailers will elucidate their views on the sustainability of a public health focused loyalty card scheme.<br/><br/>Discussion<br/>The study is designed to maximise the potential for roll-out in similar settings, by engaging the public sector and business community in designing and delivering the intervention. We have developed a sustainable business model using a ���points��� based loyalty platform, whereby local businesses ���sponsor��� the incentive (retail vouchers) in return for increased footfall to their business.<br/><br/>

Impacto das caracter��sticas e condi����es de trabalho no absentismo em assistentes operacionais de escolas e jardins de inf��ncia

O trabalho �� capaz de proporcionar sentimentos de identifica����o, permitindo a partilha de experi��ncias, a aquisi����o de status social e identidade profissional, mas tamb��m pode colocar o trabalhador em situa����es desagrad��veis. As condi����es a que os trabalhadores est��o expostos no seu trabalho e os constrangimentos organizacionais podem despoletar riscos para a sua sa��de mental, social e f��sica. A exposi����o a riscos psicossociais no trabalho tem consequ��ncias para a sa��de dos trabalhadores. Riscos estes que est��o relacionados com a organiza����o do trabalho, com o conte��do das tarefas e com o ambiente vivenciado no local de trabalho. Para al��m de consequ��ncias para a sa��de, a exposi����o a fatores de risco pode ter consequ��ncias que prejudicam o trabalhador, a organiza����o e a sociedade em geral, exemplo dessa consequ��ncia �� o absentismo. O absentismo �� caracterizado pela aus��ncia do trabalhador ao seu local de trabalho, podendo ter na sua ess��ncia m��ltiplas causas, sendo, por sua vez, causador de diversos problemas. A insatisfa����o com as condi����es e caracter��sticas do trabalho e os problemas de sa��de causados e agravados pela exposi����o aos riscos leva ao elevado absentismo. Esta disserta����o tem como intuito compreender a perce����o dos assistentes operacionais acerca da exposi����o a fatores de riscos psicossociais, compreender a que se deve o elevado ��ndice de absentismo laboral e perceber se existe rela����o entre este e as condi����es de trabalho e a perce����o de exposi����o a riscos psicossociais. Participaram do estudo 85 assistentes operacionais, entre os 32 e os 65 anos, de escolas e jardins de inf��ncia do conselho. A recolha de dados foi realizada atrav��s do question��rio INSAT2013 e pela t��cnica de observa����o n��o sistematizada, onde se procurou observar, com o intuito de compreender, as atividades, comportamentos, dificuldades, intera����es/rela����es e satisfa����o do trabalhador assistente operacional. Os principais resultados apresentam uma percep����o moderada, por parte dos trabalhadores a riscos psicossociais de modo geral e a sua rela����o com o elevado absentismo. Umas das conclus��es que se destaca na disserta����o �� que a elevada carga de trabalho refor��ada com a redu����o de colaboradores levam ao aumento do absentismo.

Qualidade de vida de adolescentes: um estudo no 3.�� ciclo do ensino b��sico (PAQPIEF)

Disserta����o de Mestrado em Ci��ncias da Educa����o - ��rea de especializa����o em Educa����o Especial

Management of presenteeism. The effects on productivity of a food processing company

Presenteeism consists in going to work without conditions to produce, which can have a much higher impact than absenteeism on the productivity of an organisation. Presenteeism translates in both physical as psychological perturbations. It is a difficult to quantify reality, as is its translation into direct and indirect costs within the organisation. Our goal was to analyse the effects of presenteeism on the productivity of a company in the food-procession sector through a descriptive and transversal study of exploratory nature. The Stanford Presenteeism Scale SPS-6 (validated by Ferreira et al, 2010) and a semi-structured interview were used. Most of the workers referred having already gone to work feeling ill at least two days in the last year, mentioning that their health condition affected their performance, made them feel desperate and lacking pleasure from work. Management mentioned that presenteeism has a direct impact on productivity without, however, being able to quantify the true costs. Presenteeism is a reality in organisational scenarios, exceling in the educational and health sectors. We underline the importance of making organisations aware of the psychosocial risks and the importance of having healthy leaderships, work stress control and the presence of clinical psychologists and professional coaches.

Accidents at work by excessive efforts / inappropriate movements in nurses

Nurses continuously develop various activities that expose them to excessive force and inappropriate movements. Characterize the accidents reported by overexertion and inappropriate movements in Portuguese nurses during 2009 and 2010. Retrospective cross-sectional study, covering the period from January 1, 2009 to December 31, 2010. Were defined as inclusion criteria, be nurse and having notified by excessive straining and improper motion accident. The information was obtained by reference to the computer record of accidents at work General Administration of Health Services, relating to 672 nurses. There were 672 notifications of accidents by overexertion/ inappropriate moves in Portuguese nurses. The higher prevalence of these accidents was in nurses with over 10 years of service 277 (41.2%), 565 were female (42.6%) in the age group 25-29 (29.9%) and practice time for 555 shifts (82.6%). At admission there were 387 (57.3%) within 3 hours of work 330 (49.1%) and the third day after weekly rest 216 (32.1%). The Mobilization of patients was the most frequent cause of this accident 430 (64.0%). The main effects were the sprains and strains 321 (47.8%), mainly the trunk reached 367 (54.7%) and absenteeism caused 373 (55.5%). On average 17.7 days missed a total of 12.054 days. There was a high prevalence of accidents during the mobilization of prayer on patients so importante to invest in the implementation of mechanical equipment for the mobilization and transport of patients.

Work engagement among school directors and teachers' behavior at work

Using data from a representative sample of public primary schools in Madagascar, this paper analyzes engagement at work among school directors and investigates the impact of school heads' supervisory roles on teachers' behavior at work. The results show clear signs of weak management within public primary schools. We find that school heads' engagement at work is positively associated with their employment conditions, job satisfaction, and overall working environment. The results also indicate that principals' management styles have a positive effect on teachers��� commitment at work, but no significant impact on absenteeism.

Aplica����o do m��todo POLD�� na redu����o da sintomatologia ��lgica da lombociatalgia

Projeto de Gradua����o apresentado �� Universidade Fernando Pessoa como parte dos requisitos para obten����o do grau de Licenciado em Fisioterapia

Patolog��as lumbares: determinaci��n de los factores ocupacionales y carga prestacional en una entidad promotora de salud en Bogot��

Resumen: Introducci��n El dolor lumbar es un trastorno m��sculo esquel��tico que afecta la parte baja de la espalda, considerado como un problema de salud p��blica y catalogado como un desastre en el sitio de trabajo, se encuentra en las 10 primeras causas de enfermedad profesional reportadas por las entidades prestadoras de servicios de salud, generando ausentismo y discapacidad laboral en los pa��ses industrializados, con costos que oscilan de los 20 mil a los 98 millones de d��lares en los Estados Unidos. Objetivo Determinar la prevalencia de patolog��as lumbares calificadas y sus factores ocupacionales asociados en una entidad promotora de salud de Bogot�� Colombia durante 2013 al 2014. Metodolog��a Se realiz�� un estudio de corte transversal con datos secundarios pertenecientes a 318 pacientes de una entidad promotora de salud en la ciudad de Bogot�� que fueron diagnosticados con patolog��as lumbares (lumbalgia-lumbago, discopat��a lumbar, trastorno de disco intervertebral, espondilolistesis, espondil��lisis, hernia discal), y remitidos a medicina laboral o solicitaron calificaci��n de origen en primera oportunidad, en el periodo comprendido entre el a��o 2013 al 2014. Las variables incluidas fueron sociodemogr��ficas, ocupacionales y diagn��sticos m��dicos, espec��ficamente patolog��as lumbares. Se realiz�� distribuciones de frecuencias, medidas de tendencia central y dispersi��n, an��lisis de asociaci��n mediante la prueba Chi cuadrado de Pearson y un an��lisis multivariado a trav��s del modelo de regresi��n binaria log��stica y el an��lisis de concordancia usando el ��ndice de Kappa. Para las pruebas se utiliz�� un nivel de significaci��n de 0,05. Se digit�� y depur�� en SPSS versi��n 23. Resultado El total de usuarios diagnosticados con patolog��as lumbares fue de 318 de los cuales el 57,2% fueron de sexo masculino con edad promedio de 43 a��os (D.E 7,9 a��os). Se encontr�� asociaci��n significativa entre lumbalgia y movimientos de columna lumbar y levantamiento de carga (p<0,05); discopat��a lumbar y movimientos de columna lumbar y factores multicausales (p<0,05); trastorno de disco intervertebral y factores multicausales (p<0.05), hernia de disco y levantamiento de cargas (p<0,05). Respecto a espondilolistesis y espondil��lisis no se encontr�� asociaci��n con ning��n factor de riesgo, pero si se encontr�� asociaci��n significativa entre origen y movimientos de columna lumbar (p= 0.010), con postura mantenida (p= 0.014), con causas multifactoriales (p= 0.000). El grado de concordancia entre la entidad promotora de salud y la administradora de riesgos laborales arroj�� un valor en el ��ndice de kappa de 0.432 (p= 0.000) correspondiendo a un grado de acuerdo moderado; para la concordancia entre la entidad promotora de salud y la junta de calificaci��n el ��ndice de kappa fue de 0.680 (p= 0.000) grado de acuerdo alto. Conclusi��n Las patolog��as lumbares tienen un alta prevalencia en la poblaci��n trabajadora como en la no trabajadora, encontr��ndose un gran n��mero de factores condicionantes a estas enfermedades generando altos costos en d��as perdidos laborales y en d��as de incapacidad: Por lo tanto, es importante determinar si estas son catalogadas de origen com��n o de origen laboral, para establecer programas de vigilancia epidemiol��gica y programas preventivos.

Accidentes de trabajo e ��ndice de masa corporal en vigilantes atendidos en una I.P.S. de salud ocupacional, Bogot�� - Colombia, 2015

INTRODUCCI��N: Todos los individuos dentro de una sociedad tienen derecho a disfrutar de una integridad f��sica, mental y de sus bienes materiales, que en principio debe ser garantizada por el Estado, sin embargo, debido a la ineficacia y falta de alcance en la disponibilidad de hombres y mujeres para cuidar a cada persona y empresa, la Seguridad Privada ha surgido como actividad econ��mica para garantizar ��ste servicio de manera individualizada. No obstante a ello, poco se sabe acerca de las caracter��sticas de las personas que desempe��an ��sta labor, as�� como las demandas inherentes a ��sta actividad econ��mica; sin embargo, en poblaciones econ��micamente similares, se documenta a trav��s de la literatura la aparente relaci��n entre la condici��n f��sica del individuo y la presentaci��n de accidentes de trabajo. OBJETIVO: Establecer la relaci��n entre los accidentes de trabajo y el ��ndice de masa corporal (IMC) en vigilantes atendidos en una I.P.S. de Salud Ocupacional en la ciudad de Bogot��-Colombia, durante el a��o 2015. MATERIALES Y M��TODOS: Se llev�� a cabo un estudio de corte transversal, con datos secundarios de una base de datos de 76 registros, procedentes de las historias cl��nicas m��dico ocupacionales realizadas a una poblaci��n de trabajadores del sector de la Vigilancia o Seguridad Privada, durante su atenci��n en una Instituci��n Prestadora de Salud (I.P.S.) de Salud Ocupacional. Se incluyeron variables sociodemogr��ficas, ocupacionales, las relacionadas con los accidentes de trabajo y el ��ndice de masa corporal. Se obtuvieron las frecuencias univariadas y para las variables de tipo cuantitativo, medidas de tendencia central y dispersi��n, adem��s de buscar potenciales asociaciones estad��sticas, para conocer las variables que se relacionan con el evento estudiado. RESULTADOS: En ��ste proyecto se destaca que de los trabajadores que desempe��an la actividad econ��mica de Vigilancia y Seguridad Privada, se encuentran en el grupo de 20 a 39 a��os (56.5%) y pertenecen al g��nero masculino (84.2%); dichos factores contribuyen a la ocurrencia de los accidentes de trabajo (OR de 1.7 y 2.0 respectivamente). Adem��s el I.M.C. de sobrepeso (OR 1.8), la obesidad (OR 1.4); y en s�� el cargo de Vigilante concurren a la accidentalidad laboral (OR de 1.1) y con ello al incremento de incapacidad laboral en un 85.5% de 0 a 60 d��as. CONCLUSIONES: Se deben establecer medidas encaminadas al emprendimiento de sistemas de vigilancia epidemiol��gica que mitiguen y minimicen el riesgo, con ello la presencia de eventos no deseados en el ��mbito laboral para ��sta poblaci��n y la disminuci��n del ausentismo laboral.

Trastornos musculoesquel��ticos en trabajadores de la industria automotriz: revisi��n de la literatura 2000 a 2016.

Los trastornos musculoesquel��ticos (TME) tienen alta relaci��n con la industria automotriz afectando a los trabajadores en quienes se puede encontrar varias patolog��as como S��ndrome Del T��nel Del Carpo, Epicondilitis, S��ndrome del Manguito Rotador, discopat��a lumbar y lumbalgias, entre otros. Entre los factores de riesgo asociados a estos trastornos est��n los movimientos repetitivos, posturas inadecuadas, vibraci��n, uso manual de herramientas, tareas f��sicas demandantes y el mal levantamiento de pesos. Todas estas patolog��as son causa de ausentismo laboral en todo el mundo, lo que conlleva a un aumento en el costo econ��mico por incapacidades, ayudas diagn��sticas y tratamientos. Se realiz�� una revisi��n de la literatura cienti��fica de art��culos publicados del a��o 2000 a 2016 con relaci��n a los trastornos musculoesquel��ticos en la industria automotriz en las bases de datos de Pubmed, Ebsco Host, ScienceDirect y Embase. La evidencia encontrada sugiere que la patolog��a lumbar es la que presenta mayor prevalencia en la industria, con 65% en la poblaci��n Europea, 42% en Asia, Norteam��rica en un 20% y en Am��rica Latina en un 46%. A pesar que en la industria automotriz predominan como fuerza laboral los hombres, se report�� que las mujeres eran las que ten��an mayores factores de riesgo para desarrollar un TME y dentro de estos las posturas inadecuadas, movimientos repetitivos, sobrecarga laboral y levantamiento de pesos, sumado al tiempo de exposici��n que fue un com��n denominador en cada uno de los estudios analizados. Las conclusiones fueron que la prevalencia de TME en esta industria es elevada y esto amerita la implementaci��n de programas de prevenci��n m��s enfocados en este tema. Adem��s no se encontr�� en la literatura la existencia de un m��todo eficiente para an��lisis postural y de sobrecarga f��sica, lo que habla de una necesidad urgente de realizar m��s investigaciones enfocadas en este tipo de poblaci��n.