bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying Barriers to Recovery from Work Related Upper Extremity Disorders: Use of a Collaborative Problem Solving Technique
Authors: Shaw William S. , Feuerstein Michael , Miller Virginia I. , Wood Patricia M.
Published: March 2019

Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers’ compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers’ reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p < .05), but not to medical care. Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.
Short Term Disability, Long Term Disability, Social Security Disability Insurance, and Family Medical Leave Act—Relationship to Case Management Practice
Authors: Haag Annette B. , Kalina Christine M. , Tourigian Robin
Published: March 2019

Case Management Update appears as part of Clinical Rounds in the Journal. The panel approach provides a forum for sharing ideas, viewpoints, and perspectives. Panel members come with expertise from a variety of case management arenas and have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Annette B. Haag, Christine M. Kalina, and Robin Tourigian.
Communicating Hearing Loss Information to Young Children: Effectiveness of Lecture and Printed Materials
Authors: Randolph Robert F. , Hudak Roberta L , Vaught Charles
Published: March 2019

Developing positive attitudes and behaviors toward hearing loss prevention is more effective the earlier it begins. This study evaluated two training techniques for educating young children about noise and hearing loss. Third grade students from seven Pennsylvania elementary schools received either no intervention between the pre-tests and post-tests, a lecture about hearing loss, or an informational bookmark along with the same lecture. A 10 item quiz was administered as a pre-test and post-test to assess changes in knowledge. Scores on the quiz improved the most for the lecture intervention groups regardless of whether they received the bookmark. Adding the bookmark did not have a significant effect on knowledge gain. The findings reinforce the value of providing an educational foundation along with communication products.
Reaching Managers at an Industry Association Conference: Evaluation of Ergonomics Training
Authors: Curwick Christy C. , Reeb-Whitaker Carolyn K. , Connon Catherine L.
Published: March 2019

Managers rarely receive targeted safety and health training, despite the belief that management support is important for a successful workplace safety and health program. A program evaluation was performed on an ergonomics workshop for managers attending an industry association conference. The goals were to determine whether the conference was an effective setting for the training, to assess whether the training led to an increase in participants' knowledge and ability, and to determine whether participants could use what was taught in an applied exercise. The majority of participants (97%) believed the conference was an effective setting for the training. Participants' knowledge and ability to identify musculoskeletal risks increased significantly following the training. Additionally, participants were able to identify musculoskeletal risk factors and suggest solutions during the applied exercise. Occupational health nurses should consider trade association meetings as a venue for educational training sessions and for disseminating their research results.
Exploring Variables among Medical Center Employees with Injuries: Developing Interventions and Strategies
Authors: Brown Norman Depaul , Thomas Nancy I.
Published: March 2019

Data for this study were collected via retrospective chart review. The study shows the variables associated with work related injury (WRI) in Central Arkansas Veterans Healthcare System medical center employees from 1998 to 2000 in terms of age, gender, employment type, employment status, shift length, body mass index (BMI), workers' compensation claims prior to current employment, employee health and wellness activity attendance, lost time claims, medical/loss of productivity costs. Notable characteristics of injured employees included advancing age, female gender, long working hours, increased BMI, history of prior back and upper extremity injuries, no health and wellness activity attendance, and lost time with injury. Back and shoulder strain, falling accidents, and repetitive motion injuries were the most severe and costly injuries. Further study of medical center employees is warranted to determine risk factors for WRI and develop appropriate protective interventions and safety promotion strategies.
Defining the Roles and Functions of Occupational Health Nurses in Japan
Authors: Ishihara Itsuko , Yoshimine Toshiko , Horikawa Junko , Majima Yukie , Kawamoto Rieko , Salazar Mary K.
Published: March 2019

The purposes of this study were to obtain descriptive information about the job duties and tasks of Japanese occupational health nurses and to compare the roles and functions of occupational health nurses in the United States and Japan. A modified version of a job analysis survey developed by the American Board for Occupational Health Nurses was used to collect data. The findings indicated 62% of Japanese occupational health nurses perform direct care roles, approximately half perform educating or advising and consulting roles, and approximately 40% perform management roles. Details related to specific tasks and differences in nurses with varying preparation also are presented. Although there were many similarities in the types of tasks performed by nurses in Japan and the United States, the proportion of time devoted to specific tasks in the two countries varied. These results support the need for developing an educational system to enhance occupational health nursing practice in Japan. The information derived from the study provides a knowledge base that can be used to provide guidance and direction to the content of occupational health nursing programs.
Carpal Tunnel Syndrome—The Role of Psychosocial Factors in Recovery
Authors: Hopp Patricia T. , Lee Kendrick E. , Gest Steven A. , Richlin Danielle
Published: March 2019

Two women, Ms. N and Ms. E, are employed by the same local hospital, but work in different departments. The women file claims 3 days apart. Both are diagnosed with carpal tunnel syndrome in their dominant hand and are operated on by the same surgeon at the same surgery center within several weeks of one another, and both receive the same standardized preoperative and postoperative course of treatment. The perioperative process for both is described below.
Mold at Home Can Cause Illness at Work
Authors: Sitzman Kathy
Published: March 2019

John, a machinist, held out his arms. “I have developed this rash in the past couple of days. My eyes are itching, and my nose is running. I have never had allergies. Has anything changed in the manufacturing materials lately? I think I might be allergic to something.” After confirming that no changes had been made, Lois, the occupational health nurse, explored further. John's finished basement flooded a month ago and he was currently in the process of removing old sheetrock and carpet. Lois began to consider the possibility that exposure to mold at home might be the cause of John's rash.
Occupational Health Nursing in the United Kingdom: Exploring the World through International Occupational Health Programs
Authors: Harrison Cathy , Harriss Anne , Maw Jan
Published: March 2019

The next International Commission on Occupational Health (ICOH) Congress will be a celebration of its 100th anniversary, held in Milan, Italy from June 11 to 16, 2006. With significant improvements in the understanding of occupational health at the international level, it is hoped that all occupational health professionals throughout the world can celebrate 100 years of progress and accomplishments at this Congress. With this goal, the AAOHN Journal has been running a special series of articles focusing on “Exploring the World Through International Occupational Health Programs” organized by OiSaeng Hong, PhD, RN, Assistant Professor and Director, Occupational Health Nursing Program, Division of Health Promotion and Risk Reduction, School of Nursing, University of Michigan, Ann Arbor, Michigan. This is the third article of the series.
Employee Wellness Program in a Small Rural Industry: Employee Evaluation
Authors: Carter Melondie , Gaskins Susan , Shaw Lynda
Published: March 2019

The primary purpose of this study was to determine employees' perceptions of a wellness program resulting from collaboration between a small rural industry and a College of Nursing. Focus group methods were used to elicit evaluative data from 27 employees. A semi-structured interview guide of open-ended questions was used to elicit information. The employees readily identified the screenings and information they had received related to hypertension, blood sugar, and cholesterol to be helpful. Health behavior changes the employees identified based on the health promotion activities and screenings included diet changes, different food preparations, and exercise. The screenings were found to be beneficial because they helped them to understand the significance of the results and how they could alter them with health behaviors. The repeated screenings provided an opportunity for them to see how health behavior changes had affected their results.
Smoking-Related Health Behaviors of Employees and Readiness to Quit: Basis for Health Promotion Interventions
Authors: Ott Carol H. , Plach Sandra K. , Hewitt Jeanne Beauchamp , Cashin Susan E. , Kelber Sheryl , Cisler Ron A. , Weis Jo M.
Published: March 2019

This report describes patterns of cigarette smoking and interest in smoking cessation programs among employees in a public worksite (n = 6,000) and a private worksite (n = 14,000). Of the 622 employees who attended an employee assistance program (EAP) orientation, 110 (18%) were current smokers. A significantly greater proportion of public employees smoked cigarettes, smoked more heavily, and evaluated their health more poorly compared to private employees. Smokers in both sites were over-represented in unskilled positions. Regardless of worksite, respondents who smoked had similar desires to quit or cut down and were annoyed by the comments of others, felt guilty about smoking, awakened with a desire to smoke, and felt they had a smoking problem. Overall, more than one third of individuals were interested in joining a smoking cessation program. Occupational health nurses may use these findings to design and implement smoking cessation interventions in their workplaces.
Vulnerable Worker Populations— Special Issue
Authors: Nester Robert M.
Published: March 2019

The views and opinions expressed in this editorial are solely those of the author and do not necessarily represent those of the U.S. government or its subsidiaries. No endorsement of any product, material, program or the like mentioned in the proceeding is intended or implied.
Conversion to Low-Protein, Powder-Free Surgical Gloves: Is it Worth the Cost?
Authors: Komiewicz Denise M. , Chookaew Nantiya , El-Masri Maher , Mudd Kim , Bollinger Mary Elizabeth
Published: March 2019

This study was conducted to determine changes in overall costs associated with conversion to powder-free gloves including cost of workers' compensation cases for natural rubber latex (NRL)-related symptoms and health care workers' glove satisfaction. The study, a 2–year, longitudinal design with retrospective and prospective aspects, was developed to determine health care worker use of powder-free, low-protein NRL gloves, sensitization, cost, and glove satisfaction. Informed consent was obtained from 103 health care workers. Prior to glove conversion, nearly one-half (44%, 36 of 82) of the operating room staff reported symptoms related to NRL exposure. At the end of the 14–month data collection period, only 27% (22 of 82, McNemar test = .007) reported symptoms related to NRL exposure. Additionally, a cost savings of $10,000 per year for gloves was evident with reports of increased user satisfaction. This study demonstrated that conversion to the use of powder-free, low-protein NRL gloves not only reduces health care worker NRL symptoms, but also positively affects the costs of glove purchases and workers' compensation.
Proper Positioning of Clients: A Risk for Caregivers
Authors: Fragala Guy , Fragala Maren , Pontani-Bailey Livia
Published: March 2019

The primary objective of this study was to learn more about the occupational risk of client repositioning by caregivers. This study also included information on frequency demands and factors contributing to the need to reposition clients and future risk-reduction solutions and interventions. A questionnaire was administered to caregivers at 12 hospitals. Targeted groups were client care units with caregivers who are required to reposition clients in bed. The task of client repositioning presents a high frequency demand to caregivers. Some characteristics such as size and health condition made it more likely clients would require repositioning. Researchers need to study client repositioning further and look for methods that will reduce the caregiver occupational risk factors. Caregivers are seeking new devices and techniques that facilitate client repositioning and benefit both the caregiver and the client.
The Diabetes Prevention Program: A Worksite Experience
Authors: Aldana Steven G. , Barlow Marilyn , Smith Rebecca , Yanowitz Frank G. , Adams Ted , Loveday Ladonne , Arbuckle Janae , Lamonte Michael J.
Published: March 2019

The purpose of this study was to determine if the U.S. National Institutes of Health Diabetes Prevention Program (DPP) could be successfully implemented in a worksite setting. Thirty-seven adult employees of BD Medical Systems of Sandy, Utah were enrolled in a single-group time-series study using the DPP. Two-hour oral glucose tolerance tests (OGTT) and other outcomes were measured at baseline, 6 months, and 12 months. Weight, body mass index, waist circumference, 2-hour OGTT, very low density lipoproteins, triglycerides, and aerobic fitness were significantly improved at 6 and 12 months and showed overall significant improvement across time. Fasting blood insulin, total cholesterol, low density lipoproteins, and total cholesterol/high density lipoproteins ratio were significantly improved at 6 months, but not at 12 months. Eighteen of the program participants (51%) were no longer in the pre-diabetes and diabetes categories after 1 year. Existing worksite health promotion and occupational health professionals can successfully offer the DPP and help employees improve glucose tolerance.
Factors Associated with Work-Related Injury among Hospital Employees
Authors: Thomas Nancy I. , Brown Norman DePaul , Hodges Linda C. , Gandy Jay , Lawson Louanne , Lord Janet E. , Williams David K.
Published: March 2019

The Central Arkansas Veterans Healthcare System (CAVHS) spends $1 million annually on occupational illnesses and injuries. To address the problem of injuries among hospital employees, a retrospective case-control study was conducted to examine select risk factors for work-related injuries (WRI) among CAVHS employees. Study methods included a review of employee health charts and computer and manual databases from 1997 to 2002 ( N = 2,050). The researchers found that WRI increased with age; WRI occurred more often in women than in men; WRI was greater among maintenance and custodial staff compared to direct caregivers, and less among clerical staff; WRI occurred less often in part-time than full-time staff; and WRI increased with increasing body mass index. Developing standards, guidelines, and policies for preplacement screening, preventive measures, training, and education may help to minimize WRI and associated costs.
Preventing Occupational Injuries
Authors: Landry Lynette G.
Published: March 2019

Perception of injury risk is associated with an individual's propensity to act. This study examined the relationship between women's demographic, occupational, and risk characteristics, and health and occupational stressors as predictors of their perceptions of injury risk to self and other women from occupational musculoskeletal exposures. This cross-sectional study included a random sample of women who were employed in the 12 months prior to survey administration ( N = 123, 27% response rate). A telephone survey consisting of 154 items was administered in English or Spanish. For the perception of injury risk to self, the final multiple regression equation explained approximately 66% of the variance with significant unique contributions identified for bodily pain, occupational exposure to repeated strenuous physical activity or repetitive hand motion, perceived seriousness and controllability of the risk, and perception of risk to other women. Similarly, for perception of injury risk to other women, the final multiple regression equation explained approximately 57% of the variance with significant unique contributions identified for household size, occupational exposure to repetitive hand motion, familiarity of the risk, and perception of injury risk to self. Exposure experiences and risk characteristics were found to increase women's perceptions of risk from occupational musculoskeletal exposures.
Health Effects following 9/11
Authors: Pak Victoria M. , O'Hara MaryEllen , McCauley Linda A.
Published: March 2019

The attacks on the World Trade Center in 2001 resulted in hazardous environmental exposures of enormous magnitude, bringing about persistent respiratory and psychological problems among survivors. Approximately 40,000 men and women worked at Ground Zero, the former site of the World Trade Center in New York City, and at the Staten Island landfill, the main wreckage depository, in the days, weeks, and months following 9/11. First responders such as firefighters and police, construction workers, and utility and public sector workers were involved. These individuals were at high risk for injury, respiratory complications, and psychological distress from the traumatic event. This article highlights the controversy surrounding 9/11 research and reports, identifies populations at high risk for exposure, and examines the health effects. Occupational health nurses should not only be empowered to provide the best care for workers affiliated with 9/11, but also contribute to research to protect worker health in future disaster responses.
Integrated Absence Management and the Family and Medical Leave Act
Authors: Morris Judy A.
Published: March 2019

Intermittent unscheduled absenteeism often challenges employers to meet the needs of their employees, control direct absenteeism costs, and maintain the staff needed to serve customers. Occupational health nurses have opportunities to play an important role in addressing this challenge. Measurable financial impacts have been demonstrated from integrating the management of intermittent FMLA leave with an employer's existing absence management program.
Workplace Health Promotion—Strategies for Low-Income Hispanic Immigrant Women
Authors: Strasser Patricia B. , Zarate-Abbott Perla , Etnyre Annette , Gilliland Irene , Mahon Marveen , Allwein David , Cook Jennifer , Mikan Vanessa , Rauschhuber Maureen , Sethness Renee , Muñoz Laura , Lowry Jolynn , Jones Mary Elaine
Published: March 2019

Addressing health disparities for vulnerable populations in the United States is a national goal. Immigrant Hispanic women, at increased risk for heart disease, face obstacles in receiving adequate health care. Health promotion, especially for Hispanic women, is hindered by language, access to care, lack of insurance, and cultural factors. Innovative health education approaches are needed to reach this population. This article describes the development and evaluation of a culturally sensitive cardiac health education program based on findings from a study of 21 older immigrant Hispanic women employed as housekeepers at a small university in south Texas. Systolic and diastolic blood pressures had decreased 17 months after the intervention.
Educating Supervisors of Employees with Diabetes
Authors: Strasser Patricia B. , Wood Felecia G. , Jacobson Sharol
Published: March 2019

The worksite presents special challenges not only for employees with diabetes, but also for their supervisors. Supervisors wonder whether certain behaviors are willful misconduct or indicative of health problems, as well as if and how to accommodate employees with diabetes to meet the needs of the employees and the company, within the law. The purpose of this research was to pilot test an innovative educational program for supervisors of employees with diabetes to benefit employees' health and diabetes control while meeting the legal requirements of the Americans with Disabilities Act (ADA). Nine supervisors completed a 6-hour program that included innovative teaching strategies—“living the life” of a person with diabetes for 2 days and case studies to practice decision making according to the ADA. The program increased supervisors' reported self-efficacy for supervising employees with diabetes and should improve work life for employees with diabetes, ultimately decreasing employers' health care costs.
When No One Has Time
Authors: Morrison Janet , Lindberg Per
Published: March 2019

Technological change is a constant in today's workplace, especially the modern health care workplace. The introduction of electronic health records changes workloads, job demands, interactions with other health care professionals, and work roles—all elements that have previously been noted to increase work stress and impact health. Despite the significant changes that accompany computerization, it is seldom studied as a source of stress. Also, the health effects of computerization within health care have not been extensively studied. This article summarizes the potential environmental impact of computerization on workers, with special reference to health care workers, and suggests ways occupational health nurses can monitor the health consequences of new technology and intervene in case of adverse health impact. In many health care organizations, high work pressure and staff shortages make it impractical, and perhaps impossible, to use standard in-depth research methods to investigate this issue. Therefore, several less obtrusive methods that can be triangulated are suggested as an alternative.
Herpes Zoster in the Workplace
Authors: Chalupka Stephanie
Published: March 2019

Employees infected with zoster lose, on average, more than 129 hours of work per episode.
Influenza Vaccination
Authors: Childre Frances , Foster Donna
Published: March 2019

Health care professionals may be contributing to the low rates of influenza vaccination.
Data Security in Occupational Health
Authors: Damrongsak Mantana , Brown Kathleen C.
Published: March 2019

Occupational health nurses are increasingly using computer systems in the delivery of efficient, high-quality occupational health services. However, potential breaches in data security are posing more risks to these data systems. The purpose of this article is to address concerns related to data security in occupational health nursing. Occupational health nurses must protect the personal health information of employees by proactively developing methods to ensure data security.
Thiuram Allergy—A Potential Dermal Allergy among Health Care Workers
Authors: Green-McKenzie Judith , Pak Victoria M. , Crawford Glen H. , Childre Frances
Published: March 2019

Occupational health nurses should be cognizant of the myriad exposures that can result in dermal reactions among health care workers.
Preventing Employee Injury
Authors: Springer Pamela J. , Lind Bonnie K. , Kratt Johanna , Baker Ed , Clavelle Joanne T.
Published: March 2019

A lift team was implemented at an urban medical center in the Pacific Northwest to reduce employee injuries. The lift team consisted of a lift technician and a nursing assistant both trained in lifting techniques. The trial lasted 1 year. Data on employee injuries and day versus night injuries before and during lift team implementation are presented. Results do not show the same reduction in employee injuries described by previous authors. Possible explanations are related to the use of the lift team and policy development.
Hazard Analysis and Critical Control Point
Authors: Olga S. Tompkins
Published: March 2019

The application of hazard analysis and critical control point principles is an effective method for ensuring employee food safety in both large and small businesses.
Changing the Conversation—The Occupational Health Nurse's Role in Integrated HS3™
Authors: Weiss Marjorie D. , Strasser Patricia B.
Published: March 2019

Occupational health nurses have the skills and knowledge to provide a holistic perspective in advancing their company's triple bottom line, healthy people, healthy planet, and healthy profits. The HS3™ model provides a road map for integrating health, safety, sustainability, and stewardship, all of which directly impact every company's triple bottom line. Occupational health nurses can use the HS3™ model to promote healthy lifestyles, reduce risk and injuries, protect the natural environment, and improve resource alignment. Occupational health nurses have a unique opportunity to demonstrate the value they bring to their employers using synergistic HS3™ planning that cost-effectively finks work injury management, health promotion, environmental protection, safety training and surveillance, and regulatory compliance. Implementing the HS3™ model requires occupational health nurses to be innovators who can change the conversation.
How to Help When Disaster Strikes
Authors: Litchfield Sheila M.
Published: March 2019

Nurses aligned with a specific disaster relief system maximize their opportunities to participate “on the ground” when a disaster strikes. Nurses can align with many excellent governmental and nongovernmental organizations in preparation for local, state, national, or international emergency relief responses. This article discusses some of the primary health care-related disaster relief organizations, how to connect with them, and the considerations in preparing for deployment.
Establishing an Incident Review Committee
Authors: Zichello Christine , Thomas Sotirios
Published: March 2019

A well-defined incident review committee may prevent losses, identify areas for corrective action, and promote overall safety in an organization. A multidisciplinary committee will involve employees in the safety process and heighten safety awareness. Reviewing injuries, incidents, occupational illnesses, and workers' compensation claims assists in root cause analysis and enables an organization to be proactive in preventing further employee incidents and injuries.
It Starts with an Idea!
Authors: Wachs Joy E. , Williamson Geraldine , Moore Pamela V. , Roy Deborah , Childre Frances
Published: March 2019

Writing for publication is a responsibility of all a profession's members; however, nurses may not have had the opportunity to learn the process of writing and publishing manuscripts in professional journals. The process of writing for publication begins with an idea that is focused on and slanted toward a particular audience. Nurse authors must then create space in their fast-paced day for writing in an environment that supports their concentration and creativity. Several strategies can be used, including reading well-written manuscripts, to assist nurses in writing quality manuscripts that are likely to be published.
Update on the Nurse Licensure Compact
Authors: Litchfield Sheila M.
Published: March 2019

Occupational health nurses' practice boundaries continue to expand as they find it increasingly necessary to practice in more than one state, and telenursing as well as advances in technology encourage communication between nurses and clients via telephone, e-mail, fax, and teleconference. Thirteen years have passed since the American Association of Occupational Health Nurses, Inc. (AAOHN) endorsed the Nurse Licensure Compact (NLC) and issued the AAOHN Multistate Practice Advisory. This article updates readers on the status of the NLC and provides resources for additional information.
Delegation—Better Safe Than Sorry
Authors: Neumann Thomas A.
Published: March 2019

Occupational health nurses, like other Registered nurses, often must decide whether to delegate. They must be familiar with the laws and standards governing delegation of nursing tasks. Many different resources exist for obtaining this information (e.g., jurisdictional nurse practice acts, position papers from boards of nursing, and publications from professional and regulatory organizations). Registered nurses who delegate must know which tasks may be delegated, how to determine the competence of delegates, and the level of supervision necessary.
Integrating Environmental Health into Nurse Practitioner Training—Childhood Pesticide Exposure Risk Assessment, Prevention, and Management
Authors: Beitz Jolene , de Castro A. B.
Published: March 2019

The use of pesticides in agriculture, public places, and private homes and gardens is ubiquitous throughout the United States. Children are particularly vulnerable to pesticide exposure because of immature biological and developmental processes. Thus, it is important that primary health care providers identify clients at risk for pesticide exposure and poisoning and know how to respond effectively if clients experience exposure. However, many primary health care providers are not adequately trained or prepared to manage the health-related effects of pesticide exposure. Recent efforts, supported by the U.S. Environmental Protection Agency, have addressed this shortcoming in nursing and medical education. A primary initiative is to find ways to integrate basic environmental health content, specifically regarding pesticide exposure, into nursing and medical curricula. As one strategy to achieve this, a pilot case study was developed by revising and enhancing an existing pediatric case study used in a required course for nurse practitioner students. The aim was to raise students' awareness of risk assessment, prevention, and appropriate care strategies for pesticide exposure. Evaluation of students' experience with the pilot case study suggested it was a meaningful and valued addition to their training, as well as an efficient way to introduce environmental health content into primary health care provider curricula.
An Evaluation of Alcohol Dependence Prevention Measures at a Japanese Newspaper Company
Authors: Ariyoshi Hiromi
Published: March 2019

Alcohol dependence prevention measures were implemented at a Japanese newspaper company, a company undergoing restructuring. An occupational health nurse interviewed each employee twice a year, providing guidance about reducing daily alcohol consumption and binge drinking. These nursing interventions were evaluated through individual employee health examinations conducted in 2000 and 2007. The examinations revealed that fewer employees drank alcohol in 2007 than in 2000 (8.4% and 11.6%, respectively). Employees who drank at least 1,500 milliliters of alcohol daily decreased from 13.7% to 7.0% ( p = .004). By gathering case studies, the effectiveness of the occupational health nursing interventions was made clear.
The Aging Nurse
Authors: Keller Simone M. , Burns Candace M.
Published: March 2019

With the aging of the current nursing work force, nursing leaders must develop strategies to maintain current employment levels and improve availability of nurses to care for patients. One way to maintain current levels is to retain older nurses at the bedside by adapting the current working environment to meet the needs and the limitations associated with aging. This article includes a review of literature on the effects of aging on the human body, cognitively, physically, and psychosocially; current trends in the aging population; the advantages and disadvantages of employing aging nurses; retention strategies to keep aging nurses at the bedside; methods to adapt the work environment to aging nurses' needs; policies that address the needs of aging nurses; and implications for occupational health nursing practice. This article is limited to aging as it relates to nurses employed in hospitals.
Six Sigma
Authors: Carter Pam
Published: March 2019

When I was first introduced to the Six Sigma process, I resisted it with every ounce of energy I had. I continuously fabricated reasons so that I was unable to complete the training that my company required. When it came time for my performance review, I could not hide the truth from my manager; I had not completed the required training. It was then that I began my journey into the world of Six Sigma. Once I understood that a black belt and a green belt certification had nothing to do with karate, I felt much better.
Lessons Learned and New Challenges: Re-evaluation of End-User Assessment of a Skills-Based Training Program for Urology Trainees
Authors: Flanders Damian , Pirpiris Athina , Corcoran Niall , Forsyth Robert , Grills Richard
Published: March 2019

Objectives:

To re-assess the perceived benefit and relevance of simulation sessions to Victorian urology trainees and to identify areas for potential improvement.

Subjects and methods:

All trainees attending skills training sessions between 2011 and 2016 were asked to complete a structured questionnaire at the completion of the session. The questionnaire included 11 topic areas ranging from the year of surgical training to degree of usefulness of the session, including several sections for free-text response to offer more detailed feedback. Sessions were examined both individually and collectively to assess end-user satisfaction with the structure and content of the program.

Results:

In total, 24 individual skills sessions were held over the 6-year period, with a total of 355 attendees. Of these, 331 attendees completed the majority of the questionnaire, a response rate of over 93%. Overall 88% of the surveyed attendees stated that they had both the support of their supervising consultant and the flexibility of workload to attend the session; 90% of trainees felt that there was adequate reading material provided prior to the skills session, an improvement from 76% in the previous study period; and 97% of those surveyed felt that the existing session structure was appropriate and the same proportion found the sessions both useful and interesting, compared with just 63% in the previous study period. Analysis of individual topics demonstrates some variability in outcome measures, but for nearly every assessed parameter, greater than 90% of participants agreed that the session fulfilled the expected criteria. New topics developed since the 2011 analysis, including renal transplant and vascular repair, also had high levels of satisfaction. The practical models used have been refined and achieved higher scores than those in the previous assessment period.

Conclusion:

The urology skills-based training program has been well received by the surveyed trainees and is now embedded and accepted as part of the Victorian training program. The format of the sessions has matured and the overall rating, both individually and collectively, was high. There has been a clear increase in satisfaction across most areas assessed when compared with previous feedback. Despite this, there remain areas that can be improved, such as the amount and quality of available equipment and the inclusion of video demonstrations of operative techniques.
Systemic View to Understanding Design Change Causation and Exploitation of Communications and Knowledge
Authors: Yap Jeffrey Boon Hui , Skitmore Martin , Gray Jason , Shavarebi Kamran
Published: March 2019

Frequent changes pervasively undermine project schedule performance. Despite voluminous research into project delays, however, the persistence of the problem demands that a systemic approach be adopted to investigate design change causation and to explore the efficacy of communications and knowledge as strategic project controls. Drawing on a hybrid research design, the critical variables are identified and mapped onto causal loop diagrams to enable practical holism. The findings indicate that effective project communications engenders collaborative team dynamics and collective learning, whereas project learning contributes to knowledge reuse and the improved expert judgment needed for transforming design change management and schedule control.
Therapy-Related Cardiac Risk in Childhood Cancer Survivors: An Analysis of the Childhood Cancer Survivor Study
Authors: Bates James E. , Howell Rebecca M. , Liu Qi , Yasui Yutaka , Mulrooney Daniel A. , Dhakal Sughosh , Smith Susan A. , Leisenring Wendy M. , Indelicato Daniel J. , Gibson Todd M. , Armstrong Gregory T. , Oeffinger Kevin C. , Constine Louis S.
Published: March 2019

PURPOSE

The impacts of radiotherapy dose and exposed cardiac volume, select chemotherapeutic agents, and age at exposure on risk for late-onset cardiac disease in survivors of childhood cancer remain unresolved.

PATIENTS AND METHODS

We determined the rates of severe to fatal cardiac disease in 24,214 5-year survivors in the Childhood Cancer Survivor Study diagnosed between 1970 and 1999 at a median age of 7.0 years (range, 0 to 20.9 years), with a median attained age of 27.5 years (range, 5.6 to 58.9 years). Using piecewise exponential models, we evaluated the association between cardiac disease rates and demographic and treatment characteristics.

RESULTS

The cumulative incidence of cardiac disease 30 years from diagnosis was 4.8% (95% CI, 4.3 to 5.2). Low to moderate radiotherapy doses (5.0 to 19.9 Gy) to large cardiac volumes (≥ 50% of heart) were associated with an increased rate of cardiac disease (relative rate, 1.6; 95% CI, 1.1 to 2.3) compared with survivors without cardiac radiotherapy exposure. Similarly, high doses (≥ 20 Gy) to small cardiac volumes (0.1% to 29.9%) were associated with an elevated rate (relative rate, 2.4; 95% CI, 1.4 to 4.2). A dose-response relationship was observed between anthracycline chemotherapy and heart failure with younger children (age ≤ 13 years) at the greatest risk for heart failure after comparable dosing.

CONCLUSION

These observations support advances in radiation field design and delivery technology to reduce cardiac dose/volume and should guide future treatment protocols. They also inform clinical practice guidelines for post-therapy surveillance and risk-reducing strategies.
Socioeconomic Differences in Referral to Phase I Cancer Clinical Trials: A Danish Matched Cancer Case-Control Study
Authors: Gad Katrine Toubro , Johansen Christoffer , Duun-Henriksen Anne Katrine , Krøyer Anja , Olsen Maja Halgren , Lassen Ulrik , Mau-Sørensen Morten , Oksberg Dalton Susanne
Published: March 2019

PURPOSE

In this nationwide registry study, we investigated socioeconomic and structural patterns in referral to phase I cancer trials in a case-control study design.

METHODS

Personal identification numbers on all Danish patients referred to the Danish Phase I Unit at Rigshospitalet from 2005 to 2016, and a control group matched on age, sex, type of cancer, year of diagnosis, and time from diagnosis to referral ensured individual-level linkage between several registries. We examined the association between nonclinical factors—indicators of socioeconomic position and distance to the Phase I Unit—and referral using a conditional logistic regression analysis adjusted for several clinical factors. Association between nonclinical factors and enrollment once referred was examined with a Cox proportional hazards regression analysis in an historical cohort study design.

RESULTS

Complete data were available for 1,026 (84%) of 1,220 referred patients. Significantly decreased odds for referral were identified for patients with long distance to the Phase I Unit compared with short distance (adjusted odds ratio [OR], 0.35; 95% CI, 0.30 to 0.41), for less education (less than 9 years) compared with more (more than 12 years; OR, 0.69; 95% CI, 0.56 to 0.91), and for belonging to the lowest income quintile compared with the highest (OR, 0.78; 95% CI, 0.62 to 0.97). Medium education (9 to 12 years) compared with more, being outside the workforce compared with being within, and living alone compared with living with a partner were also negatively associated with referral. Among patients referred, 252 enrolled in a trial. Nonclinical factors were not associated with enrollment.

CONCLUSION

On the basis of individual long-term registry data from an unselected cohort, novel anticancer therapies seem to be tested on a socially selected group of patients with cancer.
Temporal Changes in Head and Neck Cancer Incidence in Thailand Suggest Changing Oropharyngeal Epidemiology in the Region
Authors: Argirion Ilona , Zarins Katie R. , Defever Kali , Suwanrungruang Krittika , Chang Joanne T. , Pongnikorn Donsuk , Chitapanarux Imjai , Sriplung Hutcha , Vatanasapt Patravoot , Rozek Laura S.
Published: March 2019

PURPOSE

Head and neck cancer is the sixth most common cancer in the world, and the largest burden occurs in developing countries. Although the primary risk factors have been well characterized, little is known about temporal trends in head and neck cancer across Thailand.

METHODS

Head and neck squamous cell carcinoma (HNSCC) occurrences diagnosed between 1990 and 2014 were selected by International Classification of Diseases (10th revision; ICD10) code from the Songkhla, Lampang, Chiang Mai, and Khon Kaen cancer registries and the US SEER program for oral cavity (ICD10 codes 00, 03-06), tongue (ICD10 codes 01-02), pharynx (ICD10 codes 09-10, 12-14), and larynx (ICD10 code 32). The data were analyzed using R and Joinpoint regression software to determine age-standardized incidence rates and trends of annual percent change (APC). Incidence rates were standardized using the Segi (1960) population. Stratified linear regression models were conducted to assess temporal trends in early-onset HNSCC across 20-year age groups.

RESULTS

Although overall HNSCC rates are decreasing across all registries, subsite analyses demonstrate consistent decreases in both larynx and oral cavity cancers but suggest increases in tongue cancers among both sexes in the United States (APCmen, 2.36; APCwomen, 0.77) and in pharyngeal cancer in Khon Kaen and US men (APC, 2.1 and 2.23, respectively). Age-stratified APC analyses to assess young-onset (< 60 years old) trends demonstrated increased incidence in tongue cancer in Thailand and the United States as well as in pharyngeal cancers in Khon Kaen men age 40 to 59 years and US men age 50 to 59 years.

CONCLUSION

Although overall trends in HNSCC are decreasing across both Thailand and the United States, there is reason to believe that the etiologic shift to oropharyngeal cancers in the United States may be occurring in Thailand.
2018 Hematology/Oncology Pharmacist Association Best Practices for the Management of Oral Oncolytic Therapy: Pharmacy Practice Standard
Authors: Mackler Emily , Segal Eve M. , Muluneh Benyam , Jeffers Kate , Carmichael Jenna
Published: March 2019

PURPOSE:

The aim of the current work was to present a pharmacy practice standard from the Hematology/Oncology Pharmacy Association (HOPA) on the management of oral oncolytic therapy.

METHODS:

The HOPA Standards Committee organized a work group of oncology pharmacist specialists to create a pharmacy practice standard for the management of oral oncolytic therapy that describes the pharmacist’s role on the cancer care team, provides examples of practice tools and resources, summarizes current data related to outcomes, and discusses opportunities to enhance the care of patients with cancer who receive oral oncolytic therapy. We reviewed primary literature, including currently published oral oncolytic guidelines and HOPA’s Scope of Hematology/Oncology Pharmacy Practice.

RESULTS:

Management of oral oncolytic therapy was divided into the following primary areas: prescribing, education, dispensing and distribution, and monitoring and follow-up. Pharmacists’ roles were summarized in each area with a focus on interprofessional collaboration, communication, patient safety, and quality of patient care. Standards describe the best practices in each area ( Table 1 ).

CONCLUSION:

Multiple opportunities exist for pharmacists to enhance the care of patients with cancer who receive oral oncolytics through collaboration with oncology care team members. The role of the oncology pharmacist in the care of this patient population is critical given the complexities related to cost, tolerability, and safety of oral oncolytic medications; issues of access; and the monitoring and follow-up of patients receiving this therapy.
Long-Term Efficacy of a Single Session of RFA for Benign Thyroid Nodules: A Longitudinal 5-Year Observational Study
Authors: Deandrea Maurilio , Trimboli Pierpaolo , Garino Francesca , Mormile Alberto , Magliona Gabriella , Ramunni Maria Josefina , Giovanella Luca , Limone Piero Paolo
Published: March 2019

Context

Radiofrequency ablation (RFA) of benign thyroid nodules has been gaining consensus. However, no solid information on its long-term efficacy is available.

Objective

To analyze the long-term results of single-session RFA.

Design

Retrospective longitudinal observational study.

Setting

Primary care center.

Patients or Other Participants

Adult outpatients who underwent a single-session RFA and posttreatment follow-up of least 3 years.

Intervention

Ultrasound-guided RFA was performed after local anesthesia by “moving-shot” technique. RFA was performed with a median power of 55W and a median time of 14 minutes with an internally cooled 18-gauge electrode with an active 10-mm tip.

Main Outcome Measures

Objective (trend of nodule volume) and subjective (compressive and cosmetic concerns) response to RFA were evaluated. Continuous variables were analyzed by the Wilcoxon and ANOVA test and their correlations by using the Spearman test. Categorical variables were compared by Pearson χ2 test.

Results

Two hundred and fifteen patients were included. An early significant reduction of nodule volume was found at 1 year, lasting up to 5 years. A 67% nodule shrinkage was observed at the end of the observation period. The best response was recorded in nodules below 10 mL (79% reduction early and 81% at 5 years). Patients’ symptoms were significantly reduced.

Conclusions

This study, by demonstrating a durable shrinkage of benign thyroid nodules treated by RFA with an improvement of subjective symptoms, establishes the reliability of RFA as alternative to surgery in the management of thyroid nodules, thus representing a remarkable novelty for clinical practice.