A qualitative exploration of work-related head injury: vulnerability at the intersection of workers' decision making and organizational values.

BACKGROUND: Work-related head injury is a critical public health issue due to its rising prevalence; the association with profound disruption of workers' lives; and significant economic burdens in terms of medical costs and lost wages. Efforts to understand and prevent these types of injuries have largely been dominated by epidemiological research and safety science, which has focused on identifying risk at the level of the individual worker, population group, or organizational sector. Limited research has focused on the perspectives of the workers, a key stakeholder group for informing understanding of vulnerability to work-related head injury. This study explored workers' perspectives to better understand their decision-making and how and why their injuries occurred. METHODS: We conducted a qualitative study using in-depth semi-structured interviews with thirty-two adult workers who had sustained a work-related head injury. Workers were recruited from an urban clinic in central Ontario, Canada. Labour Process Theory informed the thematic analysis. RESULTS: Three hazardous work conditions were identified: insufficient training; inadequate staffing; and inattention to the physical environment. In addition, professional and organizational norms were implicated in vulnerability to head injury including putting the client before the worker and the pressure to work unsafely. The findings also highlight a complex interrelationship between workers' decision-making and professional and organizational norms that produces vulnerability to head injury, a vulnerability which oftentimes is reproduced by workers' decisions to work despite hazardous conditions. CONCLUSIONS: Our findings suggest that, beyond the need to redress the inattention to hazards in the physical environment, there is a need to address norms that influence worker decision-making to improve the safety of workers. Using Labour Process Theory highlights an important social dynamic within workplace sectors that could inform future development and implementation of multi-level and integrated public health strategies to reduce work-related head injury.

An examination of retention factors among registered practical nurses in north-eastern Ontario, Canada.

INTRODUCTION: Literature from the past two decades has presented an insufficient amount of research conducted on the nursing practice environments of registered practical nurses (RPNs). The objective of this article was to investigate the barriers and facilitators to sustaining the nursing workforce in north-eastern Ontario (NEO), Canada. In particular, retention factors for RPNs were examined. METHODS: This cross-sectional research used a self-administered questionnaire. Home addresses of RPNs working in NEO were obtained from the College of Nurses of Ontario (CNO). Following a modified Dillman approach with two mail-outs, survey packages were sent to a random sample of RPNs (N=1337) within the NEO region. Logistic regression analyses were used to determine intent to stay (ITS) in relation to the following factor categories: demographic, and job and career satisfaction. RESULTS: Completed questionnaires were received from 506 respondents (37.8% response rate). The likeliness of ITS in the RPNs' current position for the next 5 years among nurses aged 46-56 years were greater than RPNs in the other age groups. Furthermore, the lifestyle of NEO, internal staff development, working in nursing for 14-22.5 years, and working less than 1 hour of overtime per week were factors associated with the intention to stay. CONCLUSIONS: Having an understanding of the work environment may contribute to recruitment and retention strategy development. The results of this study may assist with addressing the nursing shortage in rural and northern areas through improved retention strategies of RPNs.

The role of oxytocin and oxytocin receptor gene variants in childhood-onset aggression.

Aggressive antisocial behaviours are the most common reasons why adolescents are referred to mental health clinics. Antisocial behaviours are costly in social and financial terms. The aetiology of aggressive behaviours is unknown but growing evidence suggests it is heritable, and certain genetic variants have been implicated as contributing factors. The purpose of this study was to determine whether genes regulating the hormone oxytocin (OXT) were associated with aggressive antisocial behaviour. The case-control study sample consisted of 160 cases of children displaying extreme, persistent and pervasive aggressive behaviour. This case sample was compared with 160 adult controls. We used polymerase chain reaction (PCR) to determine the genotype for three oxytocin gene (OXT) single nucleotide polymorphisms (SNPs): rs3761248, rs4813625 and rs877172; and five oxytocin receptor gene (OXTR) SNPs: rs6770632, rs11476, rs1042778, rs237902 and rs53576. Genotypic analyses were performed using stata, while differences in haplotypic and allelic frequencies were analysed using Unphased. We also performed within-case analyses (n = 236 aggressive cases) examining genotypic and allelic associations with callous-unemotional (CU) scores (as measured by the psychopathic screening device). OXTR SNPs rs6770632 and rs1042778 may be associated with extreme, persistent and pervasive aggressive behaviours in females and males, respectively. These and haplotype results suggest gender-specific effects of SNPs. No significant differences were detected with respect to CU behaviours. These results may help to elucidate the biochemical pathways associated with aggressive behaviours, which may aid in the development of novel medications.

Workplace support for employees with cancer.

OBJECTIVE: The aim of the present study was to survey human resources personnel about how their northeastern Ontario workplaces assist employees with cancer. STUDY DESIGN AND SETTING: This cross-sectional study was conducted from December 2007 to April 2008. Surveys were sent to 255 workplaces in northeastern Ontario with 25 or more employees, and 101 workplaces responded (39.6% response rate). Logistic regression modelling was used to identify factors associated with more or less workplace support. More or less workplace support was defined by provision of paid time to employees with medical appointments and an offer of a return-to-work meeting and reduced hours for employees with cancer. Factors considered in the model included organization size, geographic location (urban, rural), and workplace type (private sector, public sector). RESULTS: Most of the human resources staff who completed the surveys were women (67.4%), and respondents ranged in age from 25 to 70 years (mean: 45.30 +/- 8.10 years). Respondents reported working for organizations that ranged in size from 25 to more than 9000 employees. In the logistic regression model, large organization size [odds ratio (or): 6.97; 95% confidence interval (ci): 1.34 to 36.2] and public sector (or: 4.98; 95% ci: 1.16 to 21.3) were associated with employer assistance. Public sector employers provided assistance at a rate 5 times that of private sector employers, and large organizations (>50 employees) provided assistance at a rate 7 times that of smaller organizations. CONCLUSIONS: In the population studied, employees with cancer benefit from working in larger and public sector organizations. The data suggest a need for further support for employees with cancer in some other organizations.