Mental Health Stigma and Wellbeing Among Commercial Construction Workers: A Mixed Methods Study.

OBJECTIVE: The aim of this study was to understand the relationship between mental health stigma and wellbeing in a sample of commercial construction workers. METHODS: A sequential quantitative to qualitative mixed methods study was conducted. First, 264 workers were surveyed and logistic regression examined the associations between mental health stigma and psychological distress, substance abuse, and sleep; then, data from eight key informant interviews and six focus groups with workers were analyzed thematically. RESULTS: Stigma was significantly associated with psychological distress and impaired sleep, but not with substance abuse. Key informants and workers discussed the prominence of stigma on worksites and how the masculine culture of the industry and job insecurity contributed to stigma. CONCLUSION: Stigma poses a barrier to addressing mental health among workers; peer support and improved human resources may be promising.

The Effects of Alcohol Priming on the Subsequent Value of Alcohol.

OBJECTIVE: Previous research has investigated the effects of substance priming (i.e., substance exposure or preload) on the subsequent value of alcohol. Studies suggest that substance priming may serve as a cue, resulting in increased desire for the substance or drug-related behavior; however, results have been inconsistent. The current studies aimed to examine the effects of a priming dose of alcohol, compared with placebo, on the relative reinforcing effects of subsequent alcohol. METHOD: Undergraduate students (Study 1: N = 46 [33 women]; Study 2: N = 69 [50 women]) completed the Multiple Choice Procedure (MCP) during individual, lab-based sessions. The MCP was used to assess the relative reinforcing value of alcohol compared with concurrently available alternatives. Study 1 compared a standard dose of alcohol (one standard drink) with placebo, and Study 2 compared g/kg dosing of alcohol (controlling for gender) with placebo. RESULTS: Data revealed no statistically significant priming effect of alcohol on the subsequent value of alcohol in either study. CONCLUSIONS: The conditions under which alcohol priming does (and does not) occur are still not fully understood, and further systematic work is necessary to determine potential clinical utility.

Changing agricultural practices: potential consequences to aquatic organisms.

Agricultural practices pose threats to biotic diversity in freshwater systems with increasing use of glyphosate-based herbicides for weed control and animal waste for soil amendment becoming common in many regions. Over the past two decades, these particular agricultural trends have corresponded with marked declines in populations of fish and mussel species in the Upper Conasauga River watershed in Georgia/Tennessee, USA. To investigate the potential role of agriculture in the population declines, surface waters and sediments throughout the basin were tested for toxicity and analyzed for glyphosate, metals, nutrients, and steroid hormones. Assessments of chronic toxicity with Ceriodaphnia dubia and Hyalella azteca indicated that few water or sediment samples were harmful and metal concentrations were generally below impairment levels. Glyphosate was not observed in surface waters, although its primary degradation product, aminomethyl phosphonic acid (AMPA), was detected in 77% of the samples (mean = 509 µg/L, n = 99) and one or both compounds were measured in most sediment samples. Waterborne AMPA concentrations supported an inference that surfactants associated with glyphosate may be present at levels sufficient to affect early life stages of mussels. Nutrient enrichment of surface waters was widespread with nitrate (mean = 0.7 mg NO3-N/L, n = 179) and phosphorus (mean = 275 µg/L, n = 179) exceeding levels associated with eutrophication. Hormone concentrations in sediments were often above those shown to cause endocrine disruption in fish and appear to reflect the widespread application of poultry litter and manure. Observed species declines may be at least partially due to hormones, although excess nutrients and herbicide surfactants may also be implicated.

Defining the evolving role of the EMR Implementation Team.

With the electronic medical record (EMR) system implementation underway in a large multi-site physician practice, the EMR Implementation Team faces several challenges. Dealing with each challenge requires strategic thinking in order to meet short- and long-term goals. In doing so, the Implementation Team begins to evolve both in role and in function.

Triumphs and tribulations of an EMR go-live.

With customization of the electronic medical record (EMR) system winding down, ENT and Allergy Associates took the plunge with implementation of the system in its first practice location. Was the Implementation Team comfortable that the current status of the development was good enough to use? This article discusses what was learned as the EMR was unveiled for the first time.

EMR implementation: big bang or a phased approach?

There are two major strategies to implementing an EMR: the big-bang approach and the phased, or incremental, approach. Each strategy has pros and cons that must be considered. This article discusses these approaches and the risks and benefits of each as well as some training strategies that can be used with either approach.

Customizing an EMR: lessons learned.

No electronic medical record (EMR) system is ready to use out-of-the-box. Vendors provide rudimentary clinical content with the expectation that physicians will want to modify it to meet the needs of their individual practice style. This article discusses some key factors involving our experience with customizing our EMR system that, in hindsight, are thought to be valuable points of knowledge.

A retrospective of EMR implementation in one large practice.

This article is the last of a six-part series regarding the implementation of an electronic medical record system in a large multisite physician practice. This particular article is meant to provide some insight regarding two matters any practice delving into this project should be prepared to consider: 1) don't underestimate the value of utilizing as many employees as possible in the pre-implementation planning stage; and 2) have a detailed plan for entering patient history information.

The search for an EMR system: weighing every option to ensure the best fit.

Having recently implemented a new practice management system, ENT and Allergy Associates began the search for an electronic medical record system. An integrated system seemed to be the obvious and logical choice, but researching all of the options ensured a well-informed decision and the comfort of knowing that the best product for the practice was selected. Therefore, the practice undertook an extensive search, finally narrowing the field down to two contenders: one that would be integrated, the other interfaced. With both products having different, yet considerable, strengths, the decision was a difficult one.