Hospital injury rates in relation to socioeconomic status and working conditions.

OBJECTIVES: To describe the risk of work injury by socioeconomic status (SES) in hospital workers, and to assess whether SES gradient in injury risk is explained by differences in psychosocial, ergonomic or organisational factors at work. METHODS: Workforce rosters and Occupational Safety and Health Administration injury logs for a 5-year period were obtained from two hospitals in Massachusetts. Job titles were classified into five SES strata on the basis of educational requirements and responsibilities: administrators, professionals, semiprofessionals, skilled and semiskilled workers. 13 selected psychosocial, ergonomic and organisational exposures were assigned to the hospital jobs through the national O*NET database. Rates of injury were analysed as frequency records using the Poisson regression, with job title as the unit of analysis. The risk of injury was modelled using SES alone, each exposure variable alone and then each exposure variable in combination with SES. RESULTS: An overall annual injury rate of 7.2 per 100 full-time workers was estimated for the two hospitals combined. All SES strata except professionals showed a significant excess risk of injury compared with the highest SES category (administrators); the risk was highest among semiskilled workers (RR 5.3, p<0.001), followed by nurses (RR 3.7, p<0.001), semiprofessionals (RR 2.9, p = 0.006) and skilled workers (RR 2.6, p = 0.01). The risk of injury was significantly associated with each exposure considered except pause frequency. When workplace exposures were introduced in the regression model together with SES, four remained significant predictors of the risk of injury (decision latitude, supervisor support, force exertion and temperature extremes), whereas the RR related to SES was strongly reduced in all strata, except professionals. CONCLUSIONS: A strong gradient in the risk of injury by SES was reported in a sample population of hospital workers, which was greatly attenuated by adjusting for psychosocial and ergonomic workplace exposures, indicating that a large proportion of that gradient can be explained by differences in working conditions.

Piloting use of computerized practice tests.

This study piloted the use of computerized practice tests in an undergraduate nursing pathopharmacology course and collected questionnaire data on the students' experiences. Two computer-administered practice tests were available to help students prepare for the course's paper-and-pencil unit examinations. The software testing package, LXR-Test 5.1, was used to generate the practice tests. Twenty-eight students took one or both computer practice tests. Group mean course examination scores were higher for subjects taking the computer practice tests compared with subjects who did not take the computer practice tests, but these scores were not found to be significantly different (P = 0.29; P = 0.07). Final questionnaire results showed students enjoyed taking the computerized practice tests to prepare for course examinations and liked the immediate scoring and test summary printouts. After this experience, students felt more prepared to take the computerized licensure examination. Did students feel ready to take required course examinations via computer in future courses? Responses were mixed.

A study of factors related to the use of online resources by nurse educators.

A descriptive cross-sectional survey was used to collect data from nurse educators related to the use of online electronic resources for scholarly pursuits. The 35-question survey was divided into 4 sections, Environment, Stressor, Utilization, and Demographics information. Two open-ended questions were also included to allow respondents to elaborate on factors that they believed facilitated or detracted from use of online resources but were not adequately covered in the survey. Data were received from 489 respondents who were faculty members currently teaching in 1 of 38 colleges or universities located in the 6 New England states offering a minimum of a baccalaureate degree in nursing. Quantitative and qualitative data analysis revealed that many of the same issues, previously reported as deterrents to the use of computers, also play a significant role in preventing the use of online resources. The two open-ended questions provided clarification of facilitators and detractors to use of online resources and were used to understand better the quantitative results. Based on the findings of this study, recommendations for administrators, educators, staff developers, and technical support personnel are discussed.

Selected autoimmune diseases in the dog.

In summary, previous attempts to explain the role of inheritance in autoimmune disorders through family studies have been hampered by the variable degree of phenotypic expression. Our evidence utilizing dogs in family studies is consistent with the concept that genetic factors play some role in determining disease susceptibility. Recognizing the complexity of the genetic components involved in these studies, we have proposed a hypothesis of two classes of genes, one that relates to immunoregulation and another that specifies pathologic lesions (and thus the clinical signs). This dual system of interacting genes provides a rational explanation for many of the observations previously encountered in both human and canine studies.