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The American Academy of Pediatrics is committed to all its constituents supporting workplaces and educational settings free of sexual harassment. The purpose of this statement is to heighten awareness and sensitivity to this important issue, recognizing that institutions may have existing policies.
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A joint partnership between a University and its local hospitals developed and implemented Practice Learning Teams (PLTs) to enhance student nurse learning experiences. In order to achieve this, PLTs arrived at clear aims and purposes, with educators and nurses working collaboratively and being jointly responsible for the quality of students' placement experience. This study occurred after a year of implementation, and a range of stakeholders were interviewed in order to evaluate perceived effectiveness. Findings of this report suggest the majority of respondents thought PLTs should be retained, recognising that they were new, and thus required development. There was a clear difference between effective and ineffective PLTs. Effective teams were considered to support the students' practice-based learning and mentors, while providing a forum for sharing 'good practice', discussion and problem solving. Less effective teams were characterised by having a low attendance or a membership that lacked enthusiasm and/or willingness to participate.
OBJECTIVE: To determine the prevalence of microalbuminuria in a mixed, ethnic population and to find the extent that ethnic variation in microalbuminuria can be explained by abnormal glucose metabolism, obesity, hypertension, hypertriglyceridemia, and life-style factors. RESEARCH DESIGN AND METHODS: Urinary albumin concentrations were measured in 5467 middle-aged Maori, Pacific Islander, and European workers who participated in a health-screening survey of 46 New Zealand companies. Participants provided a first-voided, morning urine sample; had a 75-g oral glucose tolerance test; had weight, height, and blood pressure measured; and completed a self-administered questionnaire about past medical history and sociodemographic status. RESULTS: A significantly higher prevalence of microalbuminuria was found in individuals with new cases of diabetes mellitus (24.1%), in cases of diabetes mellitus previously diagnosed (20.6%), and in those with impaired glucose tolerance (16.1%) compared with nondiabetic individuals (4.0%). Moreover, in the general population, a piecewise linear relationship was detected between albuminuria and plasma glucose with significant changes of slope corresponding with 2 h plasma glucose concentrations (95% confidence interval) of 6.7 (6.4-7.0) and 9.2 (8.6-9.8) mM, respectively. After adjusting for sex, obesity, hypertension, hypertriglyceridemia, cigarette smoking, and heavy alcohol consumption in a multivariate model, glycemia was the most significant determinant of urinary albumin concentrations in all three ethnic groups. However, blood glucose concentrations did not completely explain the higher relative risk (95% confidence interval) of microalbuminuria in Maori (5.97; 4.48-7.78) and Pacific Islander (5.33; 4.13-6.87) workers compared with European workers. CONCLUSIONS: Of the variables investigated, hyperglycemia was the most important factor explaining the high prevalence of microalbuminuria in Maori and Pacific Islander workers compared with the European workers. However, only 14.9% of the variation in urinary albumin concentrations was found in our multivariate model, and we have speculated on the contribution of other factors such as diet and coexisting renal diseases.
This study was conducted to elucidate sickness absence due to mental disorders in Japanese companies. Data on sickness absence taken for seven consecutive days or more at eight companies (total number of employees: 44,816) was used for the analysis. Diagnosis of mental disorders was based on medical certificates prepared by physicians. The frequency of absence due to all diseases and mental disorders was 3.0% and 0.3%, respectively. The proportion of frequency absence due to mental disorders compared to that for all diseases was 9.4%. Figures for absence prevalence were almost the same as those for frequency absence. The average length of absence due to mental disorders and non-mental disorders was 119.5 days and 47.3 days, respectively. Rate of absence days due to mental disorders compared to that for all diseases was 21.0%. Percent of sickness absenteeism was 0.4%. In one company, the proportion of frequency absence and rate of absence days due to mental disorders compared to those for all diseases had an increasing tendency over the last six years.
This article presents the results of an Internet-based review conducted in January and February 2003 to assess the educational opportunities available in veterinary public health, epidemiology, and preventive medicine at the 27 veterinary schools in the United States. Most professional veterinary curricula are designed to train students for careers as highly qualified private practitioners, although there is an increased need for veterinary perspectives and contributions in the public health sector. The future of veterinary public health relies on the opportunities available in education to teach and encourage students to pursue a career of public service. The results of this review indicate the availability of a wide variety of required courses, electives, and post-graduate training programs to veterinary students in the United States. Veterinary students are exposed to a median of 60 hours of public health, epidemiology, and preventive medicine in required stand-alone courses in these areas. Four veterinary schools also have required rotations for senior students in public health, preventive medicine, or population medicine. Contact time for required public health, epidemiology, and preventive medicine courses ranges from 30 to 150 contact hours. Advanced training was available in these subjects at 79% of the 27 schools. Greater collaboration between veterinary schools, schools of public health, and the professional public health community will increase exposure to and opportunities in public health to all future veterinarians.
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The crisis of a nursing shortage is encouraging unemployed nurses to return to practice. A refresher course is needed before they return safely. Historically, schools of nursing and hospital-based continuing education departments offered refresher courses in the traditional classroom-based environments. Nurses in less populated, geographically dispersed areas have limited access to these educational opportunities. Refresher courses, whether in an academic or a hospital-based setting, are expensive and depend on class size to be cost-effective. An answer to the problem of cost and access is collaborative distance education using web-based instruction.
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Many health economists recommend that employers provide employees with a risk-adjusted choice among competing health insurance plans. However, formal risk adjustment is rarely if ever used by employers. This paper examines a range of health benefit design options available to employers, focusing attention not only on risk adjustment but also on its alternatives. We argue that while formal risk adjustment is rare, employers commonly use strategies that accomplish some of the same objectives at less cost.
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