Full-time Equivalent Employees Research Articles

Case managers within general practices in 11 Western countries: repeat cross-sectional studies.

In the context of an ageing population and increasing health needs, primary care reform is needed and several new models have emerged, including the introduction of case managers in general practitioner practices. To describe the frequency of case managers in general practices in eleven Western countries between 2012 and 2019 and to investigate the characteristics of general practitioners and their practices associated with case manager frequency. A secondary analysis of the Commonwealth Fund International Health Policy Surveys of Primary Care Physicians, which were international cross-sectional studies conducted in 2012, 2015 and 2019. Random samples of general practitioners were selected in 11 Western countries (2012: n = 9776; 2015: n = 12,049; 2019: n = 13,200). The use of case managers in general practitioner practices was determined with the question "Does your practice use personnel, such as nurses or case managers, to monitor and manage care for patients with chronic conditions that need regular follow-up care?", with possible answers "Yes, within the practice", "Yes, outside the practice", "Yes, both within and outside the practice" or "No". Other variables characterising general practitioners and their practices were considered. Mixed-effects logistic regression was performed. The frequency of case managers within general practitioner practices varied greatly by country, with an overall trend towards an increase from 2012 to 2019. In the multivariate analysis, more case managers were found in practices located in small towns (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.2-1.7) and in rural areas (OR 1.9; 95% CI 1.5-2.4) compared to cities. The frequency of case managers was higher in larger practices, as shown in comparisons of practices in the second, third and fourth quartile of full-time equivalent employee counts compared to those in the first quartile (Q2: OR 1.7, 95% CI 1.4-1.9; Q3: OR 2.1, 95% CI 1.6-2.9; Q4: OR 3.8, 95% CI 3.0-4.9). There was no significant difference in frequency with respect to the age and sex of the general practitioners. The use of case managers in general practitioner practices is a promising approach, but its practice varies greatly. This practice has been developing in Western countries and is tending to increase. The implementation of case managers seems to be associated with certain characteristics linked to general practitioner practices (practice location, practice size), whereas it does not seem to depend on the personal characteristics of general practitioners, such as age or sex.

Oil and Gas Extraction Industry Workers' Compensation Claims and Proposed Safety Interventions.

This study analyzed Ohio workers' compensation data to identify potential prevention strategies for common oil and gas extraction industry claims. Claim rates for 2001-2018 were calculated per full-time equivalent employee. Descriptive analyses on free-text descriptions of lost-time (LT) claims (>7 days away from work) identified common characteristics among claims and injured workers. Among 3134 claims, 860 (27%) were LT. The industry group, drilling contractors, experienced the highest LT claims rate, whereas the cost from servicing contractors was the highest. Contact with objects and equipment caused the highest LT claims rate. The most frequent LT occupation was roustabout, and the most frequent LT work activity was material handling. Transportation incidents caused most fatalities and hospitalizations. Over half of LT claims were from short-tenured workers. Both proven and innovative approaches are needed to reduce severe workers' compensation claims in this industry.

Mapping pre-consumer food waste in quick service restaurants on a university campus: Two Australian case studies

Mapping and monitoring the process of pre-consumer food waste generation in the foodservice sector is needed to fully understand food waste, identify hotspots, and strengthen the evidence-base in this sector of the food supply chain. The purpose of this study was to validate a tool for separation and quantifying pre-consumer food waste in a quick service restaurant (QSR) setting, and to map the food waste generation process using statistical process control methodology. This included consideration of food waste categories and edible versus inedible waste. The study also explored key foodservice and menu practices which may impact food waste production. Food waste audits were undertaken in two food outlets (FOs) in an Australian university campus over a two-week operating period for each outlet using a direct weighing method. Foodservice operation and menu practices occurring in the outlets during the audit period were also recorded. These observations validated practices reported by the owner-manager of the FOs during interviews. The amount of waste collected separately from each outlet was analysed using statistical process control methodology. While each FO was treated as a separate case study, the same methodology was applied to each, allowing some comparison between outlets. Despite differences in foodservice style and menus, the average daily pre-consumer food waste produced from all food waste categories was approximately 25 kg for both outlets, with about 60% from inedible waste. This equated to approximately 5.5–6.1 kg of pre-consumer waste per full-time-equivalent employee (FTE) per day. Used coffee grounds was the largest single contributor of total pre-consumer waste for both FOs. Both FOs demonstrated compliance with Australian best practice in foodservice operations and menu design. The study concludes that the method used to separate pre-consumer food waste into different categories and quantify this waste was a practical tool for these QSRs and allowed researchers to validate both the separation process and the amount of waste collected. Analysis of data using statistical process control allowed differentiation between common and special cause of variations. These findings can help inform processes which generate food waste in these types of foodservice settings and assist with the development of food waste reduction initiatives.

Occupational Carbon Monoxide Poisoning in Wisconsin: Results From a Statewide Electronic Disease Surveillance System and From the Wisconsin Poison Center, 2018-2021.

Prevention methods for carbon monoxide (CO) poisoning in Wisconsin address occupational and nonoccupational exposures together, but differences between the settings could inform new approaches to preventing occupational CO poisonings. We described occupational CO poisonings in Wisconsin from July 1, 2018, through July 1, 2021, using surveillance data from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. We identified cases of CO poisoning from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. Occupational CO poisonings were records where "workplace" was recorded as the location of exposure. We excluded records classified as suspect/not a case, those missing laboratory results or information on exposure source/location, and intentional poisonings. We compared characteristics between occupational and nonoccupational settings using odds ratios (ORs), and we estimated crude incidence rates of occupational exposures by occupation. We identified 614 cases of CO poisoning, of which 168 (27.4%) were occupational exposures. When compared with patients with nonoccupational exposures, patients with occupational exposures were more likely to be male (OR = 3.8; 95% CI, 2.4-6.1), Hispanic (OR = 2.4; 95% CI, 1.4-4.2), and younger (mean difference [SD] = 6.6 [20.9]). Several CO sources were significantly associated with occupational poisonings: forklifts (OR = 58.4; 95% CI, 13.9-246.1; P < .001), pressure sprayers (OR = 2.4; 95% CI, 1.3-4.4; P = .003), and other gasoline-powered tools (OR = 3.8; 95% CI, 2.3-6.3; P < .001). The natural resources, construction, and maintenance occupation group had the highest crude incidence rate-45.0 poisonings per 100 000 full-time equivalent employees. Incorporating data from the Wisconsin Poison Center improved data quality, but surveillance is limited by underreporting. Creating strategies to increase reporting would allow for a more comprehensive understanding of occupational CO poisoning.

Construction industry workers’ compensation injury claims due to slips, trips, and falls – Ohio, 2010–2017

Problem: Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers’ Compensation. Methods: STF injury claims in the Ohio construction industry from 2010–2017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 0–7 days away from work, DAFW) or lost-time (LT, ≥8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. Results: 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were “other.” Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms.

Quarterly business review for digital transformation: insights from the automotive industry

PurposeAs quarterly business reviews (QBRs) remained unexplored in the scholarly community, this paper sheds light on what QBRs are, how they are being used across organisations and provides deep insights into the implementation of the QBR at an incumbent car manufacturer’s digital transformation business unit. Particular attention has been paid to decision processes, portfolio management, challenges and success factors.Design/methodology/approachGiven the explorative nature of the research, a case study is well suited to explore the phenomenon in its real-world context, especially given the dynamic and volatile business environment. This article is based on insights from an incumbent car manufacturer undergoing a business-wide transformation.FindingsThe car manufacturer introduced the QBR process and themes to improve business effectiveness and efficiency through (1) focusing on the biggest issues, (2) concentrating efforts, (3) providing autonomy and stability, (4) building and maintaining strong relationships, and (5) building domain expertise. Through the QBR process, themes were (de)prioritised, resources allocated, financial value (estimates) agreed upon, and key performance indicators (e.g. £m/FTE; FTE, full-time equivalent employees) introduced. Digital product managers’ were assigned to the prioritised themes, and portfolio management structures were presented.Originality/valueManaging short- and long-term objectives is challenging for most businesses but essential to perform well in uncertain environments. The QBR process can help organisations continuously (de)prioritise work and reallocate resources based on changing environments and aligned with strategic priorities.

Adapting a Telephone-Based, Dyadic Self-management Program to Be Delivered Over the Web: Methodology and Usability Testing.

The COVID-19 pandemic has amplified the need for web-based behavioral interventions to support individuals who are diagnosed with chronic conditions and their informal caregivers. However, most interventions focus on patient outcomes. Dyadic technology-enabled interventions that simultaneously improve outcomes for patients and caregivers are needed. This study aimed to describe the methodology used to adapt a telephone-based, facilitated, and dyadic self-management program called Self-care Using Collaborative Coping Enhancement in Diseases (SUCCEED) into a self-guided, web-based version (web-SUCCEED) and to conduct usability testing for web-SUCCEED. We developed web-SUCCEED in 6 steps: ideation-determine the intervention content areas; prototyping-develop the wireframes, illustrating the look and feel of the website; prototype refinement via feedback from focus groups; finalizing the module content; programming web-SUCCEED; and usability testing. A diverse team of stakeholders including content experts, web designers, patients, and caregivers provided input at various stages of development. Costs, including full-time equivalent employee, were summarized. At the ideation stage, we determined the content of web-SUCCEED based on feedback from the program's original pilot study. At the prototyping stage, the principal investigator and web designers iteratively developed prototypes that included inclusive design elements (eg, large font size). Feedback about these prototypes was elicited through 2 focus groups of veterans with chronic conditions (n=13). Rapid thematic analysis identified two themes: (1) web-based interventions can be useful for many but should include ways to connect with other users and (2) prototypes were sufficient to elicit feedback about the esthetics, but a live website allowing for continual feedback and updating would be better. Focus group feedback was incorporated into building a functional website. In parallel, the content experts worked in small groups to adapt SUCCEED's content, so that it could be delivered in a didactic, self-guided format. Usability testing was completed by veterans (8/16, 50%) and caregivers (8/16, 50%). Veterans and caregivers gave web-SUCCEED high usability scores, noting that it was easy to understand, easy to use, and not overly burdensome. Notable negative feedback included "slightly agreeing" that the site was confusing and awkward. All veterans (8/8, 100%) agreed that they would choose this type of program in the future to access an intervention that aims to improve their health. Developing and maintaining the software and hosting together cost approximately US $100,000, excluding salary and fringe benefits for project personnel (steps 1-3: US $25,000; steps 4-6: US $75,000). Adapting an existing, facilitated self-management support program for delivery via the web is feasible, and such programs can remotely deliver content. Input from a multidisciplinary team of experts and stakeholders can ensure the program's success. Those interested in adapting programs should have a realistic estimate of the budget and staffing requirements.

Retrospective Analysis to Define Appropriate Physics FTE Support for Online Adaptive Radiotherapy Programs

<h3>Purpose/Objective(s)</h3> In 2019, ASTRO published an update to "Safety is No Accident", a comprehensive reference guide to promote safety in radiation oncology. Included in this report are staffing guidelines that provides a simple way to calculate physics and dosimetry staffing for individual centers. Since this publication, the use of online adaptive radiotherapy (ART) has been on the rise with RT delivery units (CT- and MR-based) being cleared for clinical use. While some centers have adopted the use of online ART delivery systems, it remains unclear how to properly define the staffing of full-time equivalent (FTE) employees for an ART program. Current staffing models rely on physics to lead the delivery of adaptive sessions, including contouring and plan evaluation/selection. Our hypothesis here is that ART programs are more demanding (in terms of physics FTE) than SRS/SBRT programs. <h3>Materials/Methods</h3> In-house software was developed to query treatment delivery logs from our institution's treatment delivery system. The system's daily machine logs contain detailed information for individual patient's treatment session including time-stamps for each step in the ART treatment delivery workflow. For this study, we identify time points for the following steps in the adaptive workflow: 1) patient session is started (when patient's identity is verified prior to treatment set up), 2) start of auto-contouring review (after acquisition of CBCT), 3) completion of contour review/editing (this marks the start of dose optimization/calculation), 4) start of treatment delivery, and 5) patient session is completed (required prior to removing patient from Linac). We use methodology by Batista et al to estimate per patient relative FTE factors for physicists using treatment session times. <h3>Results</h3> Machine logs from August 2021 to February 2022 were analyzed for this study. During this time, our clinic delivered over 450 online daily adaptive treatments for 26 unique patients. Treatment sites included prostate, GYN, lungs, breast, H&N, and abdomen. On average (± std. dev.), adaptive sessions took 37 ± 16 mins from start to end. Average contour review/edit time was 7.8 ± 5.5 mins. After contour approval, it took an average of 10.1 ± 3.4 mins for plan generation, evaluation, and selection to start of treatment delivery. Based on overall session times, we calculate a conservative estimate of relative FTE factor of 0.02 for physicists per number of adaptive cases per year (w/ 30 fx/pt, 45 min/session, and 2000 work-hours/yr ≈ 0.012 + 0.008 from [1] for IGRT-based planning/QA). <h3>Conclusion</h3> The clinical adoption of online ART will increase demand for physics support. To our knowledge, this is the first data-driven analysis to make recommendations of physics staffing for CBCT-based online ART programs. The relative FTE factor measured in this study should be confirmed using multi-center data.

REVIEW ON THE HISTORY AND EMOTIONAL BEHAVIOR CHANGES OF R&amp;D HUMAN RESOURCES IN JAPAN, SOUTH KOREA AND SINGAPORE

BackgroundIn order to pay attention to the observation of R & D personnel, especially the changes of emotion, attitude and behavior in the process of R & D, most Asian countries will provide their own strength to improve the quality and quantity of R & D personnel. This study tracked the deviation of R & D personnel and total R & D revenue in GDP in Japan, South Korea and Singapore from 2002 to 2007. Technology is developing rapidly in Japan, Taiwan, South Korea and Singapore, as many researchers and educators obtain master's and doctoral degrees from western countries and then return to Asian countries to teach new technology, which brings rich human resources. This is why the four little dragons (Hong Kong, South Korea, Singapore and Taiwan) have strengthened high-tech and economic development.Research Objects and MethodsThe percentages of R & D personnel in the total population in Japan, South Korea and Singapore are expressed in full-time equivalent (FTE) and total employees (HC) respectively. The correlation between gross R & D revenue per GDP (GERD) and FTE and HC is studied. The data for this study are from the open database of the Institute for statistics of the United Nations Educational, scientific and Cultural Organization (UNESCO). This study also used DASS-21 to conduct a questionnaire survey on the samples. Subjective perceived social support questionnaire the subjective perceived social support questionnaire was revised by Zhao Xia based on the social relationship network questionnaire (NRI) compiled by Furman (1985) and others and revised by Zou Hong in 2003. The scale consists of 27 items and 5 dimensions: emotional support, instrumental support, companionship, affirmation and intimacy. The scale adopts 5-level scoring, “never” is recorded as 1 point, and “almost always” is recorded as 5 points. The higher the total score of the scale, the higher the individual's perceived level of social support. The internal consistency coefficient of the scale in this study is 0.94.ResultsThe results are as follows: (1) statistics show that language policy is conducive to reducing the cost of education and science and technology in Singapore. (2) From 2002 to 2007, the correlation coefficient between “R & D full-time personnel in total R & D revenue per GDP (rdftep)” and “R & D personnel in total R & D revenue per GDP (rdhcp)” in Japan exceeded 0.9. In addition, the correlation coefficients of “rdftepv. Sgerd / GDP” and “rdhcpv. Sgerd / GDP” in South Korea are both 0.99. All variables are positive, i.e. R & D professionals play an active and beneficial role in these countries.ConclusionThis study tracked the R & D personnel in Japan, South Korea and Singapore from 2002 to 2007 and their correlation with the total R & D revenue of each FRP. The findings are as follows: Singapore is a member of the Commonwealth. English is the first official language, which makes it easier to communicate with developed countries. The language policy has enabled her to benefit from lower costs of education, science and technology. R & D personnel in industrialized countries are very important. The study shows that R & D professionals were very valuable between 2002 and 2007, because from a statistical point of view, R & D professionals accounted for 2.44 to 7.10 of GDP per capita. The further impact of R & D personnel should be greater than the statistical data. R & D output is usually ahead of industrial technology. In short, we should pay full attention to the important role of R & D personnel in design elements, actively pay attention to the changes of their psychological emotion and behavior, as well as the impact of R & D effect and healthy behavior, and be good builders, managers, coordinators and collaborators of design methods. According to the psychological characteristics of these groups, we should actively and flexibly organize colorful activities, strive to create a relaxed and harmonious living atmosphere, create a friendly and mutually beneficial R & D relationship, encourage and guide these groups, adjust their psychology to the best state, and promote the healthy development of their good cognition and life.AcknowledgementsThis work was jointly supported by Natural Science Foundation of Guangdong Province under Grant 2019A1515010830 and Guangdong University of Petrochemical Technology under Grant 702-519244, Guangdong, China.

The Role of Worker Age in Ohio Workers' Compensation Claims in the Landscaping Services Industry.

This study employed analysis of workers' compensation (WC) claims in the landscaping services industry to identify occupational factors associated with claims from workers of different ages. Private sector claims for 2005 to 2017 to the Ohio Bureau of Workers' Compensation (OHBWC) and their free-text descriptions were used along with data from the US Census Bureau American Community Survey to examine rates and types of WC claims by worker age. Although the claim rate for younger workers was higher than that for older workers overall (593 vs 261 per 10,000 full-time equivalent employees, P < 0.001), claims from older workers had higher nonzero median cost ($1002 vs $522, P < 0.001). Analysis of WC claim rates shows significant differences between claims in different age groups. These differences can be used to target safety interventions for the greatest impact.

The Challenge of Employee Retention in Medical Practices across the United States: An Exploratory Investigation Into the Relationship between Operational Succession Planning and Employee Turnover.

Employee turnover is a growing challenge for health-care providers delivering patient care today. US population demographics are shifting as the population ages, which leaves the field of health care poised to lose key leaders and employees to retirement at a time when patient care has grown more complex. This means health care will lose its core of key employees at a time when skilled leadership and specialized knowledge is most needed and directly impacts health care's ability to deliver quality care. Operational succession planning (OSP) may be one solution to manage this looming challenge in health care, as the process identifies and develops the next generation of leadership. Thus, this exploratory national study used a quantitative and cross-sectional design to examine the relationship between OSP and employee turnover. Demographic and 10-point Likert scale data were collected from n = 66 medical practices, using an online survey instrument. Data were analyzed using various descriptive and inferential statistical methods. Distribution (frequency and chi-square) analyses of the study sample, one-way analysis of variance (ANOVA), and regression analyses were performed across seven demographic characteristics of the medical practices: Specialty, Ownership Structure, Number of full-time equivalent (FTE) Physicians, Number of FTE Clinical Employees, Number of FTE Nonclinical Employees, Number of FTE Employees Left Position, and Region. Study results provided statistically significant evidence to support the relationship between OSP and employee turnover, highlighting that OSP was associated with lower employee turnover. The finding suggests that OSP can serve as an effective mechanism for increasing employee retention.

Unionisation and injury risk in construction: a replication study

ObjectiveTo replicate, in a more recent time period, a previous cross-sectional study to estimate the association between unionisation and the risk of workers’ compensation injury claims.MethodsThe sampling frame was workers’...

Examining trends in substance use disorder capacity and service delivery by Health Resources and Services Administration-funded health centers: A time series regression analysis.

The opioid epidemic and subsequent mortality is a national concern in the U.S. The burden of this problem is disproportionately high among low-income and uninsured populations who are more likely to experience unmet need for substance use services. We assessed the impact of two Health Resources and Services Administration (HRSA) substance use disorder (SUD) service capacity grants on SUD staffing and service use in HRSA -funded health centers (HCs). We conducted cross-sectional analyses of the Uniform Data System (UDS) from 2010 to 2017 to assess HC (n = 1,341) trends in capacity measured by supply of SUD and medication-assisted treatment (MAT) providers, utilization of SUD and MAT services, and panel size and visit ratio measured by the number of patients seen and visits delivered by SUD and MAT providers. We merged mortality and national survey data to incorporate SUD mortality and SUD treatment services availability, respectively. From 2010 to 2015, 20% of HC organizations had any SUD staff, had an average of one full-time equivalent SUD employee, and did not report an increase in SUD patients or SUD services. SUD capacity grew significantly in 2016 (43%) and 2017 (22%). MAT capacity growth was measured only in 2016 and 2017 and grew by 29% between those years. Receipt of both supplementary grants increased the probability of any SUD capacity by 35% (95% CI: 26%, 44%) and service use, but decreased the probability of SUD visit ratio by 680 visits (95% CI: -1,013, -347), compared to not receiving grants. The significant growth in HC specialized SUD capacity is likely due to supplemental SUD-specific HRSA grants and may vary by structure of grants. Expanding SUD capacity in HCs is an important step in increasing SUD access for low income and uninsured populations broadly and for patients of these organizations.

Clinical Trial Metrics: The Complexity of Conducting Clinical Trials in North American Cancer Centers.

PURPOSE:Cancer clinical trials offices (CTOs) support the investigation of cancer prevention, early detection, and treatment at cancer centers across North America. CTOs are a centralized resource for clinical trial conduct and typically use research staff with expertise in four functional areas of clinical research: finance, regulatory, clinical, and data operations. To our knowledge, there are no publicly available benchmark data sets that characterize the size, cost, volume, and efficiency of these offices, nor whether the metrics differ by National Cancer Institute (NCI) designation. The Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) steering committee developed a survey to address this knowledge gap.METHODS:An 11-question survey that addressed CTO budget, accrual and trial volume, full-time equivalents (FTEs), staff turnover, and activation timelines was developed by the AACI CRI steering committee and sent to 92 academic cancer research centers in North America (n = 90 in the United States; n = 2 in Canada), with 79 respondents completing the survey (86% completion rate).RESULTS:The number of FTE employees working in the CTOs ranged from 4.5 to 811 (median, 104). The median number of analytic cases (ie, newly diagnosed or received first course of treatment) reported by the main center was 3,856. Annual CTO budgets ranged from $250,000 to $23,900,000 (median, $8.2 million). The median trial activation time, based on 61 centers, was 167 days. The median number of accruals per center was 480 (range, 5-6,271) and median number of trials per center was 282 (range, 31-1,833). Budget and FTE ranges varied by NCI designation.CONCLUSION:The response rate to the survey was high. These data will allow cancer centers to evaluate their CTO infrastructure, funding, portfolio, and/or accrual goals as compared with peers. A wide range in each of the outcomes was noted, in keeping with the wide variation in size and scope of cancer center CTOs across the United States and Canada. These variations may warrant additional investigation.

An integrated methodology for assessing ecological and economic impacts for marine management: A case study for abrasion and mobile fishing gear effects

Ensuring a balance of conservation and human activities within the marine environment requires complex decisions on how to achieve conservation objectives whilst considering the likely economic and social costs and benefits of such decisions. We assessed the risk of adverse effects from abrasion caused by bottom fishing, as a case study, to demonstrate an integrated spatial management methodology. Risk was quantified in the Galway Bay, Ireland region using a 1 km grid, as the ratio between mortality and recovery of benthic infauna exposed to abrasion effects estimated from fishing data. Risk was considered high if annual mortality exceeded recovery. A Bayesian network model, incorporating ecological and economic data, compared three management scenarios: i) business as usual (BAU), ii) exclusion of fishing vessels over 18 m within 6 nautical miles (68% of study area) (Length) and iii) a network of marine protected areas (MPAs) closed to all fishing vessels (11% of study area) (MPA). The BAU scenario indicated that risk was high for 85.6% of the study area. The length scenario resulted in a 14.6% reduction in high risk cells, affecting €0.9 M of landings, €0.7 M of indirect output and 19 full time equivalent (FTE) employees. The MPA scenario resulted in a 1.7% reduction of high risk cells. This scenario affected €0.17M in landings, €0.13M in indirect outputs and 3 FTE employees. We present a method which provides a quantitative, spatial, risk and economic impact assessment of the effects of human activities and pressures on the marine environment that assesses potential costs and benefits of management options to mitigate against these pressures. Future development of a mortality-recovery ratio for defined time periods would enable application across multiple habitats, human activities and pressures.

Critical Foundations for Implementing the VA's Public Health Approach to Suicide Prevention.

Critical Foundations for Implementing the VA's Public Health Approach to Suicide Prevention.

Preventing fall-from-height injuries in construction: Effectiveness of a regulatory training standard

Introduction: A regulatory training standard for construction workers using fall protection equipment became mandatory in 2015 in the province of Ontario, Canada. By the end of the transition period in 2017, 418,000 workers had been trained to the new standard. Two primary research questions were posed: (1) To what extent does the WAH training affect practices at the worksite? and (2) Has there been a change in the incidence of fall-from-height injuries coincident with the introduction of the WAH Training Standard? Materials and methods: A longitudinal survey of 633 learners was conducted in 2017 at one-, four- and seven-week post-training. A quasi-experiment estimated the incidence of lost-time injuries attributed to falls from heights in 2017 compared to 2012–2014 for a census of construction workers insured for work disability in Ontario, Canada. Results: Learners self-reported substantial increases in knowledge of and improvements in safe work practices when working at heights. The incidence rate of lost-time claim injuries attributed to falls targeted by the training declined by 19.6% (95% CI: 10.7, −27.6), compared to corresponding declines of 2.1% (95% CI: −6.3, 9.9) for other fall injuries and 7.2% (95% CI: 1.8, 12.3) for non-fall traumatic injuries. The observed decline was largest among the smallest employers (<5 full-time equivalent employees). Conclusion: The evaluation findings provide consistent support for a conclusion that the mandatory training standard was effective in reducing the incidence of injuries targeted by the training. However, the effects were modest and did not eliminate the problem. Practical application: A mandatory training standard should be considered as one approach to preventing traumatic injuries. However, other approaches higher in the hierarchy of risk controls should also be considered.

Economic Contributions of a College of Pharmacy to the Surrounding Communities and State

Objective. To quantify the monetary value of economic contributions of a state-funded college of pharmacy as it pursues its missions of teaching, research, service, and patient care. Methods. An economic analysis was performed by applying the Impact Analysis for Planning (IMPLAN) Economic Input-Output Model to financial and enrollment data of the University of Tennessee Health Science Center College of Pharmacy. Results. A total of $94.1 million was attributed to the college in fiscal year 2018, which included $50.7 million of total direct expenditures by the college, its students, and visitors; the indirect effect of over $17 million; and the induced effect of $26.4 million. The college directly employed 117 full-time equivalent employees and 39 pharmacy residents, and supported 763 additional jobs through the economic activities it stimulated. In addition, the presence of the college and its economic contribution enabled federal, state, and local taxing authorities to collect $12 million in tax revenues to support government and public programs. Conclusion. Demonstrating the economic value of colleges of pharmacy is critical when seeking support from campus administrators, state legislators, charitable foundations, government agencies, and industry.

Comparison of naloxone prescribing patterns due to educational outreach conducted by full-time and part-time academic detailers at the U.S. Veterans Health Administration

ObjectiveTo examine the impact of full-time equivalent employee (FTEE) allocation to academic detailers on naloxone prescribing at the U.S. Veterans Health Administration (VA). DesignLongitudinal nonequivalent control group posttest-only design using a random effects model. Setting and participantsClosed cohort of primary care providers exposed to academic detailing between September 1, 2016, and September 20, 2018, at VA. Outcome measuresPrevious analysis identified a cutoff of 0.40 FTEE was associated with a greater return on investment. We evaluated whether this level of FTEE allocation was associated with increases in naloxone prescribing rates and compared providers who had an interaction with an academic detailer allocated 0.4 FTEE or greater (high FTEE) to providers who interacted with an academic detailer allocated less than 0.4 FTEE (low FTEE). ResultsAmong VA primary care providers who received academic detailing, 1770 (68%) had interactions with a high FTEE academic detailer. There were no differences in demographics between providers who interacted with high FTEE and low FTEE academic detailers except for the distribution of provider classes (P = 0.004) and geographic districts (P < 0.001). Providers who interacted with high FTEE academic detailers had a greater average monthly number of naloxone prescriptions prescribed compared with low FTEE academic detailers (0.60 vs. 0.53; P = 0.005). In the random effects model, there was a 65% greater increase in the average monthly number of naloxone prescriptions prescribed among providers who interacted with a high FTEE academic detailer compared with providers who interacted with low FTEE academic detailers (P = 0.027). We also observed a dose-dependent relationship between the number of naloxone prescribed and the amount of FTEE allocated. ConclusionThis observational study highlights the potential benefits (e.g., increased naloxone prescribing) of academic detailers having more FTEE allocated. Hence, implementation of academic detailing needs to consider the amount of dedicated time for academic detailers, given competing VA priorities.

Provider Practice Competition and Adoption of Medicare's Oncology Care Model.

There is a concern that the Oncology Care Model (OCM), a voluntary bundled payment program, may incentivize mergers and acquisitions among physician practices leading to reduced competition and price increases. These concerns are heightened if OCM is preferentially adopted in competitive health care markets because it could result in reduced competition, but little is known about the characteristics of markets where OCM is adopted. To measure the association between regional market competition among medical oncologists with the initial adoption of OCM. The Herfindahl-Hirschman Index (HHI), a measure of competition, was calculated for hospital referral regions (HRRs) using secondary data from the Centers for Medicare and Medicaid Services. The relationship between HHI and OCM adoption was assessed using a 2-part regression model adjusting for the market-level number of practices, physician density, average practice size, sociodemographic characteristics, and medical resources. A count model on all HRRs was also estimated to assess an overall effect. A total of 10,788 physicians in 3,537 practices who billed Medicare for oncology services in 2015. OCM was adopted in 114 (37%) of the 306 HRRs. We found that practices in competitive health care markets were more likely to adopt OCM than in noncompetitive markets. Two-part regression analysis indicated a nonlinear relationship between HHI and OCM adoption. Average practice size, number of practices in an HRR, and the hospital bed rate were positively associated with adoption, whereas the rate of full-time equivalent hospital employees to 1000 residents was negatively associated with adoption. OCM adoption was higher in HRRs with greater competition. Careful monitoring of market-level changes among OCM adopters should be undertaken to ensure that the benefits of the OCM outweigh the negative consequences of possible changes in competition.