Sick Leave Research Articles

Family-Leave Mandates and Female Labor at U.S. Firms: Evidence from a Trade Shock

Abstract We examine how the 1993 Family and Medical Leave Act (FMLA) impacts the gender composition at U.S. firms experiencing a negative demand shock. Combining changes in Chinese imports across industries between 2000 and 2003 and a sharp regression discontinuity to identify FMLA status, we find that an increase in import competition decreases the share of female employment, earnings, and promotions at FMLA relative to non-FMLA firms. This effect is driven by women in prime childbearing ages and without college degrees; and is pronounced at firms with all male managers. These results suggest that job-protected leave mandates may exacerbate gender inequalities in response to adverse shocks.

Predictability of the National Psychological Stress Screening for Subsequent Long-Term Psychiatric Sick Leave Among Employees: A Multicenter Nested Case-Control Study.

The aim of the study is to predict employees' long-term sick leave due to psychiatric disorders using the national psychological stress screening program. University employees who took long-term psychiatric sick leave in 2016-2018 were assigned as cases. Those who were present at work and matched for sex, age, and occupation type were assigned as controls. Answers in a 57-item questionnaire were analyzed by multivariable regression, and a prediction model was developed. It was validated in cases and matched controls in 2019. Six items were identified as independent predictors by multivariable regression and included in a prediction model. The area under the receiver-operating characteristics curve was 0.768 (95% confidence interval: 0.723-0.813). This finding was similar to that in the validation sample. The performance of the prediction model was modest and the national Stress Check Program should be further refined.

A cost-consequence model of using the 21-gene assay to identify patients with early-stage node-positive breast cancer who benefit from adjuvant chemotherapy in the Netherlands

Background Patients with early-stage hormone receptor positive, human epidermal growth factor receptor-2 (HER2) negative invasive breast cancer with 1–3 positive lymph nodes (N1) often undergo surgical excisions followed by adjuvant chemotherapy (ACT). Many patients have no benefit from ACT and receive unnecessary, costly treatment often associated with short- and long-term adverse events (AEs). Gene expression profiling (GEP) assays, such as the 21-gene assay (i.e. the Oncotype DX assay), can identify patients at higher risk for recurrence who may benefit from ACT. However, the budgetary consequence of using the Oncotype DX assay versus no GEP testing in the Netherlands is unknown. Our study therefore assessed it using a cost-consequence model. Methods A validated model was used to create the N1 model. The model compared the costs and consequences of using the Oncotype DX assay versus no GEP testing and MammaPrint, and subsequent ACT use with corresponding costs for chemotherapy, treatment of AEs, productivity losses, GEP testing, and treatment of recurrences, according to the Oncotype DX results. The model time horizon was 5 years. Results Costs for the total population amounted to €8.0 million (M), €16.2 M, and €9.5 M, and cost per patient amounted to €13,540, €27,455, and €16,154 for using the Oncotype DX assay, no GEP testing, and MammaPrint, respectively. Total cost savings of using the Oncotype DX assay amounted to €8.2 M versus no GEP testing and €1.5 M versus MammaPrint. Using the Oncotype DX assay would result in fewer patients receiving ACT and thus fewer AEs, sick days, and hospitalizations, leading to overall cost savings compared with no GEP testing and MammaPrint. Conclusions Implementing Oncotype DX testing in this population can prevent unnecessary overtreatment, reducing clinical and economic burden on the patient and Dutch healthcare system.

Managing Medications During “Sick Days” in Patients With Diabetes, Kidney, and Cardiovascular Conditions: A Theory-informed Approach to Intervention Design and Implementation

ObjectivesOur aim in this work was to 1) explore barriers and enablers to patient and health-care provider (HCP) behaviours related to sick-day medication guidance (SDMG), 2) identify theory-informed strategies to advise SDMG intervention design, and 3) obtain perspectives on an eHealth tool for this purpose. MethodsA qualitative descriptive study using qualitative conventional content analysis was undertaken. Interviews and focus groups were held with patients and HCPs from January 2021 to April 2022. Data were analyzed using the Behaviour Change Wheel and Theoretical Domains Framework to inform intervention design. ResultsForty-eight people (20 patients, 13 pharmacists, 12 family physicians, and 3 nurse practitioners) participated in this study. Three interventions were designed to address the identified barriers and enablers: 1) prescriptions provided by a community-based care provider, 2) pharmacists adding a label to at-risk medications, and 3) built-in prompts for prescribing and dispensing software. Most participants accepted the concept of an eHealth tool and identified pharmacists as the ideal point-of-care provider. Challenges for an eHealth tool were raised, including credibility, privacy of data, medical liability, clinician remuneration and workload impact, and equitable access to use of the tool. ConclusionsPatients and HCPs endorsed non-technology and eHealth innovations as strategies to aid in the delivery of SDMG. These findings can guide the design of future theory-informed SDMG interventions.

The Efficacy of Digital Help for Divorced Danes: Randomized Controlled Trial of Cooperation After Divorce (CAD) and Sick Days

Few digital divorce interventions have undergone rigorous randomized control trial study (RCT) testing of their physical and psychological health effects. This paper describes the Cooperation after Divorce (CAD) intervention including background, target group, design and engagement strategies, intervention development, content, and theoretical cornerstones. The 17-module digital psychoeducational intervention addresses three main content areas: (1) the divorcee themselves, (2) the children, and (3) co-parenting. The content of the modules provided psychoeducation and therapeutic activities focused on the maladaptive interactional patterns between former partners and how to develop new interactional schemas, including a focus on when and how to communicate with the former partner in a way that does not escalate conflict. A randomized controlled trial (N = 778) assessed the effect of CAD in terms of number of sick days. Participants were assessed at 3-, 6- and 12-month post-divorce. Independent samples t test revealed that participants in the intervention group on average reported 5.82 fewer sick days one year post-divorce than did participants in the control condition. The results suggest that digital post-divorce interventions decrease sick days for newly divorce individuals, thereby offering long-term human, family, and public health benefits.

The impact of paid sick leave mandates on women's employment and economic security

ABSTRACTThe United States does not guarantee job‐protected paid leave to workers when they or a family member are ill or need to seek medical care. Prior research shows that women are less likely to have access to paid sick leave (PSL) through their employers. I examine the impacts of three recent state‐level paid sick leave policies in California, Massachusetts, and Oregon on women's employment and economic security using data from the American Community Survey. Using difference‐in‐differences and dynamic effects models, I find that PSL mandates increase women's employment by 1.2 percentage points (a 1.7% increase over the pre‐policy baseline mean) with an average increase in income from wages and salary of $2,347, accompanied by steady decreases in poverty in the years after policy implementation. Effects are strongest among mothers and women without college degrees. This study demonstrates that PSL improves women's employment and economic security and may play an essential role in the package of policies supporting women's employment and earnings.

A117 WORK PRODUCTIVITY IMPAIRMENT IN PERSONS WITH INFLAMMATORY BOWEL DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Background Inflammatory bowel diseases (IBD), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic disorders that affect approximately 6.8 million people globally. IBD often develops at an early age and can have a significant impact on employment outcomes and work productivity. Individuals with IBD have higher rates of unemployment, sick leave, and work disability compared to the general population. Nevertheless, there remains a paucity of standardized reporting on work productivity impairment and the associated indirect costs in patients with IBD. Aims In this systematic review and meta-analysis, we evaluate work-related outcomes and employment data among patients with IBD. This may inform clinical and policy decisions to facilitate workplace accomodations for patients with IBD and improve their work productivity. Methods A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane library, in addition to Scopus, ProQuest, and clinicaltrials.gov from inception to February 2023. We included full-texts and abstracts of observational and clinical trials that reported work-related outcomes in patients with IBD aged ampersand:003E18 years. We collected work-related data as described by the Work Productivity and Activity Impairment (WPAI) tool, in addition to other outcomes including employment, sick leaves, disability pensions, and indirect costs due to productivity loss. Pooled effect analysis was conducted using a random-effects model for pooled estimates of continuous and proportional data with 95% confidence intervals (CIs). Odds ratios (ORs) and mean differences were used to compare data between patients with active disease vs. remission. Results We included 134 studies (96 full-text articles and 38 abstracts). Among all patients with IBD, the pooled estimates were 16.41% [13.89-18.93] for absenteeism, 35.91% [31.11-40.72] for presenteeism, 39.41% [33.93-44.88] for overall productivity loss, and 45.96% [39.46-52.46] for non-work related activity impairment. Indirect costs were estimated at 1,813.9, 3,562.49, and 5,131.09 euros/patient/year for absenteeism, presenteeism, and overall work impairment respectively. For other non-WPAI outcomes, the pooled estimate for employment was 65.6%, 39.5% of patients reported sick days, 21.3% reported disability at work due to IBD directly, 12.3% received disability pensions, and 29.6% had lost jobs due to IBD. Overall, patients with active disease had worse WPAI and employment outcomes than those in remission. Conclusions IBD may result in significant work productivity impairment, lower employment, and significant indirect costs due to productivity loss. Larger studies with standardized definitions for work outcomes are needed to better evaluate the impact of IBD on work productivity. Funding Agencies Mount Sinai Resident Research Funding

Investigating a multi-session virtual reality relaxation intervention for mental health staff: protocol for a feasibility and acceptability study

PurposeClinical staff working in mental health services experience high levels of work-related stress, burnout and poor well-being. Increased levels of stress, burnout, depression and anxiety and poorer mental well-being among health-care workers are associated with more sick days, absenteeism, lower work satisfaction, increased staff turnover and reduced quality of patient care. Virtual reality (VR) relaxation is a technique whereby experiences of pleasant and calming environments are accessed through a head-mounted display to promote relaxation. The purpose of this paper is to describe the design of a study that assesses the feasibility and acceptability of implementing a multi-session VR relaxation intervention amongst mental health professionals, to improve their relaxation levels and mental well-being.Design/methodology/approachThe study follows a pre–post-test design. Mental health staff will be recruited for five weeks of VR relaxation. The authors will measure the feasibility and acceptability of the VR relaxation intervention as primary outcomes, alongside secondary outcomes evaluating the benefits of VR relaxation for mental well-being.FindingsThe study aims to recruit 20–25 health-care professionals working in both inpatient and specialist community mental health settings.Originality/valueResearch indicates the potential of VR relaxation as a low-intensity intervention to promote relaxation and reduce stress in the workplace. If VR relaxation is shown to be feasible and acceptable, when delivered across multiple sessions, there would be scope for large-scale work to investigate its effectiveness as an approach to enable health-care professionals to de-stress, relax and optimise their mental well-being. In turn, this may consequently reduce turnover and improve stress-related sick leave across health-care services.

Work Ability in Patients with COPD: Sick Leave Frequency and Duration

Work Ability in Patients with COPD: Sick Leave Frequency and Duration

Validation of the Return-to-Work Obstacles and Self-Efficacy Scale for Women on Sick Leave Due to Breast Cancer (ROSES-BC).

Breast cancer (BC) is the most frequently diagnosed cancer among women. Approximately 40% of BC survivors are diagnosed during the peak years of their professional career. Women face numerous obstacles when returning to work (RTW) after BC. Their decision-making process and self-efficacy to overcome these barriers may undergo alterations. The objective of this study was to validate the Return-to-work Obstacles and Self-Efficacy Scale (ROSES) for BC survivors, with a focus on three psychometric properties: construct validity, test-retest reliability, and predictive validity. This prospective study consists of three phases: Phase 1 (baseline, during sick leave) was conducted to evaluate construct validity, Phase 2 (2 weeks later) assessed test-retest reliability, and Phase 3 (6-month follow-up, RTW or not) aimed to evaluate predictive validity. A total of 153 BC survivors participated in Phase 1 of the study, where they completed the 10 dimensions of the ROSES (e.g., fear of relapse, cognitive difficulties). Confirmatory factor analyses (CFA), Pearson correlations, and Cox regressions were performed, with respect to each phase. The mean duration for RTW with the same employer was 62.7 weeks. CFAs confirmed the ROSES structure, which had previously been established for other health conditions, showing satisfactory coefficients. Significant Pearson correlation coefficients were observed between the ROSES dimensions from Phase 1 to Phase 2, ranging from 0.66 to 0.88. When considering various confounding variables, chemotherapy treatment and cognitive difficulties (ROSES dimension) emerged as the only significant predictors of RTW. These findings support the utilization of the ROSES in clinical and research settings for BC survivors to improve their successful RTW. After an initial screening using the ROSES, occupational health professionals can further conduct a focused and thorough evaluation of specific dimensions, such as cognitive difficulties. Additional research and information are required to assist BC survivors in dealing with cognitive impairments induced by chemotherapy when they return to work.

N14 The IBD nurse's role in screening for iatrogenic adrenal insufficiency in children with inflammatory bowel disease on discontinuing glucocorticoid therapy

Abstract Background With a wide range of medical treatment on offer, ensuring patient safety by monitoring and or preventing side effects is a key part of holistic care. Glucocorticoids are widely used in inflammatory bowel disease (IBD) treatment to induce remission or treat flares. Iatrogenic adrenal insufficiency (AI), due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis is an established side effect of exogenous glucocorticoids. Symptoms of AI can range from life-threatening adrenal crisis to more subtle chronic symptoms including fatigue, abdominal pain and diarrhoea. The rate of AI in this population is unknown. There is no standard guidance or recommendations to suggest routine screening of paediatric IBD (pIBD) patients. This study aimed to report our experience on set up a monitoring pathway to manage pIBD patients coming off glucocorticoid therapy(GT). Methods A database was created to capture all IBD patients under the age of 18 who had received GT for IBD between March 2022 and July 2023. At the time of starting treatment, predicted last day on GT was identified and patients were booked in for testing serum early morning cortisol (Vitros Ortho Clinical Diagnostics immunoassay) and ACTH. After tapering, patients remained on the lowest dose of GT until results review. Evaluation of the adrenal-axis response was then assessed by a protocol piloted by this study – see figure 1. The patients needing treatment for AI were seen in the Nurse led clinic for prescribing, education and training. The training included IM injection training, sick day training and safety netting. To ensure safe evidence based training, the IBD nurse had received training form the endocrine nurse before the pilot. Results Following the initial screening, 9 patients were seen in the clinic with AI ( 8 prednisolone and 1 Budesonide). Of these 9,8 (88%) were followed up by the IBD nurse and 1(11%) was followed up by a local paediatrician with an endocrine interest. Treatment with hydrocortisone was commenced and follow up 3 months blood tests organised. The school was notified of the risk of Adrenal suppression and emergency kits provided. Repeat adrenal axis testing was offered at 3 months (5 of 9) and 6 months (3 of 9). AI was noted in 3 patients and 2 patients at 3 and 6-month respectively. At the 6 month mark, patients were discharged from the clinic if they had returned to a normal adrenal axis or referred to the endocrine team for further follow up. Patients were discussed in a multi-displinary meeting at every point on the pathway and no child suffered an adrenal crisis during the study period. Conclusion AI following GT is common in this small pIBD cohort. The IBD nurse can play a critical role in providing safe care for these patients.

Sexual jokes and conversations at the workplace and their relation to employee well‐being: Results from a longitudinal study

AbstractAmbient social sexual behaviour at work refers to sexual jokes and conversations at the workplace. Prior cross‐sectional studies indicate that this behaviour is relatively widespread and tends to be associated with negative well‐being. We revisit this research by investigating the outcomes of sexual jokes and conversations at work after 1 year in a comparatively large employee sample. The perceived frequency of sexual jokes and conversations at work was negatively related to job satisfaction and positively related to sick days and anger 1 year later, controlling for baseline levels. Moderating effects of gender and age were not significant. Half of the sample reported that such jokes and conversations were relatively common in their workplace, both before and after the onset of the MeToo movement. We discuss implications and propose ideas for studying the theoretical mechanisms of this phenomenon.

Can an educational intervention in the context of inpatient pulmonary rehabilitation improve asthma self-management at work? A study protocol of a randomized controlled trial

BackgroundAsthma self-management (e.g., trigger avoidance or correct medication use) is a cornerstone of therapy. Its successful implementation in everyday working life is determined by psychosocial working conditions, in particular by support from superiors and colleagues and the job decision latitude (i.e., when and how to carry out which tasks). To empower individuals with asthma to modify their working conditions, employees need to use certain communication skills and acquire specific knowledge. Both could be taught as part of patient education during pulmonary rehabilitation. Therefore, the aim of the planned study is the development and multicentre implementation of an education module for individuals with asthma during their rehabilitation and to generate evidence on its effectiveness.MethodsParticipants (n ≥ 180) will be recruited, randomized into an intervention and a control group, trained and surveyed in two rehabilitation clinics. The intervention group will receive the supplementary patient education module “Asthma and Work” while the control group will participate in a program on " Eating behaviour” (both 2 × 50 min). The effectiveness of the intervention will be examined based on pre-post measurements (T1 and T2) and a 3-month follow-up (T3). We will consider behavioural intention (T2) and asthma self-management at work (T3) as primary outcomes. Secondary outcomes will include self-management-related knowledge, self-efficacy, number of sick days, number of exacerbations, asthma control (Asthma Control Test), asthma-related quality of life (Marks Asthma Quality of Life Questionnaire), and subjective employment prognosis (Brief Scale Measuring the Subjective Prognosis of Gainful Employment). The pre-post comparisons are to be evaluated using univariate analyses of covariance.DiscussionImproving asthma self-management at work could increase the work ability and social participation of employees with asthma. This could reduce costs, e.g. in terms of asthma-related sick leave.Trial registrationGerman Clinical Trials Register (ID: DRKS00031843)

Adapting COVID-19 research infrastructure to capture influenza and respiratory syncytial virus alongside SARS-CoV-2 in UK healthcare workers winter 2022/23 and beyond: protocol for a pragmatic sub-study

Introduction During the COVID-19 pandemic, extensive research was conducted on SARS-CoV-2; however, important questions about other respiratory pathogens remain unanswered. A severe influenza season in 2022–2023 with simultaneous circulation of SARS-CoV2 and respiratory syncytial virus is anticipated. This sub-study aims to determine the incidence and impact of these respiratory viruses on healthcare workers, the symptoms they experienced, the effectiveness of both COVID-19 and influenza vaccination and the burden of these infections on the National Health Service (NHS) workforce. Methods and analysis This is a longitudinal prospective cohort sub-study, utilising the population and infrastructure of the SARS-CoV-2 Immunity & Reinfection Evaluation (SIREN) study, which focuses on hospital staff in the UK. Participants undergo fortnightly nucleic acid amplification testing on a multiplex assay including SARS-CoV-2, influenza A and B and RSV, regardless of symptoms. Questionnaires are completed every two weeks, capturing symptoms, sick days, exposures, and vaccination records. Serum samples are collected monthly or quarterly from participants associated with a SIREN site. This sub-study commenced on 28/11/22 to align with the predicted influenza season and participants’ influenza vaccine status. The SIREN Participant Involvement Panel shaped the aims and methods for the study, highlighting its acceptability. UK devolved administrations were supported to develop local protocols. Analysis plans include incidence of asymptomatic and symptomatic infection, comparisons of vaccination coverage, assessment of sick day burden, and effectiveness of seasonal influenza against infection and time off work. Data are also integrated into UKHSA nosocomial modelling. Ethics and dissemination The protocol was approved by the Berkshire Research Ethics Committee (IRAS ID 284460, REC Reference 20SC0230) on 14/11/2022. Participants were informed in advance. As the frequency and method of sampling remained the same, implied consent processes were approved by the committee. Participants returning to the study give informed consent. Regular reports to advisory groups and peer-reviewed publications are planned to disseminate findings and inform decision making. Clinical trial registration number: ISRCTN11041050; registration date: 12 January 2021. Sub study included in protocol version: v8.0, and amended in v9.0

Drug-Related Problems and Sick Day Management Considerations for Medications that Contribute to the Risk of Acute Kidney Injury.

Medication use during acute illness increases the risk of experiencing drug related problems (DRPs), including acute kidney injuries. It is recommended that potentially nephrotoxic medications are withheld during acute illness, including sulfonylureas, angiotensin converting enzyme inhibitors, diuretics, metformin, angiotensin receptor blockers, non-steroidal anti-inflammatories and sodium glucose co-transporter 2 inhibitors (SADMANS). It is unknown if Australian pharmacists currently provide sick day medication management advice regarding SADMANS medications. Hence, we aimed to identify current DRPs and the recommendations made during residential medication management reviews (RMMRs), especially with SADMANS medications. A retrospective review of 408 RMMRs was conducted. DRPs and pharmacist recommendations were classified according to a modified DOCUMENT system. General practitioners' (GP) recommendations were also categorised. Over 97% of residents experienced at least one DRP. Common problems for non-SADMANS medications were "toxicity or adverse drug reaction", "drug selection" and "over/underdosing" and those for SADMANS medications included "toxicity or adverse drug reaction", "monitoring" and "drug selection". GPs agreed with pharmacist recommendations approximately 40% of the time. No pharmacists provided sick day medication management advice for SADMANS medications. DRPs remain highly prevalent in aged care facilities. Medication reviews effectively identify and resolve DRPs approximately 40% of the time, but do not currently minimise the risk associated with using SADMANS medications during sick days, which is a potential area of improvement.

Effect of the health and wellness Kneipp concept on health promotion and reduction of sick days for kindergarten children: a cluster randomized controlled trial protocol.

The holistic health and wellness Kneipp concept, has a long tradition in Europe with demonstrated health benefits. Based on the five elements of the Kneipp concept, kindergartens in and around Germany are used to certify "Kneipp Kindergartens" that practice regular Kneipp applications and activities: cold water applications, exercise, nutrition, herbs and mind-body interventions. Little is known about the potential health benefits for children, however. This study protocol describes our study design and intervention of the Kita Kneipp Study to investigate the effect of the Kneipp concept on kindergarten children aged 2-6 years. The Kita Kneipp Study, registered with the German Clinical Trial Register (DRKS-ID: DRKS00029275), is a confirmatory, mixed-method, two-armed, waitlist, clinical, cluster randomized controlled trial (RCT). Kindergartens in Berlin, Germany that would like to implement the Kneipp concept into their facility will be recruited and randomized to the intervention or control group. Changes in the number of kindergarten sick days will be the primary outcome measure. Kindergarten attendance and reason for absence including illness will be collected on a weekly basis at two time points for 6 weeks from the parents and kindergarten directors: baseline and 1 year after baseline. Secondary outcomes will measure cold symptoms through the Common Cold Questionnaire (CCQ) and National Cancer Institute - Common Terminology Criteria for Adverse Events (NCI-CTCAE) Scales describing gastroenterological-based symptoms Kindergarten educator sick days will be aggregately reported for the same time period. Kneipp concept activities will be recorded on a weekly basis over the one-year intervention period. To understand the experience of Kneipp concept implementation and possible changes in the kindergarten, expert interviews will be conducted with intervention kindergarten educators and focused ethnographies will be planned to observe and analyze the intervention activities. This mixed method study design has potential to help identify if the Kneipp concept can be used for salutogenic purposes among young children and provide insights and experience of the implementation and practicing a holistic health and wellness concept in a kindergarten setting.

Sick Leave and Medical Leave in the United States: A Categorization and Recent Trends

Sick Leave and Medical Leave in the United States: A Categorization and Recent Trends

Inheritance of feed intake-based resilience traits and their correlation with production traits in Finnish pig breeds.

High resilience against diseases, changing environmental conditions, and other stress factors and the ability to efficiently recover to normal status, is becoming increasingly important in pig production. Finding new phenotypes that relate to resilience is a crucial step for improving the resilience of pigs through selection. The objective of this study was to extract resilience-related phenotypes based on fluctuations in daily feed intake (DFI, g) and time spent in feeding per day (TPD, min) and to estimate the heritability of these traits and genetic correlations with production traits (PT). Resilience-related traits with high enough heritability and with either favorable or neutral genetic correlation with PT could be used in the selection program to improve the productivity and welfare of pigs. In this study, we used data from 7,347 Finnish Yorkshire, Landrace, and crossbred pigs raised at the test station. Six pig-specific resilience-related phenotypes were extracted from the individual DFI and TPD: root mean square error (RMSE), quantile regression (QR), and coefficient of variation (CV). RMSE was calculated from the differences between the actual DFI (or TPD) and the pig-specific predicted values. QR was based on the number of days that a pig belonged to the group with the lowest 5% of pigs based on DFI (or TPD), and CV was calculated over the daily observations of DFI (or TPD). PT included average daily gain (ADG, g), backfat thickness (BF, mm), and feed conversion rate (FCR, g/g). The heritability estimates for resilience-related traits varied between 0.07 ± 0.02 (QRDFI) and 0.20 ± 0.03 (RMSETPD). The genetic correlations between resilience-related traits and PT were mostly neutral, but for example, RMSEDFI had a favorable genetic correlation with FCR and BF but an unfavorable correlation with ADG. Lastly, we observed that pigs belonging to the lowest 10% group based on their breeding value (BV) for QRTPD had a lower proportion (10% incidence) of sick days compared to the highest 10% BV group (30% incidence). Therefore, pigs exhibiting small TPD variation (related to high resilience) tend to be less susceptible to sickness than pigs with large TPD variation (related to low resilience). Given its moderate heritability, neutral genetic correlation with PT, and positive effect on health, QRTPD can be considered the most promising resilience-related trait in the Finnish production system.

The last resort: reducing avoidable employee harm by improving the application of the disciplinary policy and process.

There is growing evidence within the healthcare sector that employee investigations can harm individuals involved in the process, an organization's culture and the delivery of its services. This paper details an intervention developed by an NHS Wales organization to reduce the number of its employee investigations through an organization-wide focus that promoted a 'last resort' approach and introduced the concept of 'avoidable employee harm'. A range of associated improvement initiatives were developed to support behavior change among those responsible for determining whether an employee investigation should be initiated. Over a 13-month period, organizational records showed an annual reduction of 71% in investigation cases post-intervention, resulting in an estimated 3,308 sickness days averted annually and total estimated annual savings of £738,133 (based on direct savings and costs averted). This indicates that the organization has started to embrace the "last resort" approach to using employee investigations to address work place issues. The programme was supported with training for those responsible for commissioning and leading the organization's employee investigations. Analysis of survey data from those who attended training workshops to support the programme indicated that participants showed an increased awareness of the employee investigation process post-workshop and an understanding of the concept of avoidable employee harm. The programme is congruent with the Healthy Healthcare concept, as the study illustrates how its practices and processes have a beneficial impact on staff, as well as potentially on patients. This study highlights wider issues for consideration, including the: (1) the role of Human Resources (HR), (2) taking a multi-disciplinary approach, (3) culture and practice, (4) the responsibility of the wider HR profession.

Labor Market Effects of Paid Sick Leave: The Case of Seattle

Labor Market Effects of Paid Sick Leave: The Case of Seattle