Specific Working Groups Research Articles

Post-Covid-19 syndrome – a new challenge with an unknown end

The long-term effects of SARS-CoV-2 infection (or the so-called post - COVID - 19 syndrome) have a lasting physical, psycho-social and socio-iconic impact on survivors and their relatives and especially among some specific work groups (e.g. health workers). Concomittant chronic diseases (obesity, hypertension, diabetes mellitus and respiratory disorders) also affect patients' ability to work and their return to work. Globally, between 30% and 50% of those infected with COVID-19 experience long-term symptoms of COVID (long Covid, LC), with over 85% of patients of working age. Various author collectives report that symptoms of long-term COVID (a total of 203 of which the most frequent are dyspnea on exertion and at rest, fatigue, cognitive dysfunction, asthenia, arthralgias and myalgias, sleep disorders, cough), which can last up to 9 and more months after an infection, hinder and delay the return to work (RTW), reduce the patients' ability to work, force them to return to work with restrictions (reduced working hours, changed duties at the workplace, etc.), to change their job or lose it. Returning to work after a post-critical illness is often delayed or does not occur at all, causing an impact on the overall quality of life among survivors and their families (the so-called "family syndrome"). Some patients (especially those who have had severe COVID or have been hospitalized in an intensive care unit) are forced to take periodic sick leave and delay their return to work for at least 5 weeks from the onset of symptoms of COVID-19, such as the main cause is fatigue or weakness. Social functioning was assessed as impaired, as up to 90% of survivors did not reach their functional level 6 months after intensive care unit (ICU) discharge. Differences in return to work are based on mean age of patients (better outcomes are seen in younger patients), country (presenteeism is common in China, where the best RTW outcomes have been reported) and social policy (not all US employees are entitled to paid sick leave). A large proportion of patients (up to 64.4%) reported moderate to severe financial difficulties and an inability to cover the costs of research or treatment. Some authors recommend specific rehabilitation for patients after acute COVID-19 to restore physical and neuropsychological performance and to improve performance. Patients have better outcomes following an integrative health approach that combines traditional medical treatment, non-pharmacological treatments including physical therapy, and behavioral and lifestyle changes.

Research priorities in children and adults with congenital heart disease: a James Lind Alliance Priority Setting Partnership

ObjectiveTo bring together patients, parents, charities and clinicians in a Priority Setting Partnership to establish national clinical priorities for research in children and adults with congenital heart disease.MethodsThe established James...

Conceptualizing disability accommodation device acceptance by workgroups through a sociomaterial lens

PurposeThe provision of accommodation devices is said to aid organizational inclusion of employees with a disability. However, devices that are meant to enable might only partially facilitate productivity, independence, and social inclusion if these devices are not accepted by the user's workgroup. The authors outline a conceptual model of accommodation device acceptance through a sociomaterial lens to suggest conditions influencing workgroup device acceptance.Design/methodology/approachTo build the model, the authors draw upon the sociomateriality and disability literature to frame accommodation devices as experienced in ongoing interactions, representing the goals, feelings, and interpretations of specific workgroups. The authors also unpack attributes of devices—instrumentality, aesthetics, and symbolism—and propose how each of these can pattern social conduct to influence device acceptance. The authors then draw upon the disability literature to identify attributes of workgroups that can be expected to amplify or diminish the effect of device attributes on device acceptance in that workgroup.FindingsThe conceptualization, which the authors illustrate with examples particular to visual impairment, presents implications for who and what serves as a gatekeeper to accommodation device acceptance and thereby workgroup inclusion.Originality/valuePrior research has focused on conditions under which devices are requested by users or made available by organizations, undergirded by the assumption that devices are well-specified once provided and that they operate relatively predictably when used in various workgroups. The authors focus instead on what happens after the device is provided and highlight the complex and dynamic interaction between an accommodation device and the workgroup, which influences device and user acceptance.

Impacto emocional de un programa pionero de simulación médica avanzada para residentes de cardiología: más allá de las habilidades técnicas

Simulation is a learning method based on experience, which has become increasingly more present in training programs in medicine. Interactive, reflective scenarios or even with the possibility of putting non-technical skills or technical resources into practice, from diagnosis to treatment, make simulation an expanding tool. The Spanish Society of Cardiology has included simulation among its training activities, promoting the training of teachers, specific work groups and training programs during the different stages of residents. The organization of this form of learning implies an adequate structuring, for which a correct introduction to the scenario or case (briefing) and, very especially, the subsequent reflective conversation (debriefing) is essential. To objectively evaluate the results of these programs, different scales have been implemented. These scales allow the evaluation of several important aspects, such as previous knowledge, participants’ perception of the activity or even the emotional impact of complex scenarios. Simulation is a growing learning method, with a clear usefulness in the acquisition of both theoretical and, specially, technical, and non-technical skills. It has become evident that simulation has come to stay, and that it will be increasingly used in skills development of future cardiologists in training and other clinical specialties.

Community Workforce Differences in Mental Health Across Gender and Job Description in Southwest Indiana

Background and Hypothesis: In May 2020, a community partnership was built in Southwest Indiana to determine the local prevalence of COVID-19 to guide reopening in the region. One year later, a follow-up survey study was launched to address new, pressing questions related to mental health in the community workforce. We hypothesized that adverse mental health symptoms would be disproportionately experienced by specific worker groups based on degree of in-person contact over the past year and demographic characteristics such as age and gender. 
 Methods: For the 2021 survey, participants were invited through their place of employment or via phone to participate in a short online survey consisting of questions related to demographics, general work roles, company policies over the past year, and wellness. When examining mental health, the Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorder-2 (GAD-2) were used to determine feelings of depression and anxiety, respectively. 
 Results: 480 participants filled out the 2021 online survey (73% of which were returning). 442 of these responses were complete and eligible for analysis of mental health and degree of in-person contact. 345 responses were complete and eligible for information regarding age. No correlation was found between age and mental health. However, differences were observed based on gender and job description. Women (n=244) and customer-facing employees (n=99) reported more frequent symptoms of anxiety and depression, with customer-facing women reporting the most. Comparing only employees that did not work remotely during the pandemic, customer-facing employees still reported more frequent symptoms of anxiety and depression. 
 Conclusion and Potential Impact: The impacts of COVID-19 on the workforce are still being studied, but the pandemic continues to take its toll. These mental health trends will help guide future policies to support and improve employee wellbeing, both within participating companies and the workforce at large.

The Burden of Gynecologic Cancers in the UAE

There is limited published data about gynecological cancers in the UAE. The latest cancer registry data published in 2020 for the 2017 reports a total of 7% (301/4299 ) out of the total cases of all cancer among the UAE population. The most diagnosed gynecologic cancers were uterine, cervix uteri and ovarian cancer, which ranked 5th, 6th, and 8th, respectively among all female malignant cancers in the UAE. There were 111 cases of uterus cancer, which accounted for 4.93% of all cancer cases among females, diagnosed in 2017. Due to various well-structured programs in the UAE for cervical cancer prevention, including implementation of HPV vaccination for females, aged 15-26 years and screening with a pap test for women 25-65 years, regardless of their HPV vaccination status. The rate of carcinoma in situ of cervix uteri in the UAE has declined by over 50% (from 81 cases in 2015 to 38 cases in 2017). There were 70 cases of ovarian cancer, accounted for 3.11% of all cancer cases among females, diagnosed in 2017. The highest number of ovarian cancer cases has been reported in the age group of 50-54. The malignant neoplasm of cervix uteri makes up to 1.9% of the total deaths (ranked 6th), caused by cancer in the UAE population, in 2017. Currently, the gynecology cancer research in the UAE is very limited. There is a need for initiation of gynecology specific working groups to facilitate the research in this area with focus on prevention, early diagnosis, and screening specific to the UAE population.

Prevention of Pressure Ulcers in a Pediatric Cardiac Intensive Care Unit.

Background:Pressure ulcer (PU) is an injury to skin or underlying tissue as a result of pressure or pressure with shear stress. We classify PUs by the level of tissue injury: stage I–IV, unstageable, suspected deep tissue injury. This quality project was aimed to reduce the incidence of PUs > stage II in the cardiothoracic intensive care unit.Methods:We reviewed PUs > stage II from March 2010 to December 2017. Interventions included: PU bundle (April 2010, revised January 2013); multidisciplinary huddles for PUs > stage II (October 2011); multidisciplinary weekly skin rounds (March 2010, revised August 2012); unit specific workgroup (October 2012); caregiver input form (December 2012). The PU bundle included diaper barrier cream, pulse oximeter probe rotation, turning schedule, pressure reduction surfaces, heel pressure release, head of the bed elevation.Results:Between 2010 and 2014, PUs decreased from 15.7 events per 1,000 patient days to a new baseline of 2.9 events per 1,000 patient days. We have sustained this rate for 3 years. PUs related to immobility decreased from 35 in 2010–2011 to 4 in 2016–2017. PU related to medical devices decreased from 34 in 2010–2011 to 15 in 2016–2017.Conclusions:Institution of PU bundle, multidisciplinary weekly skin rounds, and huddles for PUs > stage II reduced PUs related to immobility, allowed for earlier identification of stage II PUs and reduced stage III PUs. Challenges remain in reducing PUs related to medical devices. Importantly, we sustained this improvement over the past 3 years.

With Few Eyes, All Hoaxes are Deep

Quality control is critical to open production communities like Wikipedia. Wikipedia editors enact border quality control with edits (counter-vandalism) and new article creations (new page patrolling) shortly after they are saved. In this paper, we describe a long-standing set of inefficiencies that have plagued new page patrolling by drawing a contrast to the more efficient, distributed processes for counter-vandalism. Further, to address this issue, we demonstrate an effective automated topic model based on a labeling strategy that leverages a folksonomy developed by subject specific working groups in Wikipedia (WikiProject tags) and a flexible ontology (WikiProjects Directory) to arrive at a hierarchical and uniform label set. We are able to attain very high fitness measures (macro ROC-AUC: 95.2%, macro PR-AUC: 74.5%) and real-time performance using word2vec-based features. Finally, we present a proposal for how incorporating this model into current tools will shift the dynamics of new article review positively.

Cross-national research on female working poor in Belgium and China

In general, the gendered trends in working poor are reshaping a new relationship between a processing globalized market and numbers of women, both in developed and developing nations. In this research, we draw up a socio-demographic picture of female working poor between Belgium and China. And within such a cross-national profile examination, we focus on the common and different ways that working poor women were experiencing life. In short, we found that in-work poverty shows a gendered tendency that has been a chronic condition, particularly among women with low income in both nations. Otherwise, in-work poverty focuses on different specific female working groups under varied socioeconomic national contexts.

Sustainable landscape management based on cultural ecosystem services

AbstractTo sustain cultural ecosystem services and cultural heritage it is important to go in depth in the science policy interface, because efficient governance mechanisms emerge from the cooperation of scientists and practitioners. In the Basque Country, we are on the road towards adaptive and resilient landscape management through an integrative approach that enhances the link between science, policy-making and society. Key elements of this approach are: The establishment from the outset of a transdisciplinar community of practice; the creation of specific transdisciplinar working groups to go in depth with concrete applicability measures; a strong outreach strategy and educational programs development; and last but not least, the involvement of stakeholders at multiple stage of the process. Diverse research lines are carried out during the process (e.g. mapping ecosystems services, analyzing social perceptions), whose results are combined to help identify response options for sustainable landscape. Relevant policy implementations of the results of this broad research are already taking place in the Basque Country. The proved utility of this working mechanism makes key agents to continue involved, and to attract more agents into the process. These transdisciplinary processes facilitate the creation of synergies and win-win solutions towards sustainable management of cultural ecosystem services.

Development of Canadian National Guidelines for Pediatric Donation After Circulatory Determined Death (pDCD)

Introduction/Hypothesis pDCD uptake has been slow in Canada, where most pediatric hospitals do not have active programs and pDCD represents only 8% of pediatric deceased donation. This project generated national, pediatric specific clinical practice guidelines (CPGs) to inform the development of ethical and effective pDCD practice. Methods We followed a process of CPG development based on World Health Organization (WHO) and Canadian Medical Association (CMA) methods. These included application of the Appraisal of Guidelines, Research and Evaluation (AGREE II) tool, and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Questions requiring recommendations were generated based on: 1) 2006 Canadian DCD guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pDCD leaders, and 3) a scoping review of the pDCD literature (1). Input from these sources drove drafting of actionable questions and Good Practice Statements (GPSs), as defined by the GRADE group. We performed additional literature reviews for all actionable questions. Evidence was assessed for quality using GRADE, and then formulated into evidence profiles that informed recommendations through the Evidence-to-Decision framework. Recommendations were revised through consensus among the members of 7 topic specific working groups (WGs), and finalized during meetings of WG leads and the planning committee. External review was provided by pediatric, critical care, and critical care nursing professional societies as well as patient partners. Results 65 GPS recommendations and 7 GRADEd recommendations covering: 1) Ethics, Consent and Withdrawal of Life Sustaining Therapy (WLST) 2) Eligibility 3) WLST Practices 4) Ante and Post Mortem Interventions 5) Death Determination 6) Neonatal pDCD 7) Cardiac and Innovative pDCD 8) Implementation. Conclusions This process showed that rigorous, evidence based CPGs are possible in the domain of pediatric deceased donation. We hope that these CPGs will increase access to pDCD across Canada and serve as a model for international CPG development in deceased donation. Reference: 1. Weiss MJ, Hornby L, Witteman W, Shemie SD. Pediatric Donation After Circulatory Determination of Death. Pediatr Crit Care Med. 2016 Mar;17(3):e88–108.

Meaningful clinical communication and Integrated Care in Barcelona. Eight years of experience

Context: Public healthcare system in Catalonia is based on yearly contracts stablished among the Public Healtcare Administration (Catsalut) and the different Healthcare Organizations (HCO). Each one has its own Electronic Patient Record (EPR) system.In 2006 a task force group was committed for a radical redesign of the healthcare in an area of Barcelona with a population on 600.000 inhabitants with a focus on the improvement in the relationship between Primary care (PC) and Specialized Care (SC) for a better integrated care for the population. Once the new model was accepted by all the HCO, an specific workgroup was created to develop a ICT-supported system to interchange meaningful clinical information and enable the continuity of care. Twenty-three centers were involved. They belong to nine different HCO: three hospitals, one SC outpatient clinic and six PC organizations. Initial analysis of the departure situation resulted in a high heterogeneity in relation to the degree of technological investment, development and maturity in the use of EPRs by the professionals. Several ICTs options were considered. The decision was to implement an interchange platform using structured xml files with clinical content based on standadrd HL7 v2.5 messages.Results: The solution got the integrated connection of all the EPRs of the different HCOs in spite of their big differences. Also the project has speed-up the process of investment and maturity in the use of EPR in those HCOs with a worse departure situation. The overall system supports the full information cycle of several clinical processes like the patient referral from PC to SC with all the possible circumstances at each step in the workflow and the return of clinical documentation, the request for specific procedures from PC to SC with the return of the report and the related images if it’s the case, the communication to PC of the admission of a patient at the Emergency ward and the return of the discharge reports, as well as new collaboration processes like the teleconsultation in Dermatology. All the messages are completely generated and fully integrated in all the different EPRs of the nine HCOs.Since January 2010 until December 2015 statistics showed a total of 323360 requests from PC to the SC centers, 577.575 professional integrated care activities done over the patients, 839.779 relevant clinical documents and 91374 images done at the hospitals delivered on time at the point of care accessible by the PC centers. All of these transactions are the result of standardize and improve existing workflows using ICTs. Outstanding results have been the start up of Teledermatology, a new service made possible through ICTs. Quality of the images provided by the PC physicians were good enough in 94,3% of the cases. Delay in the SC answer has been reduced to 1,84 days and avoiding more than a half of the SC visits at the hospital (58,2%).Conclusions: Several management and clinical scores demonstrates the benefits of such implementation in the quality of care of the population covered by the HCOs. The other big achievement has been the standardization of the clinical processes in this area of the Barcelona city.A good Governance model of the different IT departments involved as well as the ICT providers, based upont profesionalism, leadership and transparency, is a key point for the successAt this moment we are in the process to evolve to a bigger platform with the capability to connect all the HCO and centers in Catalonia.

Out of hours workload management: Bayesian inference for decision support in secondary care.

In this paper, we aim to evaluate the use of electronic technologies in out of hours (OoH) task-management for assisting the design of effective support systems in health care; targeting local facilities, wards or specific working groups. In addition, we seek to draw and validate conclusions with relevance to a frequently revised service, subject to increasing pressures. We have analysed 4 years of digitised demand-data extracted from a recently deployed electronic task-management system, within the Hospital at Night setting in two jointly coordinated hospitals in the United Kingdom. The methodology employed relies on Bayesian inference methods and parameter-driven state-space models for multivariate series of count data. Main results support claims relating to (i) the importance of data-driven staffing alternatives and (ii) demand forecasts serving as a basis to intelligent scheduling within working groups. We have displayed a split in workload patterns across groups of medical and surgical specialities, and sustained assertions regarding staff behaviour and work-need changes according to shifts or days of the week. Also, we have provided evidence regarding the relevance of day-to-day planning and prioritisation. The work exhibits potential contributions of electronic tasking alternatives for the purpose of data-driven support systems design; for scheduling, prioritisation and management of care delivery. Electronic tasking technologies provide means to design intelligent systems specific to a ward, speciality or task-type; hence, the paper emphasizes the importance of replacing traditional pager-based approaches to management for modern alternatives.

Labor markets and health: an integrated life course perspective.

Current work and health research is fragmented, focusing on jobs, exposures, specific worker groups, work organization, or employment contracts. An emphasis on the labor market in framing the work and health relationship conceptualizes work not only as an exposure that increases or lessens health risk but also as a life course experience that is dependent on place and time. The intention is to illustrate how the labor markets and health framework coupled with a life course perspective extends other epidemiological approaches to work and health to identify new research questions. Taking the changing nature of work and labor markets into account, this paper updates the labor markets and health framework. It then reviews, defines, and integrates key life course concepts. A model is developed that guides the understanding of how labor markets and health trajectories emerge from the consideration of the working life course in a social context. The application leads to new research questions investigating characteristics of labor markets and health trajectories that may lead to positive health outcomes over the life course.

Labour market dynamics and worker heterogeneity during the Great Recession – Evidence from Europe

Using harmonised micro data, this paper investigates the effects of the early phase (2008-10) of the recent economic crisis on transitions between labour market states in Europe. Our analysis focuses on individual heterogeneity, on the type of employment contract, and on cross-country differences. Our analysis shows that specific worker groups, such as men and young persons, were particularly strongly hit by the crisis. Furthermore, more transitions from employment, especially temporary employment to unemployment, were the main factor behind rising unemployment. Reduced unemployment outflows did not contribute substantially to the increase in unemployment during the early phase of the crisis. JEL classification: J6, E24

Labour Market Dynamics and Worker Heterogeneity during the Great Recession: Evidence from Europe

Using harmonized micro data, this paper investigates the effects of the early phase (2008-10) of the recent economic crisis on transitions between labour market states in Europe. Our analysis focuses on individual heterogeneity, on the type of employment contract, and on cross-country differences. Our analysis shows that specific worker groups, such as men and young persons, were particularly strongly hit by the crisis. Furthermore, more transitions from employment, and especially temporary employment to unemployment, were the main factor behind the rise in unemployment; while reduced unemployment outflows did not contribute substantially to the increase in unemployment during the early phase of the crisis.

Examining National Trends in Worker Health With the National Health Interview Survey

To describe data from the National Health Interview Survey (NHIS), both the annual core survey and periodic occupational health supplements (OHSs), available for examining national trends in worker health. The NHIS is an annual in-person household survey with a cross-sectional multistage clustered sample design to produce nationally representative health data. The 2010 NHIS included an OHS. Prevalence rates of various health conditions and health behaviors among workers based on multiple years of NHIS core data are available. In addition, the 2010 NHIS-OHS data provide prevalence rates of selected health conditions, work organization factors, and occupational exposures among US workers by industry and occupation. The publicly available NHIS data can be used to identify areas of concern for various industries and for benchmarking data from specific worker groups against national averages.

Protocol enhancements for “greening” optical networks

The last decade has spurred a number of research efforts around energy efficiency in information and communication technologies (ICT). To reduce the energy consumed by optical transport networks, one option is to switch-off a certain number of optical systems according to the amount of transported traffic. Consequently, dynamic power management of optoelectronic devices and link sleep-mode approaches have been proposed; these capabilities quantitatively optimize the power requirements and the available bandwidth of the network as a whole. This paper presents enhancements embedded in Generalized Multiprotocol Label Switching (GMPLS)-based protocols enabling power control in optical devices, and then analyzes the impact of controlling the daily energy consumption of optical switching equipment in the network. We also present ongoing activities in specific standardization working groups for “greening the network” along with their proposals to improve the energy efficiency of future optical networks.

Doing Safer Masculinities: Addressing at-Risk Gendered Behaviours on Mine Sites

Doing Safer Masculinities: Addressing at-Risk Gendered Behaviours on Mine Sites

The present and future of thoracic surgery within the European Association for Cardio-Thoracic Surgery (EACTS)†

On 10 February 2012, a Strategic Conference was organized by the European Association for Cardio-Thoracic Surgery (EACTS) in Windsor during the inauguration of the newly acquired EACTS house. In this review, the present and future of thoracic surgery are discussed. With the creation of the Thoracic Domain, thoracic surgery has been strengthened and made clearly visible within the general EACTS structure. A clearly identified thoracic track is provided during the Annual Congress. Specific working groups have been created that deal with varying topics of thoracic surgery and diseases of the chest. The European School of Cardiothoracic Surgery has been restructured, providing not only theoretical but also practical education in thoracic surgery. At national and international levels, interdisciplinary cooperation is encouraged. Harmonization of thoracic training within Europe is necessary to allow better exchange between different countries. Guidelines dealing with specific thoracic procedures should be further developed. The Thoracic Domain of EACTS will remain a key player in promoting thoracic surgery in Europe and internationally, and in providing high-level scientific output, education and training in thoracic surgery and diseases of the chest, which requires continuous, close cooperation between thoracic and cardiothoracic surgeons.