Assessing psychological distress of healthcare workers with and without work injuries: The role of job control.

INTRODUCTION: The study investigates the relationship between work-related injuries, psychological distress, and the influence of perceived job control on healthcare workers, using Bakker and Demerouti's (2007) job demands-resources model as theoretical grounding. METHOD: We analyzed data from 610 healthcare workers (81.1% female) at a northern UK hospital, incorporating both self-reported and organizationally recorded work injury incidents over the three years preceding the survey, along with measures of psychological distress and perceived job control. RESULTS: Unexpectedly, we found that the occurrence of work-related injuries, irrespective of the method of reporting, is not related to lower psychological distress among those employees who report a high level of job control. This relationship holds even when adjusting for various demographic and occupational variables. CONCLUSIONS AND PRACTICAL APPLICATIONS: Given the prevalence of work injuries in the healthcare sector, our findings suggest a need for a deeper exploration into how job characteristics might interact to offset the consequences of work injuries, challenging existing assumptions and opening new avenues for research into the psychology of workplace safety.

The hidden psychological cost of lack of access to dental care.

This opinion piece highlights the hidden psychological and other costs of the lack of access to dental care.

Intersection of Intimate Partner Violence, Partner Interference, and Family Supportive Supervision on Victims' Work Withdrawal.

This study investigates the link between intimate partner violence (IPV) and work withdrawal (including absence frequency, partial absenteeism, and turnover intentions) in the context of partners' interference with victims at work and family supportive supervision of victims at work. Using the work-home resources model, we propose that (1) partner interference with victims at work will worsen the relationship between IPV and work withdrawal, and (2) family supportive supervision of victims at work will alleviate this relationship. Our analysis of a sample of 249 female employees found a three-way interaction between IPV, partner interference, and family supportive supervision on victims' absence frequency: IPV victims whose partners interfered with their work had lower absence frequency when they received high (compared to low) levels of family supportive supervision at work. Importantly, family supportive supervision was only related to lower absence frequency when both IPV and partner interference were present. This suggests that organizations have a unique opportunity to reduce the negative effects of IPV and partner interference not only for the victim but also for other employees who are indirectly affected. Our findings have significant implications for organizations, which have ethical, legal, and practical responsibilities to create a safe working environment for all employees.

How does subjective invulnerability impact young workers' safety voice?

INTRODUCTION: Young workers are at risk of workplace injuries for numerous reasons. One contentious yet untested theory is that subjective invulnerability to danger-a sense of indestructability in the face of physical hazards-can affect some young workers' reactions to workplace hazards. This study contends that subjective invulnerability can affect these reactions in two ways: (a) perceptions of physical hazards at work generate less fear of injury among those who perceive themselves as more invulnerable and/or; (b) fear of injury does not motivate speaking up about safety concerns (safety voice) among those who perceive themselves as more invulnerable. METHOD: This paper tests a moderated mediation model in which higher perceptions of physical hazards at work are related to higher safety voice intentions via higher fear of injury, but that subjective invulnerability reduces the extent to which: (a) perceptions of physical hazards at work are associated with fear of injury and/or; (b) fear of injury is associated with safety voice. This model is tested in two studies of young workers (Study 1 on-line experiment: N = 114, M age = 20.67, SD = 1.79; range = 18-24 years; Study 2 field study using three waves of data collected at monthly intervals: N = 80, M age = 17.13, SD = 1.08, range = 15-20 years). RESULTS: Contrary to expectations, the results showed that young workers who feel more invulnerable to danger are more likely to speak up about safety when experiencing higher fear of injury, and that perceptions of physical hazards-safety voice relationship is mediated by fear of injury for those who perceive themselves to be more invulnerable to danger. Conclusions/Practical Applications: Rather than subjective invulnerability silencing safety voice as predicted, the current data suggest that subjective invulnerability may serve to accelerate how fear of injury motivates safety voice.

Circulating HPV DNA as a Biomarker for Pre-Invasive and Early Invasive Cervical Cancer: A Feasibility Study.

BACKGROUND: High-risk HPV infection is responsible for >99% of cervix cancers (CC). In persistent infections that lead to cancer, the tumour breaches the basement membrane, releasing HPV-DNA into the bloodstream (cHPV-DNA). A next-generation sequencing assay (NGS) for detection of plasma HPV circulating DNA (cHPV-DNA) has demonstrated high sensitivity and specificity in patients with locally advanced cervix cancers. We hypothesised that cHPV-DNA is detectable in early invasive cervical cancers but not in pre-invasive lesions (CIN). METHODS: Blood samples were collected from patients with CIN (n = 52) and FIGO stage 1A-1B CC (n = 12) prior to treatment and at follow-up. DNA extraction from plasma, followed by NGS, was used for the detection of cHPV-DNA. RESULTS: None of the patients with pre-invasive lesions were positive for CHPV-DNA. In invasive tumours, plasma from one patient (10%) reached the threshold of positivity for cHPV-DNA in plasma. CONCLUSION: Low detection of cHPV-DNA in early CC may be explained by small tumour size, poorer access to lymphatics and circulation, and therefore little shedding of cHPV-DNA in plasma at detectable levels. The detection rate of cHPV-DNA in patients with early invasive cervix cancer using even the most sensitive of currently available technologies lacks adequate sensitivity for clinical utility.

Reconciling general transformational leadership and safety-specific transformational leadership: A paradox perspective.

INTRODUCTION: Research exploring the relationship between transformational leadership and safety has used transformational leadership in context-free (e.g., "general transformational leadership," or GTL) and context-specific forms (e.g., "safety-specific transformational leadership," or SSTL), assuming these constructs are theoretically and empirically equivalent. In this paper, a paradox theory is drawn on (Schad, Lewis, Raisch, & Smith, 2016; Smith & Lewis, 2011) to reconcile the relationship between these two forms of transformational leadership and safety. METHOD: This is done by: (a) investigating whether GTL and SSTL are empirically distinguishable; (b) testing the relative importance of GTL and SSTL in explaining variance in context-free work outcomes (i.e., in-role performance, organizational citizenship behaviors) and context-specific (i.e., safety compliance, safety participation); and (c) examining the extent to which perceived safety concern in the work environment renders GTL and SSTL distinguishable. RESULTS: Two studies (one cross-sectional, one short-term longitudinal) show that GTL and SSTL are psychometrically distinct albeit highly correlated. Furthermore, SSTL explained statistically more variance than GTL in both safety participation and organizational citizenship behaviors, whereas GTL explained more variance in in-role performance than did SSTL. However, GTL and SSTL were only distinguishable in low-concern contexts but not high-concern contexts. CONCLUSIONS AND PRACTICAL APPLICATIONS: These findings challenge the "either-or" (vs "both-and") approach to considering safety and performance, cautioning researchers to consider nuanced differences in context-free and context-specific forms of leadership and to avoid further proliferation of often redundant context-specific operationalizations of leadership.

Association Between County-Level Natality and Income in the US, 2000-2020.

Importance: It is generally accepted that birth rates are negatively associated with income. However, less is known about the nature and evolution of natality differences between high- and low-income counties and how these differences are associated with the recent decline in the birth rate overall in the US. Objective: To quantify the association between county-level income and natality between 2000 and 2020 and explore how natality inequality is associated with recent nationwide natality declines. Design, Setting, and Participants: This cross-sectional study included all births to US women aged 15 to 44 years among county-year-level observations with at least 100 women of the same age. Exposures: County-level median household income rank. Main Outcomes and Measures: Association between natality and income and between natality inequality and national natality trends. Income ventiles were used to rank counties from 1 to 20, with each ventile including 5% of the female population aged 15 to 44 years. A counterfactual simulation was used to estimate natality rates while holding natality inequality constant at its year 2000 value. Results: A total of 86 679 356 births were aggregated to 65 554 county-year-level observations from 2000 to 2020. The analysis yielded 2 main results. First was the changing nature of inequality. Estimates of the natality income gradient, which reflect the association between county-level natality and county-level income, changed from -0.061 (95% CI, -0.200 to 0.078) in 2000 to -0.572 (95% CI, -0.678 to -0.466) in 2020, reflecting an increase in natality inequality. Intuitively, a negative gradient reflects that natality is lower in higher-income counties compared with lower-income counties. Second, the counterfactual simulation showed that there would have been an additional 3.5 million births (an increase of 4.1%) over the remainder of the study period had natality inequality remained constant at its year 2000 value. While this counterfactual is based on strong assumptions that are unlikely to hold in practice, it suggests that natality may have been higher during this period absent the rise in natality inequality. Conclusions and Relevance: The findings of this cross-sectional study suggest that natality inequality has increased in recent years and is likely associated with nationwide natality declines. The causes of this inequality remain to be explored in future work.

Examining associations between work-related injuries and all-cause healthcare use among middle-aged and older workers in Canada using CLSA data.

INTRODUCTION: Prior studies examining the relationship between work- related injuries and healthcare use among middle-aged and older workers were mainly cross-sectional and reported inconsistent results. OBJECTIVE: The objective of this study was to examine the associations between work-related injuries and 10 types of healthcare service use for any cause among middle-aged and older Canadian workers using longitudinal data. METHODS: Our study involved longitudinal analysis of baseline and 18-month follow-up Maintaining Contact Questionnaire data from the Canadian Longitudinal Survey on Aging (CLSA) for a national sample of Canadian males and females aged 45-85 years who worked or were recently retired (N = 24,748). RESULTS: Among CLSA participants who worked or were recently retired, 361 per 10,000 reported a work-related injury within the year prior to the survey. Work-related injuries decreased with increasing age. Work-related injury was associated with emergency department visits, overnight hospitalization, visits to dentists, and visits to physiotherapists, occupational therapists, or chiropractors at follow-up in bivariate analyses. Compared to those with no work-related injuries, Canadians with work-related injuries had used, on average, a significantly higher number of health services within the last 12 months prior their survey. When controlling for the contribution of various socio-demographic, work-related, and health-related characteristics, work-related injuries remained a significant predictor of emergency department visits and visits to physiotherapists, occupational therapists, or chiropractors. CONCLUSIONS: The relationship between work-related injuries, emergency department visits, and visits to physiotherapists, occupational therapists, or chiropractors in middle-aged and older workers in Canada suggests that workplace injuries can be associated with ongoing health problems. PRACTICAL APPLICATIONS: Healthcare services used by injured employees must be considered priorities for employment insurance coverage, if not already covered. Future research should more fully examine whether pre-existing health conditions predict both work-related injury and subsequent health problems. Injury-specific healthcare use following work-related injuries in middle-aged and older workers, as well as economic costs, should also be examined.

Young workers and safety: A critical review and future research agenda.

INTRODUCTION: Research on young worker safety often relies on inconsistent definitions of young workers and poorly delineated indicators of occupational safety. This review aims to reconcile these fundamental issues by critically integrating research across disciplines and providing clear directions for future research on young worker safety. METHOD: We critically review the extant research on young worker safety. RESULTS: We first reconcile the inconsistent definitions of young workers and specify the indicators of occupational safety used in young worker safety research. We next describe the prevalence of workplace injuries and population-level predictors of these injuries among young workers and then outline other factors that increase young workers' susceptibility to workplace injuries. Finally, we discuss the convergence of many of these issues on family farms-a context commonly studied in young worker safety research. CONCLUSIONS: Clearer definitions of young workers and indicators of occupational safety can improve the interpretation and comparability of extant research findings. Furthermore, the prevalence of workplace injuries and population-level predictors of injury among young workers are subject to the interactions among age, gender, minority status, and job characteristics. Other factors that increase young workers' susceptibility to injury include young workers' responses to hazardous work, individual differences stemming from young workers' biological and psychological development, managerial attitudes about young workers, and the limited safety training young workers are thus provided, the types of work that young workers typically perform, and the range of social influences on young workers. PRACTICAL APPLICATIONS: Safety campaigns and safety training should consider interactions among young workers' age, gender, minority status, and job characteristics, rather than considering these features independently.

Practical guidance for running late-phase platform protocols for clinical trials: lessons from experienced UK clinical trials units.

BACKGROUND: Late-phase platform protocols (including basket, umbrella, multi-arm multi-stage (MAMS), and master protocols) are generally agreed to be more efficient than traditional two-arm clinical trial designs but are not extensively used. We have gathered the experience of running a number of successful platform protocols together to present some operational recommendations. METHODS: Representatives of six UK clinical trials units with experience in running late-phase platform protocols attended a 1-day meeting structured to discuss various practical aspects of running these trials. We report and give guidance on operational aspects which are either harder to implement compared to a traditional late-phase trial or are specific to platform protocols. RESULTS: We present a list of practical recommendations for trialists intending to design and conduct late-phase platform protocols. Our recommendations cover the entire life cycle of a platform trial: from protocol development, obtaining funding, and trial set-up, to a wide range of operational and regulatory aspects such as staffing, oversight, data handling, and data management, to the reporting of results, with a particular focus on communication with trial participants and stakeholders as well as public and patient involvement. DISCUSSION: Platform protocols enable many questions to be answered efficiently to the benefit of patients. Our practical lessons from running platform trials will support trial teams in learning how to run these trials more effectively and efficiently.

Role of work breaks in well-being and performance: A systematic review and future research agenda.

Recovery from work is a critical component for employees' proper functioning. While research has documented the beneficial effects of after-work recovery, it has focused far less on the recovery that happens while at work in the form of work breaks. In this review, we systematically review available empirical evidence on the relationship between work breaks and well-being and performance among knowledge workers. Doing so enables us to (a) integrate studies from multiple disciplines, (b) propose a conceptual framework for categorizing work breaks, and (c) provide a future research agenda for studying the role of work breaks in employee well-being and performance. Using Cochrane's guidelines, we review observational and intervention studies (N = 83). Based on the extant research, we propose that work breaks can be described and classified in terms of five features: initiator, duration, frequency, activities, and experiences. The result of our review is an integrative model that comprehensively captures the relationship between work breaks and well-being and performance outcomes, as well as the mechanisms and boundary conditions of these relationships. We conclude by proposing avenues for the future study and practice of work breaks. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Adapting, adopting, and advancing change: A framework for future research in the psychology of occupational safety.

INTRODUCTION: While there are numerous reviews of the research on the psychology of occupational safety, these studies provide weak guidance on where the research should go next. Accordingly, we introduce a simple framework for thinking about future research in this area: the adapting, adopting, and advancing change framework. This framework summarizes how external, technological, and theoretical developments have driven research in the psychology of occupational safety and uses these observations as evidence to imagine ways in which they may continue to do so. METHOD: We critically reviewed seminal research in the psychology of occupational safety using the adapting, adopting, and advancing change framework. Adapting to change means considering external changes such as the fluctuating nature of work and the labor market. Adopting change refers to incorporating the latest technological and technical advances to facilitate more robust research methods and analyses. Finally, advancing change refers to theoretical advances and how they will push psychology of occupational safety research forward. RESULTS: We highlight several avenues for future research that emerge at the convergence of the framework's three themes, including developing the safety skill construct, assessing variation in demand appraisals on safety outcomes, distinguishing safety climate from related constructs, and examining safety constructs that are usually considered as outcomes (e.g., injuries) as predictors instead. CONCLUSIONS: In doing so, we provide a clear structure to help researchers better identify the most effective directions for future research on the psychology of occupational safety.

A meta-analysis of leadership and workplace safety: Examining relative importance, contextual contingencies, and methodological moderators.

Given the high human and economic costs of workplace safety, researchers and practitioners have paid increasing attention to how leadership behaviors relate to workplace safety. Previous research has demonstrated that leadership behaviors are important for workplace safety. In this meta-analysis, we extend our understanding of the leadership-workplace safety relationship by (a) examining the associations between a broader range of five leadership categories-change-oriented, relational-oriented, task-oriented, passive, and destructive-and seven workplace safety variables; (b) investigating the relative importance of these leadership categories in explaining variance in these workplace safety variables; and (c) testing contextual and methodological contingencies of the leadership-workplace safety relationship. Using effect sizes from 194 samples (N = 104,364), we find that although leadership behaviors are associated with workplace safety, the leadership categories vary considerably in their relative importance. Task-oriented leadership followed by relational-oriented leadership emerge as the most important contributors to workplace safety. Change-oriented leadership (which includes transformational leadership) does not emerge as the largest contributor for any of the seven tested safety variables, despite it being the most frequently examined leadership model in the workplace safety literature. Effectiveness of leadership behaviors in relation to workplace safety varies by national culture power distance, industry risk, workforce age, as well as by contextualized forms of leadership (i.e., safety-specific vs. generalized). Finally, there is meta-analytic evidence for publication bias and common-method variance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Biomarkers of Response and Resistance to Palbociclib Plus Letrozole in Patients With ER+/HER2- Breast Cancer.

PURPOSE: To determine (i) the relationship between candidate biomarkers of the antiproliferative (Ki67) response to letrozole and palbociclib alone and combined in ER+/HER2- breast cancer; and (ii) the pharmacodynamic effect of the agents on the biomarkers. EXPERIMENTAL DESIGN: 307 postmenopausal women with ER+/HER2- primary breast cancer were randomly assigned to neoadjuvant treatment with letrozole for 14 weeks; letrozole for 2 weeks, then letrozole+palbociclib to 14 weeks; palbociclib for 2 weeks, then letrozole+palbociclib to 14 weeks; or letrozole+palbociclib for 14 weeks. Biopsies were taken at baseline, 2 and 14 weeks and surgery at varying times after stopping palbociclib. Immunohistochemical analyses were conducted for Ki67, c-PARP, ER, PgR, RB1, CCNE1, and CCND1. RESULTS: Higher baselines ER and PgR were significantly associated with a greater chance of complete cell-cycle arrest (CCCA: Ki67 <2.7%) at 14 weeks and higher baseline Ki67, c-PARP, and CCNE1 with a lower chance. The interaction with treatment was significant only for c-PARP. CCND1 levels were decreased c.20% by letrozole at 2 and 14 weeks but showed a tendency to increase with palbociclib. CCNE1 levels fell 82% (median) in tumors showing CCCA but were unchanged in those with no CCCA. Only 2/9 tumors showed CCCA 3-9 days after stopping palbociclib. ESR1 mutations were found in 2/4 tumors for which surgery took place ≥6 months after starting treatment. CONCLUSIONS: High CCNE1 levels were confirmed as a biomarker of resistance to letrozole+palbociclib. Ki67 recovery within 3-9 days of discontinuing palbociclib indicates incomplete suppression of proliferation during the "off" week of its schedule.

Exploring safety knowledge sharing among experienced and novice workers.

INTRODUCTION: This paper investigates how members of a culinary and hospitality arts program generate, share, and learn safety knowledge via social and identity mechanisms. METHOD: We conducted semi-structured interviews with 20 participants of varying roles and experience (i.e., students, culinary instructors, and restaurant chefs) in the culinary and hospitality arts program at a large polytechnic in western Canada. RESULTS: The emergent themes from these interviews indicated that the circulation of safety knowledge relied on the interaction among individuals with various levels of experience, such that those who were more experienced in the culinary arts were able to share safety knowledge with novices, who had less experience. Comparing safety knowledge gleaned from within the school against that gleaned from within the industry highlighted differences between the construction of safety in the two contexts. Notably, many aspects of safety knowledge are not learned in school and those that are may not apply in the industry context. We found that safety knowledge was shared through informal means such as storytelling, a process that allowed members to come to a deep, collective understanding of what safety meant, which they often labeled "common sense." CONCLUSION: We found that safety knowledge was a currency through which participants achieved legitimacy, generated through continual practical accomplishment of the work in interaction with others. Practical Applications: Our findings provide novel insights into how safety knowledge is shared, and we discuss the implications of these findings for classroom, work-based learning, and other forms of curricula.

Making safety training stickier: A richer model of safety training engagement and transfer.

INTRODUCTION: Compared to other types of occupational training, safety training suffers from several unique challenges that potentially impair the engagement of learners and their subsequent application or "transfer" of knowledge and skills upon returning to the job. However, existing research on safety training tends to focus on specific factors in isolation, such as design features and social support. The aim of this research is to develop an overarching theoretical framework that integrates factors contributing to training engagement and transfer. METHOD: We conducted a comprehensive qualitative review of safety training research that was published between 2010 and 2020. We searched Web of Science, Scopus, and Google Scholar, yielding 147 articles, and 38 were included. We content analyzed article summaries to arrive at core themes and combined them with contemporary models of general occupational training to develop a rich model of safety training engagement and transfer. RESULTS: We propose that training engagement is a combination of pre-training factors such as individual, organizational, and contextual factors, that interact with design and delivery factors. Safety training engagement is conceptualized as a three-component psychological state: affective, cognitive, and behavioral. Organizations should prioritize pre-training readiness modules to address existing attitudes and beliefs, optimize the safety training transfer climate, and critically reflect on their strategy to design and deliver safety training so that engagement is maximized. CONCLUSIONS: There are practical factors that organizations can use before training (e.g., tailoring training to employees' characteristics), during training (e.g., ensuring trainer credibility and use of adult learning principles), and after training (e.g., integrating learned concepts into systems). Practical Applications: For safety training to 'stick,' workers should be affectively, cognitively, and behaviorally engaged in learning, which will result in new knowledge and skills, improvements in attitudes, and new safety behaviors in the workplace. To enable engagement, practitioners must apply adult learning principles, make the training relevant, and tailor the training to the job and individual needs. After training, ensure concepts are embedded and aligned with existing systems and routines to promote transfer.

Human resource management practices and organizational injury rates.

INTRODUCTION: This study investigated the extent to which five human resource management (HRM) practices-systematic selection, extensive training, performance appraisal, high relative compensation, and empowerment-simultaneously predicted later organizational-level injury rates. METHODS: Specifically, the association between these HRM practices (assessed via on-site audits by independent observers) with organizational injury rates collected by a national regulatory agency one and two years later were modeled. RESULTS: Results from 49 single-site UK organizations indicated that, after controlling for industry-level risk, organization size, and the other four HRM practices, only empowerment predicted lower subsequent organizational-level injury rates. Practical Applications: Findings from the current study have important implications for the design of HRM systems and for organizational-level policies and practices associated with better employee safety.

Parents' work injuries and children's mental health: The moderating role of children's work centrality.

INTRODUCTION: The purpose of this study is to explore the relationship between parents' work-related injuries and their children's mental health, and whether children's work centrality - the extent to which a child believes work will play an important part in their life - exacerbates or buffers this relationship. METHOD: We argue that high work centrality can exacerbate the relationship between parental work injuries and children's mental health, with parental work injuries acting as identity-threatening stressors; in contrast, high work centrality may buffer this relationship, with parental work injuries acting as identity-confirming stressors. We test this relationship with a sample of Canadian children (N = 4,884, 46.2% female, M age = 13.67 years). RESULTS: Children whose parents had experienced more frequent lost-time work-related injuries reported worse mental health with high work centrality buffering this negative relationship. CONCLUSIONS: Our study highlights the vicarious effects of work injuries on salient others, specifically parental work injuries on children's mental health, as well as the role of work centrality in shaping children's sense-making and expectations about the consequences of work.