The Influence of Teleworking in a Pandemic Context on the Work Experience of Individuals with Physical Disabilities: A Quebec Qualitative Study.

The COVID-19 pandemic has led to numerous changes in work environments. Thousands of workers quickly found themselves having to telework without being prepared, which had consequences on their work experience and health. Authors proposed telework practices that promote the healthy work experience of workers in a pandemic context, but less attention has been paid to consider the realities and needs of individuals with physical disabilities. Purpose This study aimed to explore the influence of telework during the pandemic on the work experience of people with physical disabilities. Methods Following an interpretive descriptive research design, interviews were conducted with 16 workers with physical disabilities (i.e., motor, or sensory). The data were analyzed using a thematic analysis strategy. Results The results revealed 15 factors that influence the work experience of teleworkers with physical disabilities. These factors are related to interactions between three spheres of the worker's life: the individual, the organization, and the environment. Ten recommendations are proposed to consider the reality and needs of individuals with physical disabilities in the telework practices. Conclusion Given that telework has expanded since the onset of the COVID-19 pandemic and will likely continue to remain a widespread modality of work delivery, it becomes even more important to expand knowledge about it, to benefit the work experience of teleworkers with physical disabilities.

Orthopedist involvement in the management of clinical activities: a case study.

BACKGROUND: The rapid shift in hospital governance in the past few years suggests greater orthopedist involvement in management roles, would have wide-reaching benefits for the efficiency and effectiveness of healthcare delivery. This paper analyzes the dynamics of orthopedist involvement in the management of clinical activities for three orthopedic care pathways, by examining orthopedists' level of involvement, describing the implications of such involvement, and indicating the main responses of other healthcare workers to such orthopedist involvement. METHODS: We selected four contrasting cases according to their level of governance in a Canadian university hospital center. We documented the institutional dynamics of orthopedist involvement in the management of clinical activities using semi-structured interviews until data saturation was reached at the 37th interview. RESULTS: Our findings show four levels (Inactive, Reactive, Contributory and Active) of orthopedist involvement in clinical activities. With the underlying nature of orthopedic surgeries, there are: (i) some activities for which decisions cannot be programmed in advance, and (ii) others for which decisions can be programmed. The management of unforeseen events requires a higher level of orthopedist involvement than the management of events that can be programmed. CONCLUSIONS: Beyond simply identifying the underlying dynamics of orthopedists' involvement in clinical activities, this study analyzed how such involvement impacts management activities and the quality-of-care results for patients.

The Scope of Hospital-Based Simulation.

BACKGROUND: Healthcare simulation has expanded dramatically; however, little is known about the scope of simulation in acute care hospitals. METHODS: A descriptive, cross-sectional online survey was used. Participants included nurse executives from acute care hospitals in California. RESULTS: Most organizations (96%) used simulation primarily for education, 37% used simulation for health system integration and systems testing, 30% used it for error investigation, 15% used it for research, and 15% used it for patient/family education. CONCLUSIONS: Organizations have a substantial opportunity to increase the scope of simulation beyond education to include systems integration, clinical systems testing, and other translational simulation activities. This targeted focus on patient safety and quality will allow hospitals to improve financial performance and maximize scarce resources.

Leptospira interrogans Retains Direct Virulence After Long Starvation in Water.

Mostly studied as a zoonosis, leptospirosis is also an environment-borne infection and most human cases originate from soil or water contaminations. Yet, only few studies have been interested in the survival of pathogenic Leptospira in freshwater. In this study, water microcosms were designed to evaluate the survival and virulence of Leptospira spp. for 2 years. Four commercial bottled drinking waters and a non-ionized water, all previously filter-sterilized, were studied. Either one of two Leptospira interrogans strains, one Leptospira borgpetersenii strain, or a saprophytic Leptospira biflexa was inoculated in these waters under nutrient-deprived conditions. Molecular, microscopic and cultural approaches were used to study Leptospira survival. Direct virulence of the pathogens was assessed using animal challenge without re-culturing. Our results confirmed the capacity of pathogenic Leptospira to survive for more than a year in water. In addition, we showed the ability of L. interrogans in nutrient-deprived conditions to directly cause systemic infection in susceptible animals. To our knowledge, this is the first report of direct infection of a susceptible host with Leptospira following a long starvation and survival period in nutrient-deprived water. Our results also suggest that Leptospira turned into a physiological "survival" state in harsh freshwater conditions. These data are of prime importance considering that freshwater is a major source of Leptospira infections. Environmental survival and virulence of pathogenic Leptospira spp. are becoming a crucial challenge to determine the environmental risk and adopt relevant prevention and control strategies.

Introduction of the Anopheles bancroftii Mosquito, a Malaria Vector, into New Caledonia.

In June 2017, an Anopheles mosquito species was detected in New Caledonia. Morphologic identification and genomic sequencing revealed that the specimens tested belong to An. bancroftii genotype A1. This introduction underscores the risk for local malaria transmission and the vulnerability of New Caledonia to vector introduction.

Evidence of human leptospirosis cases in a cohort of febrile patients in Bangui, Central African Republic: a retrospective study, 2012-2015.

BACKGROUND: In spite of a local favorable environment, leptospirosis has never been described in Central African Republic so far mainly because of the weakness of diagnostic tests and differential diagnostic strategy for febrile jaundice cases negative for yellow fever virus. Here we bring a complementary insight to conclusions of Gadia CLB et al. regarding the presence of leptospirosis in Central African Republic in YFV-negative febrile icteric patients. METHODS: Our study included 497 individuals presenting with fever and jaundice but negative for yellow fever infection, retrospectively selected from the national surveillance biobank for yellow fever in Institut Pasteur de Bangui, Central African Republic. A combination of serological (ELISA, agglutination) and molecular biology techniques (quantitative real-time polymerase chain reaction) was used to identify Leptospira or the patient's immune response to the bacteria. Statistical analyses were done using the non parametric Mann-Withney U test with a 5% statistical threshold. RESULTS: ELISA test results showed 46 positive serum samples while 445 were negative and 6 remains equivocal. In addition, the reference microscopic agglutination test for leptospirosis diagnostic confirmed that 7 out of 32 samples tested were positive. Unfortunately, all 497 serum samples tested for leptospirosis were negative using the molecular techniques. CONCLUSIONS: Unlike Gadia et al., we confirmed that leptospirosis is circulating in Central African Republic and therefore may be responsible for some of the unexplained cases of febrile jaundice in the country. Thus, leptospirosis needs to be investigated to improve identification of aetiological pathogens. Our study also suggests a need to improve sample transportation and storage conditions.

High level of IL-10 expression in the blood of animal models possibly relates to resistance against leptospirosis.

Leptospirosis is a severe zoonosis which immunopathogenesis is poorly understood. We evaluated correlation between acute form of the disease and the ratio of the anti-inflammatory cytokine IL-10 to the pro-inflammatory TNF-α and IL-1ß expression during the early phase of infection comparing resistant mice and susceptible hamsters infected with two different species of virulent Leptospira. The IL-10/TNF-α and IL-10/IL-1ß expression ratios were higher in mouse compared to hamster independently of the Leptospira strain, suggesting a preponderant role of the host response and notably these cytokines in the clinical expression and survival to leptospirosis. Using an IL-10 neutralization strategy in Leptospira-infected mouse model, we also showed evidence of a possible role of this cytokine on host susceptibility, bacterial clearance and on regulation of cytokine gene expression.

[Updates in HIV infection therapeutics]. / Actualités thérapeutiques dans l'infection par le VIH.

UPDATES IN HIV INFECTION THERAPEUTICS. Human immunodeficiency virus (HIV) is still a world public health challenge, with constant therapeutic innovations involved. Very efficient treatments, with a high impact on HIV morbimortality, are now used in routine. Therefore, the new challenges focus on transmission prevention, side effects reduction and quality-of-life improvement. Therapeutic news in the management of patients living with HIV is varied: new molecules, changes in treatment modalities, prevention….

ACTUALITÉS THÉRAPEUTIQUES DANS L'INFECTION PAR LE VIH. L'infection par le virus de l'immunodéficience humaine (VIH) reste en France et dans le monde un problème de santé publique et fait l'objet d'innovations thérapeutiques constantes. Après la réussite des traitements qui ont fait la preuve de leur efficacité en matière de morbi-mortalité liée au VIH, les nouveaux défis sont aujourd'hui tournés vers la prévention de la transmission, la réduction des effets indésirables et l'amélioration de la qualité de vie des patients. Les actualités thérapeutiques dans la prise en charge des patients vivant avec le VIH sont variées : nouvelles molécules, évolution des modalités de traitement, prévention….

Managing Virtual Presenteeism during the COVID-19 Pandemic: A Multilevel Study on Managers' Stress Management Competencies to Foster Functional Presenteeism.

Teleworking remains an attractive option for many workers since the COVID-19 pandemic, but it presents significant management challenges, particularly when employees face health issues. The management of virtual presenteeism, where employees continue teleworking despite being ill, has received limited attention. This study explores the relationship between managers' stress management competencies (SMCs), mental health, and job performance of virtual presentees, aiming to fostering more functional presenteeism. We examine whether managers' SMCs promote functional presenteeism by comparing managers' self-assessments with employee assessments, and analyzing how agreement levels between the two affect mental health and job performance. Data were collected from 365 teleworkers supervised by 157 managers in a large public organization in Québec. The results indicate that virtual presentees' mental health and job performance are closely linked to employees' assessment of their managers' SMCs. Employees who agreed with their manager or overestimated their managers' SMCs exhibited better mental health and job performance than those who agreed with their manager on low SMCs or underestimated their managers. This study expands on the health-performance framework of presenteeism and self-other agreements, highlighting management practices that should be enhanced in the context of virtual presenteeism.

The effects of artificial intelligence on human resource activities and the roles of the human resource triad: opportunities and challenges.

Introduction: This study analyzes the existing academic literature to identify the effects of artificial intelligence (AI) on human resource (HR) activities, highlighting both opportunities and associated challenges, and on the roles of employees, line managers, and HR professionals, collectively referred to as the HR triad. Methods: We employed the scoping review method to capture and synthesize relevant academic literature in the AI-human resource management (HRM) field, examining 27 years of research (43 peer-reviewed articles are included). Results: Based on the results, we propose an integrative framework that outlines the five primary effects of AI on HR activities: task automation, optimized HR data use, augmentation of human capabilities, work context redesign, and transformation of the social and relational aspects of work. We also detail the opportunities and challenges associated with each of these effects and the changes in the roles of the HR triad. Discussion: This research contributes to the ongoing debate on AI-augmented HRM by discussing the theoretical contributions and managerial implications of our findings, along with avenues for future research. By considering the most recent studies on the topic, this scoping review sheds light on the effects of AI on the roles of the HR triad, enabling these key stakeholders to better prepare for this technological change. The findings can inform future academic research, organizations using or considering the application of AI in HRM, and policymakers. This is particularly timely, given the growing adoption of AI in HRM activities.

Knowledge, skills, and attitudes (KSAs) of adaptable academic nurse educators.

AIM: Using the Knowledge, Skills, and Attitudes (KSAs) framework, the aim of this study was to explore the specific knowledge, skills and attitudes of adaptable nurse educators to help inform the preparation of current and future educators for smooth transitions during periods of change. BACKGROUND: External events, such as hurricanes, earthquakes, floods and wildfires can force programs to relocate and suspend classes for several days or weeks. These natural disasters have the potential to have a negative impact on the number of nursing students graduating on time as well as the quality of the clinical education experience and preparation for practice. Many lessons about educator adaptability can be learned from the COVID-19 restrictions. Identifying the KSAs of adaptable nurse educators during the rapidly changing educational landscape provided the opportunity for a foundational needs assessment to guide the preparation of educators for seamless transitions during times of change. DESIGN: To identify the KSA's of adaptable nurse educators, an exploratory qualitative study using focus groups was conducted. The study used thematic analysis. METHODS: The research team developed, and pilot-tested focus group interview questions based on content areas identified in the literature. Targeted questions included queries specific to the KSAs necessary for adaptation and successful teaching using simulation. Educators from pre-licensure nursing programs in the United States participated in one of five 60-minute focus groups held virtually via a secure online meeting platform. RESULTS: Adaptable nurse educators have knowledge of resources, ongoing assessment, evaluation and teaching strategies and an understanding of the skillsets of their colleagues. Their skills include leadership, teamwork, redesigning learning and assessment. They demonstrate qualities such as resilience, empathy, acceptance, openness and positivity. CONCLUSION: With the current nursing workforce crisis, external events cannot be allowed to slow academic progression and graduation from nursing programs. In this exploratory qualitative study using focus groups, the KSAs held by adaptable nurse educators were explored. The findings of this study highlight the importance of collaboration and teamwork in academic institutes. The findings can be used as the foundation for nursing programs to prepare for future external events.

NMDA antagonist agents for the treatment of symptoms in autism spectrum disorder: a systematic review and meta-analysis.

Aims: This systematic review and meta-analysis aimed to assess the efficacy of NMDA antagonists in ASD (Autism Spectrum Disorder) on the core (communication and social interaction, repetitive behavior) and associated symptoms (irritability) of ASD, as well as their safety. Methods: PubMed, CENTRAL, CINHAL, EMBASE, and PsycINFO databases were searched until November 2023. Two authors independently selected the studies and extracted data. Randomized controlled trials assessing the efficacy of NMDA receptor antagonists in participants with ASD aged <18 years were included. The quality of the studies was assessed using the Risk of Bias-2 tool. A random-effect meta-analysis model was used to calculate standardized mean differences (SMD) or odds ratios (OR) using meta package in R. Results: This systematic review included ten studies (588 participants). Most studies did not report scales assessing core symptoms of ASD. Meta-analysis of efficacy on ASD core symptoms included three studies (248 participants). NMDA antagonists were not superior to placebo [SMD = 0.29; CI 95% (-1,94; 1.35); I2 = 0%]. NMDA antagonists was not superior to placebo concerning response (four studies, 189 participants) [OR = 2.4; CI 95% (0.69; 8.38); I2 = 35%]. Meta-analysis of efficacy on irritability included three studies (186 participants); NMDA antagonists were not superior to placebo [MD irritability = -1.94; CI 95% (-4.66; 0.77); I2 = 0%]. Compared with placebo, significantly more participants in the NMDA antagonist group reported at least one adverse event (five studies, 310 participants) [OR = 2.04; CI 95% (1.17; 3.57); I2 = 0%]. Conclusion: Current evidence does not support the effectiveness of NMDA antagonists in the treatment of ASD symptoms or irritability. Further research is needed due to the limited and low quality data available. Systematic Review Registration: PROSPERO CRD42018110399.

Leptospira interrogans biofilm transcriptome highlights adaption to starvation and general stress while maintaining virulence.

Life-threatening Leptospira interrogans navigate a dual existence: surviving in the environment and infecting mammalian hosts. Biofilm formation is presumably an important survival strategy to achieve this process. Understanding the relation between biofilm and virulence might improve our comprehension of leptospirosis epidemiology. Our study focused on elucidating Leptospira's adaptations and regulations involved in such complex microenvironments. To determine the transcriptional profile of Leptospira in biofilm, we compared the transcriptomes in late biofilms and in exponential planktonic cultures. While genes for motility, energy production, and metabolism were downregulated, those governing general stress response, defense against metal stress, and redox homeostasis showed a significant upsurge, hinting at a tailored defensive strategy against stress. Further, despite a reduced metabolic state, biofilm disruption swiftly restored metabolic activity. Crucially, bacteria in late biofilms or resulting from biofilm disruption retained virulence in an animal model. In summary, our study highlights Leptospira's adaptive equilibrium in biofilms: minimizing energy expenditure, potentially aiding in withstanding stresses while maintaining pathogenicity. These insights are important for explaining the survival strategies of Leptospira, revealing that a biofilm lifestyle may confer an advantage in maintaining virulence, an understanding essential for managing leptospirosis across both environmental and mammalian reservoirs.

Workers' perspectives on the effects of telework during the COVID-19 pandemic on their well-being: A qualitative study in Canada.

BACKGROUND: The COVID-19 pandemic caused an unprecedented health emergency across the world. Public health measures aimed at slowing the spread of the virus impose measures concerning physical distancing that citizens must observe. Thousands of workers quickly found themselves having to telework, with no preparation by their organizations. The literature reports the positive effects of teleworking on certain indicators of well-being, as well as best teleworking practices in a normal context. The urgent and unplanned nature of the switch to teleworking in a crisis may have changed the relationship between teleworking and well-being. OBJECTIVE: This study aimed to explore workers' perspectives on teleworking in the context of the COVID-19 pandemic, regarding its effects on their well-being. METHODS: Following a descriptive interpretive research design, we collected qualitative data from 15 teleworkers via focus groups and individual interviews. Two researchers used a thematic analysis strategy to analyze the data. RESULTS: Data analysis led to identifying 16 factors that participants cited as influencing the well-being of teleworkers. These form eight categories: delays related to uncertainty, manager practices, organizational practices, social interactions, job characteristics, teleworking space, personal realities and personal practices. The results show the influence of interactions between work demands, control and social support on the well-being of workers. CONCLUSION: Because of its many advantages, organizations and their workers will increasingly engage in telework. The influences of telework on people's well-being call for implementing concrete "best practices" that are applicable and that consider workers' perspectives.

Switching off automatic pilot to promote wellbeing and performance in the workplace: the role of mindfulness and basic psychological needs satisfaction.

Introduction and method: Building on self-determination theory, this study aims to advance the happy-productive worker thesis by examining a sequential mediation linking trait mindfulness to task performance through basic psychological need satisfaction and psychological wellbeing at work. Whereas most of the papers published on the topic stem from USA and Europe, we tested our model in a Canadian sample of 283 French-speaking workers. Results: Based on structural equation modeling, results show that the three need satisfactions at work mediate the relationship between trait mindfulness and psychological wellbeing at work. Rather than observing a sequential mediation, we find an indirect effect of trait mindfulness on task performance through the satisfaction for one of the basic psychological need (i.e., competence). Discussion: The present research goes beyond previous studies by exploring a new pair of happy construct-productive criteria alongside an emergent intrapersonal factor contributing to this relationship.

Organizational culture and leadership behaviors: is manager's psychological health the missing piece?

Background: In a context where organizations struggle to attract and retain highly qualified workers, organizations need to prioritize the psychological health of employees as a retention factor. To do so, they need to provide a healthy work environment. As an integral part of the employee experience, managers are an important factor in employee retention. In past studies, researchers have focused on the importance of leadership in boosting employees' health without, however, considering factors encouraging such behavior in managers. Recently, some scholars have become interested in managers' health as a resource allowing them to adopt good leadership behavior. Indeed, these studies reveal interesting links between managers' emotional state and their behavior as leaders. Other studies, underscore the importance of considering the organizational context to better understand managers' psychological health that may influence their leadership behaviors. This study proposes to examine the complex process by which organizational culture influences managers' psychological health, which acts as a resource favoring the adoption of good leadership behaviors that are known to be constructive and have positive effects on employee. Methods: Path analyses with the CALIS procedure SAS software, version 9.4 were conducted on a sample of 522 managers in three healthcare facilities in the province of Quebec, Canada. Results: The results revealed that group culture is associated with the two indicators of managers' psychological health at work. The results also demonstrated that managers' psychological distress at work is positively related to transactional and laissez-faire leadership styles whereas psychological well-being at work is positively related to transformational and transactional leadership. Concerning indirect associations, there is a significant and positive indirect association between group culture and transformational leadership and there is also a significant and negative association between group culture and laissez-faire leadership. Finally, there is also an indirect association between hierarchical culture and transactional leadership. Conclusion: Our study provides a more in-depth understanding of the relationship between organizational culture and leadership styles. More specifically, our findings highlight the benefits of implementing a group organizational culture to enhance psychological well-being, reduce psychological distress symptoms and promote good leadership behaviors.

Leading well and staying psychologically healthy: the role of resources and constraints for managers in the healthcare sector.

PURPOSE: Maintaining a healthy and productive workforce is a challenge for most organizations. This is even truer for health organization, facing staff shortages and work overload. The aim of this study is to identify the resources and constraints that influence managers' mental health and better understand how they are affected by them. DESIGN/METHODOLOGY/APPROACH: A qualitative approach was chosen to document the resources, the constraints as well as their consequences on managers in their day-to-day realities. The sample included executive-, intermediate- and first-level managers from a Canadian healthcare facility. A total of 62 semi-structured interviews were conducted. The coding process was based on the IGLOO model of Nielsen et al. (2018) to which an employee-related level was added (IGELOO). FINDINGS: Results highlight the importance of considering both resources as well as constraints in examining managers' mental health. Overarching context, organizational constraints and the management of difficult employees played important roles in the stress experienced by managers. PRACTICAL IMPLICATIONS: The results offer a better understanding of the importance of intervening at different levels to promote better organizational health. Results also highlight the importance of setting up organizational resources and act on the various constraints to reduce them. Different individual strategies used by managers to deal with the various constraints and maintain their mental health also emerge from those results. ORIGINALITY/VALUE: In addition to addressing the reality of healthcare managers, this study supplements a theoretical model and suggests avenues for interventions promoting more sustainable organizational health.

One down, fifty to go: managers' perceptions of their workload and how they cope with it to maintain their psychological health.

Background: Like many other countries, healthcare services in Canada face numerous organizational changes with the main objective of doing more with less. The approach taken within different healthcare networks has brought about a reform in healthcare facilities in Quebec, leading to several mergers and eliminating over 1,000 managerial positions. As a result, this has placed a progressively heavier workload on the shoulders of the remaining managers. Research on mental health in the workplace has mainly focused with the workforce and generally neglects managers. However, studies have shown that workload is a risk factor for managers. Therefore, the objectives of our study are to (1) better understand the elements that make up a manager's workload and the factors that influence it and (2) identify the coping strategies used by managers to deal with their workloads. Methods: Employing a qualitative approach, we analyzed 61 semistructured interviews through an abductive method, utilizing diverse frameworks for data analysis. The participants came from the same Quebec healthcare establishment. Results: Our findings align with the notion that workload is a multifaceted phenomenon that warrants a holistic analysis. The workload mapping framework we propose for healthcare network managers enables pinpointing those factors that contribute to the burden of their workload. Ultimately, this workload can detrimentally impact the psychological wellbeing of employees. Conclusion: In conclusion, this study takes a comprehensive look at workload by using a holistic approach, enabling a more comprehensive understanding of this phenomenon. It also allows for the identification of coping strategies used by managers to deal with their workloads. Finally, our results can provide valuable guidance for the interventions aimed at addressing workload issues among healthcare network managers in Quebec by utilizing the specific elements we have identified.

Oxidized hemoglobin triggers polyreactivity and autoreactivity of human IgG via transfer of heme.

Intravascular hemolysis occurs in diverse pathological conditions. Extracellular hemoglobin and heme have strong pro-oxidative and pro-inflammatory potentials that can contribute to the pathology of hemolytic diseases. However, many of the effects of extracellular hemoglobin and heme in hemolytic diseases are still not well understood. Here we demonstrate that oxidized hemoglobin (methemoglobin) can modify the antigen-binding characteristics of human immunoglobulins. Thus, incubation of polyclonal or some monoclonal human IgG in the presence of methemoglobin results in an appearance of binding reactivities towards distinct unrelated self-proteins, including the protein constituent of hemoglobin i.e., globin. We demonstrate that a transfer of heme from methemoglobin to IgG is indispensable for this acquisition of antibody polyreactivity. Our data also show that only oxidized form of hemoglobin have the capacity to induce polyreactivity of antibodies. Site-directed mutagenesis of a heme-sensitive human monoclonal IgG1 reveals details about the mechanism of methemoglobin-induced antigen-binding polyreactivity. Further here we assess the kinetics and thermodynamics of interaction of a heme-induced polyreactive human antibody with hemoglobin and myoglobin. Taken together presented data contribute to a better understanding of the functions of extracellular hemoglobin in the context of hemolytic diseases.