Implementation of participatory organizational change in long term care to improve safety

Introduction: Long Term Care (LTC) facilities are fast-paced, demanding environments placing workers at significant risk for injuries. Health and safety interventions to address hazards in LTC are challenging to implement. The study assessed a participatory organizational change intervention implementation and impacts. Methods: This was a mixed methods implementation study with a concurrent control, conducted from 2017 to 2019 in four non-profit LTC facilities in Ontario, Canada. Study participants were managers and frontline staff. Intervention sites implemented a participatory organizational change program, control sites distributed one-page health and safety pamphlets. Program impact data were collected via Survey (self-efficacy, control over work, pain and general health) and observation (Quick Exposure Checklist). Interviews/focus groups were used to collect program implementation data. Results: Participants described program impacts (hazard controls through equipment purchase/modification, practice changes, and education/training) and positive changes in culture, communication and collaboration. There was a statistically significant difference in manager self-efficacy for musculoskeletal disorder (MSD) hazards between the control and intervention sites over time but no other statistical differences were found. Key program implementation challenges included LTC hazards, staff shortage/turnover, safety culture, staff time to participate, and communication. Facilitators included frontline staff involvement during implementation, management support, focusing on a single unit, training, and involving an external program facilitator. Conclusion: A participatory program can have positive impacts on identifying and reducing MSD hazards. Key to success is involving frontline staff in identifying hazards and creating solutions and management encouragement on a unit working together. High turnover rates, staffing shortages, and time constraints were barriers as they are for all organizational change efforts in LTC. The implementation findings are likely applicable in any jurisdiction. Practical Application: Implementing a participatory organizational change program to reduce MSD hazards is feasible in LTC and can improve communication and aid in identification and control of hazards.     

Male care and mating effort among Hadza foragers

Paternal care figures prominently in many scenarios of human evolution. Recently, however, such scenarios have been challenged on two scores. First, the level of male contribution may be insignificant. Second, male care may be provided as a form of mating effort, rather than parenting effort. In theory, since men can enhance their Darwinian fitness both by providing care to their own offspring if this raises offspring fitness and by pursuing additional mates if this leads to additional offspring, men should respond to payoffs from both mating and parenting effort. If men respond to payoffs from parenting effort, paternity ought to make a difference. And if men respond to payoffs from mating effort, mating opportunities ought to make a difference. I analyzed the impact of these two factors on variation in male care among the Hadza, a foraging society in Tanzania. Two predictions were tested: (1) biological children will receive more care than stepchildren, and (2) men will provide less care to their biological children as their mating opportunities increase. Both predictions were supported. These results suggest men provide care, in part, as parenting effort, and that they trade off parenting effort for mating effort when they have greater mating opportunities. Received: 21 January 1998 / Received in revised form: 24 January 1999 / Accepted: 1 February 1999     

长三角一体化示范区青浦区水环境中22种PPCPs的多介质分布特征及风险评估

采集了长三角一体化示范区青浦区(包括太浦河、金泽水库周边和青西郊野公园)的25个采样点的50个表层水体和沉积物样品,利用高效液相色谱串联质谱(HPLC/MS-MS)分析了样品中的22种药物与个人护理品(PPCPs),详细分析了研究区域目标PPCPs的分布特征、来源和影响因素,并利用商值法对目标PPCPs的生态风险和健康...     

污水处理厂进出水及其受纳水体中典型PPCPs的污染特征

以对乙酰氨基酚为目标物,利用固相萃取(SPE)-高效液相色谱(HPLC)法测定了该药物在泰安市污水处理厂进出水和地表水体中的含量。结果表明,对乙酰氨基酚在污水处理厂进水中均被检出,质量浓度为0.9~238μg/L,表明生活污水为污水处理厂该药物活性成分的来源,出水中质量浓度为ND~8.3μg/L,去除率较高,其中生物降解是主要的降解机制。在泮河中的质量浓度为ND~3.59μg/L,与国内外其他地表水体相比,处于同一个数量级,且污水厂排水口下游水体中目标物浓度高于上游,反映出污水处理厂排放可能是其受纳水体中PPCPs的主要来源之一。     

固相萃取-液质联用分析药物和个人护理品

建立了固相萃取-液质联用分析药物和个人护理品(PPCPs)的方法,采用Oasis HLB固相萃取柱分别在酸性条件下和碱性条件下对PPCPs进行富集提取,该法对于宜兴地区能够检出的30种PPCPs均具有良好的线性,相关系数为0.990~0.999,检出限为1.37~10.12 ng/L。应用该法对宜兴地区地表水中存在的PPCPs进行分析,结果显示30种PPCPs均有不同程度检出,分布最广泛的7种分别为避蚊胺、阿替洛尔、对乙酰氨基酚、普鲁卡因、β-雌二醇、卡马西平和苯佐卡因,阿替洛尔浓度较高,普遍为5~600 ng/L。避蚊胺虽然出现频率最高,但其在各个采样点浓度偏低,普遍为1~50 ng/L。     

超声波萃取-高效液相色谱-串联质谱同时测沉积物中10种PPCPs化合物

基于EPA1694方法,应用超声波萃取-高效液相色谱-串联质谱技术,建立了沉积物中对乙酰氨基酚、林可霉素、甲氧苄啶、咖啡因、阿奇霉素、磺胺甲唑、泰乐菌素、地尔硫卓、卡马西平及氟西汀等10种药物和个人护理品(PPCPs)的分析检测方法。样品经超声萃取、离心和SAX阴离子交换柱净化,以高效液相色谱-串联质谱仪多反应监测(MRM)模式进行离子定性、定量分析。10种药物加标回收率实验结果表明:添加低浓度样品20 ng/g,回收率为61.1%~128.5%,相对标准偏差(RSD)为1.7%~17.5%(n=5);添加高浓度样品400 ng/g,回收率为66.4%~126.7%,RSD为2.3%~18.0%(n=5),最低检测限为0.12~4.46 ng/g。该方法具有检测限低和回收率高的特点,并经实际样品验证发现,该方法适用于检测沉积物中10种PPCPs化合物。     

环境中药品和个人护理品的复合污染风险

在环境中污染物常以混合物的形式存在,从而扩大或减小了其对环境和生物的效应。指出目前对药品和个人护理品(PPCPs)环境健康风险的研究多停留在单一物质表观层面,造成其风险值出现偏差。系统分析了PPCPs与有机和无机污染物之间的复合污染,提出加强复合污染毒性风险及致毒机理等方面的研究,为有效降低环境水体中PPCPs潜在的安全风险提供理论支持。