CDC – NIOSH Total Worker Health Webinar Series

NIOSH Total Worker Health® program

Source: CDC – NIOSH Total Worker Health Webinar Series

Webinar Series

Recognizing the complex, often interlinked hazards affecting the health, safety, and well-being of today’s workforce, the NIOSH Total Worker Health® program is excited to present a free webinar series aimed at providing the latest research and case studies for protecting the safety and health of workers everywhere. All 90-minute webinars are recorded and are available for on-demand viewing.

Webinar Series Learning Objectives

  • Describe recent trends in demographics, employment conditions, worker safety, injury, and illness as they relate to the health and well-being of workers.
  • Describe the relationship between at least one health condition and at least one condition of work.
  • Discuss the latest findings supporting rationale for implementing a Total Worker Health® approach.
  • List one potential opportunity for integration between health protection and policies, programs, and practices that promote health and advance worker safety, health and well-being.
  • Develop workplace programs and interventions that integrate elements of occupational safety and health protection with policies, programs, and practices that promote health and advance worker safety, health and well-being.
  • Identify sources of information on prevention of adverse worker health and safety outcomes and the promotion of Total Worker Health®.

Nurse Suicide: Breaking the Silence – National Academy of Medicine

Source: Nurse Suicide: Breaking the Silence – National Academy of Medicine | National Academy of Medicine

ABSTRACT | The purpose of this paper is to raise awareness of and begin to build an open dialogue regarding nurse suicide. Recent exposure to nurse suicide raised our awareness and concern, but it was disarming to find no organization-specific, local, state, or national mechanisms in place to track and report the number or context of nurse suicides in the United States. This paper describes our initial exploration as we attempted to uncover what is known about the prevalence of nurse suicide in the United States. Our goal is to break through the culture of silence regarding suicide among nurses so that realistic and accurate appraisals of risk can be established and preventive measures can be developed.

I Use a Wheelchair. And Yes, I’m Your Doctor. – The New York Times

When I was in the third year of my medical residency, I was asked to evaluate a new state-of-the-art, fully accessible exam table that would be used in doctors’ offices to better provide care for patients with mobility-related disabilities. The table could go as low as 18 inches off the ground to enable easier transfers for wheelchair users and had extra rails and grips to provide support for patients with impaired balance. I was to assess this equipment as a “user expert.” Although the table was designed

Source: I Use a Wheelchair. And Yes, I’m Your Doctor. – The New York Times

When I was in the third year of my medical residency, I was asked to evaluate a new state-of-the-art, fully accessible exam table that would be used in doctors’ offices to better provide care for patients with mobility-related disabilities. The table could go as low as 18 inches off the ground to enable easier transfers for wheelchair users and had extra rails and grips to provide support for patients with impaired balance.

I was to assess this equipment as a “user expert.” Although the table was designed to accommodate patients with disabilities, I rolled up to it to evaluate it from the perspective of a physician. “Do you want my opinion as a patient, or as a doctor?” I asked the surprised representatives from the medical equipment company.

I have been a wheelchair user since early childhood, when I sustained a spinal cord injury in a farming accident. I am now a practicing physician in the field of rehabilitation and sports medicine.

In my busy outpatient clinical practice, I witness the spectrum of patients’ reactions when they find out that their doctor is, herself, disabled. Typically those first few seconds after entering an exam room — before the patient’s guard goes up — are the most informative.

I find that these reactions are somewhat generational. Younger patients, having grown up amid a growing awareness of disability in society, typically do not react at all. They have clearly encountered empowered people with disabilities working in various professional roles. Older patients often seem confused, curious or, in rare circumstances, dismayed.

Several months ago, I wheeled into the room of an elderly woman. She looked at me, placed her hand on mine and, with a kind look asked, “Are you an invalid?” More recently, a jovial older man exclaimed, “You’ve got to be kidding me!” A few times, patients will hesitate to tell me their concerns, indicating “Well, doc, I feel bad complaining about this to you, when clearly your problems are bigger than mine.”

Several years ago, while in my residency, I was in line at our hospital cafeteria. Although my badge reading “Dr. Blauwet” and stethoscope were clearly visible, a man next to me in line said: “You look like you are doing pretty well. When are you going to be discharged?” Clearly, my wheelchair was the only thing he saw. Moreover, he equated my wheelchair with illness, rather than empowerment.

Over the years, I’ve thought a lot about situations like these, and I do not believe they come so much from direct prejudice as from people’s lack of experience with doctors who are also wheelchair users. A recent study revealed that less than 3 percent of medical school trainees are people with disabilities, and of these, only a small proportion are individuals with mobility impairment. How can we expect our patients or colleagues to know about the perspectives and needs of physicians with disabilities when we remain invisible to them? The reason for this underrepresentation is complicated. Most physicians with mobility disabilities will tell you that the problem is not that we lack the ability to do our job competently. As with many other educated, skilled professionals, we know how to choose a path that suits our talents and abilities. Reasonable accommodations, such as the use of standing wheelchairs in the operating room, give us the access we need to do our work. The larger barrier to entry for prospective doctors with disabilities, however, is bias, both overt and hidden.

A colleague who is quadriplegic recounted a medical school admissions officer telling him, “I’m afraid that you will not meet the technical standards for admission.” Although steeped in bias and probably illegal, this response was at least more direct than the more common form of discrimination where otherwise strong applicants with disabilities simply do not receive an interview or a call back. As our peers are accepted into prestigious schools and academic positions, we sit on the sidelines, left to question whether the fault lies with us or the system. Many give up their aspirations of a career in medicine altogether, electing to pursue work more “traditionally suited” for people with disabilities. Others lose sleep, questioning whether it was the right decision to disclose their disability in the application materials.

Anyone can enter, at any time, the minority group of people with disabilities. The most common cause of new, adult-onset disability is — simply put — aging. Physicians are often reluctant to disclose new-onset or progressive disability (like loss of hearing or vision, or reduced mobility) because of the fear of being stigmatized; medicine, after all, is still dominated by the prototype of physical prowess.

Dr. Lisa Iezzoni, a professor of medicine at Harvard Medical School, has been an important mentor to me for many years. She recounted her experience as a medical student at Harvard in the early 1980s, a decade before the passage of the Americans With Disabilities Act. In her first year at the medical school, after experiencing some physical and sensory symptoms, she was given a diagnosis of multiple sclerosis. Late in her third year, after a fall, she started using a cane, but her aspirations to pursue an internal medicine residency remained, despite the overt discouragement she received. At a student-faculty dinner, an influential professor told her: “There are too many doctors in the country right now for us to worry about training a handicapped physician. If that means someone gets left by the wayside, that’s too bad.”

The medical school refused to write a letter of recommendation for her residency application, so she could not pursue the training required for clinical practice. She pursued health policy research instead and became the first female professor of medicine at the Beth Israel Deaconess Medical Center and now directs the Mongan Institute Health Policy Center at Massachusetts General Hospital. Despite having had an extraordinarily successful career, she sometimes wonders what could have been if she had been able to practice medicine.

My experience, more than two decades later, was vastly different. As an undergraduate at the University of Arizona, I became interested in applying to medical school. I investigated the application process and took coursework that would set me up for success. I studied, networked, did internships and engaged in various activities that would strengthen my application. Additionally, throughout this time, I nurtured my alter ego as an athlete, pursuing the sport of wheelchair racing, and ultimately represented the United States in three Paralympic Games.

In the fall of 2002, I applied to medical school, received interviews at several prestigious universities and was accepted to the Stanford University School of Medicine. Throughout this process, I never once feared that my disability would get in the way of success. I could focus on my academic performance rather than expending mental energy around concerns of hidden bias.

As a member of the “A.D.A. generation,” I was blissfully ignorant that my visible disability could, in fact, derail my success. I simply assumed that I would be evaluated on merit, like my peers. (I also realized that my athletic success perhaps made me seem more “able.”) I now understand the privilege of that perspective. I cannot completely separate my disability identity from my professional role.

People with disabilities often express fear or dissatisfaction with our health care system because they face poor access and discriminatory attitudes. This must change. Perhaps having more doctors with disabilities is one solution. As with any underrepresented group in medicine, professional diversity should reflect our population’s diversity. That simple change can bring awareness, empathy and a shared experience that ultimately makes all of us better.

Cheri A. Blauwet (@CheriBlauwetMD), an assistant professor at Harvard Medical School, is a seven-time Paralympic medalist and serves on the board of the United States Olympic Committee.

Disability is a weekly series of essays, art and opinion by and about people living with disabilities.

The entire series can be found here. To reach the editors or submit an essay for consideration, write opinionator@nytimes.com and include “Disability” in the subject field. Follow The New York Times Opinion section on Facebook and Twitter (@NYTOpinion), and sign up for the Opinion Today newsletter.

Working and Training with a Disability Just How Far Have Attitudes Evolved: Neurology Today

Professionalism: Working and Training with a Disability Just How Far Have Attitudes Evolved?

Source: Working and Training with a Disability Just How Far Have Attitudes Evolved: Neurology Today

Professionalism: Working and Training with a Disability Just How Far Have Attitudes Evolved?

Hurley, Dan

doi: 10.1097/01.NT.0000526684.14066.b8
Neurologists and physicians who have neurologic disorders and disabilities discuss the challenges they have overcome to train and work with patients.

Dealing with severe bilateral sensorineural hearing loss is straightforward enough for Regina Troxell, MD, now in her fifth year as a child neurology fellow at Memorial Hermann in Houston: She relies on a hearing aid and lip reading to communicate. But, she said, dealing with some of her colleagues is sometimes somewhat more complicated.

“If an attending says something when we’re rounding and I don’t hear because there’s background noise in the hallway, or they’re not facing me, it can become an issue,” Dr. Troxell said. “A couple of times it has come up during evaluations, where they wrote, ‘I don’t know if she didn’t hear what I told her or just didn’t do it.’ Maybe they’re not comfortable asking me at the time of the event because it’s a disability.”

Getting misunderstood or underestimated has been a near-universal experience, said neurologists and other physicians who happen to have disabilities in interviews with Neurology Today. The physicians and medical students — who discussed a wide range of disabilities, from hemiparesis, multiple sclerosis, and cerebral palsy to spinal injuries and hearing loss — said handling their disability is often easier than handling their fellow physicians’ biases. But there are signs that progress has been made toward greater acceptance, they said.

Internet and cell phone usage patterns among young adults with intellectual disabilities

Source: JARID

Authors Cristina Jenaro, Noelia Flores, Maribel Cruz, Ma Carmen Pérez, Vanessa Vega, Víctor A Torres

First published: 24 July 2017

Abstract

Background

The risks and opportunities associated with the use of technologies are of growing research interest. Patterns of technology usage illuminate these opportunities and risks. However, no studies have assessed the usage patterns (frequency, duration, and intensity) and related factors in young people with intellectual disabilities.

Methods

Questionnaires on Internet and cell phone usage patterns, the Internet Over-Use Scale and the Cell-Phone Over-Use Scale, as well as the Beck Depression Inventory were filled out in one-on-one interviews of 216 youth with intellectual disabilities.

Results

Young people with disabilities make more social and recreational rather than educational use of these tools, and show higher rates of excessive use of both technologies than a comparison group of 410 young people without disabilities. Also, their overuse is associated with other unhealthy behaviors.

Conclusion

The framework of support needs of people with disabilities should be considered to promote healthy Internet and cell phone use.

What Effect Does Transition Have on Health and Well-Being in Young People with Intellectual Disabilities? A Systematic Review

 Source: JARID

Background Transition to adulthood might be a risk period for poor health in people with intellectual disabilities. However, the present authors could find no synthesis of evidence on health and well-being outcomes during transition in this population. This review aimed to answer this question. MethodPRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed, and grey literature was searched. Papers were selected based on clear inclusion criteria. Data were extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. Results A total of 15 985 articles were extracted; of these, 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and well-being issues in this population during transition to adulthood, including obesity and sexual health issues. Conclusion This review reveals a gap in the literature on transition and health and points to the need for future work in this area.

Prospects for an Impact Evaluation of Project SEARCH: An Evaluability Assessment

Source: Prospects for an Impact Evaluation of Project SEARCH: An Evaluability Assessment

Authors: Arif A. Mamun, Lori Timmins, and David C. Stapleton

Project SEARCH has emerged as a promising program to address the challenges related to improving employment outcomes of youth with disabilities. It is a high school to work transition program that integrates employers and businesses with other educational and community rehabilitation service providers to engage youth with disabilities in paid work experiences. Recent monitoring and evaluation efforts suggest promising employment outcomes for Project SEARCH participants, but there has not yet been a rigorous impact evaluation with a large sample to demonstrate that these outcomes are substantially better than they would be if the participants had only relied on services and supports that are available outside of Project SEARCH.

In this report we present several design options for a rigorous impact evaluation of Project SEARCH. Relying on information we gathered from document reviews and from site visits conducted for this evaluability assessment, we propose two leading evaluation designs: one under the existing setting, where we take Project SEARCH sites, students, and other partners as given; and another under a demonstration setting, where we allow for the evaluation to play a role in determining the setting within which these players interact. We also discuss a few other alternative design options that we considered, but have concluded they are less appealing than those recommended.

How I bridge 2 worlds as a deaf medical student

Growing up as a deaf person has given me unique insights into patient care, which I hope to incorporate into my practice when I’m a physician.

Source: How I bridge 2 worlds as a deaf medical student

 

I was born profoundly deaf in both ears, which means I could only hear sound above 95 decibels. Without hearing aids, I could hear extremely loud sounds, such as a plane taking off or a train going by, only if I was near them. With hearing aids, I could hear sound at 40 decibels and up, so I could understand one-on-one conversations as long as there was no background noise, the person didn’t mumble and I could see his or her mouth clearly.

Before starting medical school, I got a cochlear implant, which helps me hear so much more than I could before. When I listen to music now, I can hear all the different sounds rather than one static sound, and it’s much easier to differentiate between the instruments. Understanding speech has also become much easier. I now communicate orally with hearing people and via sign language with deaf people. However, I am still deaf, and there are still times when I am unable to understand what people are saying, such as group settings where there’s a lot of ambient noise.

I chose osteopathic medicine because I heard from many patients who spoke highly of DOs, and the osteopathic philosophy resonated with me as well. I strongly believe in treating the person as a whole and that lifestyle factors can dramatically affect a person’s health. Ultimately, I hope to become an obstetrician-gynecologist. I’d like my practice to include caring for deaf patients—some deaf people have very little health literacy due to communication barriers growing up, which is something I hope to combat.

Culture and communication

Growing up as a deaf person has given me insights I hope to incorporate in my future practice as a physician. The first is the importance of maintaining eye contact during conversations. That’s not only because it helps me lip-read and understand what’s being said; eye contact shows that you are truly listening to the other person. It shows respect.

Secondly, because of growing up in the deaf culture, I’m very aware that all cultures are different. Physicians may not encounter deaf patients frequently, but they will definitely care for patients who have special needs when receiving medical care, such as a disability or an interpreter if English isn’t their primary language. As a patient, I’ve learned that I need to speak up about my needs, because sometimes people just are not aware. As a physician, I’ll know to ask patients what they need.

Victoria MacPherson, OMS II (center), attends the Philadelphia College of Osteopathic Medicine, as do Victoria Gordon, OMS II, (left) and Helen Lesser, OMS II (right). (Photo provided by Victoria MacPherson)

Tips for physicians

Physicians should keep in mind that American Sign Language is its own language, so written English doesn’t automatically translate to ASL. A deaf person who uses exclusively ASL and is not fluent in English might have trouble understanding written text, which is why some patients prefer to use an interpreter.

At the end of the visit, I appreciate being asked to repeat back my treatment plan so my physician can be sure I fully understand what was said. Receiving a written copy of my doctor’s recommendations is also very helpful—that’s probably true for any patient, not only those who are deaf.

If you’re unsure how to communicate with a patient who is deaf, or anyone with a disability, just ask! I suggest language such as, “I believe in offering top-notch accessible care. Do you need any special accommodations?” Then let the patients explain to you what they need, because they are the experts on themselves.

Employers, looking for a roadmap to make your workplace is accessible to all?

Source: Accessible Technology Action Steps: A Guide for Employers

Looking for a roadmap to ensure that the technology in your workplace is accessible to all employees and job applicants? Visit: Partnership on Employment & Accessible Technology (PEAT)

Whether you’re just getting started on accessible technology or looking for more advanced guidance, PEAT offers resources that can help. Simply check out the Action Steps below, in any order.

Doctors With Disabilities: Why They’re Important – The New York Times

There’s good reason to believe a more diverse work force — one that includes doctors with disabilities — would be good for patients and doctors. Patients of various backgrounds tend to feel more comfortable with physicians like them, and that’s true for people with disabilities as well.

Source: Doctors With Disabilities: Why They’re Important – The New York Times

More than 20 percent of Americans — nearly 57 million people — live with a disability, including 8 percent of children and 10 percent of nonelderly adults. And while the medical profession is devoted to caring for the ill, often it doesn’t do enough to meet the needs of the disabled.

Read entire article… Doctors With Disabilities- Why They’re Important – NYTimes

 

Dr. Gregory Snyder, a physician at Brigham and Women’s Hospital in Boston, has paralysis in his legs after a spinal cord injury during medical school. He uses a wheelchair and says that he’s sometimes mistaken for a patient while working. But that’s not necessarily a bad thing.

“It reminds us that at some point we’ll all be patients,” he said. “And perhaps, when we least expect it.”

Over the course of our lives, most of us will acquire a disability: More than two thirds of Americans over the age of 80 have a motor, sensory or cognitive impairment.

Dr. Snyder remembers the difficulty of adjusting to life as a patient after his accident, and the long road to recovery. But he says his disability and rehabilitation have fundamentally changed the way he cares for patients — for the better.

“I would have been this six-foot-tall, blond-haired, blue-eyed Caucasian doctor standing at the foot of the bed in a white coat,” he said. “Now I’m a guy in a wheelchair sitting right next to my patients. They know I’ve been in that bed just like they have. And I think that means something.”

There’s good reason to believe a more diverse work force — one that includes doctors with disabilities — would be good for patients and doctors. Patients of various backgrounds tend to feel more comfortable with physicians like them, and that’s true for people with disabilities as well.

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