Biological sex and sociocultural gender represent major sources of diversity among patients, and recent research has shown the association of sex and gender with health. A growing body of literature ...describes widespread associations of sex and gender with cells, organs, and the manner in which individual patients interact with health care systems. Sex- and gender-informed medicine is a young paradigm of clinical practice and medical research founded on this literature that considers the association of sex and gender with each element of the disease process from risk, to presentation, to response to therapy.
Characteristics that underlie sex and gender involve both endogenous and exogenous factors that change throughout the life course. This review details clinical examples with broad applicability that highlight sex and gender differences in the key domains of genetics, epigenomic modifiers, hormonal milieu, immune function, neurocognitive aging process, vascular health, response to therapeutics, and interaction with health care systems. These domains interact with one another in multidimensional associations, contributing to the diversity of the sex and gender spectra. Novel research has identified differences of clinical relevance with the potential to improve care for all patients.
Clinicians should consider incorporating sex and gender in their decision-making to practice precision medicine that integrates fundamental components of patient individuality. Recognizing the biological and environmental factors that affect the disease course is imperative to optimizing care for each patient. Research highlights the myriad ways sex and gender play a role in health and disease. However, these clinically relevant insights have yet to be systematically incorporated into care. The framework described in this review serves as a guide to help clinicians consider sex and gender as they practice precision medicine.
This paper examines the 'what', 'why' and 'how' of employee well-being. Beginning with the 'what' of well-being, the construct of mental health was explored with the aim of building a model of ...employee well-being. It was proposed that employee well-being consists of three core components: (1) subjective well-being; (2) workplace well-being and (3) psychological well-being. Following this, the 'why' of employee well-being was investigated; that is, why employee well-being should be an important matter for organisations. It was argued that employee well-being is an important precursor to organisational well-being, as indicated by its links to employee turnover and performance. The next section was concerned with the 'how' of employee well-being; that is, how well-being can be reliaby enhanced. Drawing on two models of strengths and a practice model of psychological assessment, it was asserted that strength-based development can reliably enhance employee well-being. A solid framework for understanding and measuring employee well-being is offered in the hope that it will foster a more integrated approach to assessing and optimising employee well-being.
Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads ...or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations.
To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work-related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy.
An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace.
Early life stress leads to long lasting effects on behavior. Neuroimmune cells have been implicated as key mediators of experience-induced changes in brain and behavioral development, in that they ...are highly responsive to stress. Mast cells are one such type of neuroimmune cell, but little is known about their role in brain development or following early life stress. Here, we assessed the impact of three different early life stress exposure paradigms on mast cell dynamics in the developing brain of male and female rats, focusing on the hippocampus and hypothalamus, where most mast cells reside. We found that exposure to two weeks of chronic variable stress during gestation led to increased mast cell number and activation in the female offspring hypothalamus on the day of birth. Acute exposure to maternal separation stress on postnatal day (PN) 2 led to significant decreases in mast cells within the hypothalamus and hippocampus of females, but not males. In contrast, one week of exposure to brief daily maternal separation stress (e.g., handling), increased mast cell numbers in the female, but not male, hippocampus. We found significant sex differences in mast cell number and activation, including males having more mast cells than females in the hippocampus on the day of birth and males having significantly more degranulated mast cells on PN11. Thus, mast cells may be an unappreciated mediator of sex-specific brain development in response to early life perturbations.
•We compared the effects of early life stress paradigms mast cell numbers in the male and female rat brain.•Prenatal stress had no effect on mast cell numbers, acute postnatal stress decreased numbers in females, and handling increased numbers in females, but not males.•Males had more mast cells on PN0 than females, and more degranulated mast cells on PN11.
Salt marsh vegetation provides the structure that supports key wetland functions and the success of wetland restoration efforts depend on the establishment of vegetation, which can take decades. ...Field experiments aimed at identifying the factors that limit the colonization rate of marsh vegetation can be useful for guiding restoration efforts. We used field experiments and additional measurements to determine the causes for persistently low vegetation cover in a restored salt marsh in southern California. First, we characterized the soil properties of the marsh and found that high salinity and low soil moisture increased with elevation and improved with vegetation. Using this information, we conducted two field experiments—one in the high marsh and the other in the mid marsh to determine the effectiveness of different remedial actions (e.g. irrigation, soil decompaction, soil amendments, and planting and seeding different species) on increasing vegetation cover; the mid marsh experiment evaluated planting and seeding only. In the high marsh, plantings increased cover, and irrigation in combination with soil decompaction facilitated natural plant establishment. In the mid marsh, increases in vegetation cover varied by species planted. In both experiments, the marsh dominant (Salicornia pacifica) naturally recruited, increasing cover whereas seeding did not increase cover. In general, the magnitude and pace of vegetation growth was greater in the mid marsh relative to the high marsh that received less tidal inundation. Collectively, our results show how information gained from experiments conducted during wetland restoration can inform the processes underlying the establishment of vegetation.
This paper details the design and evaluation of a positive psychology-based employee well-being program. The effect of the program on well-being was evaluated using a mixed method design comprising ...of an RCT to assess outcome effectiveness, and participant feedback and facilitator field notes to assess process and impact effectiveness. Fifty government employees were randomly allocated to either an intervention or a control group (reduced to n = 23 for complete case analysis). The intervention group participated in the 6-week Working for Wellness Program and completed measures of subjective, psychological, affective and work-related well-being (SWB, PWB, AWB and WWB) at pre-intervention, post-intervention, and three and 6 month follow-ups. The control group completed the questionnaires only. As predicted, mixed ANOVAs revealed improvements in SWB and PWB for intervention group participants over time relative to control participants but these effects had reduced by time 4. There was a main effect of group on AWB in the predicted direction but no effect on WWB. Participant feedback indicated that the focus on strengths and group delivery were the most effective components of the program. Key issues were sample attrition and a lack of on-the-job support for change. Findings suggest employees can learn effective strategies for sustainably increasing their subjective and psychological well-being.
Communicative participation is restricted in many conditions associated with dysarthria. This position paper defines and describes the construct of communicative participation. In it, the emergence ...of this construct is reviewed, along with the predictors of and variables associated with communicative participation in the dysarthrias. In doing so, the features that make communicative participation unique and distinct from other measures of dysarthria are highlighted, through emphasizing how communicative participation cannot be predicted solely from other components of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), including levels of impairment or activity limitations. Next, the empirical literature related to the measurement of communicative participation and how this research relates to dysarthria management is presented. Finally, the development of robust clinical measures of communicative participation and approaches to management is described from the point of view of the clinician. We argue that communicative participation should be a primary focus of treatment planning and intervention to provide patient-centered, holistic, and value-based clinical interventions which are responsive to the needs of individuals living with dysarthria.
Purpose The purpose of this study was to obtain a self-reported account of the experience of living with oromandibular dystonia (OMD) to gain a better understanding of both the daily facilitators and ...barriers to communicative participation and the strategies used for adapting to life with OMD. Method Eight individuals with OMD and dysarthria participated in 1 face-to-face, semistructured interview. Interviews were audio-recorded and transcribed verbatim. Qualitative, phenomenological methods of coding, immersion, and emergence were used in the analysis of interview data. Results Three major themes and 7 subthemes emerged from the analysis of interview data. First, "speaking is different now" provided examples of how speech changes are manifested in various life situations. Second, "my roles have changed" addressed how OMD has impacted work, home, and social roles. Third, "I accept it and move on" involved finding strategies that help and adopting a different perspective. Conclusion We suggest that the management of OMD must take a more holistic approach by addressing consequences beyond the physical symptoms and be tailored to each individual based on his or her personal concerns and goals.
Background
We conducted a cluster randomized trial of a workplace mental health intervention in an Australian police department. The intervention was co‐designed and co‐implemented with the police ...department. Intervention elements included tailored mental health literacy training for all members of participating police stations, and a leadership development and coaching program for station leaders. This study presents the results of a mixed‐methods implementation evaluation of the trial.
Methods
Descriptive quantitative analyses characterized the extent of participation in intervention activities, complemented by a qualitative descriptive analysis of transcripts of 60 semistructured interviews with 53 persons and research team field notes.
Results
Participation rates in the multicomponent leadership development activities were highly variable, ranging from <10% to approximately 60% across stations. Approximately 50% of leaders and <50% of troops completed the mental health literacy training component of the intervention. Barriers to implementation included rostering challenges, high staff turnover and changes, competing work commitments, staff shortages, limited internal personnel resources to deliver the mental health literacy training, organizational cynicism, confidentiality concerns, and limited communication about the intervention by station command or station champions. Facilitators of participation were also identified, including perceived need for and benefits of the intervention, engagement at various levels, the research team's ability to create buy‐in and manage stakeholder relationships, and the use of external, credible leadership development coaches.
Conclusions
Implementation fell far short of expectations. The identified barriers and facilitators should be considered in the design and implementation of similar workplace mental health interventions.
Workplace Stress Page, Kathryn M.; Milner, Allison J.; Martin, Angela ...
Journal of occupational and environmental medicine,
2014-August, Letnik:
56, Številka:
8
Journal Article
Recenzirano
OBJECTIVE:To examine whether positive mental health (PMH)—a positively focused well-being construct—moderates the job stress–distress relationship.
METHODS:Longitudinal regression was used to test ...two waves of matched, population-level data from a sample of older, working Australian adults (n = 3291) to see whether PMH modified the relationship between work stress and later psychological distress.
RESULTS:Time 1 work stress was positively associated with distress at both time points. Positive mental health was negatively associated with work stress at both time points. Positive mental health modified the impact of work stress on psychological distress. This effect only occurred for those with the highest levels of PMH.
CONCLUSIONS:Positive mental health may help protect workers from the effect of workplace stress but only in a small proportion of the population. Therefore, to improve workplace mental health, workplaces need to both prevent stress and promote PMH.
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