Toxic coworkers linked to worse mental health

Working college students were more likely to have mental health problems if they had toxic relationships with co-workers than if they were on friendly terms with colleagues in a small new US study.

“If you think about a typical 24-hour day for a college student, aside from sleeping, students are going to school and studying and also working part-time, four hours a day on average,” lead study author Allison Vaughn, a psychology researcher at San Diego State University, said by email.

“It makes sense that the people a college student works with would also have the potential to be health-relevant,” she added. “Students who need to work their way through school should try to make the most of these workplace relationships, just as you would with any friendship or romantic relationship.”

Many college students work during school, with estimates ranging from 58 percent to 72 percent of undergraduates, Vaughn and colleagues write in the Journal of American College Health. Working at least 20 hours a week is also a reality for 24 percent to 47 percent of these students.

To understand the connection between students’ relationships at work and their mental health, the researchers surveyed 170 working students enrolled in an introductory psychology class in March 2011.

Students ranged in age from 18 to 35, and on average were about 20 years old.

Most participants worked part-time, averaging about 19 hours a week, and had typically held their current jobs for about 15 months.

The questionnaires touched on the quality of relationships with supervisors and up to three co-workers, job satisfaction and mental health issues such as stress, depression and anxiety.

Generally, the students rated their supervisors as being moderately or very helpful and their co-workers as being only slightly upsetting. They described the majority of their work relationships as supportive, or were ambivalent.

Participants who were ambivalent about their supervisors had poorer mental health than their peers who had positive relationships with their bosses.

The students who felt ambivalent also had lower job satisfaction and less support, more thoughts about leaving the job and more burnout.

Results for coworkers were similar, with ambivalent relationships linked to worse mental health.

The students who had more supportive relationships at work had fewer symptoms of stress, lower depression and anxiety and higher satisfaction with life, the authors note.

The study is small, and doesn’t prove a cause-and-effect connection between troubles at work and poor mental health, the researchers caution. It’s also possible that students’ perceptions of their work relationships don’t match up with reality, they acknowledge.

“Perceptions of relationships may be colored by mental health, so it might actually be that students with better mental health or higher self-confidence to start with interpreted relationships at work as being more positive in general,” said Kathy Rospenda, a researcher in psychiatry and psychology at the University of Illinois at Chicago.

Even so, the findings add to a growing body of evidence that negative experiences at work can contribute to mental health problems among students, Rospenda, who wasn’t involved in the study, said by email.

The best time for students to assess whether a job will provide a positive work environment is during the hiring process, said Rebecca Vidourek, a researcher in health promotion and education at the University of Cincinnati in Ohio.

“It is important for students to ask good questions when they interview,” Vidourek, who wasn’t involved in the study, said by email. “Asking about demographics, work climate, flexibility for students, etc. can help determine if a workplace will be a good personal fit.”

Once they’re on the job, challenges in relationships with supervisors or coworkers may also be an opportunity for students to learn communication skills, Paola Pedrelli, a mental health researcher at Massachusetts General Hospital in Boston, said by email.

“Some students may be passive and then resent the responsibilities they have been assigned because they were not assertive or may be aggressive and be reprimanded,” Pedrelli, who wasn’t involved in the study, said by email.

At the same time, students who work more hours also have to be cognizant of how work can impact their mental health, she added.

“Students who work full-time may not have time to sleep, eat well, exercise and engage in pleasant activities,” Pedrelli said. “Neglect of these areas may lead to low energy, irritability, and poor concentration and academic performance and overall dissatisfaction.”

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Cold-pressed juice a growing health trend in Regina, Saskatoon

Juice bars are popular in big cities like Vancouver and Los Angeles, and now they have finally made their way to Regina and Saskatoon.

Cold-pressed juice is billed as a grab-and-go nutrient-packed alternative to eating whole fruits and vegetables or even junky snack food.

The Thrive Juice Co. truck has been set up at the Regina Farmers Market for the past three weeks. (Roxanna Woloshyn/CBC)

Danica Slattery started Thrive Juice Co. in Saskatoon with her business partner in January of last year because she felt there was a gap in the market for healthy options.

“I just found there was nowhere to grab something quick, easy yet healthy that you actually knew what was in the product,” said Slattery.

Before they opened the storefront in Riversdale, they bought and remodeled their Thrive Juice Co. truck, which makes appearances at both the Saskatoon and Regina Farmers Markets.

One of Thrive’s employees has been driving in the freshly pressed juice from Saskatoon to Regina every Saturday and Wednesday for the last three weeks. They are also looking at setting up a permanent location in Regina.

Cold-pressed juice unlike other juices

Danica is the co-owner of Thrive Juice Co. in Saskatoon, which sells cold-pressed fruit and vegetable juices. (Roxanna Woloshyn/CBC)

Slattery says cold-pressed juice is not like something you’ll find in the grocery store and the pressing process is nothing like your mother’s home juicer.

Cold-pressed juicing does not use a blade or any type of spinning process that would heat up the produce.

Instead, two large metal plates press the vegetables together to draw out the juice and nutrients.

“That ensures optimum enzyme activity with no damage and then there is no spinning blade, so it doesn’t start oxidizing right away,” said Slattery.

“So it allows our juice to have a four-day shelf life without losing its nutritional value.”

Added expense

But at about $10 a bottle, some say cold-pressed juice pulls too hard on the purse-strings.

Slattery says when you factor in all organic produce, and several pounds of vegetable pressed into each bottle, quality is what drives the price up.

“That was definitely a learning curve for us. We do try to use as much local and organic as possible, so that doesn’t come cheap,” said Slattery.

Juice bars planned for Regina

Leslie Genoway plans to open her juice bar called Glow Juicery on University Park Drive sometime in August. (Roxanna Woloshyn/CBC)

Leslie Genoway, a personal trainer who owns LG fitness in Regina, is working on opening her own cold-pressed juicery off of University Park Drive in August.

She says she wanted to be able to offer her clients the nutrition side of health and wellness along with the fitness aspect.

And the idea for Glow Juicery came from a very personal experience.

Her cousin died of cancer last year, and she believes he would have lived longer had nutrition been incorporated into his medical plan.

Glow Juicery will offer cold-pressed juices with two to five pounds of produce in each bottle. (Glow Juicery)

“I wanted to be able to introduce another path or method to our pre-existing clients (of LG fitness) so that we could get down to those basics again going back to food is medicine and it heals from the inside out.” said Genoway.

She acknowledged that there is a misconception that juicing is solely about weight loss, and she said that is not her focus.

“Our primary concern is being able to get the nutritional value out of our fruits and vegetables. Someone that is looking for weight loss, that is something they’d want to talk to a dietitian about,”  said Genoway.

Better to eat your greens, says dietitian

Kaylee Michnik, a registered dietitian with the Regina Qu’Appelle Health Region, says cold-pressed juice is fine to drink, but eating fruits and vegetables is always better. (Roxanna Woloshyn/CBC)

But while cold-pressed juice is touted as being a healthy alternative, experts say it may not be all it is cracked up to be.

The cold-pressed method removes the skin and pulp from the juice, which is where you find the fibre. Dietitians say that is problematic because fibre staves off hunger.

The Canada Food Guide does currently list half a cup of juice as an example of a serving of fruit and vegetables.

However, Health Canada is reviewing whether or not juice should be considered a fruit serving in the guide.

Kaylee Michnik, a registered dietitian who works for the Regina Qu’Appelle Health Region, says cold-pressed isn’t bad for you, but it’s not the best way to get your nutrients.

“If you bought that same produce for $10, it would probably feed you for a few days, versus having that juice for a mid-morning snack,” said Michnik.

“Really there is no reliable scientific evidence showing that juicing our produce is more healthy than consuming fruits and vegetables.”

Ultimately, Canada’s Food Guide advises people to choose fruit and vegetables more often than juice.

Both Genoway and Slattery say their juice isn’t supposed to entirely replace eating your fruits and vegetables.

Instead, they say, it’s a convenient way to get some nutrients in when you are on the go.

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QuantiaMD Improves Physicians’ Patient Safety Practices

As part of a guest column posted to Health IT Outcomes, Elsevier’s Michelle Troseth writes, “Healthcare is in a state of flux. Providers, payers, government, vendors, and patients will no longer tolerate a system dominated by care silos, fragmentation, costly duplication, and uneven outcomes. A re-invigorated healthcare system will take root only if professionals advance a framework for interprofessional care coordination and collaboration across the expanding continuum.”

That sentiment is backed up by the results of a QuantiaMD report which fond 65 percent of physicians implemented better patient safety practices after participating in expert-led presentations within Quantia’s web and mobile physician community. The findings indicate a direct relationship between delivery of relevant clinical content by trusted experts in a convenient online format and changes in the way physicians think about and practice medicine, potentially leading to improved quality of life for millions of patients and significant cost savings for the health systems that serve them, according to a release.

The report is based on opinions of a panel of physicians who had interacted with specific, expert-led presentations on QuantiaMD including Common and Costly PICC-related DVTs, presented by Dr. Vineet Chopra, MD, MSc, University of Michigan; Reducing Risk of PICC-Associated Bloodstream Infection, also presented by Dr. Chopra; and Sepsis: A Review and Update, delivered by Margaret Johnson, MD, Mayo Clinic Florida.

After the DVT presentation, 59 percent of respondents reported it influenced how they manage the use of PICCs to reduce deep vein thrombosis (DVT). Meanwhile, 55 percent of respondents reported the PICC presentation influenced how they manage the use of PICCs to reduce central line-associated bloodstream infections (CLABSI), and 81 percent of respondents reported that the Sepsis presentation influenced how they diagnose and manage sepsis in patient care. Ninety-two percent reported they have adopted at least one of the key recommendations and 72 percent said they may have prevented a sepsis patient death using the Surviving Sepsis Guidelines.

The three examples above represent millions of dollars in annual costs savings for a health system of 3,000 providers serving one million patients. Such savings could be realized if the same proportion of physicians in that sample system reported a similar level of influence as our survey respondents.

“In an effort to reduce costs and improve outcomes, health systems are making clinicians more accountable for infection control rates and other patient safety measures. In fact, 40 percent of our surveyed physicians say they have access to infection control data and/or reports from their health system’s analytic system, and are expected to act on this information as it relates to their practice,” said Dan Malloy, Executive Vice President of Quantia.

“Health systems are finding that our platform helps them better engage their physicians on the topics that drive these patient safety measures through concise, expert-led interactive presentations—all within a community that physicians already value and trust.”

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UN health agency to mark World Hepatitis Day with pilot initiative to curb unsafe injections

23 July 2015 – The World Health Organization (WHO) announced today that it will commemorate the fifth World Hepatitis Day next week with a global ?injection safety initiative campaign in three pilot countries together with the foundation arm of IKEA to combat the “silent epidemic” that kills more than 1.4 million each year.

“Egypt, Uganda and India are three of the flagship countries that will be taking on the first steps on this campaign,” Dr Edward Kelley, WHO’s Director of Service Delivery and Safetytold reporters in Geneva, Switzerland.

The global campaign is designed to raise public awareness for safe injections to combat Hepatitis B and C, ministry engagement for national plans to deal with the infections and to engage the private sector, including the syringe manufacturing community, Dr. Kelley said.

He also noted that the most frequent medical procedure in the world today is administering of injections, “about 16 billion a year and the rate of unsafe injections of those 16 billion – the estimate is up to 40 per cent.”

At the press conference devoted to World Hepatitis Day, which falls on July 28 – the birthday of the American scientist Baruch Blumberg who is associated with his work on the hepatitis B – the UN health agency highlighted the urgent need for countries to urgently enhance action to prevent viral hepatitis infection and to ensure that people who have been infected are diagnosed and offered treatment.

“We call hepatitis the ‘silent epidemic,’” said Dr. Stefan Wiktor, team leader of WHO’s Global Hepatitis Programme. “It’s really underappreciated – it’s level of importance as a cause of death and disease.”

“We estimate about 1.4 to 1.5 million deaths every year from all the various types of hepatitis. That put it about the seventh leading cause of death,” he said. WHO’s flagship event next week takes place in Egypt, a country the health agency says has one of the world’s highest hepatitis burdens.

“It is estimated that 10 per cent of the ?population between 15 and ??59 years is chronically ?infected with hepatitis C,” WHO said in a fact sheet. It adds that between 2007 and 2014, more than 350,000 people with hepatitis C have been treated. Since the introduction of newer, more effective medicines in 2014, the number of people being treated continues to increase.

WHO emphasizes the need for all health services to reduce risks by using only sterile equipment for injections and other medical procedures, to test all donated blood and blood components for hepatitis B and C and to promote the use of the hepatitis B vaccine. Safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms), also protect against transmission.

The WHO officials also noted that the prices of medicines have come down considerably in developing countries where generic drug manufacturers being able to produce the drugs at lower costs but that the challenge remained in middle-income countries such as Russia, China and Ukraine where pharmaceutical companies were trying to make a profit by negotiating country by country.

Both officials also stressed the importance of treating hepatitis “comprehensively.”

“We have to push prevention and we have to push treatment,” Dr. Wiktor said. “What we are really promoting is that countries address hepatitis comprehensively.”

Dr. Wiktor announced that in September this year, countries will have the opportunity to share best practice at the first-ever World Hepatitis Summit to be held in Glasgow, Scotland.

The summit, which is co-sponsored by WHO and the World Hepatitis Alliance, aims to raise the global profile of viral hepatitis, to create a platform for exchange of country experiences and to focus on working with countries to develop national action plans.

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Biden talks health care at medical products firm in Newark

Vice President Joe Biden on Thursday visited a medical products firm in Newark, where he praised what he called a “new paradigm” of advances in health care technology flourishing in the Silicon Valley and stressed what he called significant White House efforts to improve preventive health care.

“Science is going to catch up, in some cases within months … to be able to do so much more for people,” Biden told about 150 employees and invited guests at Theranos, which makes laboratory testing products. “But a big piece of that is making it available, changing the paradigm about how we go about it, dealing with cost, dealing with availability.”

The vice president’s stop in the Bay Area, which focused on “the importance of preventative health care” and the role of the private sector and technology in developing better access to health care, gave him the opportunity to underscore the administration’s support of tech advances coming from Silicon Valley.

“What we have learned is that … government has a role in basic and applied research,” he said, adding that the Obama administration has focused on new ways to gather and share medical data to help companies like Theranos make “cutting-edge investments” in the field.

“We’re going to look back on this period … and maybe we can say we played a little role in prevention, protection and research and improved the quality of delivery,” he said.

Biden toured the facility with Theranos CEO Elizabeth Holmes, whom he praised as a model for “inspiration” and innovation. He opened his remarks offering his condolences to the family and friends of fallen Hayward police Officer Scott Lunger, killed this week on a routine traffic stop.

At one stop on the tour, company wellness technician Tiffany Shu stood at the ready with equipment — gloves, needles and swabs — to draw Biden’s blood. He opted out, greeting the technician effusively but not sitting in the white lounger that had been set up for his use. Theranos has produced tests for hundreds of diseases and viruses, including Hepatitis C and HIV, and tests for drugs including ecstasy, cocaine and marijuana.

Biden later took part in a roundtable discussion about health care with industry leaders before an audience of about 150 invited guests. Attendees at the round table — the media wasn’t granted access — included Robert Harrington, chairman of the Stanford University department of medicine; Amir Dan Rubin, CEO of Stanford Hospital; Gary St. Hilaire, CEO of Capital Blue Cross; Bert Lubin, CEO of Children’s Research Center of Oakland; and Mark Laret, CEO of UCSF Medical Center.

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Public/Private Partnership To Address Housing And Health Care For Children With Asthma

Mary (not her real name) is an elementary school student with moderate to severe asthma. She struggles to manage her condition and uses her rescue inhaler frequently. Mary’s mother is concerned about several problems in their apartment, including an unresolved pest infestation and bedbugs. As Mary’s pediatrician learned during a recent appointment, the family faces eviction for non-payment of rent.

Stories like Mary’s are common in Worcester, Massachusetts, where more than one in ten children suffer from asthma. Kids with uncontrolled asthma have poor health and development, and they miss a large number of school days. Many of these children live in low-income neighborhoods where substandard housing conditions—such as mold, pests, and lack of heat—often exacerbate asthma symptoms.

Due to poverty-related instability, they often move one or more times during the year, causing them to switch schools and fall behind. Helping these children control their asthma requires both good clinical care and better, more stable housing conditions. Yet in many communities, these are often seen as separate problems.

The city of Worcester, Massachusetts is an exception. The City’s Division of Public Health and its partners in the medical and legal communities use a multi-sector approach to address housing and health needs for children at high-risk for asthma.

Both Housing And Health Matter For High-Risk Pediatric Asthma Patients

Since 2003, Community Legal Aid and UMass Memorial Medical Center have had a medical-legal partnership in which pediatric primary care staff connect patients with civil legal aid services when housing, insurance, education, or public benefit problems interfere with their health. In 2014, the partners began using the program specifically as a vehicle to address housing conditions that can trigger asthma attacks.

The Massachusetts Medical Society funded a small pilot program at UMass Memorial in which attorneys trained community health workers to screen families for housing-related civil legal problems—in particular for substandard housing conditions and threats of eviction—during home visits in the Belmont Street Community School neighborhood. The health workers then provided asthma management education and a healthy home assessment, addressing both medication management and housing conditions simultaneously. The health workers were able to initiate code enforcement actions and refer families who needed legal counsel in addressing housing conditions to the medical–legal partnership attorney.

The pilot served 30 children and gave community health workers, UMass Memorial providers, and civil legal aid partners an opportunity to build strong relationships and hone service delivery, from referral mechanisms to case feedback loops. After the pilot concluded, they received a grant from the Massachusetts Prevention and Wellness Trust Fund, scaling the asthma home visiting project from a single neighborhood intervention to a city-wide approach.

The grant project brought in new partners, including the City of Worcester Division of Public Health and Worcester’s two federally qualified community health centers — Edward M. Kennedy Community Health Center and Family Health Center of Worcester. Together, these centers provide a medical home to many of the low-income asthmatic children in Worcester. The target population of the new grant is the approximately 700 low-income children in Worcester who are listed on participating clinical sites’ asthma registries.

Improving Each Sector’s Effectiveness By Working Together

The driving idea behind this program is that these various interventions—medicine provided by clinicians, housing laws and conditions enforced by lawyers, and empowerment-focused asthma education provided by community health workers—can be more effective if their delivery is integrated.

Commonwealth Medicine and the Massachusetts Department of Public Health are currently conducting evaluations of this program; preliminary results will be available in 2016. However, the project has already played a role in reducing school absenteeism. The team has also seen early changes in its capacity to address asthma care and prevention, and in the ability of each type of professional on the team to work at the top of his or her license.

Community Health Workers

Community health workers can now do asthma education in the home setting and connect the results of the home assessment with the child’s health care provider. With the support of attorneys, they help families navigate the Inspectional Services process and advocate with housing code officials or landlords to exterminate pests causing asthma attacks. Health workers know that if the issue becomes more complex, or a family suddenly faces eviction, they can refer families to the medical-legal partnership attorney.

Legal Aid Attorneys

Legal aid attorneys traditionally dedicate their time to crises. Currently, resources are sufficient to address only one in five civil legal problems in the U.S. Where housing is concerned, this shortage has led many legal agencies to help only those individuals who show up at their offices with an eviction notice in hand.

In the Worcester program, attorneys see problems earlier based on community health workers’ screening and referrals. In addition, by building health workers’ capacity to help families before a court intervention is required, attorneys can use their resources to address the more challenging issues that require their more specialized skills — including systemic problems that impact multiple families at once.

For example, one family served by the project was living in a building in complete disrepair. By working with this family, Community Legal Aid learned that poor conditions existed in many units and is now helping other families in the same building who may never have made it to legal aid’s door. Working alongside clinical providers and community health workers, attorneys identify patterns of pest infestation, substandard conditions, and other barriers that could be addressed with targeted advocacy and the collaboration of housing code departments.

Clinical Partners

For clinical partners, an integrated approach has the potential to improve medication compliance while reducing unnecessary use of emergency rooms. In addition, as reimbursement from both public and private payers continues to shift away from fee-for-service to value-based purchasing, clinic-community linkages could impact cost-containment and quality improvement efforts.

The Role Of Local Government

In Worcester, the local public health department serves an important convening role for this project. City leadership understood that innovations in healthy living and clinical care require collaboration and dialogue across sectors. Having the local public health department involved ensures that the project is informed by city public health data and is connected to other asthma initiatives happening across the city.

It also gives clinical, community, and legal aid partners a place where they feel safe sharing the challenges of identifying and reaching families eligible for the intervention and implementing home visits. The public health department provides a forum where partners learn from the successes of others and work on process improvements together. For example, the clinical and community-based partners are currently working on Plan-Do-Study-Act (PDSA) cycles to improve home visits.

This project led to the creation of an Asthma Task Force in Worcester, comprised of the Prevention and Wellness Trust Fund grantees and other community stakeholders. Members meet regularly to discuss policy and systemic solutions to the issues identified through this collaboration. The Task Force created a policy subcommittee, currently working with educational stakeholders and in partnership with City and school officials to improve the built environment in locations where children spend time.

Public health departments and health care systems are natural choices to convene these partnerships because they have city-wide asthma data and hold the asthma registry lists that identify the individuals that most need intervention. But legal aid can play a critical role, not only as a partner in addressing asthma, but in detecting where in the community intervention is most needed. For example, in Cincinnati, when health care data around asthma admissions were coupled with legal data around housing code violations, a medical-legal partnership detected substandard housing clusters ripe for policy and population level interventions.

If health care, public health, and legal aid organizations share their data around asthma and housing, they may identify common patients/clients and common goals. Together, these potential clinical, community, and legal aid partners should investigate funding opportunities that will support multi-sector prevention work. In Massachusetts, the Prevention and Wellness Trust Fund was an important funder, but more opportunities may become available as private and public payers look for ways to pay forpopulation health interventions.

A Healthy Home for Mary

Mary was one of the first asthma patients enrolled in Worcester’s new asthma program. Her community health worker connected Mary’s mom with Community Legal Aid. An attorney interviewed Mary’s mother to identify her healthy housing goals and represented her in court. As a result of the legal intervention, the eviction was dismissed, her subsidized housing voucher was protected, and the poor conditions were addressed. Through a combination of asthma education, medicine, and better housing, the team stabilized Mary’s asthma.

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Serial entrepreneur starts firm for commercializing health IT

An entrepreneur is plowing seeds from selling a digital marketing agency into what he sees as fertile ground for health-care IT.

Bill Balderaz headed the Central Ohio-based health-care arm of Fathom Online Marketing for four years after the Cleveland agency acquired his Webbed Marketing LLC.

Now he’s launching Futurety LLC: A consultant to idea-stage and established health-care companies seeking to capitalize on the growing retail mindset in medicine via software, telemedicine or wearable technology.

“The big vision is helping health-care IT companies grow,” he said, whether that’s validating the market potential of an idea or breaking into a larger market.

As interest in health data and wellness apps grows, he said, Columbus has a disproportionately low share of the deals. Meanwhile, health systems are looking for ways to operate efficiently, boost patient satisfaction and prevent readmissions.

“I saw a lot of good ideas that weren’t being commercialized,” he said. “I talked to investors … who weren’t sure where to find the deal flow.”

For now Balderaz, a member of the Ohio TechAngel Funds, invests personally in some of the companies. Futurety itself does not have a fund – but the coalition of its backers is committed to raising one, he said.

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