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Nanette Clinch - One of the best experts on this subject based on the ideXlab platform.
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Tattoos in the Workplace
Journal of Critical Incidents, 2014Co-Authors: Asbjorn Osland, Nanette ClinchAbstract:Carmen Taylor, a senior at Cal State University, was a server. Her employer, the Old Italian Kitchen, had a written personnel Policy that required its servers to cover tattoos and remove facial piercings, other than earrings. Though she thought the Policy Restrictive, it didn't apply to her since the tattoo she had envisioned could have been covered at work and would have only been visible when her side was exposed. She described (email, 24 June 2014) the prospective tattoo as follows: "It was a very complex tattoo, but basically it was ... scenery with mountains, a cactus, flowers, and it would have been very colorful. I was planning on it taking up my entire right side from the right side of my rib cage to the right side of my waist." Her mother had cautioned her against it when she turned 18 but now that she was 21 she renewed her questioning. She also wondered if her employer was out of touch with the young people that worked for the restaurant. Was the ban on exposed tattoos a reasonable Policy to appeal to family values or did it reflect out of sync traditional attitudes held by older executives? Consequences of Restrictive Policy Poorly Implemented An example of the consequences of a Restrictive Policy follows: Edward Rangel sued Red Robin Gourmet Burgers, Inc., (Red Robin) alleging religious discrimination because the company fired him due to his tattoos. The company claimed exposed tattoos violated its dress code Policy. Rangel practiced Kemetecism, a religion with roots in ancient Egypt. To join the religion's priesthood, he had two tattoos placed on his wrists (quarter-inch wide and encircled the wrists). Written in Coptic, the tattoos stated, "My Father Ra is Lord. 1 am the son who exists of his Father; I am the Father who exists of his son." He was tattooed following a religious ceremony after a session involving communal prayer, meditation, and ritual. He believed that intentionally covering the tattoos would have been sinful whereas inadvertently doing so when wearing a long-sleeved shirt was fine. He also covered the tattoos during the month of Mesura, the time Ra was to have died and been reborn. His church group numbered fewer than 10 members. In December 2001, Rangel began as a server with Red Robin in Bellevue, Washington. He signed the "Uniform/Appearance" Policy that specified that piercings and tattoos could not be seen. His supervisor ignored the Policy for a time; then in May 2002, he reminded Rangel of the Policy. After hearing his religious justification, the supervisor let it go. However, a month later, more senior managers noted the tattoos when Rangel attended an orientation. They insisted he cover the tattoos, he refused, and Rangel was fired on June 17, 2002. The CFO publicly stated that the company had Christian values and sought out "that all-American kid" from the suburbs instead of those with "that urban kind of experience" (government press release--disguised--September 16, 2005). Rangel's religious claim may have seemed unorthodox, but the company thought it better to settle than fight it in court (EEOC, 9-16-05). Did Employees Have a Right to Display Their Tattoos? Employees didn't have a Title VII (which barred discrimination by employers based on race, color, religion, sex, and national origin) statutory right to showing body piercings and tattoos in the workplace. Employers could have insisted that they cover them up. Employees' claims could have been coupled with religion (as in Reed's case); national origin (e g., tattoos common to Polynesian cultures); sex, if policies were applied differently to men than women (e g., women can wear earrings, but can men wear "gauges" that gradually elongate the ear lobe?); and even free speech in the case of a hospital nursing assistant who had a tattoo that stated "HIV Positive" (Modem Healthcare, 1993, Bartley, 1999) that he claimed allowed him to talk about safe sex. However, employers could adopt dress codes and appearance standards that didn't violate Title VII rights. …
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Tattoos in the Workplace
Journal of Critical Incidents, 2014Co-Authors: Asbjorn Osland, Nanette ClinchAbstract:Carmen Taylor, a senior at Cal State University, was a server. Her employer, the Old Italian Kitchen, had a written personnel Policy that required its servers to cover tattoos and remove facial piercings, other than earrings. Though she thought the Policy Restrictive, it didn't apply to her since the tattoo she had envisioned could have been covered at work and would have only been visible when her side was exposed. She described (email, 24 June 2014) the prospective tattoo as follows: "It was a very complex tattoo, but basically it was ... scenery with mountains, a cactus, flowers, and it would have been very colorful. I was planning on it taking up my entire right side from the right side of my rib cage to the right side of my waist." Her mother had cautioned her against it when she turned 18 but now that she was 21 she renewed her questioning. She also wondered if her employer was out of touch with the young people that worked for the restaurant. Was the ban on exposed tattoos a reasonable Policy to appeal to family values or did it reflect out of sync traditional attitudes held by older executives? Consequences of Restrictive Policy Poorly Implemented An example of the consequences of a Restrictive Policy follows: Edward Rangel sued Red Robin Gourmet Burgers, Inc., (Red Robin) alleging religious discrimination because the company fired him due to his tattoos. The company claimed exposed tattoos violated its dress code Policy. Rangel practiced Kemetecism, a religion with roots in ancient Egypt. To join the religion's priesthood, he had two tattoos placed on his wrists (quarter-inch wide and encircled the wrists). Written in Coptic, the tattoos stated, "My Father Ra is Lord. 1 am the son who exists of his Father; I am the Father who exists of his son." He was tattooed following a religious ceremony after a session involving communal prayer, meditation, and ritual. He believed that intentionally covering the tattoos would have been sinful whereas inadvertently doing so when wearing a long-sleeved shirt was fine. He also covered the tattoos during the month of Mesura, the time Ra was to have died and been reborn. His church group numbered fewer than 10 members. In December 2001, Rangel began as a server with Red Robin in Bellevue, Washington. He signed the "Uniform/Appearance" Policy that specified that piercings and tattoos could not be seen. His supervisor ignored the Policy for a time; then in May 2002, he reminded Rangel of the Policy. After hearing his religious justification, the supervisor let it go. However, a month later, more senior managers noted the tattoos when Rangel attended an orientation. They insisted he cover the tattoos, he refused, and Rangel was fired on June 17, 2002. The CFO publicly stated that the company had Christian values and sought out "that all-American kid" from the suburbs instead of those with "that urban kind of experience" (government press release--disguised--September 16, 2005). Rangel's religious claim may have seemed unorthodox, but the company thought it better to settle than fight it in court (EEOC, 9-16-05). Did Employees Have a Right to Display Their Tattoos? Employees didn't have a Title VII (which barred discrimination by employers based on race, color, religion, sex, and national origin) statutory right to showing body piercings and tattoos in the workplace. Employers could have insisted that they cover them up. Employees' claims could have been coupled with religion (as in Reed's case); national origin (e g., tattoos common to Polynesian cultures); sex, if policies were applied differently to men than women (e g., women can wear earrings, but can men wear "gauges" that gradually elongate the ear lobe?); and even free speech in the case of a hospital nursing assistant who had a tattoo that stated "HIV Positive" (Modem Healthcare, 1993, Bartley, 1999) that he claimed allowed him to talk about safe sex. However, employers could adopt dress codes and appearance standards that didn't violate Title VII rights. …
Christian G Huber - One of the best experts on this subject based on the ideXlab platform.
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long term reduction of seclusion and forced medication on a hospital wide level implementation of an open door Policy over 6 years
European Psychiatry, 2018Co-Authors: Lisa Hochstrasser, Andres R Schneeberger, Stefan Borgwardt, Undine E Lang, Daniela Frohlich, R D Stieglitz, Christian G HuberAbstract:Abstract Background Psychiatric inpatient treatment is increasingly performed in settings with locked doors. However, locked wards have well-known disadvantages and are ethically problematic. In addition, recent data challenges the hypothesis that locked wards provide improved safety over open-door settings regarding suicide, absconding and aggression. Furthermore, there is evidence that the introduction of an open-door Policy may lead to short-term reductions in involuntary measures. The aim of this study was to assess if the introduction of an open-door Policy is associated with a long-term reduction of the frequency of seclusion and forced medication. Method In this 6-year, hospital-wide, longitudinal, observational study, we examined the frequency of seclusion and forced medication in 17,359 inpatient cases admitted to the Department of Adult Psychiatry, Universitare Psychiatrische Kliniken (UPK) Basel, University of Basel, Switzerland. In an approach to enable a less Restrictive Policy, six previously closed psychiatric wards were permanently opened beginning from August 2011. During this process, a systematic change towards a more patient-centered and recovery-oriented care was applied. Statistical analysis consisted of generalized estimating equations (GEE) models. Results In multivariate analyses controlling for potential confounders, the implementation of an open-door Policy was associated with a continuous reduction of seclusion (from 8.2 to 3.5%; ηp2 = 0.82; odds ratio: 0.88) and forced medication (from 2.4 to 1.2%; ηp2 = 0.70; odds ratio: 0.90). Conclusion This underlines the potential of the introduction of an open-door Policy to attain a long-term reduction in involuntary measures.
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reduction of seclusion on a hospital wide level successful implementation of a less Restrictive Policy
Journal of Psychiatric Research, 2014Co-Authors: Hermannalexander Jungfer, Andres R Schneeberger, Stefan Borgwardt, Marc Walter, Marc Vogel, Stefanie K Gairing, Undine E Lang, Christian G HuberAbstract:Abstract Purpose Change of treatment Policy from closed to open ward settings has been shown to reduce coercive measures. The aim of the current study was to examine the effects of the change from closed to open wards on the frequency of seclusion and forced medication in a hospital-wide setting. Subjects and methods 2-year, longitudinal observational study with 2838 inpatient cases. Results On a hospital-wide level, the percentage of patients with at least one seclusion was decreased significantly ( χ 2 ( 1) = 5.8; p = .016), while there was no significant change in forced medication ( χ 2 (1) = .08; p = .775). The frequency of seclusions and forced medication decreased significantly on newly opened wards, and there were no significant changes regarding seclusion on permanently closed or open wards, while the number of forced medications increased significantly on closed wards. The decrease in seclusions on newly opened wards remained statistically significant after controlling for diagnoses and severity of illness. Discussion Our results indicate that a reduction of overall seclusion can be successfully attained, and that, in particular, the frequency of seclusion and forced medication on newly opened wards was decreased significantly. These changes were not accompanied by a significant increase in seclusion on other wards. Conclusion Open ward treatment was successfully implemented and was associated with a significant decrease of coercive measures in our study. It might therefore provide a good care model, strengthening the patient's right to autonomy and leading to a reduction of coercive measures.
Guillermo Carroli - One of the best experts on this subject based on the ideXlab platform.
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the cost effectiveness of routine versus Restrictive episiotomy in argentina
American Journal of Obstetrics and Gynecology, 2002Co-Authors: Josephine Borghi, Julia Foxrushby, Eduardo Bergel, Edgardo Abalos, Guy Hutton, Guillermo CarroliAbstract:OBJECTIVE: This article provides the estimates of the cost implications of switching from routine to Restrictive episiotomy in 2 provinces in Argentina (Santa Fe and Salta) from the viewpoint of the health provider. STUDY DESIGN: A decision-tree model was constructed that used the probabilities and patient outcomes (the results of a trial in Argentina), resource use, cost, and local epidemiologic data from interviews with obstetricians in the selected provinces and from literature reviews. Probabilistic sensitivity analysis was conducted, which provided 90% confidence ranges for the cost data. RESULTS: For each low-risk vaginal delivery, there is a potential reduction in provider cost of $20.21 (range, $19.36-$21.09) with a Restrictive Policy of episiotomy in Santa Fe province and a reduction of $11.63 (range, $10.89-$12.42) in Salta province. CONCLUSION: The more effective Policy of Restrictive episiotomy is also less costly than that of routine episiotomy. The results are robust and consistent in both provinces. Further research is required to confirm the appropriate indications for episiotomy and the impact on outcomes of variations in episiotomy cost rates.
Renee M. Gindi - One of the best experts on this subject based on the ideXlab platform.
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Consequences of a Restrictive syringe exchange Policy on utilisation patterns of a syringe exchange program in Baltimore, Maryland: Implications for HIV risk.
Drug and alcohol review, 2015Co-Authors: Susan G. Sherman, Shivani A. Patel, Daesha V. Ramachandran, Noya Galai, Patrick Chaulk, Chris Serio-chapman, Renee M. GindiAbstract:Introduction and Aims Syringe distribution policies continue to be debated in many jurisdictions throughout the USA. The Baltimore Needle and Syringe Exchange Program (NSP) operated under a 1-for-1 syringe exchange Policy from its inception in 1994 through 1999, when it implemented a Restrictive Policy (2000–2004) that dictated less than 1-for-1 exchange for non-program syringes. Design and Methods Data were derived from the Baltimore NSP, which prospectively collected data on all client visits. We examined the impact of this Restrictive Policy on program-level output measures (i.e. distributed : returned syringe ratio, client volume) before, during and after the Restrictive exchange Policy. Through multiple logistic regression, we examined correlates of less than 1-for-1 exchange ratios at the client level before and during the Restrictive exchange Policy periods. Results During the Restrictive Policy period, the average annual program-level ratio of total syringes distributed : returned dropped from 0.99 to 0.88, with a low point of 0.85 in 2000. There were substantial decreases in the average number of syringes distributed, syringes returned, the total number of clients and new clients enrolling during the Restrictive compared to the preceding period. During the Restrictive period, 33 508 more syringes were returned to the needle exchange than were distributed. In the presence of other variables, correlates of less than 1-for-1 exchange ratio were being white, female and less than 30 years old. Discussion and Conclusions With fewer clean syringes in circulation, Restrictive policies could increase the risk of exposure to HIV among Injection Drug Users (IDUs) and the broader community. The study provides evidence to the potentially harmful effects of such policies. [Sherman SG, Patel SA, Ramachandran DV, Galai N, Chaulk P, Serio-Chapman C, Gindi RM. Consequences of a Restrictive syringe exchange Policy on utilisation patterns of a syringe exchange program in Baltimore, Maryland: Implications for HIV risk. Drug Alcohol Rev 2015]
J Tham - One of the best experts on this subject based on the ideXlab platform.
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12 Audit to assess the local blood transfusion practise in patients who present with acute upper gastrointestinal bleeds in muhimbili national hospital, dar es salaam, tanzania
Gut, 2017Co-Authors: J ThamAbstract:Background Blood transfusion is a major component in the treatment of acute upper gastrointestinal bleeding. Its safety has been questioned in the treatment of less severe cases. A large randomised controlled trial showed significant reductions in re-bleeding and mortality rates in patients who were randomised to a Restrictive Policy (transfused when haemoglobin was less than 7 g/dL) compared to a liberal Policy (transfused when haemoglobin was less than 9 g/dL). Aim The aim of this study is to identify whether Muhimbili National Hospital in Tanzania follows the evidence-based medicine that a Restrictive Policy in blood transfusion is advantageous in the treatment of acute upper gastrointestinal bleeding. Method I performed a prospective audit of patients presenting to Mulhimbili National Hospital (MNH) with AUGIB to assess the current transfusion practice in this patient group. During a 3 week period I identified patients admitted to MNH who presented with meleana and haematemesis. I collected data about haemoglobin levels and blood transfusion from patient’s notes. Results 89.5% of patients who presented with haemoglobin 9 g/dL did receive a blood transfusion. Conclusions Muhimbili National Hospital in Dar Es Salaam in Tanzania do not follow the evidence-based medicine that Restrictive Policy in blood transfusion in acute upper gastrointestinal bleeding is beneficial compared to liberal blood transfusion.