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measures in physicians with effects potentially sustainable over 2 months. Occupational health practitioners in health care should consider this type of intervention for their workers.

The majority of U.S. worksites are smaller worksites that often employ low-wage workers. Low-wage workers have limited access to, and participation in, workplace health promotion programs. Community-based participatory research (CBPR) has been identified as a key method to directly engage employers in identifying the health promotion needs of smaller workplaces. This article describes a four-phased process where CBPR was used to tailor a workplace health promotion program to meet the needs of a smaller workplace that employees low-wage workers. Outcomes of this program were measured and reported over time.

The CBPR approach was based on the Social Ecological Model along with two additional health promotion models. Publicly available evidence-based tools were also used for this four-phased process which included the following (a) initial program assessment, (b) program planning, (c) program implementation, and (d) program evaluation. TWS119 mw Key strategies for developing a comprehensive workplace health promotion program guided the process.

The workplace's capacity for promoting health among its employees was improved. There were sustainable improvements in the health interventions and organizational supports in place.

A CBPR approach may be a way to build the capacity of smaller workplaces with low-wage employees to address the health promotion needs of their workforces. The use of publicly available strategies and tools which incorporate the social ecological determinants of health is of equal importance.

A CBPR approach may be a way to build the capacity of smaller workplaces with low-wage employees to address the health promotion needs of their workforces. The use of publicly available strategies and tools which incorporate the social ecological determinants of health is of equal importance.

Psychological violence is a persistent issue in academic medicine and affects the health and safety of health care workers. This violence is also debated as part of medical culture. Third parties, persons learning about violations after it happened, may provide an understanding of the interplay between gender and psychological violence. Perspectives on research on psychological violence in academic medicine are currently lacking.

In this qualitative exploratory study, interviews were conducted with women from a working group on equal treatment at one medical university in Austria. This group monitors discrimination and harassment and consists of medical doctors, natural scientists, administrative staff, and students. To recruit participants, an email invitation was sent to members of the working group. Of 20 eligible persons, 12 women participated. After written consent from participants, individual interviews were conducted face-to-face, audio-recorded, and transcribed verbatim. Data were analyzed with geriencing harm. Occupational health practice should include training in sensitization to psychological violence, protection of those targeted, deconstructing power accumulation, and promoting diversity in career patterns and working styles.

The experiences of graduate nurses and midwives transitioning into the clinical environment as beginning practitioners has been reported as a time period of great challenge. For the graduate double degree nurse midwife, often transitioning into two disciplines of practice concurrently, their experiences have the potential to be heightened. The aim of this research was to explore the transition to practice experiences of double degree graduate nurse midwives practicing in either or both nursing and midwifery in the Australian health care system.

This research used a Husserlian descriptive phenomenological approach to understand the experiences of 23 double degree graduate nurse midwives working in 20 different health care facilities across Australia.

The findings showed that most participants experienced exhaustion from an emotional, physical, and mental perspective during their first year of practice. These experiences were linked with cognitive saturation, professional loneliness, sleep deprivation, and an inability to achieve a work-life balance. The data also highlighted the graduate nurse midwife's concerns for safe practice when feeling mentally, physically, and emotionally depleted.

Safe practice is paramount for both patient and health care worker. The levels of exhaustion described by the participants in this study influenced their perceived ability to practice safely. As a result, it should be recognized that the graduate nurse midwife's health and well-being is central to their perceptions of safe practice and is fundamental to a positive transition to practice experience.

Safe practice is paramount for both patient and health care worker. The levels of exhaustion described by the participants in this study influenced their perceived ability to practice safely. link2 As a result, it should be recognized that the graduate nurse midwife's health and well-being is central to their perceptions of safe practice and is fundamental to a positive transition to practice experience.Purpose This study reports findings from a clinical trial that implemented an early stuttering treatment program integrated with evidence-based parenting support (EBPS) to children who stutter (CWS) with concomitant self-regulation challenges manifested in elevated attention-deficit/hyperactivity disorder (eADHD) symptoms and compared those outcomes to CWS receiving stuttering treatment without EBPS. Method Participants were 76 preschool CWS and their parent(s). Thirty-six of these children presented with eADHD and were quasirandomized into two groups stuttering treatment only (eADHDstandard) or stuttering treatment integrated with EBPS (eADHDintegrated). The remaining children did not meet criteria for eADHD symptoms and received stuttering treatment only (No-eADHDstandard). link3 Pre, post, and 3-month follow-up measures of stuttering treatment outcomes as well as treatment effects on measures of child behavior difficulties and parenting practices were examined. Results Significant reduction in stuttering was found for all groups. However, the eADHDintegrated group showed a greater reduction in stuttering frequency than the eADHDstandard group, and at follow-up, stuttering frequencies in the eADHDintegrated group matched those of children in the No-eADHDstandard group, while stuttering in the eADHDstandard group remained significantly higher. Children with eADHD symptoms who received the integrated program also required significantly less stuttering intervention time than those children with eADHD symptoms who received stuttering treatment only. Families in the eADHDintegrated group reported large and significant improvements in child behavior and parenting practices. Conclusion This study provides support for an early treatment program for CWS. The integrated stuttering and self-regulation management program for CWS with eADHD symptoms proved successful for fluency and behavioral improvements, which were sustained at follow-up.Purpose The aims of the study were (a) to evaluate the effects of systematically varied factors of stimulus duration, interaural-level difference (ILD), and direction on perceptual and electrophysiological metrics of lateralization for fixed versus moving targets and (b) to evaluate the hemispheric activity underlying perception of fixed versus moving auditory targets. Method Twelve normal-hearing, young adult listeners were evaluated using perceptual and P300 tests of lateralization. Both perceptual and P300 tests utilized stimuli that varied for type (fixed and moving), direction (right and left), duration (100 and 500 ms), and magnitude of ILD (9 and 18 dB). Listeners provided laterality judgments and stimulus-type discrimination (fixed vs. moving) judgments for all combinations of acoustic factors. During P300 recordings, listeners discriminated between left- versus right-directed targets, as the other acoustic parameters were varied. Results ILD magnitude and stimulus type had statistically significant e left hemispatial perceptual bias and right hemispheric dominance for spatial listening.Background. Touchless interaction devices have increasingly garnered attention for intraoperative imaging interaction, but there are limited recommendations on which touchless interaction mechanisms should be implemented in the operating room. The objective of this study was to evaluate the efficiency, accuracy, and satisfaction of 2 current touchless interaction mechanisms-hand motion and body motion for intraoperative image interaction. Methods. We used the TedCas plugin for ClearCanvas DICOM viewer to display and manipulate CT images. Ten surgeons performed 5 image interaction tasks-step-through, pan, zoom, circle measure, and line measure-on the 3 input interaction devices-the Microsoft Kinect, the Leap Motion, and a mouse. Results. The Kinect shared similar accuracy with the Leap Motion for most of the tasks. But it had an increased error rate in the step-through task. The Leap Motion led to shorter task completion time than the Kinect and was preferred by the surgeons, especially for the measure tasks. Discussion. Our study suggests that hand tracking devices, such as the Leap Motion, should be used for intraoperative imagining manipulation tasks that require high precision.Inspiratory muscle training (IMT) and functional IMT (IMTF exercise-specific IMT activities) has been unsuccessful in reducing respiratory muscle fatigue following load carriage. IMTF did not include load carriage specific exercises. Fifteen participants split into two groups (training and control) walked 6 km loaded (18.2 kg) at speeds representing ∼50%V̇O2max in cold-hypoxia. The walk was completed at baseline; post 4 weeks IMT and 4 weeks IMTF (five exercises engaging core muscles, three involved load). The training group completed IMT and IMTF at a higher maximal inspiratory pressure (Pimax) than controls. Improvements in Pimax were greater in the training group post-IMT (20.4%, p = .025) and post-IMTF (29.1%, p = .050) compared to controls. Respiratory muscle fatigue was unchanged (p = .643). No other physiological or subjective measures were improved by IMT or IMTF. Both IMT and IMTF increased the strength of respiratory muscles pre-and-post a 6 km loaded walk in cold-hypoxia. Practitioner Summary To explore the interaction between inspiratory muscle training (IMT), load carriage and environment, this study investigated 4 weeks IMT and 4 weeks functional IMT on respiratory muscle strength and fatigue. Functional IMT improved inspiratory muscle strength pre-and-post a loaded walk in cold-hypoxia but had no more effect than IMT alone. Abbreviations ANOVA analysis of variance; BF breathing frequency; CON control group; EELV end-expiratory lung volume; EXP experimental group; FEV1 forced expiratory volume in one second; FiO2 fraction of inspired oxygen; FVC forced vital capacity; HR heart rate; IMT inspiratory muscle training; IMTF functional inspiratory muscle training; Pemax maximal expiratory pressure; Pimax maximal inspiratory pressure; RMF respiratory muscle fatigue; RPE rate of perceived exertion; RWU respiratory muscle warm-up; SaO2 arterial oxygen saturation; SpO2 peripheral oxygen saturation; V̇E minute ventilation; V̇O2 rate of oxygen uptake.