Factors Predicting Readmission to Inpatient Psychiatric Hospitals

Readmission to inpatient psychiatric hospitals within one year of discharge is approximately 40-50% (Bridge & Barb, 2004).  Given that most psychiatric conditions are characterized as having a chronic, relapsing course, readmission seems quite possible. Such prevalence and course of the illness indicates that readmission is a noteworthy concern, especially related to the impact on the patient’s life, as well as the cost on the health care system (Moss et al., 2014).  Additionally, readmission rates are often considered a quality of care indicator, reflecting the quality of care received while inpatient and the transition back to outpatient care (Simone, Taylor, Fung, & Kurdyak, 2013).  Consequently, readmission is often perceived negatively, at times a failure, in that the goal of discharge is for the patient to successfully reintegrate into the community.  Thus, understanding factors associated with readmission is vital and hopefully associated with the development of preventive measures.


This review will discuss findings from two studies, one conducted by Moss et al. (2014) in examining readmission over a period 180 days, and the other conducted by Callaly, Hyland, Trauer, Dodd, and Berk (2010) examining rapid readmission over a period of 28 days.


Moss et al. Review
Moss et al. (2014) conducted a study to determine predictors of readmission to a general psychiatry inpatient unit.  They note that given the deinstitutionalization of mental health care, hospital stays are often shorter and readmission is noted to be an indicator for future admissions.  In their literature review, Moss et al. indicated that history of previous admissions, length of stay, the presence of a psychiatric illness, substance abuse, personality disorder diagnosis, medical comorbidity, male gender, marital status, homelessness, unemployment, and first involuntary admission are all significant predictive factors for readmission.  Also, specific to service-related factors, access to follow-up care, community support, and being discharged against medical advice were predictive of readmission.


Purpose and Methods
Moss et al.’s (2014) study conducted a retrospective review of inpatient data over a 30 month period between 2006 and 2008 at a 35 bed teaching hospital.  They restricted readmission to within 180 days from the initial admission date.  The assessment instrument, Minimum Data Set-Mental health (MDS-MH), was administered upon admission and prior to discharge.  The MDS-MH collected data on 135 variables to capture demographic, health, and service related information.  Data from patients admitted during this time period were followed for 180 days monitoring for readmissions; resulting in identification of 758 (minus exclusions) discharges, with 190 patients diagnosed (DSM-IV criteria) with Schizophrenia and related disorders and 387 diagnosed with mood disorders.


Analyses and Results
A Cox regression analysis was used to analyze variables associated with time to readmission and possible covariates.  Based on the literature, Moss et al. (2014) identified variables as possible predictors:  age at admission, diagnosis of schizophrenia and related disorders, level of education, marital status, length of stay, gender, diagnosis of a personality disorder, substance abuse disorders, Global Assessment of Functioning (GAF) at discharge, maximum number of alcoholic drinks in one sitting, employment, income insurance assistance, history of ER visit, vocational, history of violence, number of psychiatric admission in past two years, and receiving a pass.


Within this sample, 21% (159) were readmitted within 180 days of discharge.  The sample was predominately male (45.3%), with an overall mean age of 39.6 (SD = 20.7).  The mean length of stay was 19.3 (SD = 21.2) days.  Covariates associated with time to readmission were receiving a pass, having one to two admissions in the past two years, and more than three psychiatric admissions in the past two years.  Other variables were not found to be significant.  In post hoc analyses, statistics indicate that the groups that did and did not receive a pass were not significantly different respective of diagnoses, but those with passes consisted of more men, longer lengths of stay, and higher GAF scores.


Overall, results indicate that previous admissions were associated with readmission, in that patients with one to two admissions within the past two years were 15.6 times more likely to be readmitted, and those with greater than three admissions in the past two years were 24.2 times more likely to be readmitted.  Also, patients receiving a pass were 3.5 times more likely to be readmitted.  Though rationale for issuing passes are variable (i.e., ease transition back into the community, assess readiness for discharge), the literature suggests that the efficacy of such a practice is not well supported (Moss et al., 2014).  Unfortunately, the authors note that the use and purpose of the passes with these patients were unknown; however, Moss et al. (2014) contend that “the use of a pass does not fully mitigate the influence of these other factors” (Moss et al., 2014. P. 429).  Of note, they indicate the upon discharge participation in service related treatment was also unknown, which in the past has shown to significantly influence readmission.  Also, contrary to the literature, many factors previously associated with readmission were not significant in this study.  Concerning these findings and compared to the literature, Moss et al. (2014) conclude that specific predictive factors are not consistently associated with readmission.  Overall, previous admissions and use of passes prior to discharge were predictors of readmission at the facility sampled.


Callaly et al. Review


Purpose and Methods
Callaly et al. (2010) examined personal characteristics, characteristics of the initial admission, as well as characteristics of follow-up care after the initial admission to identify patients at high risk for readmission.  Their reference period for readmission was 28 days, for which same-day admissions were excluded.  The population for the study was from an integrated community and acute inpatient hospital with 20 adult beds for psychiatric admission.  During the period of the study (2005-2006) there were 635 admissions, with a 12% to 13% readmission rate.  Callaly et al. (2010) examined 26 variables associated with increased rapid readmission; though all variables were not listed, those selected were said to be consistent with the literature, as well as inclusive of data obtained from the Health of the Nation Outcome Scales (HoNOS) and information regarding follow-up care.  The sample consisted of 54 patients with consecutive readmission and 61 patients chosen at random of whom were not readmitted.  Data were analyzed through simple comparison and logistic regression.


The trend of readmission indicated that of the patients who were readmitted, 45% were readmitted within 7 days, 68% readmitted within 14 days, and 91% readmitted in 21 days.  Comparison data between the readmitted group and the non-readmitted group indicated that patients who were readmitted were more likely to have had an admission the previous year, were more likely to be on Disability support, and were less likely to have had a discharge plan in place.  Further, patients who received follow-up care within seven days were more likely to be readmitted.  A notable data trend was that patients with Borderline Personality Disorder or who were unemployed were more likely to be readmitted.  The authors note no significant difference between the groups respective of sex, discharge facility, age on onset for psychiatric care, and recent history of substance use or criminal involvement.   There were also no significant differences in HoNOS scores between groups.


Of the variables examined, seven factors that were significantly (or nearly significant) different between the two groups were entered in to a multiple logistical regression analysis.  Results indicate that the number of previous admissions, having no discharge plan in place or sent to the patient’s general physician, and contact with community mental health within seven days were associated with early readmission.  Finally, to examine the relationship further, these results were entered into a forward stepwise regression, which again indicated that number of admissions in the previous year, no discharge plan being sent, and contact within first seven days after discharge were all significant predictors of rapid readmission.


The authors note that low treatment efficacy within the inpatient setting, poor discharge planning, and inadequate follow-up care may contribute to early readmission.



Unfortunately, the literature specific to identifying predictors for readmission are at times contradictory, and may be specific to the setting or region being studied.  Overall, the most consistent and strongest predictor in Callaly et al. (2010) was the number of prior admissions.  They highlight the importance of discharge planning, in that more preparation, especially for those with previous admissions, may be beneficial to the patient. Even still, the factors associated with rapid readmission are complex; and consequently, the interrelatedness of the factors associated with readmission may reflect reasons for rapid relapse.  In short, the authors recommend to further examine after care of those who are not readmitted in order to identify factors associated with readmission of comparable others.


General Conclusion
As noted by both sets of authors, readmission to a psychiatric facility is complex and multidimensional.  The literature indicates many potential factors are associated with readmission, but as Moss et al. (2014) and Callaly et al. (2010) both note, the findings are at times contradictory.  It appears that significant differences within the literature are related to diverse service characteristics and divergent sample characteristics being studied.  Therefore, differences create unique and perhaps limited generalizability of the findings, making it difficult to act proactively regarding preventative patient care.  The purpose of identifying predictive factors should be in regard to preventing readmission and providing the best care or after care for the patient.  For practical use, identifying factors within a comparable setting may be useful to understanding readmission patterns for a particular type of facility.


Overall, in both studies, and consistent with the literature, having previous hospital admissions increases the likelihood of readmission.  As noted by Callaly et al. (2010), examining discharge planning and after care may be necessary to direct intervention.  Yet, patient treatment compliance also becomes a critical factor, in that increased efforts for after care or discharge planning may be attempted, but ultimately rests on the participation of the client.  Even still, having the knowledge and awareness of potential high-risk patients for readmission may prompt practitioners to emphasize such trends upon discharge to the patient.   Finally, given the diverse findings throughout the literature makes it difficult to consistently identify factors associated with readmission.  Since readmission in not only detrimental to the patient but is often viewed as a quality indicator for the service provider, efforts to identify these variables should be continued.


Bridge, J. A., & Barb, R. P. (2004). Reducing hospital readmission in depression and Schizophrenia: Current evidence. Current Opinion in Psychiatry, 17, 505–511.

Callaly, T., Hyland, M., Trauer, T., Dodd, S., & Berk, M. (2010). Readmission to an acute psychiatric unit within 28 days of discharge: Identifying those at risk. Australian Health Review, 34(3),  282-228.

Moss, J., Li, A., Tobin, J., Weinstein, I. A., Harimoto, T., & Lanctoto, K. L. (2014). Predictors of readmission to a psychiatry impatient unit. Comprehensive Psychiatry, 55, 426-430.

Vigod, S. N., Taylor, V. H., Fung, K., & Kurdyak, P. A. (2013). Within-hospital readmission: An indicator of readmission after discharge from psychiatric hospitalization. Canadian Journal of Psychiatry, 58(8), 476-481.


Dannie S. Harris, M.A., M.A., M.A.Ed., Ed.S.
Practicum Trainee

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Friday Factoids: Making Better Choices with Holiday Food



With Thanksgiving behind us and the next holiday season coming up, many of us would like to avoid the extra pounds of holiday feasts! Psychcentral.com provided “5 Simple Steps to Avoid Overeating this Holiday Season.”


Acknowledging that most of us ignore our willpower over the holiday season, they created simple steps to help us make better choices with our food this holiday season.


These steps include:


1.  “Look at the food that is tempting you.” The author stated that looking at the food and recognizing that eating it is our choice is step number 1.


2.  “Imagine eating it.” He said that it’s okay to let your mouth water as you imagine eating and tasting the food, but make sure you keep going down these steps!


3.   “Now, imagine the food going down your throat and into your gut, where it will sit for the next several hours.” That thought might ruin the mouth watering! The author says to think about how your energy level will be and what your stomach will feel like after eating the food.


4.   “Ask yourself the question, “Do I want to feel how this food will make me feel?” Many of us struggle with mindless eating. We eat without thinking, which allows us to eat foods we wouldn’t normally eat and eat more than we would like to.


5.  “Make a choice.” If the answer to question 4 is “Yes” then go ahead! If the answer to question 4 is “No” it’s time to walk away.


The author stated that the purpose of this activity is to anticipate the feelings before you even eat the food. He wants us to think with our whole body (mind, stomach, taste buds) rather than just our taste buds.


He also highlighted that “self-sabotage” can be an issue for people and recommended this video to understanding self-sabotage and helping stop it!


Bundrant, M. (December 8, 2014). 5 Simple Steps to Avoid Overeating this Holiday Season. PsychCentral.com.


Brittany Best
WKPIC Doctoral Intern


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Friday Factoid: Vitamin D Has a Mental Health Connection


An article from U.S. News & World Report wrote about the importance of vitamin D and how our lives could depend on it! The article noted that some studies suggest that half of the world’s population has a vitamin D

deficiency. They went on to discuss the conditions to which vitamin D deficiency can lead including cancer, heart disease, multiple sclerosis, tuberculosis, brittle bones, the common cold, and depression. A study released in August noted a link between vitamin D deficiency and increased risk of developing Alzheimer’s. Furthermore, a study published this week even found a link between low levels of vitamins D and risk of early death. The article quoted John Cannell, found of the Vitamin D Council who stated, “Thirty-seven different tissues in the human body utilize vitamin D and need it for adequate functioning.”

How can you get enough vitamin D?


1.     The sun! Although the article stated that production of vitamin D from the sun


decreases with age and those individuals with darker skin need more sun exposure for sufficient levels of vitamin D. Furthermore, sunscreen decreases the production of vitamin D (Sunscreen is very important! There are other ways to get vitamin D. Read on!)


2.     Some foods: egg (especially egg yolks), fatty fish (e.g. salmon, mackerel, and tuna), fo


rtified cow’s milk, fortified cereals and bread products.


3.     Supplements. According to the article, 800 international units of vitamin D per day is typically advised. It is possible to take in too much vitamin D, so do your research!




Woodham, C. (November 20, 2014). Are you getting enough vitamin D? U.S. News & World Report Health.


Brittany Best,
WKPIC Intern



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Friday Factoids: Is the Internet Destroying Reading Habits?


Is the proliferation of technology and social media destroying the reading habits of young people?


It seems commonplace to assume that America’s younger generation has been inundated with technology driven efficiency to the extent of being devoid of the sustained attention and patience required to soak in a nice novel.  However, a recent Pew Research study piloted by Katherine Zickuhr and Lee Raine (2014) found that Americans ages 29 and younger were more likely to read a book in the past year than those ages 30 and older. When compared to their elders, Millennials possess similar reading habits, as nearly 43% of each group endorsed reading a book on a daily basis in the past year. Despite this, 88% of Millennials were found to have completed a book in the past year, compared to 79% of those older than age 29.


Reading a book via tablet has traditionally been a practice most prevalent within older generations; however, research now suggests that 37% of individuals between the ages of 18-29 read an ebook last year, a rate similar to those within their 30’s and 40’s. Adults ages 65 and older were the least likely to have read a book in the past year (67%), while teens ages 16-17 demonstrated the strongest reading habits, with 90% having read a book in the past year, and also reading books in print more than any other age group. Also interesting, people under 30 were more likely to say that there is “a lot of useful, important information that is not available on the internet.”


Based on these findings, it appears that the book, either print or electronic, is alive and well.



Zickuhr, K., & Raine, L. (September 10, 2014) Younger Americans and Public Libraries. How those under 30 engage with libraries and think about libraries’ role in their lives and communities. Pew Research Internet Project.


Graham Martin, MA
WKPIC Doctoral Intern

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Friday Factoids: That’s such great news! But why am I crying?

Discordant expressions of emotions, such as crying at a wedding, or laughing when one hears a sad story may actually play an important role in our psychological functioning. Yale researcher Oriana Aragon has been studying this phenomenon via experiments in her lab, and she posits that when people are at risk of being overwhelmed by their emotions, the outward display of the opposite emotional state functions to restore balance.


Our threshold for emotional intensity tends to vary, which is why some individuals are more prone to ill-fitting responses than others. This is why some, but certainly, and thankfully, not all, might be witnessed crying during a wedding. Adults possess a more highly developed capacity for emotional regulation, which is why children more often provide responses that signify discordant emotional expressions. This concept is vividly and hilariously depicted within 2011’s viral video of Lily being informed that she was going to Disneyland.


In her lab experiments, Aragon and her colleagues asked participants to imagine a scenario in which they were informed that they had just won the lottery. Most participants responded as one may expect, with intense expressions of joy. A smaller percentage of participants, however, responded to the news with facial expressions of sadness, and occasionally tears. More subtle demonstrations of discordant expressions of emotions were also witnessed in examining participants’ responses to pictures of infants. Common expressions of affection that highlight this phenomenon included, “I want to pinch those cheeks. That baby is so cute I want to eat it up.” Younger babies tended to elicit expressions of playful aggression more often when photographs of younger babies were presented. Furthermore, participants who displayed discordant emotional reactions via expressions of playful aggression also endorsed the tendency to cry when reuniting with a loved one.


Wray, H. (2014, November, 6). Nervous Laughter, Tears of Joy.


Graham Martin, MA
WKPIC Doctoral Intern

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Friday Factoid: The Power of Positive Thinking. . .with a Healthy Dose of Realism


Many of us have been advised to “think positive”, but is this platitude truly helpful? The ubiquity of such advice is undeniable, and its efficacy seems intuitively strong, but the bulk of research is now showing that optimism may actually serve as a hindrance. While a happy-go-lucky attitude may work wonders in reducing stress, it also depletes us of the energy we need to successfully pursue our goals.


Individuals who are particularly adept at imagining positive results fool their brains into reacting as if the positive outcome occurred in reality. This, in turn, slackens ones readiness to actively pursue his or her goals. Think of a time during which you felt particularly optimistic about an exam, only to feel confounded and ambushed on test day, earning a score far below that which you expected. Now think of a time during which you were notably anxious about an upcoming exam, with the potential for flunking ever salient. Such a pessimistic outlook, if entertained early enough, may have led to a great deal of studying and preparation in order to minimize the chances of receiving a failing grade, leading to a performance on the exam that far exceeded your expectations.


Acknowledging the notion that optimism and positive thinking might hinder performance does not, however, imply that negative thinking and pessimism is the optimal strategy for success. Rather, researchers have endorsed a hybrid theory which recommends blending positive thinking with a healthy dose of realism. This can be applied by spending a few minutes vividly imagining a wish coming true, followed by a few minutes imagining all of the potential obstacles that might get in the way. This process, referred to as mental contrasting (Oettingen, 2014), has produced powerful results in experiments, leaving participants feeling more energized and subsequently resulting in greater success, compared to groups tasked with positive thinking alone.


So the next time you are faced with a challenge, expect to succeed, but also prepare for the various contingencies that might get in your way. As Zig Ziglar famously stated, “Expect the best. Prepare for the worst.”


Oettingen, G. (2014, October 24). The Problem with Positive Thinking. Retrieved from nytimes.com .


Graham Martin, MA
WKPIC Doctoral Intern



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Friday Factoids: New iPhone or Famous Pancakes?




Last weekend I waited in line for an hour and a half to try the famous pancakes from The Pancake Pantry in Nashville, Tennessee. During my ample time to ponder, I wondered about whether or not such a long wait time would enhance or hinder my dining experience. Also while waiting in line, I noticed myself staring into the screen of my old iPhone, which is due for an upgrade.


Somewhat serendipitously, I came across an article this week on npr.com that addressed the concept of happiness, and whether or not it can be purchased. The article cited a growing body of research that suggests experiences tend to make people happier than the acquisition of material possessions, and referenced an article entitled Waiting for Merlot: Anticipatory Consumption of Experiential and Material Purchases that tracked 100 college students and more than 2,200 randomly selected adults in order to assess their feelings about material possessions compared to lived experiences. The findings suggest that, while people tend to feel excitement about both, they express more positive feelings about experiences. This is likely due to the creativity involved in planning and executing an experience, while making a new purchase tends to be more concrete. We know what to expect when we buy a new computer, because we have likely done the necessary research in order to make an informed purchase, but planning a vacation or an afternoon on the town tends to offer more fluidity and more anticipatory excitement.


As I waited in line, I engaged in a pleasant conversation with my girlfriend about what kind of pancakes to order, did some people watching, and my appetite and excitement seemed to grow as I inched ever closer to the dining area. In the end, I was more than satiated, and left the restaurant feeling better than I had when I arrived. More importantly, the memory of this experience gets better with each reflection, which cannot be said about recollections of past purchases. So when you ask yourself which experience might yield the most happiness, try to recall how you felt before and after waiting in line for that big Black Friday sale, versus how you felt before and after a great ride at Six Flags, or a delicious meal with friends.


Graham Martin, MA
WKPIC Doctoral Intern


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Article Review: Benefits and Challenges of Fun in the Workplace (Everett, 2011)



Results yielded by studies indicate that fun in the workplace may be an inexpensive and profitable method of engagement that directly correlates with higher rates of employee satisfaction and increased morale amongst employees, which in turn can positively affect products and customer service outcomes. Studies posit that younger employees desire more fun in the workplace than their older counterparts. Many managers and supervisors are realizing this, thereby attempting to create a more fun, playful, and creative work environment in order to boost employee happiness, and consequently, productiveness (Everett, 2011).


However, the consensus is far from unanimous, as other studies have yielded contradictive or more ambivalent results. Some studies postulate that creating a “fun” and playful workplace may be not be effective. While generational differences are part of the reason, personality differences play a part as well.  The simple fact is that there generally will not be a “fun” idea that pleases everyone. Bolton and Houlihan (2009) emphasize the important distinction between organic fun and manufactured fun. Manufactured fun is when the concept of fun becomes just that—a concept, which may be devoid of authenticity and earnestness. It is a sense of “fun” that feels contrived, forced, and ultimately transparent, as the company’s agenda is painfully obvious. Conversely, organic fun descends from a positive organizational culture, is adaptive, and has the ability to thrive in the most diverse of environments and atmospheres (Bolton & Houlihan, 2009). Everett (2011) notes that although it is often impossible to create a fun philosophy in the workplace that will be approved and heralded by every employee, the benefits gained from implemented fun in the workplace far outweigh the challenges.


Many organizations are in competition with one another to recruit and retain employees; thus an impetus is created, and an organization should shoulder the responsibility of creating policies and workplace philosophies that maximize the contentedness of its employees. This is especially true in the public and non-profit sectors, as employees often sought out the profession or chose that particular vocational trajectory for altruistic reasons or for reasons of wanting intrinsic fulfillment. These employees are often overworked, underpaid, and they feel woefully underappreciated. Everett cites Google as the gold-standard in successfully instituting a sense of fun in the workplace, stating that Google is rumored to receive more than 3000 applications per day as they have created a harmonious balance and integrative between work and play (Everett, 2011).


Everett (2011) posits that although infusing playfulness and fun into public and non-profit settings may be a challenging endeavor, it may be well worth the challenge as fun workplaces have a tendency to enhance learning and increase productivity and creativity, while reducing the potential for absenteeism and stress-related burnout. Workplace fun can help employees feel acknowledged, appreciated, and validated. Everett states that job satisfaction (or dissatisfaction) can affect life satisfaction.


Positive feelings towards one’s job can generate more positive feelings towards life in general; conversely, negative feelings towards one’s job can create the sense of more negativity in life. Many factors contribute to job satisfaction, such as wages, work relationships, the perception of supervisors, and maintenance of a fun, balanced work environment. A sense of fun and play in the workplace can be a viable mechanism that is utilized to establish trust, encourage creativity, and increase communication amongst everyone in the company. Everett (2011) also suggests that deregulating the work environment can be a vital in creating a more fun workplace, as it will provide opportunities for managers to better, more colloquially connect with subordinates, and establish a bond of relatedness. This can also atmospherically diminish the sense of looming hierarchical overtures, as supervisors may not be deemed as threatening or daunting (Ramsey, 2001). A playful atmosphere in the workplace goes beyond the actual acts of “fun.” For example, company picnics or casual Fridays are actually about creating an organizational culture, which can be defined as “the part of an organization’s internal environment that incorporates a set of assumptions, beliefs, and values that organization members share and use to guide their functioning” (Weinstein, 1996, pg. 31).


Research suggests that fun in the workplace does have a positive influence on customer service. A common example is Pike’s Place Market, in Seattle, WA, that prepares and sells fish. Instead of being the typical, malodorous fish market, the owners decided to inject a sense of fun and play in the equation, and it has become a very popular tourist destination (Ramsey, 2001). Many other companies, from banks, retail stores, and corporate headquarters, have instituted fun philosophies in the workday. For example, Gymboree, a children’s clothing store, participates in twice weekly “recess,” in which employees have snack time and get to play outside at the on-campus lagoon. A bank in Missouri has incorporated a weekly, 30-minute game of Charades into their schedule. These things may seem trivial or irrelevant, but they have boosted employee morale (Everett, 2011).


Fun is a conceptually ambiguous construct, and can vary dramatically depending on perspective. Managers/supervisors first need to understand their employees before beginning to determine what constitutes a fun policy. Generational identity, socioeconomic background, and the organizational culture can increase the sense of ambiguity, as it inflates the proportion of potential variance.


A major factor that contributes to how workplace fun is perceived is what is known as a generational identity. Everett states that up to four different generations can coexist in the workplace at any given time. Studies suggest that a generational identity begins early in life. In theory, people born in a certain era will develop unique values, work ethics, personalities, and beliefs. They will view the nature and function of the workplace different than those in a different generational cohort (Boltan & Houlihan, 2009). The “Baby Boomer” generation (born between 1941 and 1960) are thought to be naturally competitive; consequently, they may perceive workplace fun as antithetical to the purpose of work and counterproductive to their competitive edge. Generation X employees (born between 1961 and 1981) prefer a balance between work and play. This group tends to value fun, informality, and creativity; many of them are neutral about fun in the workplace, and many view it as a benefit. Generation Y employees (born between 1981 and 2000), also known as Millennials, are thought to have been “coddled and coached by their apologetic parents, leading to the development of strong ambition, over confidence, high achievement orientation, and a narcissistic outlook.” (Everett, 2011, page 5). While Generation X employees may view fun as a benefit, Generation Y employees exhibit a tendency to view it as a requirement. However, it appears that many of the differences between the generational cohorts have been disappearing as different generations simultaneously acclimate and assimilate to the specific culture of their workplace (Biggs, 2007; Boltan & Houlihan, 2009).


In a lifetime we will spend more than 90,000 hours in the workplace–this is too much time to not have fun! A sense of fun/playfulness on the job can augment employee motivation, increase customer support, reduce stress, increase productivity, and increase customer satisfaction. In fact, many companies have already reported increases in both productivity and customer satisfaction as a result of incorporating a fun philosophy in the workplace (Everett, 2011).




Biggs, S. (2007).  Thinking about generations: Conceptual positions and policy implications. Journal of Social Issues, 63.


Bolton, S.C., and Houlihan, M. (2009). Are we having fun yet? A consideration of workplace fun and engagement. Employee Relations, 31, 6.


Everett, A. (2011). Benefits and challenges of fun in the workplace.  Library Leadership and Management, 25, 1.


Ramsey, R. (2001). Fun at work: Lessons from the fish market. Supervision, 62, 4.


Weinstein, M. (1996). Managing to have fun. New York: Simon & Schuster.



Faisal Roberts, MA
WKPIC Doctoral Intern







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Friday Factoids: Getting Up-To-Date Info on Medications



Where do YOU look up information about prescription medications? Wikipedia is the most used resource around the world! Google and WedMD are also popular and about half of all Americans uses them. Unfortunately, these websites are not always accurate and up-to-date online resources.


A study called “Drug Safety in the Digital Age” that was published in the New England Journal of Medicine examined the reliability of drug information found on these commonly viewed sites on the Internet. The study looked at how quickly these sites are updated after the FDA issues a safety warning about a particular drug. They specifically looked at 22 prescriptions drugs over a 2-year timeframe.


They concluded that more than 1/3 of Wikipedia pages were updated within 2 weeks; however, 23% were updated in over 2 weeks and more than 1/3 were not updated more than a year later. The average length of time was 42 days.


The article stated that FDA.gov is the best resource for accurate and updated information. A caution that the article noted stated, “Currently, safety communications are housed on the Med-Watch portal, whereas electronic drug labels containing information on efficacy, dosage, and contraindications are located in the Drugs@FDA database – and there is no obvious link between these two resources.” For Twitter users, FDA also has two Twitter accounts (@FDA_Drug_Info and @FDAMedWatch).


Generally, the study suggested that people cross-reference information that they find with credible resources.


Gupta, Saarik. (2014, October). How reliable is the drug info you find online? CNN Health.


Brittany Best, BA
WKPIC Doctoral Intern



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Friday Factoids: Can Drinking Soda Accelerate Aging?



A recurring story throughout news websites this week is a study about a link found between sugar-sweetened soda/pop and aging. The study published in the American Journal of Public Health found that individuals who drank pop frequently generally had shorter telomeres in their white blood cells than did individuals who did not drink as much pop. Telomeres are found at the end of chromosomes and are critical in cell division. The length of telomeres is believed to be linked to the health of the cell. Researchers believe that shorter telomeres indicate that an individual is less healthy and aging faster.


The study noted that telomere length did not appear to be affected by consumptions of diet pop or 100% fruit juices.  The study also reported that their results indicated 1 in 5 adults drink a 20-ounce pop daily and found that this consumption “could equal 4.6 years of extra aging.”


Simply put, this means that they found a link between sugar-sweetened pop and premature aging in some cells in the body, which, according to the article, puts individuals at risk for diabetes, heart disease, and stroke. This article compared the premature aging from drinking pop to that seen in individuals who smoke.


How much sugar is safe? The American Heart Association recommends limiting added sugar to no more than 150 calories a day for men and 100 calories a day for women (one 12-ounce can of regular pop has between 140-170 calories and about 40 grams of sugar).


Kimball, Henry. (2014, October). That sweet drink may age you. CNN Health.


Brittany Best, BA
WKPIC Doctoral Intern



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