Causes and effects of employee downsizing a review …
Critical appraisal criteria were adapted from the systematic review methodological literature and existing systematic reviews of complex interventions.,,, Data were abstracted by one reviewer (ST) and checked by another (ME). We calculated effect sizes and 95% confidence intervals (CIs) where possible, but it should be noted that these sometimes differed from p values reported in the original articles, possibly because our calculations relied on summarised final sample size data reported in journals, rather than original datasets. Heterogeneity in interventions, study designs, comparison groups, outcome measures and reporting of data made meta‐analysis and comparisons of effect sizes between studies problematic. Therefore, we used narrative synthesis: categorising and tabulating data by intervention type, methodology, setting and outcome, and describing studies in a narrative that emphasised more methodologically robust (e.g. prospective, controlled) studies.,,,
and Effects of Employee Downsizing: A Review ..
Drug testing programmes create special responsibilities for those employers who undertake them (New York Academy of Medicine 1989). This is discussed more fully under "Ethical Issues" in the Encyclopaedia. If employers rely on urine tests in making employment and disciplinary decisions in drug-related cases, the legal rights of both employers and employees must be protected by meticulous attention to collection and analysis procedures and to the interpretation of laboratory results. Specimens must be collected carefully and labelled immediately. Because drug users may attempt to evade detection by substituting a sample of drug-free urine for their own or by diluting their urine with water, the employer may require that the specimen be collected under direct observation. Because this procedure adds time and expense to the procedure it may be required only in special circumstances rather than for all tests. Once the specimen is collected, a chain-of-custody procedure is followed, documenting each movement of the specimen to protect it from loss or misidentification. Laboratory standards must ensure specimen integrity, with an effective programme of quality control in place, and staff qualifications and training must be adequate. The test used must employ a cut-off level for the determination of a positive result that minimizes the possibility of a false positive. Finally, positive results found by screening methods (e.g., thin-layer chromatography or immunological techniques) should be confirmed to eliminate false results, preferably by the techniques of gas chromatography or mass spectrometry, or both (DeCresce et al. 1989). Once a positive test is reported, a trained occupational physician (known in the United States as a medical review officer) is responsible for its interpretation, for example, ruling out prescribed medication as a possible reason for the test results. Performed and interpreted properly, urine testing is accurate and may be useful. However, industries must calculate the benefit of such testing in relationship to its cost. Considerations include the prevalence of drug and alcohol abuse and dependence in the prospective workforce, which will influence the value of pre-employment testing, and the proportion of the industry's accidents, productivity losses and medical benefit costs related to the abuse of psychoactive substances.
More robust evidence is required, but the findings from this review remain broadly compatible with the UK Department of Health's view that increasing employee control is a key task for policy‐makers. We found that health improvements (e.g. improved mental health and reduced sickness absenteeism) may sometimes result from such interventions. The only negative health effects were reported in two uncontrolled studies that may have been confounded by organisational downsizing., Qualitative evidence suggests that job insecurity and communication barriers associated with workplace hierarchies may hinder participation interventions.