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PubMed2006

Improving motivation among primary health care workers in Tanzania: a health worker perspective.

In Tanzania access to urban and rural primary health care is relatively widespread, yet there is evidence of considerable bypassing of services; questions have been raised about how to improve functionality. The aim of this study was to explore the experiences of health workers working in the primary health care facilities in Kilimanjaro Region, Tanzania, in terms of their motivation to work, satisfaction and frustration, and to identify areas for sustainable improvement to the services they provide. The primary issues arising pertain to complexities of multitasking in an environment of staff shortages, a desire for more structured and supportive supervision from managers, and improved transparency in career development opportunities. Further, suggestions were made for inter-facility exchanges, particularly on commonly referred cases. The discussion highlights the context of some of the problems identified in the results and suggests that some of the preferences presented by the health workers be discussed at policy level with a view to adding value to most services with minimum additional resources.

Journal Article↗

PubMed1976

Analysis of medical records of workers and the role of their occupational doctor. Report 1. A study on some impacts of aging of workers according to their health records.

The new "Occupational Safety and Health Act" was established in October 1972. According to the Act, the employers with 50 and more employees were bound to make an occupational health doctor provide health care for the employees within the enterprises. Considering the national background mentioned above, the author examined the actual status of the medical and health care services in order to discuss the professional function of an occupational health doctor by reviewing the records concerning the workers' health at a certain paper factory managed by the National Government, under the Government Health Insurance scheme. The results were as follows: 1) Aging of the workers had an important impact on medical service and health care provided. 2) The medical service by the occupational doctor attached to the factory differed much from that by other medical institutions outside the factory in several points; particularly in days of receiving medical consultation, medical expenditure expressed in "point score," number of injections given and the frequency of laboratory examinations. 3) as a whole, the occupational health doctor was taking a role as "the first contact doctor" in primary medical care, as well as a health officer preventing disease and promoting health in the factory, whereas the medical institutions outside the factory were rather clinically oriented in treating ill-health.

Adolescent↗

PubMed2005

[Use of complementary and alternative medicines among factory workers: investigation of workers in manufacturing].

To elucidate the situation of complementary and alternative medicines (CAM) in an occupational health setting, workers in a factory of a housing construction business were surveyed using self-administered questionnaires on their utilization of CAM in the past 12 months, out-of-pocket expenditures on CAM and ordinary western medicines (OWM), and reasons for the use of CAM. A total of 263 workers (84.3%) completed the questionnaires. Among them, 134 (51%) had received CAM therapy in the last 12 months: i.e. nutritional and tonic drinks (35.4%), supplements (16.3%), massage (13.7%), chiropractic or osteopathy (8.7%), health-related appliances (6.5%), herb or kampo (3.4%), aromatherapy (1.9%), acupuncture (1.9%), or other therapy (1.5%). Reasons for the use of CAM was "the condition was not serious enough to warrant OWM" and "expectation of health promotion or disease prevention" for 70 (51.9%) and 53 (39.3%) subjects, respectively. Average annual out-of-pocket expenditures for CAM and OWM were 17,500 and 21,300 yen, respectively. It seems important to further widen awareness and knowledge of CAM in occupational health.

Adult↗

PubMedDate not supplied

[Burnout in nursing workers: relationship between nursing work and workers' health].

The study aims the understanding of the process health-illness, as it is experienced by nursing workers in the acting of its work, being bases in the social determination of that process. It evidences the particularities of the relationship between labor and health of a concrete reality. The adopted methodology permitted to establish the link between the valorization process, work process, loads and strain. This relationship of determination permit to show the unhealthy profile of those nursing workers. The sharp accidents, bones, muscles and joint diseases are characteristics damages of in this profile.

Burnout, Professional↗

PubMed2002

Case studies of violations of workers' freedom of association: migrant agricultural workers.

As part of its report "Unfair Advantage: Workers' Freedom of Association in the United States under International Human Rights Standards," Human Rights Watch conducted a series of case studies in a dozen states, covering a variety of industries and employment sectors, analyzing the U.S. experience in the light of both national law and international human rights and labor rights norms. Presented here are the case studies of migrant agricultural workers.

Agriculture↗

PubMed2002

Case studies of violations of workers' freedom of association: manufacturing workers.

Civil Rights↗

PubMed1975

[Transcultural aspects of the clinical-psychiatric pictures of foreign workers (guest workers) and their significance for neurological practice].

Referring to a previous clinical and sociopsychiatric investigation on 130 foreign workers, the transcultural psychiatric factors determining forms and contents were studied. It is stressed that remains of magic thinking and rigid tribe-centered sociocultural structures are the main factors, in addition to the beginning of the loosening of these structures accompanied by initial assimiltion of occidental ways of life in the homeland, and integrational crises through collision of Old and New after immigration. Atypical psychosis, outweighting affective and somatic factors, obliteration of the limits between classic etiological units, and the possibility of confounding magic contents with psychosis are illustrated by case histories. New criteria for diagnosis and therapy of foreign workers are suggested.

Adjustment Disorders↗

PubMed1976

Prevention of bony fluorosis in aluminum smelter workers. A 15-year retrospective study of fluoride excretion and bony radiopacity among aluminum smelter workers -- Pt. 4.

1. Fifty six aluminum smelter workers with 10 to 43 years' occupational exposure, and who had been previously studied medically, were re-x-rayed. Average urinary fluoride concentrations since 1960 were estimated to range from 2.78 mg/liter preshift and 7.71 mg/liter postshift. 2. Roentgenographic studies in 1960-66 and 1974 failed to reveal any evidence of fluoride associated bony change. 3. Although these workers represent a self-selected group, their magnitude and duration of exposure far outweighs any other group working at present or in the past at this plant. The implication that they have uniformly self-selected as fluoride resistant individuals is improbable. 4. These data indicate that group post-shift ur a long period is not associated with enhanced risk of bony fluorosis. If preshift urinary fluoride concentrations are less than 4 mg/l, the same results appears to apply.

Adult↗

PubMed2004

Prevalence of antibodies to hantavirus among family and health care worker contacts of persons with hantavirus cardiopulmonary syndrome: lack of evidence for nosocomial transmission of Andes virus to health care workers in Chile.

Nosocomial transmission of Andes virus has been documented in Argentina, but has not yet been proven in Chile. We studied 215 contacts (106 family member contacts and 109 health care worker contacts) of 20 index cases of hantavirus cardiopulmonary syndrome (HCPS) in Chile. The seroprevalence of IgG antibodies against Andes virus was 1.9% (95% confidence interval [CI] = 0.34-6.3%) among the family members and 0.0% (95% CI = 0-3.2%) among the health care workers. Our data suggest that there is no evidence for nosocomial transmission of Andes virus in region IX of Chile.

Adult↗

PubMed2004

[Mechanisms of respiratory system lesions in chemical plant workers of the environmental protection department in comparison with workers of pesticide producing departments].

In chemical plant workers producing pesticides chronic bronchitis and disturbed pulmonary ventilation are frequent. The aim of the examination of the staff (sewage-treatment plant, waste combustion plant, waste storage, industrial water pumping station)--16 males aged 21-53 years--was to assess: 1. Connective tissue metabolism--serum concentration of type I and III procollagen propeptides, collagen I telopeptide, hydroxyproline, alpha1-AP and alpha2-M antiproteases, interstitial collagenase (MMP-1) activity, as well as urine hydroxyproline and desmosine. 2. Free radical damage--serum malonic dialdehyde (TBARS) and ceruloplasmin concentration, erythrocyte antioxidant enzymes activity (SOD, catalase, GPx, GR), and neutrophils myeloperoxidase reaction. 3. Humoral (serum IgG, A and M, C3 complement component and the circulating immune complexes) and cellular (percentage of CD3, CD4 and CD8 lymphocytes) immunity rates. As compared to controls the following changes were found: 1. decreased MMP-1 activity and increased alpha2-M serum concentration; 2. increased erythrocyte SOD and GPx activities; 3. decreased percentage of T lymphocytes (CD3), increased serum concentration of the C3 complement component and the circulating immune complexes. The results were compared with those in workers of the departments producing liquid pesticides, dust pesticides and chlorfenvinphose, the changes of the investigated parameters were found to be less expressed.

Adult↗

PubMed1981

A method for monitoring the fertility of workers. 2. Validation of the method among workers exposed to dibromochloropropane.

A method has been developed for monitoring industrial workers and others exposed to environmental agents which may impair fertility. National birth probabilities specific for maternal birth cohort, age, parity, and race are used to derive expected fertility. Observed fertility is obtained by questionnaire. Standardized fertility ratios are computed for exposure and non-exposure periods and compared. The analytic techniques have been validated by applying the method to a group of 36 male factory employees working in an agricultural chemical division (ACD) where pesticides including the nematocide dibromochloropropane were formulated. Twelve of these employees in mid-1977 had been discovered to have severely depressed sperm counts related to occupational exposure. The standardized fertility ratio (SFR) computed from data available in mid-1977 for the period at risk from employment in the ACD (SFR = 0.75) was significantly lower than those derived for the entire not-at-risk period (SFR = 1.88) and the portion related to employment in other areas of the factory (SFR = 2.16). Similar differences also were evident from data available several years earlier, demonstrating that the surveillance technique would have been capable of detecting occupationally induced infertility among these workers in advance of the actual discovery date.

Antinematodal Agents↗

PubMed1978

Older workers uninsured for retired-worker benefits.

This article estimates the number of persons who have worked in employment covered by the social security program but not enough to meet minimum requirements for retired-worker benefits. On the basis of a sample of persons near retirement age in 1973, it was found that about 70 percent of these persons are women, that they have worked an average of about 8 quarters, and that many of those ineligible have had no work in covered employment since 1950. An estimated 12 percent of men and 29 percent of women aged 57--64 in 1973, with some covered employment in the period 1937--73, will be ineligible for retired-worker benefits. When only those with more recent covered employment are considered, the percentage ineligible declines. Thus, of those who have worked since 1950, 6 percent of the men and 20 percent of the women will not qualify.

Age Factors↗

PubMed1990

Evaluation of a village health worker programme: the use of village health worker retained records.

A village health worker (VHW) programme in a rural area in South Africa is evaluated, a year after the introduction of VHW-retained child record cards. The programme's success in promoting immunization and breastfeeding and the coverage of and contact with the community by the VHWs was investigated. A population survey on children under one year was matched to VHW records, showing that VHWs were reaching 70.8% of the target population. VHWs were more likely to visit a child with a Road to Health Card (RTHC) and who was born in the village. VHWs generally visit mothers once a month and make contact with most children in their first month of life. Children born before the start of the new VHW programme were compared with those born after, using survival analysis techniques and data from the RTHC on the first year of life of all children under two. An increase in polio immunization coverage was detected but there was a drop in measles immunization coverage. We conclude that a VHW-retained child record for the first year of life plays a valuable role in ongoing health care evaluation.

Breast Feeding↗

PubMed2000

Years of productivity lost among injured workers in Washington state: modeling disability burden in workers' compensation.

BACKGROUND: Few studies have examined the impact of disability from nonfatal work-related injuries and illnesses. We developed Years of Productivity Lost (YPL) as a measure of the burden of disability. METHODS: YPL was calculated for incident workers' compensation claims with compensable injuries filed in 1986 in Washington State. Final work disability status was determined in June, 1993. We estimated YPL by adding actual accumulated time loss and future lost productivity predicted from permanent partial disability awards and pensions. RESULTS: Back and neck sprains were associated with the highest YPL followed by sprains of the lower and upper extremities. Using actual accumulated time loss, we calculated 14,624 years of productivity lost for compensable injuries in 1986. After including predicted lost productivity, YPL ranged from 28,017 to 33,502 years. CONCLUSIONS: YPL can be used to quantify the burden of disability due to occupational injuries and illnesses and to prioritize efforts to prevent long-term disability.

Absenteeism↗

PubMed2000

The impact of occupational injury on injured worker and family: outcomes of upper extremity cumulative trauma disorders in Maryland workers.

BACKGROUND: Surveys have identified a dramatically rising incidence of work-related upper extremity cumulative trauma disorders (UECTDs). Outcome studies have addressed time lost from work and cost of compensation; omitting other significant consequences. We assess health, functional and family outcomes. METHODS: We identified 537 Workers' Compensation UECTD claimants. A computer-assisted telephone questionnaire was used to elicit symptom prevalence, functional impairment, depressive symptoms (CES-D scale), employment status. RESULTS: One to 4 years post-claim, respondents reported persistent symptoms severe enough to interfere with work (53%), home/recreation activities (64%) and sleep (44%). Only 64% of responses to the activities of daily living scale items indicated "normal" function. Job loss was reported by 38% of respondents, and depressive symptoms by 31%. CONCLUSIONS: Work-related UECTDs result in persisting symptoms and difficulty in performing simple activities of daily living, impacting home life even more than work. Job loss, symptoms of depression, and family disruption were common.

Activities of Daily Living↗

PubMed2004

The art of directing a workers' compensation claim: personal observations on the role of the workers' compensation claim adjuster.

Workers' compensation claims are becoming more complex and expensive every day. One of the contributing factors for the increase is the aging workforce as well as federal legislation such as the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). The workforce is aging, mobile, and educated about their rights. The key to avoiding spiraling costs is a strong safety and claims program that is sponsored by senior management,valued by the employees, and implemented by the entire company.

Eligibility Determination↗

PubMed1994

A shotgun marriage--community health workers and government health services. Qualitative evaluation of a community health worker project in Khayelitsha.

In 1988 the Western Cape Regional Services Council (RSC) initiated a community health worker (CHW) project in Khayelitsha in order to extend its preventive services to people in the community and promote 'community upliftment'. An evaluation of this project was undertaken in 1991 and 1992 in order to examine the potential of this local health authority-run CHW project to be an appropriate primary health care model. Qualitative research methods were used to explore the nature of the work done by the CHWs, whether they were accepted in their communities, and whether the project functioned as part of an integrated health service infrastructure in Khayelitsha. The CHWs were found to provide the basis for a potentially effective, community-responsive service. However, several structural problems mitigated against this service. Relations between the CHWs and nurses in all the formal public health services in the area were superficial and fraught with problems. There were significant differences and conflicting policies between the RSC's CHW project and other neighbouring non-government CHW projects, and these posed various threats to both the RSC and the non-government projects. One of the most serious of these differences was that the RSC project had no structures or plans for community involvement in the running of the project. Before a CHW project is initiated, several critical issues need to be carefully considered and discussed with all the relevant stakeholders. Furthermore, CHWs need to be flexible, and accountable to the communities in which they work. Before employing CHWs, formal public health authorities need to consider carefully whether they are able to meet these criteria.

Community Health Services↗

PubMed1986

Epidemiologic studies of Scottish oil shale workers: II. Lung function in shale workers' pneumoconiosis.

In a case control study of 122 ex-shale workers, half of whom had simple pneumoconiosis and half of whom did not, those with pneumoconiosis were found to have the poorer lung function. Significant reductions in forced expiratory capacity (FEV1), forced vital capacity (FVC), Vmax50, lung volumes, and carbon monoxide transfer were found in men with pneumoconiosis. It is suggested that these abnormalities may represent a mixture of pulmonary fibrosis and airways obstruction related to exposure to dust and fumes in shale mines and at shale retorts.

Age Factors↗