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PubMed1979

Use of drugs for malaria control in tropical Africa.

At present, in countries of tropical Africa, chemotherapy is the main and often the only operationally, administratively, and financially feasible method of malaria control. This applies particularly in rural areas. This article reviews experience with chemotherapy in Africa since the late 1940s with mepacrine, proguanil, pyrimethamine, chloroquine, amodiaquine, and sulfones and sulfonamides in combination with dihydrofolate reductase inhibitors. Chloroquine has proved to be the most effective compound and it is the drug of choice as long as malarial parasites remain susceptible to it. Because of reports from East Africa of strains of Plasmodium falciparum resistant to 4-aminoquinolines, it is essential that national and regional policies be developed for the rational use of antimalarials.In most of the countries, the scope of activities is still limited to the administration of antimalarial drugs to sick persons through a limited network of health institutions. In some countries, however, attempts have been made to extend the coverage of drug administration by involving voluntary collaborators or through the provision of suppressive treatment to vulnerable groups of the population (such as infants, young children, pregnant women, nursing mothers, and schoolchildren) but the efficacy of such methods depends on the degree of involvement of voluntary collaborators, primary health workers, and communities.

Africa↗
PubMed2004

Blood lead levels of the battery and exhaust workers and their pulmonary function tests.

In an attempt to understand the impact of inhaled lead on the pulmonary functions, we assessed the blood lead levels and pulmonary functions of the battery and exhaust workers who are potential candidates for lead inhalation. The hospital staff served as control group. The measurements of lead levels were performed using atomic absorption spectrophotometry. Pulmonary function tests (PFTs) were performed using a portable spirometer. The blood lead levels of the battery workers, exhaust workers and controls were found to be 36.83, 26.94 and 14.81 microg/dl, respectively. The values of the workers were significantly higher than the controls (p < 0.001). The lead levels of the battery workers were also significantly higher than the exhaust workers (p < 0.001). PFT results (maximum voluntary ventilation, forced expiration flow and first forced expiration volume values of the workers) were significantly worse than the controls, and their pulmonary function test results were consistent with restrictive problems in the airways.

Adult↗
PubMedDate not supplied

Prevalence of hepatitis B virus infection in healthy persons in North India.

BACKGROUND: There is scant information on the main methods through which hepatitis B virus infection is transmitted in India. We, therefore, studied the prevalence of hepatitis B surface antigen and antibody to hepatitis B surface antigen in voluntary blood donors as well as in those healthy groups who have a high risk of contracting this infection. METHODS: The groups at risk studied included commercial sex workers (635), eunuchs (28), truck drivers (217), professional blood donors (1117) and health care workers (1313). In addition, 20,435 voluntary blood donors were also studied. RESULTS: Hepatitis B surface antigen (and its antibody) was positive in 2.6% (14%) of voluntary blood donors, 3.6% (19%) of commercial sex workers, 5% (16%) of truck drivers, 12% (9%) of professional donors, 1.4% (19%) of health care workers and none (18%) of the eunuchs. Except professional donors and truck drivers, none of these groups had a higher positivity than the normal population (2.6%). CONCLUSIONS: Our results indicate that in India the so-called high risk groups, other than truck drivers and professional blood donors, are unlikely to represent major sources of infection.

Adult↗
PubMed1970

Social case-work in general practice: an alternative approach.

During a two-year period a senior case-worker was seconded by a voluntary family case-work agency, the Liverpool Personal Service Society, to work with three general practitioners. The commonest reasons for referral of the 157 new patients to the social worker over this study period were extreme poverty; housing, matrimonial, and psychiatric problems; and problems of fatherless families. The successful and valuable co-operation between the general practitioners, case-worker, and various specialist professional and financial services of the Society have proved that a professional social worker has an important role in the general-practice team.

England↗
PubMed2003

Social insurance claims as morbidity estimates: sickness or absence?

Historians have closely examined sickness claims by members of British friendly societies. Hoping that insurance records may offer insight into past health conditions, they have generally found that sickness rates increased as mortality rates declined. Aggregated fund level data from a variety of continental sickness insurance programmes from 1885 to 1908 cast doubt on this research strategy. Mortality rates fell among all funds with available data, but absenteeism trended in both directions in different groups of sick funds. Among funds that took in workers who were required to buy sickness insurance, absenteeism rose over time. Among funds in which membership was voluntary, absenteeism fell. To explain these differing trends, I note that voluntary funds attracted older and sicker workers and that the resulting financial problems made it difficult for them to pay out benefits. Social insurance claim records are so heavily influenced by governmental requirements and financial concerns that they may be better understood as records of worker absence rather than of morbidity.

Cost of Illness↗
PubMed1955

The health problems of old workers.

With the growing number of old people in many countries, the problem of the elderly worker becomes of increasing importance. Data from some countries, such as Great Britain and the USA, indicate a tendency for fewer old people to be employed than hitherto.Several studies have shown that the employment of old people may raise special problems, but that these can in most cases be solved without great difficulty. The provision of separate workshops for the elderly-a measure adopted by some firms-does not appear to be the best solution, since the workers themselves tend to resent such segregation, feeling that they are being singled out for special treatment. The ideal arrangement seems to be to place elderly workers in small groups on specific jobs, which are an integral part of the main flow of work in the factory, but are not subject to special pressures.The output of elderly workers seems on the whole to be satisfactory and comparable to that of the younger ones. In choosing suitable jobs for old workers, the heaviness of the job appears to be a less important consideration than that the effort required should not be continuous. Elderly workers seem to have a greater need than their younger workmates for good lighting at work. They may be prevented by their physical condition from doing many unskilled jobs where health and strength are essential, but they can easily be kept in productive employment in jobs which depend largely upon skill and experience. It is generally accepted that work is beneficial to old people and will help to keep up their health and morale; this has been borne out in many studies. When transferring an elderly worker to a new job, it is important to find a job with the same prestige as the former one.An annual medical examination by the industrial physician is a very useful guide when fitting the old worker to his job. The medical examination should be voluntary and must be carried out tactfully, since old workers are often suspicious that some excuse may be found for discharging them.

Aged↗
PubMed2006

Lung function in Pakistani wood workers.

The lung function impairment is the most common respiratory problem in industrial plants and their vicinity. Therefore, the purpose was to study the affects of wood dust and its duration of exposure on lung function. This was a matched cross-sectional study of Spirometry in 46 non-smoking wood workers with age range 20 - 60 years, who worked without the benefit of wood dust control ventilation or respiratory protective devices. Pulmonary function test was performed by using an electronic Spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and Maximum Voluntary Ventilation (MVV) in wood workers relative to their matched controls. This impairment was increased with the duration of exposure to wood industries. It is concluded that lung function in wood workers is impaired and stratification of results shows a dose-response effect of years of wood dust exposure on lung function.

Air Pollutants, Occupational↗
PubMed1999

[Big differences in leadership and management training within health care services. Leadership and issues concerning cooperation should be more emphasized in basic medical education].

A recent survey of medical management programmes at universities across the country showed manifest national differences to exist, both quantitative and qualitative. Using a questionnaire, the Swedish Society of Medical Management examined the programmes for physiotherapists, occupational therapists, social workers, nurses and physicians, with respect to such issues as leadership, self-awareness and communication, health economics, and administration. It was concluded that knowledge acquired differs between fields; that physiotherapy programmes tend to have a very didactic approach; that nurses are taught the importance of participation in developmental processes; that doctors are exposed to somewhat the same approach but to a large extent on a voluntary basis; and that social workers obtain good insight into the administrative skills necessary to their work. In the article it is concluded that students would benefit from orientation in the diverse approaches used in the other fields than their own, and that pooling of resources among different programmes might be a more economic alternative to current practice.

Communication↗
PubMed2004

Overcoming recruitment challenges in construction safety intervention research.

BACKGROUND: Recruiting workers in small construction companies and securing their participation in voluntary safety programs or safety research poses unique challenges. Worker turnover and worksite changes contribute to difficulties in locating and enrolling participants. Economic pressures and time demands potentially threaten ongoing participation. METHODS: Six simulation exercises designed to reduce back and fall injuries in small construction companies were developed based on data from focus groups of workers and company owners. Working with a workers' compensation insurer, we had access to owner-operators of general, heavy, and special trade construction companies reporting less than $10,000 in payroll expenses. Recruitment methods included a participation incentive, mailed invitations followed by phone contacts, and follow-up reminders. RESULTS: Despite using recruitment methods recommended in the literature, participation rates were low over a 2-year intervention period. Because of these difficulties, factors affecting participation or nonparticipation became an additional research focus. Owners' perceptions of already having a good safety record and of the time demands of participation were the most commonly cited reasons for not participating. CONCLUSIONS: Literature on recruitment emphasizes processes and procedures under investigator control rather than understanding potential participants' judgments about the adequacy of their existing practices and the potential benefits of intervention participation relative to potential time and productivity trade-offs. Greater attention to such judgments may enhance recruitment and participation in under-studied and difficult to access populations.

Accidental Falls↗
PubMed1989

Prevalence of silicosis at death in underground coal miners.

This study was initiated by the National Institute for Occupational Safety and Health (NIOSH) and the Bureau of Mines (BOM) to determine the prevalence and pathological features of silicosis in coal miners. The population base was 3,365 autopsied underground miners whose records were submitted to the U.S. National Coal Workers' Autopsy Study between 1971 and 1980. This program is voluntary and covers an estimated 10% of all coal workers who die. The mean age at death of the population was 62 years, of whom 75% were current or ex-smokers at the time of death. The average work tenure was 26 years. Lung sections from all cases were reviewed and the type and severity of pneumoconiosis documented. These findings were correlated with years of mining, job history, and geographic location of mine. Classical silicotic nodules were found in 12.5% of the population. There was a significant relationship between length of underground mining and prevalence and severity of silicosis consistent with a dose-response effect. The study also showed that job category and geographic location of the mine were important determinants of silicosis prevalence and that silicosis was strongly associated with higher categories of coal workers' pneumoconiosis.

Aged↗
PubMed2002

A synthetic vitreous fiber (SVF) occupational exposure database: implementing the SVF Health and Safety Partnership Program.

The Health and Safety Partnership Program is a voluntary workplace safety program for workers involved in the manufacture, fabrication, installation, and removal of glass wool and mineral wool products. This article describes one element of this Partnership Program, the development of an occupational exposure database that characterizes exposures by fiber type, industry sector, product type, and job description. Approximately 6000 exposure samples are included in the database, most of which were collected over the past decade, making it the most extensive and recent exposure data set on record for glass wool and mineral wool. The development of this database, as well as the initial results for exposure measurements segmented by product type and/or job description, are described. The current database shows that most applications and uses of glass wool and mineral wool involve exposures below the voluntary 1 f/cc permissible exposure limit, although some specific product types and job descriptions involve average exposures approaching the 1 f/cc limit.

Databases, Factual↗
PubMed1983

Delivery programmes for elderly and isolated populations.

The provision of dental care for the elderly and for other isolated population groups cannot be ignored. In particular, special provision must be made for the housebound and institutionalized elderly as well as for those who are isolated for social or medical reasons. Continuous liason with social service personnel and health service workers, as well as with voluntary agencies, is essential for identifying and treating these populations. The assessment of dental treatment needs must take account of the clinical dental status of the subjects, their demands for treatment and their oral handicaps. The aims should be to treat overt oral and dental pathology and to relieve oral handicaps. Treatment should be readily available and must not be an added burden for those who are already medically or socially disadvantaged. Careful consideration must be given to treatment and manpower requirements. The dental team should consist of people who are particularly skilled at treating elderly and/or handicapped people. Schemes for domiciliary visits should be devised and facilities such as mobile dental units and dental surgeries within long-stay hospitals should be made available. Most importantly, in order to provide an appropriate ongoing dental service, dental personnel and other health workers must be totally committed to making quality dental health care available to all.

Adult↗
PubMed2003

To relieve the sufferings of humanity, irrespective of party, politics or creed?: conflict, consensus and voluntary hospital provision in Edwardian South Wales.

This article examines the provision of voluntary hospital facilities for injured workers in the mining valleys of Edwardian South Wales. It considers the co-operation and conflict that characterized efforts to establish hospitals, and examines the attitudes and activities of workers, employers, and other interested groups. Despite certain instances of disagreement and conflict, this article demonstrates the significant levels of co-operation and consensus that characterized the efforts of employers and workers to provide communities with hospital facilities. This co-operation was perhaps surprising considering the bitter industrial conflict and social unrest of that period. The article uses this material to question assertions that hospitals reflect the social and political milieus of the communities in which they were situated and argues that the social relations produced by hospital provision sometimes coincided with wider social and industrial relations, but at other times differed from them or transcended them. Furthermore, the article demonstrates that the co-operation between employers and workers in the provision of hospitals in Edwardian South Wales did not stabilize social and industrial relations in the way that historians of associational voluntarism in other contexts have found.

Accidents, Occupational↗
PubMedDate not supplied

Public health nurses' views on voluntary smallpox vaccination.

Between January and June 2003, voluntary smallpox vaccination of healthcare workers and mandatory vaccination of military personnel was an important public health topic. This paper discusses the attitudes of nurses from two county public health departments in an upper-Midwestern state who were asked to volunteer to take the smallpox vaccine and to prepare to assist in the operation of possible mass immunization clinics. The responses of these healthcare professionals are compared to those of physicians and the general public. The public health nurses in this sample were less likely to view smallpox as a potential biological weapon than was the general public or other healthcare workers studied previously.

Attitude of Health Personnel↗
PubMedDate not supplied

[The foresight behavior of French general practitioners].

In France, "social insurance" is less comprehensive as concerns the independent workers that the salaried employees. Voluntary insurance is therefore a subject of crucial importance for physicians, the large majority of them being in private practice. In 1993, nearly 70% or 75% of French GP's are voluntarily insured against one risk or an other. The older generations have seemingly a lower providence level than the younger. As concerns the "vital" risks (death, disability) the insurance rate is higher among men. For the "minor" risks (e.g. income loss due to illness) women have a higher insurance rate. Effect of income appears for insurance against vital risks but it disappears when a certain income level is reached. Such a level does not exist as concerns the minor risks: the higher the income, the higher the insurance rate.

Adult↗
PubMed1997

Practical and affordable measures for the protection of health care workers from tuberculosis in low-income countries.

With the global upsurge in tuberculosis (TB), fueled by the human immunodeficiency virus (HIV) pandemic, and the increase in multidrug-resistant TB, the condition has become a serious occupational hazard for health care workers worldwide. Much of the current understanding about nosocomial TB transmission stems from the USA; however, little is known about the risk of such transmission in low-income countries. The focus of this review is on sub-Saharan Africa, since this is the region with the highest TB incidence, the highest HIV incidence, the worst epidemic of HIV-related TB, and where the risk to health care workers is probably greatest. Measures used in industralized countries to control nosocomial TB transmission (ventilation systems, isolation rooms, personal protective equipment) are beyond the resources of low-income countries. Protecting health care workers in these settings involves practical measures relating to diagnosis and treatment of infectious cases; appropriate environmental control; and relevant personal protection and surveillance of health care workers. Research needs to be carried out to examine the feasibility and cost-effectiveness of measures such as voluntary HIV-testing of health care workers (to enable known HIV-positive health care workers to avoid high-risk settings) and isoniazid preventive therapy for workers in high-risk settings. More resources are also needed to ensure full implementation of currently recommended measures to decrease the risk of nosocomial and laboratory-acquired TB.

AIDS-Related Opportunistic Infections↗
PubMed2004

Voluntary refusal of food and fluids: attitudes of Oregon hospice nurses and social workers.

As the ethical debate about euthanasia and physician-assisted suicide (PAS) continues, one alternative that has been suggested is for the patient to voluntarily refuse all food and fluids (VRFF). The article describes the results of a study of hospice nurses' and social workers' attitudes towards VRFF and compares them with their attitudes towards PAS. In 2001, a questionnaire was posted to nurses and social workers who care for Oregon residents enrolled in hospice programmes to determine their attitudes towards PAS and VRFF. In general, hospice workers expressed support for patients who choose to hasten their death by VRFF; they were less supportive of PAS. The results from this study suggest that perceptions regarding VRFF are significantly different from those regarding PAS. These results may have important clinical implications for nurses and social workers involved in end-of-life care who encounter patients who wish to hasten their deaths.

Adult↗