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PubMed2003

[Requirements and quality of health promotion in the workplace--evaluation study].

This paper presents the results of an attempt to assess the quality of voluntary activities aimed at improving the workers' health in Polish large and medium-sized enterprises in view of the health promotion requirements. Based on the data collected via a questionnaire mailed to enterprises selected at random in 1998 (147 enterprises), 2000 (755 enterprises) and 2001 (215 enterprises) the determinants of the health promotion quality are discussed. A long standing tradition to protect the workers' health was reported by 50% of enterprises as the major reason for undertaking health promotion activities. Only 25% of enterprises described their activities as health promotion understood as a tool for supporting their market strategy through well coordinated voluntary actions aimed at improving health and well-being of their employees, however, 85% of respondents reported the implementation of various health conducive programs. The most frequent failures of health-oriented activities to be of a required standard are: (a) regarding these activities as those of little importance compared with the enterprise priorities; (b) lack of a special section responsible for health promotion issues in an enterprise; (c) ignoring the employees' right to participate in planning and evaluating health promotion programs, which means that they are perceived as passive service recipients or passive performers of tasks assigned to them; (d) lack of cohesive approach towards health problems and strong belief that all the goals can be achieved through restrictions or education without any support; and (e) reluctance of enterprises to evaluate the organization, implementation and outcomes of health conductive activities. The major obstacle to health promotion is lack of money (reported by 60% of enterprises) and lack of statutory obligations (reported by more than 50% of enterprises). The former is usually reported by enterprises that are not active in this field, and the latter is an obstacle to enterprises that have invested in workplace promotion programs.

Health Plan Implementation↗
PubMed2001

Former radiation worker Medical Surveillance Program at Rocky Flats.

The United States Department of Energy (DOE), Office of Occupational Medicine and Medical Surveillance, has supported an ongoing Former Radiation Worker Medical Surveillance Program at the DOE Rocky Flats site since 1992. The program currently is managed for DOE by Oak Ridge Institute for Science and Education through a contract with Oak Ridge Associated Universities. Participation in the program is entirely voluntary and provides former Rocky Flats workers who were exposed to radiation with long-term medical monitoring and an update to the assessment of their radiation dose. Program participants receive medical examinations and in vivo and in vitro bioassay measurements of residual radioactivity. Radiation doses to participants are largely a result of internal depositions of plutonium and its radioactive decay products. The causes of many of the higher internal doses were accidents that generally are well documented. Former radiation workers are invited to participate in the program if they meet specific criteria for radiation exposure. Informed consent is documented using a consent form approved by an Institutional Review Board. Demographic, medical, and dosimetric information is maintained in a computer database and will be evaluated for any trends or correlations between exposure and health outcome.

Adult↗
PubMed2005

The need to legislate the health-care industry in the state of Washington to protect health-care workers from back injury.

There is an epidemic of health-care worker back injury in the State of Washington. Voluntary programs are not keeping pace with the increasing back injury rates to health-care workers. Adding all the health-care industry SIC codes, hospitals, nursing homes, home health and residential care puts health-care as the leading industry in the State of Washington for back injury. Licensed practical nurses, nurses aides, and registered nurses account for the majority of all claims in the health-care industry. Self-insured hospitals led the state for lost time compensable back injuries between 1993 and 2001, and combined Washington State Fund and self-insured health-care hospitals and nursing homes led all other industries for compensable soft-tissue disorders of the neck, back, and upper extremities. Legislation is needed to protect this group of workers in this type of industry. A bill will be re-introduced in the 2006 session that calls for hospitals to implement back injury prevention programs through either the Zero-Lift model, with nursing staff use of lift equipment, or the Lift-Team model, with a specially trained team using lift equipment, or a combination of the two, for all shifts. The State of Washington should provide funding, through savings created by back injury prevention programs, for small rural health-care institutions to assist them in compliance with the legislation.

Back Injuries↗
PubMedDate not supplied

Collaborative research, participatory solutions: research on asbestos in Kuruman, South Africa.

The 1998 South African National Asbestos Summit proposed a post-apartheid asbestos policy for the country. In the areas of environmental rehabilitation, health care, and compensation, it envisioned connecting asbestos mitigation to participatory development. In 2001, the Asbestos Collaborative, an international and interdisciplinary team, conducted follow-up research on the recommendations of the 1998 Summit, researching environmental, health, and compensation issues through consultation of documents and interviews with officials in urban areas and with people in Kuruman, a former crocidolite-mining site with high rates of asbestos-related disease. In Kuruman, local opinion supported the recommendations of the Asbestos Summit, insisting that policies to mitigate the problem of asbestos must also address poverty. In the wake of the 2001 research, a new organization, the Asbestos Interest Group (AIG), has been founded to facilitate grassroots participation in asbestos issues. One success of the AIG has been the settlement of a lawsuit by former workers against the former mining company in Kuruman.

Asbestos↗
PubMedDate not supplied

Adverse drug reactions reporting at a referral hospital in Zimbabwe.

OBJECTIVES: To establish factors influencing voluntary reporting of adverse drug reactions among health workers. A second objective was to establish the level of awareness on adverse drug reaction reporting and attitudes towards the voluntary adverse drug reaction reporting scheme. DESIGN: Cross sectional descriptive study. SETTING: Parirenyatwa Hospital, a major referral and teaching hospital in Harare, Zimbabwe. SUBJECTS: 200 health professionals randomly selected from various departments. MAIN OUTCOME MEASURES: Number of health workers reporting adverse drug reactions; awareness of the adverse drug reaction reporting scheme. RESULTS: 144 (72%) questionnaires were completed. About half (47.2%) of the respondents did not know how to report an adverse drug reaction and 47.1% were unaware of the existence of a formal adverse drug reaction reporting scheme in Zimbabwe. One fifth (20.1%) of the respondents had reported an adverse drug reaction at some point. Two main factors contributing to under-reporting cited by respondents were the poor feedback from the national reporting centre (59%) and inaccessibility of reporting facilities (45.8%). Beliefs that one should only report an adverse drug reaction if certain of causality (46.5%) and that really serious adverse drug reactions are well documented before a drug is marketed (35.4%) could also account for under reporting. However, 75.7%, viewed adverse drug reaction reporting as a professional obligation. CONCLUSION: Lack of awareness of healthcare professionals to the national (Medicines Control Authority of Zimbabwe) adverse drug reaction voluntary reporting scheme, poor feedback and inaccessibility of reporting facilities are the main factors contributing towards underreporting.

Adult↗
PubMed1996

The role of the specialist for families with autistic children.

This research article looks at the present and future needs of a group of children within one particular London borough, who were diagnosed as having autism or being on the autistic spectrum. A nurse was employed by a voluntary organisation as a family services worker, to provide support to these families and also to identify areas of unmet need for the children and their families. Of the 70 children identified as autistic, 42 of the families indicated that they wanted to make contact with the specialist worker. The author concludes that the specialist nurse has a pivotal role to play in reducing the stress experienced by these families.

Adolescent↗
PubMed2002

[Knowledge, attitude and practices of health personnel with regard to HIV/AIDS in Tamatave (Madagascar)].

BACKGROUND: Health care workers are key players in the prevention and management of HIV-infection. We surveyed HIV/AIDS-related knowledge, attitudes and practices of health care workers in Tamatave (Madagascar), to assess the feasibility of voluntary counselling and testing for HIV infection in antenatal care. MATERIALS AND METHOD: A Knowledge Attitude and Practice study was conducted during July 2000 in the antenatal health care centres and the hospital of Tamatave. The health workers completed a self-administrated questionnaire on HIV transmission, attitudes and practices regarding AIDS testing and counselling, HIV risk perception and attitudes regarding patients with HIV disease. RESULTS: A 90% response rate was obtained, with completed questionnaires from 45 health care workers. The sample included physicians, midwives, nurses, medical students and nursing auxiliaries. Scientific knowledge about transmissibility of HIV infection was poor: transmission was believed possible by living together without having sex (7%), by breastfeeding a HIV-positive child (9%), by using toilets after a HIV-positive patient (13%) and by blood donation (76%). 73% of the health staff believed a child born of an HIV-positive woman would systematically be infected and interventions to reduce this risk were unknown. Sixty one per cent of the health-workers reported never having advised patients to be tested and less then 10% mentioned correct counselling precautions. Seventy nine percent believed that they were at risk of acquiring AIDS, mainly through occupational exposure. Negative attitudes towards HIV-positive patients were also noted: twenty per cent of the health workers mentioned that AIDS patients should be isolated in quarantine. Physicians and paramedical staff differed only in their better knowledge about transmissibility of HIV. Physicians had the same restrictive attitude towards patients with HIV as paramedical health workers and did not differ by their counselling practice. CONCLUSIONS: Our study revealed gaps in the knowledge of health care workers about HIV infection. Before implementing voluntary counselling and testing in antenatal care, additional HIV/AIDS training for health staff seems necessary.

AIDS Serodiagnosis↗
PubMed2005

'They're all depressed, aren't they?' A qualitative study of social care workers and depression in older adults.

Statutory and voluntary social services provide care and support for vast numbers of vulnerable older adults, yet little is known about how social care practitioners respond to depression in this high risk population. This study elicited the perceptions and conceptualizations of this condition among social care staff, and views on how the response of social care and other agencies might be improved. Qualitative interviews were conducted with 20 social care practitioners working in generic services for older adults in south London. Depression was perceived to be remarkably common among clients, a phenomenon largely attributed to the adverse circumstances of old age, particularly social isolation. A key message from participants was that social causes indicate a need for social interventions. While primary care was criticised for not taking depression seriously in older people, mental health services were generally praised. Expansion of social, recreational and psychological interventions was advocated.

Aged↗
PubMed1997

Coping with Africa's increasing tuberculosis burden: are community supervisors an essential component of the DOT strategy? Directly observed therapy.

Tuberculosis incidence in Africa is increasing dramatically and fragile health systems are struggling to cope. Potential coping capacity may lie within affected communities but this capacity needs to be harnessed if tuberculosis is to be controlled. Since 1991 all patients with tuberculosis in Hlabisa health district, South Africa have been eligible for community-based directly observed therapy (DOT). Patients are supervised either by a health worker (HW) in a village clinic, or in the community by a community health worker (CHW) or a volunteer lay person (VLP). Tuberculosis incidence increased from 312 cases in 1991 to 1250 cases in 1996. By December 1995, 2622 (87%) of 3006 patients had received DOT, supervised mainly by VLP (56%) but also by HW (28%) and CHW (16%). The proportion supervised by HW fell from 46% in 1991 to 26% in 1995 (P < 0.0001). More patients supervised by VLP (85%) and CHW (88%) than by HW (79%, P = 0.0008) completed treatment. Case-holding by HW declined more between 1991 and 1995 (84% to 71%, P = 0.02) than did case-holding by both CHW (95% to 90%. P = 0.7) and VLP (88% to 84%, P = 0.4). Mortality was similar (4-6%) and stable over time, irrespective of the supervisor. High tuberculosis treatment completion rates are achievable and sustainable for several years in resource-poor settings despite a massively increased case load if community resources are harnessed. Patients may be more effectively supervised by voluntary lay people than by health workers under these circumstances, without being placed at increased risk. These findings suggest that community supervisors may be an essential component of any DOT strategy.

Antitubercular Agents↗
PubMed2002

'Floating support': implications for interprofessional working.

This article describes a floating support scheme, provided by a local housing association, which enables single vulnerable people to live independently in their own homes. The study aimed to explore the impact of the scheme from the perspectives of clients, floating support workers and representatives from health, social care and voluntary agencies. It was found that the majority of clients had long-term mental health problems and were supported by a range of professionals. Floating support was flexible in responding to individual needs. A number of themes of relevance to interprofessional working emerged from the data. These included: floating support as a community resource, links with other agencies and confidentiality, information sharing and risk management. Floating support workers worked closely with professionals from health, social care, voluntary and educational services. Although the scheme's contribution to client care was highly valued, a number of barriers to effective interagency working were evident. This study highlighted the need for discussion and presented a forum for developing an ongoing collaborative process to address the specific issues which emerged in focus group discussions.

Adolescent↗
PubMed2000

Participation in voluntary individual savings accounts: an analysis of IRAs, 401(k)s, and the TSP.

New voluntary individual savings accounts have been proposed by some as a part of, or in addition to, Social Security. The success of these proposals would depend greatly on how many workers participate. This paper compares participation rates in three existing voluntary individual account-type plans--Individual Retirement Accounts (IRAs), 401(k)s, and the federal Thrift Savings Plan (TSP)--to clarify expectations about who might participate in a voluntary individual account system. It finds that participants in IRAs, 401(k)s, and the TSP tend to be disproportionately male, higher earners, older, full-time workers, and either white or nonblack minorities compared with the population at large. Differences in earnings explain much of the difference between participation rates of men and women, however, but less of the difference between participation rates of workers of different races. Whether participation in a new system of voluntary individual accounts would resemble participation in IRAs, 401(k)s, or the TSP would depend on a number of factors. For instance, the population covered by 401(k)s and the TSP is much smaller than that covered by Social Security. Average earnings are also higher among 401(k) and TSP participants than for workers covered by Social Security, which, based on these findings, suggests that participation rates could be lower in a universal system. Participation would also depend on many other factors, however, such as the extent of matching contributions or other financial incentives, the investment options available, and the amount of education provided to potential participants.

Black or African American↗
PubMed1989

Providing services for women with difficulties with alcohol or other drugs: the current U.K. situation as seen by women practitioners researchers and policy makers in the field.

This exploratory paper reports on the current U.K. situation of service provision as seen by women practitioners, researchers and policy makers working in the area. Most agencies represented offered particular facilities for women: women-only groups, women workers and women-focussed research. Voluntary agencies were more likely to make provision than statutory agencies. The lack of childcare facilities and public stigmatization of women with addiction problems were commonly encountered problems. The study emphasised the need to develop a more adequate theoretical understanding of the area and for more specific literature on the problem to be more widely available.

Alcoholism↗
PubMed2005

Integration of posture and movement: contributions of Sherrington, Hess, and Bernstein.

Neural mechanisms that integrate posture with movement are widespread throughout the central nervous system (CNS), and they are recruited in patterns that are both task- and context-dependent. Scientists from several countries who were born in the 19th century provided essential groundwork for these modern-day concepts. Here, the focus is on three of this group with each selected for a somewhat different reason. Charles Sherrington (1857-1952) had innumerable contributions that were certainly needed in the subsequent study of posture and movement: inhibition as an active coordinative mechanism, the functional anatomy of spinal cord-muscle connectivity, and helping set the stage for modern work on the sensorimotor cortex and the corticospinal tract. Sadly, however, by not championing the work of his trainee and collaborator, Thomas Graham Brown (1882-1965), he delayed progress on two key motor control mechanisms: central programming and pattern generation. Walter Hess (1881-1973), a self-taught experimentalist, is now best known for his work on CNS coordination of autonomic (visceral) and emotional behavior. His contributions to posture and movement, however, were also far-reaching: the coordination of eye movements and integration of goal-directed and "framework" (anticipatory set) motor behavior. Nikolai Bernstein (1896-1966), the quintessence of an interdisciplinary, self-taught movement neuroscientist, made far-reaching contributions that were barely recognized by Western workers prior to the 1960s. Today, he is widely praised for showing that the CNS's hierarchy of control mechanisms for posture and movement is organized hand-in-hand with distributed and parallel processing, with all three subject to evolutionary pressures. He also made important observations, like those of several previous workers, on the goal focus of voluntary movements. The contributions of Sherrington, Hess, and Bernstein are enduring. They prompt thought on the philosophical axioms that appear to have driven their research, and the continual need for emphasis on interdisciplinary, comparative, and transnational approaches to advance movement neuroscience.

Affect↗
PubMed2002

[Involvement of Polish enterprises in workplace health promotion. Trends observed in years 1998-2001].

The author presents voluntary activities aimed at improving the workers' health in medium-sized and large enterprises in Poland, as well as the dynamic of changes in this area. The data were collected from enterprises chosen at random in 1998 (147 enterprises), 2000 (755) and 2001 (215). At present, over 60% of enterprises declare that they do more for their workers' health than it is required by legal regulations. Since 1998, the number of such declarations has been constantly growing. It is observed that the larger enterprise and the better economic situation, the more frequent health promotion activities. Two areas of activities are most commonly carried out: (1) medical services, e.g. vaccinations, extra diagnostic examinations and therapeutical services; and (2) investments in the work environment, e.g. ergonomics, improvement of interior designs. Unfortunately, promotion of healthy lifestyles, e.g. non-smoking campaigns or stress management are definitely less frequent. Although a growing number of enterprises becomes involved in health promotion, the range of their activities is diminishing. The programs aimed at promoting health conductive behaviors among workers are in particular given up. As far as smoking cessation is considered, the enterprises disseminate materials on the adverse effects of smoking or related ill-health and punish smokers for breaking smoking bans instead of helping their workers and teach them how to quit smoking or support those who want to give up this habit. In the years 2000 and 2001, the educational and supporting activities decreased whereas the punitive policy was on the rise.

Health Care Surveys↗
PubMed1989

[Human hepatitis experiments in the 2d World War].

During the Second World War a hepatitis epidemic spread across wide areas of Europe, leaving no doubt about the previously questioned infectious nature of the disease. The losses to the German forces due to hepatitis, presented a challenge to several German scientists to identify the infective agent via animal trials and experiments with humans. Kurt Gutzeit, the "Beratende Internist beim Heeres-Sanitäts-Inspekteur" was in charge of the hepatitis research in the army. Under his guidance, two co-workers conducted experiments on non-voluntary subjects: in 1941, Hans Voegt infected psychiatric patients from the mental hospital in Breslau, and in 1944, Arnold Dohmen carried out experiments on jewish children in the Sachsenhausen concentration camp. In the Nürnberg trials, Gutzeit had denied his and Dohmen's responsibility. Further investigation into the hepatitis research which was carried out by German scientists during the Second World War, especially Gutzeit's group, is regarded necessary.

Disease Outbreaks↗