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PubMedDate not supplied

[Women's health and the cooperation of Canadian voluntary medical relief workers in Afghanistan].

Canadians are increasingly being asked to become involved in international health research and intervention projects. Recently, Quebec clinicians were asked to support a project to build and run a tertiary and highly-specialized hospital for women and children, in Kabul, the capital of Afghanistan. The goal of this paper was to analyze the challenges raised by participation in such a project. The major lesson learned was the need to resist the temptation to provide aid when it involves an attractive but ineffective intervention. The current public health priority in Afghanistan is to provide as much of the population as possible with access to a nearby health centre, for primary health care and safe deliveries. When analyzing the implications of Canadian clinicians' commitment to this project, we considered three major public health challenges: public health priorities, hospital care organization and health care financing. The results indicated that, given the current Afghani context, this project was neither relevant nor appropriate and had undesirable repercussions on the population and the health care system.

Afghanistan↗
PubMed1980

The social worker's role: a study of private and voluntary hospitals.

Social workers have played an integral role in the treatment of psychiatric patients in hospitals since the earliest days of the 20th century. At first totally dependent on the support and approval of the medical profession, psychiatric social work later became professionalized and began to take responsibility for a wide variety of duties in the institution. Through a study of private and voluntary hospitals, the authors found that despite decades of acceptance by medical staff, the social worker today functions in an environment where final administrative authority on hiring staff and deciding the need for social work services often falls outside the social work department. The survey also identifies the relative importance of various professional duties and the impact of social work on institution decision-making. Involvement by social workers in patient discharge planning could well ensure the future of social work in hospitals in a time of tight budgets, they conclude.

Child↗
PubMed1996

Tuberculosis in the community: 1. Evaluation of a volunteer health worker programme to enhance adherence to anti-tuberculosis treatment.

SETTING: A voluntary health worker project (Operation Elsies River) was started in a high incidence tuberculosis (TB) area in the Western Cape of South Africa, in order to assist the local TB Control programme with case-holding. OBJECTIVE: To evaluate the effectiveness of this group of volunteers in enhancing adherence of notified TB patients to tuberculosis treatment. DESIGN: A cohort study was conducted with 351 TB patients (203 children and 148 adults). RESULTS: The data from the child and the adult groups were analysed separately. The child group was more adherent to TB treatment than adults. The supervision option with staff dedicated to the treatment of TB, such as the clinic and the SANTA crèche, achieved better adherence results for pre-school children. The supervision modalities for adults did not differ in their adherence performance even following adjustment for confounders. CONCLUSION: The supervision option provided by the volunteers did not significantly improve the adherence of adult patients to antituberculosis treatment.

Adolescent↗
PubMed2003

Spirometric evaluation of lung function (maximal voluntary ventilation) in welding workers.

OBJECTIVE: The present study was designed to study the effects of welding fumes on maximal voluntary ventilation (MVV) and to determine its severity in relation to duration of exposure. Additional objective was to reduce the potential health risks of welding workers by providing them with information concerning the hazards of welding fumes. METHODS: This study was conducted in the Department of Physiology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, Pakistan in 1999. In this study, the MVV was studied in 50 male control subjects and 50 male arc welding workers and all participants were non-smokers with an age range of 20-60 years. The subjects were matched for age, height, weight and socio-economic status. Maximal voluntary ventilation test was performed by using an electronic spirometer and results were compared by a paired t-test. RESULTS: Welding workers showed a significant reduction in MVV relative to controls. CONCLUSION: We conclude that MVV in welding workers is significantly decreased as compared to their matched controls. Stratification of results by years of welding shows a dose-response effect of years of welding on lung function.

Adult↗
PubMed2003

Influence of delta-aminolevulinic acid dehydratase (ALAD) polymorphism on the frequency of sister chromatid exchange (SCE) and the number of high-frequency cells (HFCs) in lymphocytes from lead-exposed workers.

In this study, the cytogenetic response to lead exposure in storage battery manufacturing workers carrying different alleles of delta-aminolevulinic acid dehydratase (ALAD 1 and ALAD 2) was evaluated. The cytogenetic response was measured by analysis of the frequency of sister chromatid exchange (SCE) and the number of high-frequency cells (HFCs) in peripheral blood lymphocytes from workers occupationally exposed to lead. A total of 71 voluntary male workers were enrolled in the study. According to our genotype analysis, 50 workers had the ALAD 1-1 genotype and 21 workers had the ALAD 1-2 genotype. In spite of the statistically insignificant difference in mean values of SCE per cell between ALAD 1-1 and ALAD 1-2 workers, the percentage of HFC (HFC (%)) was statistically (chi2-test, P<0.05) higher in ALAD 1-1 workers. The control group was selected among voluntary male office workers (n = 20) and genotyping was also performed for this group in order to rule out the possibility that ALAD 1-1 subjects had a higher HFC (%) than ALAD 1-2 carriers, independent of the exposure to lead. Accordingly, 11 control workers had the ALAD 1-1 genotoype and 9 workers had ALAD 1-2. The differences in mean values of SCE per cell and HFC (%) were not statistically significant when the two genotypes in the control group were compared. On the basis of this result we suggest that ALAD 1-1 subjects might be more susceptible to cytogenetic effects of lead exposure than ALAD 1-2 subjects. There were no ALAD 2-2 subjects in the exposed and control groups.

Adult↗
PubMed2001

Outcomes of a natural rubber latex control program in an Ontario teaching hospital.

BACKGROUND: Allergy to natural rubber latex (NRL) has been frequently reported in health care workers. However, there is little published evidence of the outcome of hospital intervention programs to reduce exposure and detect cases of sensitization early. OBJECTIVE: This study assesses the effects of intervention to reduce NRL allergy in an Ontario teaching hospital with approximately 8000 employees. METHODS: A retrospective review assessed annual numbers of employees visiting the occupational health clinic, allergy clinic, or both for manifestations of NRL allergy compared with the timing of introduction of intervention strategies, such as worker education, voluntary medical surveillance, and hospital conversion to low-protein, powder-free NRL gloves. RESULTS: The number of workers identified with NRL allergy rose annually, from 1 in 1988 to 6 in 1993. When worker education and voluntary medical surveillance were introduced in 1994, a further 25 workers were identified. Nonsterile gloves were changed to low-protein, powder-free NRL gloves in 1995: Diagnoses fell to 8 workers that year, and 2 of the 3 nurses who had been off work because of asthma-anaphylaxis were able to return to work with personal avoidance of NRL products. With a change to lower protein, powder-free NRL sterile gloves in 1997, allergy diagnoses fell to 3, and only 1 new case was identified subsequently up to May 1999. No increased glove costs were incurred as a result of consolidated glove purchases. CONCLUSIONS: This program to reduce NRL allergy in employees was effectively achieved without additional glove costs while reducing expenses from time off work and workers' compensation claims.

Gloves, Protective↗
PubMed2004

Development and piloting of a multidisciplinary training course for detecting and managing depression in the older person.

Depression is the most common psychiatric condition found in older people. It is associated with increased mortality and adversely affects quality of life. Although the majority of depressive episodes are seen and treated in primary care, studies suggest in primary care there is under-detection and inadequate management of depression in older people. In line with national policy in the UK this paper argues that training needs to be multidisciplinary and multiagency, and meet the requirements of local needs. It outlines a course that meets the expectation that specialist mental health workers such as mental health nurses should provide training and advice for those providing care and treatment in primary care. The paper reports upon the design and evaluation of a pilot multidisciplinary training course for health professionals and voluntary sector workers in the detection and management of depression in the older person. The course consisted of three 1-day workshops and four consecutive courses were offered, with a total of 40 health professionals and voluntary sector workers completing the training. The training was evaluated using a questionnaire examining knowledge and confidence and by a scenario using an older person whom was potentially depressed. Results found a significant difference between pre- and post-test for knowledge of depression in the older person and confidence in both detecting and managing depression. Results of the scenario revealed that there was a significant change from pre- to post-test training in the type of questions participants would ask the older person to detect and assess depression. There was also a significant increase in the ability to identify types of interventions and local services available, which would help an older person with depression. The implications, limitations and future directions for research are discussed.

Aged↗
PubMed2003

Hepatitis C infection among dental personnel in the West of Scotland, UK.

Hepatitis C virus (HCV) is considered a serious occupational hazard for healthcare workers, particularly those performing exposure-prone procedures. In the UK, the majority of dental procedures are classified as exposure prone. In order to gauge the prevalence and determinants of infection among dental healthcare workers, a voluntary anonymous survey of HCV infection among primary care dental workers employed in the West of Scotland was undertaken, in which occupational and personal risk data were collected in parallel with a blood specimen. The overall prevalence of HCV antibodies was 0.1% (1/880, 95% CI 0-0.6); this is no greater than the estimated prevalence of HCV infection in the local population. Personal risk data collected suggested that the single infection identified was acquired through a non-occupational route. These results suggest that HCV infection is not a major occupational risk for dental healthcare workers.

Dental Auxiliaries↗
PubMed1984

Cost implications of hospital unionization: a behavioral analysis.

The growth of unionization among hospital workers was sharply accelerated by the 1974 amendments to the National Labor Relations Act covering voluntary hospital workers. With continuing inflationary pressures in the hospital sector, the cost implications of the recent and projected growth of hospital unions is of some concern to policymakers. This article presents estimates of union cost impacts based on data from hospitals in Maryland, Massachusetts, New York, and Pennsylvania. Cross-sectional regressions with data for 1975 yield positive union impacts of 3.3 percent on total costs, 4.1-5.9 percent on cost per case, and 6.1 percent on cost per day. Reestimation of the model with data on changes over the 1971-1975 period yields similar results. We also find that the cost impact of unionization varies with the pattern of coverage (being lower for service employees and RNs) and with the extent of cost-based reimbursement. This suggests that future cost impacts of union growth may be moderated as prospective payment systems for hospitals become more widespread.

Costs and Cost Analysis↗
PubMed1996

Voluntary and professional disaster-workers: similarities and differences in reactions.

Forty-three rescuers responding to a bus crash that killed 12 children and 4 adults and injured many more answered questionnaires at 1 and 13 months following the crash. This study compared the responses of the voluntary and professional helpers, using the Impact of Event Scale (IES) and the General Health Questionnaire (GHQ). For all helpers taken together, the decline in IES-intrusion and IES-total scores was significant from 1 to 13 months. The voluntary helpers reported significantly more intrusion and avoidance on the IES at 1 month than professional helpers, and for avoidance the voluntary helpers still evidenced a significantly higher score than professional helpers at 13 months. The GHQ scores at 13 months reflected that the long-term negative impact of the event was low.

Accidents, Traffic↗
PubMed1996

Enhancing the role of community-health workers in research.

With recognition of the importance of meeting the needs of underserved communities and the shift to more primary care-community-health workers need to be part of health teams. Community-health workers, in voluntary and salaried positions, augment the roles of professionals through outreach and community-based work and serve as liaisons between communities and institutions. This article describes the rationale for inclusion of community-health workers in research; their roles and responsibilities; and issues in their selection, training, and supervision. Examples are given from the authors' experience with interventions by nurse and community teams. Inclusion of community-health workers enriches the comprehensiveness of a holistic scientific approach to understanding health in a community.

Career Mobility↗