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PubMed1973

Medical alliance.

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Developing Countries↗
PubMed1991

Factors relating to the development of respiratory symptoms in coffee process workers.

After several cases of occupational asthma had been reported in a coffee processing factory in England, 197 coffee workers representing 80% of the production workforce were studied to determine the factors affecting the development of work related respiratory symptoms of wheeze, cough, and dyspnoea. Two computer administered questionnaires concerning the presence of respiratory symptoms and the occurrence of work related respiratory symptoms were used. Workers underwent skin prick testing to green coffee bean extract (GCB) and 11 common inhalant allergen extracts and bronchial provocation testing with methacholine. The presence of specific immunoglobulin E (IgE) antibodies to GCB and castor bean extract (CAB) were determined by a radioallergosorbent test (RAST). The prevalence of work related respiratory symptoms was 12.7%, bronchial hyperresponsiveness 30%, atopy 54%, positive GCB skin prick test 14.7%, positive GCB RAST 14%, and positive CAB RAST 14.7%. None of the workers was sensitised to fungi present in the factory and the numbers of certain species of fungi, despite being greater than may be found out of doors or in an uncontaminated indoor environment, were fewer than are generally associated with the presence of work related respiratory symptoms among agricultural workers. Storage mites were not isolated. Green coffee bean extract and CAB RAST were significantly correlated using the McNemar test but there was limited allergenic cross reactivity in RAST inhibition studies of the two extracts. The only factors that were significantly and independently associated with work related symptoms were CAB RAST and duration of employment. Bronchial hyperresponsiveness was not independently associated with work related respiratory symptoms. The significant independent associations of bronchial hyperresponsiveness included GCB RAST, duration of employment, and resting forced expiratory volume in one second. Exposure to CAB, a highly potent antigen, may be overriding the effects of other factors such a GCB, atopy, bronchial hyperresponsiveness, and smoking. This study suggests that CAB contamination remains a potential problem in the coffee processing industry and all efforts to eliminate it from the working environment should continue.

Adolescent↗
PubMed2026

(Re)imagining the Future of Genetic Counseling: A Reflexive Qualitative Analysis of Sociopolitical Power, Cultural Safety, Systemic Racism, and Comparative Practice in the United Kingdom, Aotearoa New Zealand and, Australia.

Genetic counseling is undergoing a rapid transformation as genomic medicine becomes embedded within mainstream healthcare systems. At the same time, the profession is being challenged to respond to systemic racism, colonial legacies, technological change, and evolving expectations regarding equity and justice. Historically, genetic counseling emerged within twentieth-century medical genetics and was influenced by political, social, scientific, and medical forces that included eugenic ideology, values, and practices. The profession has since evolved substantially toward psychosocial, patient-centered, and non-directive models of care. Contemporary debates regarding "newgenics" or "neugenics" further demonstrate how concerns regarding equity, reproductive ethics, disability, and genomic stratification continue to shape genomic healthcare discourse. This qualitative reflexive practice paper explores how systemic racism, colonial legacy, cultural safety and structural power shape genetic counseling practice in the United Kingdom (UK), Aotearoa New Zealand and Australia, and how these forces continue to reshape the profession's future identity. A reflexive, narrative, and comparative qualitative approach was employed, grounded in the authors' lived professional experiences across UK and Australasian contexts and informed by purposively selected policy, professional and scholarly literature relating to cultural safety, dignity, anti-racism, and Human Rights-Based Decision-Making. Through iterative reflexive dialogue, comparative analysis, and thematic synthesis, four interrelated themes were developed examining sociopolitical context, systemic racism, cultural safety and technologization within contemporary genetic counseling practice. Comparative analysis identified substantial differences in how culturally responsive practice is conceptualized and operationalized across settings. In Aotearoa, cultural safety is strongly shaped by Te Tiriti o Waitangi, bicultural accountability, and Māori sovereignty frameworks. In Australia, culturally safer genomic care has increasingly developed through Indigenous-led initiatives and workforce reform, including the Australian Alliance for Indigenous Genomics (ALIGN). In contrast, UK practice remains largely situated within equality, diversity, and inclusion (EDI) frameworks that may insufficiently address systemic racism and structural power within increasingly diverse populations. Reflexive clinical examples demonstrated how inequities may emerge through undocumented patient values, standardized pathways, assumptions regarding autonomy, and misinterpretation of culturally specific communication styles. Re-imagining the future of genetic counseling requires more than just technological advancement. It requires reflexive engagement with dignity, inequity, and the sociopolitical realities of the populations served. These insights re-imagine a culturally grounded, socially responsive future for genetic counseling in an era shaped by genomic mainstreaming, digital transformation, artificial intelligence and workforce reform and one in which the profession remains ethically anchored, relationally attuned, and committed to justice-oriented practice.

Humans↗
PubMed1992

Health and safety implications of European community 1992 (EC92). Management committee. American Industrial Hygiene Association.

Progress toward the implementation of a single, common market in Europe is well underway. European-wide standards and regulations are being formulated to remove the physical, fiscal, and technical barriers to the free movement of goods, services, capital, and people among member states. In 1992, the target year for implementation, members of the European Community are attempting to harmonize their health and safety standards so that each nation is on equal footing. The European Community has given high priority to health and safety to the extent that 1992 has been declared the "year of health and safety in the workforce." The EC-rulemaking bodies have developed requirements for significant hazards, including risk communication and risk assessment. Efforts are underway to develop directives addressing exposure limits, product safety, and environmental protection. The result of this ambitious strategy will present substantial opportunities and challenges for the member countries, American companies with EC-based subsidiaries, and any company that sells products in the European market. The end result could have a much farther reaching effect. To emphasize this, I will quote James Tye, president of the British Safety Council, who said, "The European Community will eventually be 700 to 800 million strong as other nations join it. I have no doubt it will be the dominant market in the world, assuredly as far as the field of health and safety is concerned. I also have no doubt that the standards we will be developing in the European Community will be followed by Japan and the United States.

European Union↗
PubMed1991

An evaluation of surgery departments in community-based medical schools.

Since 1960, most newer medical schools have been community-based and have used existing community hospitals and a large number of volunteer faculty. As these schools have evolved, many have developed more traditional characteristics. To assess the positive and negative features of these new schools, chairs of departments of surgery from 21 community-based medical schools and 17 traditional schools were surveyed to acquire information on policies and practices related to faculty development, undergraduate and graduate education, hospital relationships, clinical activities, research, and relationships with community physicians. Responses were analyzed and compared. Most community-based schools have succeeded in their mission, partly at the expense of controls usually found in more traditional schools.

Attitude of Health Personnel↗
PubMed1991

Hospice care for prisoners: establishing an inmate-staffed hospice program in a prison medical facility.

U.S. Prison populations are expanding at an explosive rate and many more men and women are dying in prison, often with little attention given to their unique psychological, palliative, and spiritual care needs. This paper describes the development of an innovative hospice program at a major federal prison hospital designed to meet those needs: an inmate-staffed, hospice volunteer program. A brief history of the program's start-up and development, data on the initial six month pilot program and evaluation, a set of program standards and guidelines, and recommendations for further development are presented as a model for future hospice programs in prison medical facilities.

Hospices↗
PubMed1992

Characteristics of caregivers that promote children's development in day care.

Most available evidence on day care suggests that characteristics of the caregiver are the key components of high-quality child care. Yet, this fact is rarely appreciated by parents or policy makers. As primary health care providers, nurses can educate parents, caregivers, and policy-makers concerning the broad array of day-care features, including caregiver characteristics that should be considered. This article provides a review of the research on characteristics of caregivers that are found in high-quality day care and describes how these factors facilitate optimal development in young children. From the research findings, implications for nursing practice at the family, community, and national levels are identified.

Caregivers↗