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PubMed2001

Women workers confront one-eyed science: building alliances to improve women's occupational health.

Women suffer many health problems related to their work, but attempts to improve their situation face obstacles at two levels: recognition of their problems and ability to organize to prevent them. Recognition by occupational health specialists has been delayed due in part to: A perception that women's issues have been included in research focussed on male workers; pressure to deal with more visible issues of mortality and well-established illness; ignorance of women's working conditions; methodological biases and inadequacies. Recognition by unions is slowed when women and their concerns are absent from union membership and/or governing structures. Feminist health advocates have not often participated in these struggles, due to social class differences and difficulties in linking with some male-dominated unions. Also, due to the wide variety of hazardous working conditions, they do not emerge from population-based analyses of health determinants in the same way as do domestic violence, tobacco or poverty. The authors describe three alliances necessary for successful research, policy and practice in women's occupational health: between feminist and working-class organizations; between feminists and occupational health scientists; between researchers and women workers.

Canada↗
PubMed1986

ICWU cancer control education and evaluation program: research design and needs assessment.

The International Chemical Workers Union is implementing a 3-year nationwide field experiment in cancer prevention education. The educational program includes three stages: generalized cancer control education, education tailored to each local union, and an interactive monitoring system designed to provide ongoing communication and reinforcement for desired cancer control behaviors among local unions and their members. These alternative educational approaches will be systematically evaluated using a randomized factorial study design involving more than 120 local unions. The need for such a program is demonstrated by the results of a needs assessment survey of 690 union members. Respondents expressed strong concern regarding possible carcinogen exposures at the work site, combined with generally low ratings of co-worker knowledge of and adherence to appropriate cancer control behaviors. Engineering controls and personal protective equipment were reported to be inadequate in many work sites.

Attitude to Health↗
PubMed1998

How physician stress can hurt your practice.

Physicians are under increasing pressure to see more patients, take on more management responsibilities, and still provide the best care. That is leading to a variety of problems--everything from general malaise and burnout to early retirement and unionization. Stressed-out physicians can have a disastrous effect on the bottom line of practices. Productivity drops, staff become demoralized, turnover increases, and patients become less satisfied with the care they receive--both from the physician and support staff. There are clear warning signs of physicians under too much pressure. There are also some simple steps a practice can take to minimize the occurrence of burnout and deal with it effectively when it occurs.

Burnout, Professional↗
PubMed1996

Back to the members: the Branch Officials Training Programme.

While the union movement has had is closely examine its delegate activities since the election of the Federal Coalition government, the Association has introduced a comprehensive and long overdue programme for all branch officials. This initiative was part of the election platform of Sandra Moait and Julie Venamore, who committed themselves, to introduce, as a priority, formal delegate training. Accordingly, the first Branch Officials Training Programme was held at the Association on Wednesday 22 May, 1996.

Education, Nursing, Continuing↗
PubMedDate not supplied

[Point of view of the trade union].

The goal is "make healthy individuals in healthy organizations". The workers health tutorship isn't in contrast with the business purpose, if the business considers the workers health a development factor. He doesn't agree with so frequent clinical examination, that are useless. However we can't leave the sanitary surveillance, that must involve a lager number of workers indeed. The occupational health physician must be involved in the risk assessment and pay attention to the information coming from the workers. The public service must make the occupational health physician activity more effective, giving them a line.

Commerce↗
PubMed2007

Disability management practices in Ontario health care workplaces.

BACKGROUND: Workplace disability management programs are important in managing injury and disability. METHODS: A stratified random sample of 188 employers in health care workplaces (71 hospitals, 48 nursing homes, 42 private clinics, and 27 community clinics) completed a mailed Organizational Policies and Practices (OPP) questionnaire. The OPP asked questions about eight workplace disability management practices. This article compares disability management practices across the four types of health care workplaces. RESULTS: A one-way analysis of variance for each of the eight practices demonstrated significant differences across facility types for all practices, except ergonomic practices. For unionized versus non-unionized workplaces, there were significant differences in all practices, except ergonomic practices. For workplaces with formal policies versus those without policies, there were significant differences in all practices, except people-oriented culture and safety diligence. CONCLUSION: Variations in disability management practices in health care workplaces need to be addressed to provide more effective prevention and treatment of work-related injuries and disability.

Accidents, Occupational↗
PubMed2005

Factors influencing the use of registered nurse overtime in hospitals, 1995-2000.

PURPOSE: To assess nurse overtime in acute care general hospitals and the factors that influence overtime among various hospitals and in the same hospitals from year to year. METHODS: Staffing data from 1995 to 2000 from 193 acute general hospitals in New York State were used to examine hospital characteristics (size, location, RN unionization, hospital ownership, and teaching status) to determine whether they were associated with nurse overtime. RESULTS: The average weekly overtime RNs worked was 4.5% of total hours, varying from almost none to 16.6%. At mean overtime levels, nurses were working less overtime than the mean for manufacturing workers, but, at the extreme, nurses were working more than 6 hours overtime per week. Significant differences were observed in the use of overtime by hospital ownership and by union status. Nurses in government hospitals worked less overtime than did those in nongovernment hospitals. Nurses in unionized hospitals worked slightly more overtime than did nurses in nonunionized hospitals. CONCLUSIONS: Hospitals varied dramatically in their overtime use. That some categories of hospitals (e.g., government-owned) used little overtime indicates that hospital management can find substitutes for overtime to meet fluctuating staffing needs. The finding that hospitals with similar characteristics varied greatly in their number of overtime hours also supported this conclusion.

Acute Disease↗
PubMed1988

Structure as a causal factor in nurses' strikes.

Nurses employed in Alberta's hospitals have earned a reputation of militancy as a result of four province-wide strikes in the 11-year period 1977-1988. Based on a case study of the first three strikes, the principal causes of the labour disputes are discussed: namely, union ideology, economic factors and inherent constraints in the structure of bargaining in the public sector. Interorganizational relationships of the three main players, the United Nurses of Alberta, the Alberta Hospital Association and the provincial government have been contributing factors in all three strikes. Although issues in the disputes were primarily economic, demands associated with the needs of working women, and demands that threatened the traditional prerogatives of management were at the heart of every impasse.

Alberta↗
PubMed2005

Peer-to-peer computing in health-promoting voluntary organizations: a system design analysis.

A large part of the health promotion in today's society is performed as peer-to-peer empowerment in voluntary organisations such as sports clubs, charities, and trade unions. In order to prevent work-related illness and long-term sickness absence, the aim of this study is to explore computer network services for empowerment of employees by peer-to-peer communication. The 'technique trade-off method was used for the analysis of the system design. A Critical Incident Technique questionnaire was distributed to a representative sample of trade union shop stewards (n = 386), and focus-group seminars were arranged where a preliminary set of requirements was discussed. Seven basic requirements were identified and matched to a set of 12 design issues for computer network services, allocating a subset of design issues to each requirement. The conclusion is that the systems design displays an inexpensive and potentially feasible method for peer-to-peer computing in voluntary health-promoting organisations.

Computer Communication Networks↗
PubMedDate not supplied

[A window on the past: nurses and education].

The history and the state of the art of the debate on nursing education in the first two decades of 20th century is presented. Improvement of nursing education was a strongly felt need from nurses and physicians: feminist movements were strongly in favour of a limited role of physicians in nursing education. Nurses trade unions (Leghe degli infermieri) supported an improvement of nurses' education as a mean to protect patients rights for a better care. Only a minority of physicians opposed the introduction of the English model of nursing care, with the matron who had the power of organizing the hospital. After the advent of fascism the law of 1929 on institution of Scuole Convitto was approved, and this law hindered the development of a reform of nursing education up to the Seventies.

Education, Nursing↗
PubMed2002

Registered nurse unions and patient outcomes.

Although research shows substantial relationships between several organizational characteristics in hospitals and patient outcomes, the relationship between nurse unions and patient outcomes has not been explored. Because of the workplace chaos of the last half of the 1990s, some nurses are rethinking their relationships with unions; some have the perception that union activity has increased. It is not always clear whether changes in healthcare are associated with patient outcomes, but it is clear that hospitals/health systems with unions often engage in spirited rhetoric about what is best for patients with little objective evidence to support either view. This study examines the relationship between the presence of a bargaining unit for registered nurses and the acute myocardial infarction mortality rate for acute care hospitals in California. The authors also discuss how registered nurse wage, hospital bed size, volume of patients, and other organizational factors may influence and confound this relationship.

Acute Disease↗
PubMed2004

Ischemic heart disease mortality among heavy equipment operators.

BACKGROUND: Inhalation of fine particulate is hypothesized to increase risk of heart disease events. METHODS: Seven Ontario construction unions participated in a retrospective cohort mortality study. Proportional mortality ratios (PMRs) were computed and a mortality odds ratio (MOR) analysis was performed to compare the risk of ischemic heart disease (IHD) mortality among heavy equipment operators (HEO) to that of members of other unions. Deaths attributed to lung cancer, mesothelioma, and accidental causes were excluded from the comparison. RESULTS: Two hundred fifty nine of 1,009 deaths among the HEO were attributed to IHD. The PMR was 1.09 (0.96-1.2). None of the IHD PMRs among the other six unions exceeded 0.89. The MOR for IHD mortality, comparing the HEO to all other workers combined was 1.47 (1.17-1.84) for ages 25-64, was 1.20 (0.96-1.50) for ages 65 or more, and was 1.32 (1.13-1.55) for all ages combined. CONCLUSIONS: Increased risk of IHD mortality among HEO is consistent with the hypothesis that exposure to diesel fume has adverse effects upon the heart and circulatory system.

Adult↗
PubMed1999

The social class determinants of income inequality and social cohesion.

The authors argue that Wilkinson's model omits important variables (social class) that make it vulnerable to biases due to model mis-specification. Furthermore, the culture of inequality hypothesis unnecessarily "psychopathologizes" the relatively deprived while omitting social determinants of disease related to production (environmental and occupational hazards) and the capacity of the relatively deprived for collective action. In addition, the hypothesis that being "disrespected" is a fundamental determinant of violence has already been refuted. Shying away from social mechanisms such as exploitation, workplace domination, or classist ideology might avoid conflict but reduce the income inequality model to a set of useful, but simple and wanting associations. Using a nonrecursive structural equation model that tests for reciprocal effects, the authors show that working-class position is negatively associated with social cohesion but positively associated with union membership. Thus, current indicators of social cohesion use middle-class standards for collective action that working-class communities are unlikely to meet. An erroneous characterization of working-class communities as noncohesive could be used to justify paternalistic or punitive social policies. These criticisms should not detract from an acknowledgment of Wilkinson's investigations as a leading empirical contribution to reviving social epidemiology at the end of the century.

Authoritarianism↗
PubMed1999

Break through to success with training and teamwork.

This is a case study on the effect of training and teamwork in two different divisions within the same company. One division consisted of a nonunion manufacturing plant; the second was a unionized distribution operation. In both operations, serious problems existed--poor customer service levels, inadequate inventory turns, and insufficient profitability. These are the kinds of problems that, left untreated, can cause the death of any manufacturing or distribution operation. However, by implementing training and teamwork at both operations, impressive benefits were achieved, including customer service levels exceeding 90 percent, dramatic improvements in the inventory turnover rate, and profitability that exceeded corporate goals.

Consumer Behavior↗
PubMed1990

The politics of American health care.

The developments leading to the present American health care organization are traced. It is clear that hospitals have dominated at the expense of primary health care programmes. Health care costs have soared dramatically. There are particular problems inherent in a system shared between federal and state governments and a private health care industry. Attempts to provide a fully (or partially) tax-funded health service in the USA have been bedevilled by a number of factors. These include opposition from labour unions, politicians, vested-interest groups and, in particular, the American Medical Association. As part of its opposition, the AMA politicized itself in 1950. But, in the political literature, American nurses are not portrayed as being very politically active. Reasons for this are explored. The introduction of Medicare and Medicaid programmes is discussed and the legal, social and political implications. Recent attempts in the USA to control costs are assessed and new trends and new problems identified.

American Medical Association↗
PubMed1994

Special report. TB and health care workers: the challenge for hospitals and their safety directors.

New federal regulations seeking to prevent tubercular infection of health care workers have created conflicts between unions and hospital administrators over the best and cheapest methods of reducing the threat. Though there has been dispute over the particulars, there has been little argument that some steps must be taken, particularly in urban areas, to control the spread of a disease that has rebounded in new and deadly forms in recent years. Most agree that one of the most effective ways to avoid infection is to train employees to identify new hospital arrivals who are likely to have active cases of TB.

Humans↗