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Literacy in the World of the Aged Care Worker.
ERIC Educational Resources Information Center
Wyse, Linda; Casarotto, Nadia
Australia's Aged Care Act of 1997 mandates a number of key reforms aimed at ensuring consistency in the quality of care and well-being for all residents of aged care facilities. The law required residential aged care facilities to provide high-quality care within a framework of continuous improvement which requires aged care workers to perform the…
Older Workers' Perspectives on Training and Retention of Older Workers: Victorian Aged Care Workers Survey. Support Document
ERIC Educational Resources Information Center
Lundberg, David; Marshallsay, Zariah
Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…
Older Workers' Perspectives on Training and Retention of Older Workers: South Australian Aged Care Workers Study. Support Document
ERIC Educational Resources Information Center
Lundberg, David; Marshallsay, Zariah
Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…
[Social representations on aging by primary care health workers].
Mendes, Cristina Katya Torres Teixeira; Alves, Maria do Socorro Costa Feitosa; Silva, Antonia Oliveira; Paredes, Maria Adelaide Silva; Rodrigues, Tatyanni Peixoto
The objective of this study was to get to know the social representations on aging developed by primary care health workers. This is an exploratory study involving 204 primary health care workers, in the city of João Pessoa, in the state of Paraíba. For data collection we used a semi-structured interview. The data obtained from 204 interviews was analyzed with the help of the Alceste software version 2010. The results indicated five classes or categories: vision of aging,psychosocial dimensions, a time of doubts, aging as a process, and aging versus disease, with positive content: joy, care, children, retirement, caregiver rights, maturity and wisdom, as well as negative factors: impairments, decadence, neglect, fragility, limitation, wrinkles, dependency and disease. It was observed that these meanings associated with aging express the need for total and humanized elderly care. PMID:23405821
Valuable human capital: the aging health care worker.
Collins, Sandra K; Collins, Kevin S
With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future. PMID:16905991
Caring from Afar: Asian H1B Migrant Workers and Aging Parents.
Lee, Yeon-Shim; Chaudhuri, Anoshua; Yoo, Grace J
With the growth in engineering/technology industries, the United States has seen an increase in the arrival of highly skilled temporary migrant workers on H1B visas from various Asian countries. Limited research exists on how these groups maintain family ties from afar including caring for aging parents. This study explores the experiences and challenges that Asian H1B workers face when providing care from a distance. A total of 21 Chinese/Taiwanese, Korean, and Indian H1B workers participated in in-depth qualitative interviews. Key findings indicate that despite distance, caring relationships still continue through regular communications, financial remittances, and return visits, at the same time creating emotional, psychological, and financial challenges for the workers. Findings highlight the need for further research in understanding how the decline of aging parent's health impacts the migrants' adjustment and health in the United States. PMID:26267591
A Descriptive Analysis of Incidents Reported by Community Aged Care Workers.
Tariq, Amina; Douglas, Heather E; Smith, Cheryl; Georgiou, Andrew; Osmond, Tracey; Armour, Pauline; Westbrook, Johanna I
Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care. PMID:25526960
Knowledge of Normal and Pathological Memory Aging in College Students, Social Workers, and Health Care Professionals
ERIC Educational Resources Information Center
Cherry, Katie E.; Allen, Priscilla D.; Jackson, Erin M.; Hawley, Karri S.; Brigman, Susan
The Knowledge of Memory Aging Questionnaire (KMAQ) measures laypersons' knowledge of normal memory changes and pathological memory deficits in adulthood. In Experiment 1, undergraduate and graduate social work students and social work practitioners completed the KMAQ. Social workers and graduate students were more accurate on the pathological than…
Sherertz, R. J.; Bassetti, S.; Bassetti-Wyss, B.
Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the existence of cloud health-care workers. PMID:11294715
Decreasing the aging velocity in industry workers.
Kristjuhan, Ulo
We carried out physiological and ergonomic studies in industry from 1965 to 2000. Participants (2147) were workers in different jobs, such as light industry and the dairy, automotive, and building materials industries. Most of the groups studied included 30-50 male and female workers. In the studies we used a combination of methods and paid much attention to the quantitative assessment of discomfort during working hours. One of the aims was to avoid or postpone various age-related diseases (cardiovascular, musculoskeletal, etc.) of workers. We provided recommendations to managers and individuals: changing the technology, work organization, corrective measures of ergonomics, self-care procedures or doctor visits, correct diet, preventive exercises, and improving labor productivity. Changes based on our studies postponed age-related changes up to 20 years and pointed to close connections between the environment and aging peculiarities in the human organism. PMID:20536833
R.L. Thacker
The purpose of this calculation is to estimate radiation doses received by personnel working in the Aging Facility performing operations to transfer aging casks to the aging pads for thermal and logistical management, stage empty aging casks, and retrieve aging casks from the aging pads for further processing in other site facilities. Doses received by workers due to aging cask surveillance and maintenance operations are also included. The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation from normal operation. There are no Category 1 event sequences associated with the Aging Facility (BSC 2004 [DIRS 167268], Section 7.2.1). The results of this calculation will be used to support the design of the Aging Facility and to provide occupational dose estimates for the License Application. The calculations contained in this document were developed by Environmental and Nuclear Engineering of the Design and Engineering Organization and are intended solely for the use of the Design and Engineering Organization in its work regarding facility operation. Yucca Mountain Project personnel from the Environmental and Nuclear Engineering should be consulted before use of the calculations for purposes other than those stated herein or use by individuals other than authorized personnel in Environmental and Nuclear Engineering.
Unionizing: A Guide for Child Care Workers.
ERIC Educational Resources Information Center
Whitebook, Marcy; And Others
Including excerpts from contracts protecting unionized child care workers, this booklet explains basic terminology and facts about unionizing and addresses child care workers' concerns. Section 1 answers commonly asked questions about unions and offers advice about how to answer parents' questions about workers' attempts to organize. Section 2…
Measuring Group Care Worker Interventions in Residential Youth Care
ERIC Educational Resources Information Center
Bastiaanssen, Inge L. W.; Kroes, Gert; Nijhof, Karin S.; Delsing, Marc J. M. H.; Engels, Rutger C. M. E.; Veerman, Jan Willem
Background: By interacting with children, group care workers shape daily living environments to influence treatment. Current literature provides little knowledge about the content of youth residential care. Objective: In this study, a questionnaire called the Group care worker Intervention Checklist was developed. Method: Group care workers…
Emotional Exhaustion in Day-Care Workers
ERIC Educational Resources Information Center
Løvgren, Mette
Although childcare workers have the second-worst occupation for work-related health problems and the number of professional day-care centers is growing throughout Europe, few studies have examined these workers' emotional well-being. This study investigates the effect of position, competence, work role, role clarity, and work tasks on emotional…
Origin of a Musculoskeletal Guideline: Caring for Older Workers.
Delloiacono, Nancy
Today's employers are hiring a more age-diverse workforce. As Americans work longer, age-related changes often create activity limitations. Musculoskeletal disorders affect many older workers heightening their risk of workplace injury. Compounded by multiple comorbidities, older workers will need occupational health nurses with expert knowledge to maintain safe and productive workplaces. Older workers do not experience as many injuries as younger workers, but when they are injured, recovery is longer. The author developed and conducted a survey of New Jersey occupational health nurses. The results showed that overexertion injuries are the most frequently treated injuries in employee health offices. For occupational health nurses to keep employees safe, best practices must be delineated; this musculoskeletal safety guideline provides recommendations for evidence-based care of older workers. PMID:27154746
Help! A Handbook for Child Care Workers.
ERIC Educational Resources Information Center
Looney, Sue; And Others
Suggestions designed to aid those who work with young children, in particular, the day care workers, are provided. Following the booklet's introductory material, the following subjects are discussed: Language in the Day Care Center (Crib Babies--birth to six months; Six Months to 12 Months; Toddlers--one to two years old; and Over Two Years); Room…
Frontline Workers in Long-Term Care.
ERIC Educational Resources Information Center
Feldman, Penny Hollander, Ed.; And Others
In this theme issue, 18 articles discuss the motivation for and benefits of working with old and dying people, nursing homes, ethical issues, and the training of home health care workers. Employee recruitment and retention and the economics of health care for the frail elderly are also addressed. (JOW)
Worker senescence and the sociobiology of aging in ants
Giraldo, Ysabel Milton; Traniello, James F. A.
Senescence, the decline in physiological and behavioral function with increasing age, has been the focus of significant theoretical and empirical research in a broad array of animal taxa. Preeminent among invertebrate social models of aging are ants, a diverse and ecologically dominant clade of eusocial insects characterized by reproductive and sterile phenotypes. In this review, we critically examine selection for worker lifespan in ants and discuss the relationship between functional senescence, longevity, task performance, and colony fitness. We did not find strong or consistent support for the hypothesis that demographic senescence in ants is programmed, or its corollary prediction that workers that do not experience extrinsic mortality die at an age approximating their lifespan in nature. We present seven hypotheses concerning how selection could favor extended worker lifespan through its positive relationship to colony size and predict that large colony size, under some conditions, should confer multiple and significant fitness advantages. Fitness benefits derived from long worker lifespan could be mediated by increased resource acquisition, efficient division of labor, accuracy of collective decision-making, enhanced allomaternal care and colony defense, lower infection risk, and decreased energetic costs of workforce maintenance. We suggest future avenues of research to examine the evolution of worker lifespan and its relationship to colony fitness, and conclude that an innovative fusion of sociobiology, senescence theory, and mechanistic studies of aging can improve our understanding of the adaptive nature of worker lifespan in ants. PMID:25530660
Paraprofessional Social Workers in Day Care
ERIC Educational Resources Information Center
Peterman, Phylis Johnson
Describes an 8-week, inservice, college-level course for paraprofessional social workers employed in day care centers. Bi-weekly classes, supplemented by on-site observation and consultation, covered child development, attitudes, systems, resources, roles and practice skills. Opportunities were also provided to test roles and techniques on the…
[Calculation of workers' health care costs].
Rydlewska-Liszkowska, Izabela
In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference
Population ageing and dental care.
Harford, Jane
Population ageing is a fact in both developed and developing countries. The concern about population ageing largely arises from the combination of a greater number of older people requiring greater amounts of healthcare services and pensions, and relatively fewer people working to pay for them. Oral health and dental care are important aspects of health and health care. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Traditionally, economic studies of ageing have focused on the fiscal implications of ageing, projecting the increased burden on health and welfare services that accompanies ageing. It assumed that ageing is the major driver of recent changes and those past trends will simply be amplified by faster population ageing in the future. Less work has been done to understand other past drivers of increased healthcare spending and their implications for the future. The conclusion of these reports is usually that population ageing is unaffordable with current policy settings. They have proposed policies to deal with population ageing which focused on increasing workforce participation and worker productivity to increase the tax base and reducing entitlements. However, the affordability question is as much political as a numerical. There are no clearly articulated criteria for affordability and little opportunity for public discourse about what citizens are willing to pay in taxes to support an ageing population. While the reports do not necessarily reflect public opinion, they will certainly shape it. Predicting the future for oral health is more fraught than for general health, as oral health is in the midst of an epidemiological transition from high rates of edentulism and tooth loss to low rates. Changes in the pattern of dental expenditure in the past do not mirror the experience of rapid increases in per capita expenditure on older age groups as regards general health. Dentistry
Speech Differences of Factory Worker Age Groups.
ERIC Educational Resources Information Center
Tway, Patricia
This article, which focuses on speech differences of age groups, is part of a larger study of occupational jargon, its characteristics and underlying features and the part it plays in reflecting the workers' knowledge of their jobs and their attitudes toward jobs in general. The project incorporated a case method of research in a china factory.…
Putting the 'care' back into aged care.
Beadnell, Cathy
Aged care is well and truly back on the political agenda in Australia. While the mainstream media has recently exposed a number of horrific cases of alleged abuse in aged care facilities it has done little to highlight the failings of social policy over time or to foster debate on how to improve the care of older Australians. What are the barriers to providing safe and quality aged care to a growing number of our citizens and how do we overcome them? If you relied on the recent media coverage for your impression of aged care you could be forgiven for thinking it is all bad news. But there are facilities providing high quality care and stories of nurses working wonders in the face of adversity. Cathy Beadnell considers some of the broader cultural and workforce issues in aged care. PMID:16629211
Older Workers: An Opportunity to Expand the Long-Term Care/Direct Care Labor Force
ERIC Educational Resources Information Center
Hwalek, Melanie; Straub, Victoria; Kosniewski, Karen
Purpose: This study examined issues related to using older workers in frontline jobs in long-term care from employers' and prospective employees' perspectives. Design and Methods: Telephone surveys were conducted with employers representing 615 nursing homes and 410 home health agencies, and 1,091 low-income participants aged 40+ in Operation ABLE…
Changes in the Age and Education Profile of Displaced Workers.
ERIC Educational Resources Information Center
Rodriguez, Daniel; Zavodny, Madeline
Analysis of Displaced Workers Surveys suggests that between 1983-97, the likelihood of job loss declined among most age groups but rose for middle-aged/older workers relative to younger workers. Changes in educational attainment and industry shifts were contributing factors. Probability of displacement increased significantly for service workers.…
Firearm ownership and health care workers.
Goldberg, B W; Whitlock, E; Greenlick, M
OBJECTIVE. Health professionals have increasingly become aware of the public health hazards caused by firearms. This study was designed to determine the firearm ownership and storage practices of a group of health care workers. METHODS. All 6436 nonphysician employees of a large health maintenance organization were surveyed as part of an ongoing effort to enhance the organization's effectiveness. Two questions regarding firearm ownership and storage practices were included in the 85-question survey instrument. A total of 4999 surveys were returned, for a response rate of 78%. RESULTS. Forty-two percent of the health workers surveyed reported keeping a firearm in their home, and 35% of firearm owners stored that firearm loaded. Men were more likely than women to report having a firearm in the home. Firearm ownership and storage of a loaded firearm decreased with higher levels of education in both sexes. A measure of increased alcohol consumption was related to higher rates of firearm ownership and storage of loaded firearms in men. CONCLUSIONS. A substantial number of health care workers had firearms in their homes and did not store them safely. Counseling regarding the risks associated with easy access to firearms should be considered for inclusion in employee health programs as well as in employee assistance and alcohol treatment programs. PMID:8643818
Death anxiety among emergency care workers.
Brady, Mike
Death anxiety, or 'thanatophobia', is a state in which people experience negative emotional reactions in recognition of their own mortality. Emergency and unscheduled healthcare workers, such as emergency nurses and paramedics, are constantly reminded of death and therefore of their own mortality, and this makes them susceptible to death anxiety. This article introduces the concept of death anxiety, and highlights the need for staff, employers and universities to recognise its signs and symptoms. It also suggests some interventions that could prevent the debilitating effects of death anxiety, to improve staff's mental health and the care they provide to patients. PMID:26159347
The business of care: the moral labour of care workers.
Johnson, Eleanor K
Drawing on a case study conducted in a private residential care home, this article examines the emotional labour of care workers in relation to the moral construction of care and the practical experiences of work. An examination of the company's discursive attempts to construct, manage and demarcate its employees' emotional labour was carried out alongside an exploration of the carers' own interpretations of, and enrolment in, the care-giving role. The potential economic and emotional consequences of these occurrences were a key focus of the inquiry. The study found that carers, encouraged by the company, naturalised their emotional labour, and that this had contradictory consequences. On the one hand it justified the economic devaluation of the carer's work and left her vulnerable to emotional over-involvement and client aggression. On the other, it allowed the worker to defend the moral interests of those within her care and to see when those interests were in conflict with the economic motivations of her employer. PMID:25601068
Health disparities among health care workers.
Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann
In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field. PMID:19940090
Toward Better Child Care Worker Compensation: Advocacy in Three States.
ERIC Educational Resources Information Center
De Vita, Carol J.; Twombly, Eric C.; Montilla, Maria D.
Although the demand for child care in the United States has risen over the past 40 years, the supply of good quality child care remains both limited and costly, and the supply of well-trained and adequately compensated workers remains low. This study reviewed how advocates have moved the issue of child care worker compensation forward in the…
... Age Spots and Skin Tags Click for more information Age spots, once called "liver spots," are flat, brown ... surface. They are a common occurrence as people age, especially for women. They are ... options, specific conditions, and related issues. ...
[Biological age of asbestoscement plant workers in Ukraine].
Piatnytsa-Horpynchenko, N K
Biological age of asbestoscement workers was estimated. The accelerated ageing was recorded in asbestos cement workers, especially in male groups in comparison with female ones. It is established that with the increase of the work experience record the biological age decreases. This can be connected with biological (difference of adaptation processes in different persons) and social-economic factors. The obtained results conform to the availability the accelerated ageing among workers engaged in other industries. PMID:18822853
Preserving workers' compensation benefits in a managed health care environment.
Dembe, A E
Managed care techniques are increasingly being applied in the workers' compensation setting. Many workers, labor representatives and public health advocates fear that the introduction of managed care into workers' compensation may reflect a broader employer-driven campaign to erode benefits, tighten eligibility criteria, and weaken employees' control over health care and compensation issues. The potential threats to workers can be mitigated by involving them in the design of the workers' compensation health plan and selection of provider organization, assuring access to appropriate specialists and diagnostic testing, minimizing delays, increasing accountability through contract provisions and government oversight, and enhancing communications through the use of ombudsmen and alternative dispute resolution approaches. Additional outcomes studies assessing the long-term impact of managed care in workers' compensation are needed. PMID:9670702
State Initiatives To Increase Compensation for Child Care Workers.
ERIC Educational Resources Information Center
Twombly, Eric C.; Montilla, Maria D.; De Vita, Carol J.
Noting that wages for child care workers are among the lowest in the U.S. labor force and that generally caregivers are offered few employee benefits, this paper summarizes proposals and programs in the 50 states and the District of Columbia to raise child care worker compensation. The paper classifies state-level initiatives into two categories:…
Understanding nursing home worker conceptualizations about good care.
Chung, Gawon
This study explored how direct care workers in nursing homes conceptualize good care and how their conceptualizations are influenced by external factors surrounding their work environment and the relational dynamics between them and residents. Study participants were drawn from a local service employees' union, and in-depth interviews were conducted. Data were analyzed using a grounded theory approach, and the results revealed that direct care workers equated good care, such as resident cleanliness, comfort, and happiness as a desirable outcome of care activities. Good care also meant affectionate, respectful, and patient attitudes of direct care workers toward residents in care delivery processes. Nursing home workers internalized the perspectives of residents and other professionals about what constitutes good care, and then drew their own conclusions about how to balance, combine, and compromise those diverse demands. It is important to communicate accurate and consistent messages about what comprises good nursing home care to nursing home workers and build a working environment where workers' conceptualizations about good care can be executed without organizational barriers. PMID:22936538
Care workers, care drain, and care chains: reflections on care, migration, and citizenship.
Lutz, Helma; Palenga-Möllenbeck, Ewa
In this article, we discuss a case study that deals with the care chain phenomenon and focuses on the question of how Poland and the Ukraine as sending countries and Poland as a receiving country are affected and deal with female migrant domestic workers. We look at the ways in which these women organize care replacement for their families left behind and at those families' care strategies. As public discourse in both countries is reacting to the feminization of migration in a form that specifically questions the social citizenship obligations of these women, we also look at the media portrayal of the situation of nonmigrating children. Finally, we explore how different aspects of citizenship matter in transnational care work migration movements. PMID:22611571
Mature Age "White Collar" Workers' Training and Employability
ERIC Educational Resources Information Center
Dymock, Darryl; Billett, Stephen; Klieve, Helen; Johnson, Greer Cavallaro; Martin, Gregory
Global concerns about the growing impact of ageing populations on workplace productivity and on welfare budgets have led to a range of government-supported measures intended to retain and upskill older workers. Yet, a consistent theme in the research literature is that older workers are reluctant and harder to train than younger workers, and that,…
Reports of work related musculoskeletal injury among home care service workers compared with nursery school workers and the general population of employed women in Sweden.
Ono, Y; Lagerström, M; Hagberg, M; Lindén, A; Malker, B
OBJECTIVES--To describe the nationwide occurrence of work related musculoskeletal injuries among all home care service workers in Sweden, and to identify relative risks and risk factors of the injuries. METHODS--The study was based on work related injuries reported to the Swedish occupational injury information system in 1990-1. The work related musculoskeletal injuries were divided into overexertion accidents and musculoskeletal diseases. The incidence of the injuries in female home care service workers was compared with those in nursery school workers and all other employed women in Sweden. RESULTS--In home care service workers, the annual incidence of injury from overexertion accidents and musculoskeletal diseases were 19.2 and 15.1 per 1000 workers, respectively, which was higher than those in nursery school workers and all employed women in Sweden. For five injury locations including the back, all the age standardised relative risks (SRR) of overexertion accidents exceeded 4.0, and most of those for musculoskeletal diseases were 1.5 or more in home care service workers compared with all other employed women in Sweden. Total duration of sick leave due to overexertion accidents was 7.7 times, and musculoskeletal diseases 3.5 times, longer than in nursery school workers. National loss due to sick leave resulting from only musculoskeletal injuries in home care service workers was about 8.2% of the total work related sick leave in all employed women in Sweden, although the number of home care service workers represented only some 5% of this population. Lifting other people was most frequently reported as the main risk cause of overexertion accidents in both kinds of workers. CONCLUSIONS--The results support the hypothesis that home care service workers have higher annual injury incidence of musculoskeletal injuries than nursery school workers due to physically stressful tasks that are far less common in nursery school workers. PMID:7489060
On aging and aged care in Serbia.
Sevo, G; Davidovic, M; Erceg, P; Despotovic, N; Milosevic, D P; Tasic, M
Serbia is a demographically old nation, with 17.4 % of its residents being aged 65 years and older in 2011. The previous two decades of turbulent history have significantly affected the demographic picture of this country, and their ramifications remain visible in Serbia's economic, political, cultural, and health spheres. Major demographic forces behind population aging in Serbia can be attributed to lower fertility rates, migrations, and declining mortality (reflecting improvements in overall health leading to a longer life expectancy). In Serbia, low fertility and migrations appear to play major roles, although the relative contribution of recent migrations cannot be measured with accuracy. Patterns of demographic aging vary considerably across different geographic, socioeconomic, and cultural settings. The common denominator throughout present day Serbia is extensive political and economic transition. One would expect that, given sufficient time, this process will result in improved population health, and yet, at this stage outcomes of major health care reform in Serbia are somewhat perplexing. For the second consecutive year, Serbia's health care system has been ranked at the very bottom of the scale among 34 European countries. It is then no surprise that the elderly represent particularly vulnerable population segment. This paper discusses some of the issues relevant to these demographic patterns of aging and aged care in contemporary Serbia, focusing on the period after 2000. PMID:25943380
Potential allergy and irritation incidents among health care workers.
Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen
This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits. PMID:18669179
Commitment of Licensed Social Workers to Aging Practice
ERIC Educational Resources Information Center
Simons, Kelsey; Bonifas, Robin; Gammonley, Denise
This study sought to identify client, professional, and employment characteristics that enhance licensed social workers' commitment to aging practice. A series of binary logistic regressions were performed using data from 181 licensed, full-time social workers who reported aging as their primary specialty area as part of the 2004 NASW's national…
Oncology Social Workers' Attitudes toward Hospice Care and Referral Behavior
ERIC Educational Resources Information Center
Becker, Janet E.
Members of the Association of Oncology Social Workers completed a survey, which included the Hospice Philosophy Scale (HPS) assessing the likelihood of the worker referring a terminally ill patient to hospice, background and experience, and demographics. The respondents held overwhelmingly favorable attitudes toward hospice philosophy and care,…
Social Workers' Role in the Canadian Mental Health Care System
ERIC Educational Resources Information Center
Towns, Ashley M.; Schwartz, Karen
Objective: Using Canadian survey data this research provides social workers in Canada with a better understanding of their role in the Canadian mental health care system. Methods: By analyzing data from the Canadian Community Health Survey, Cycle 1.2 Mental Health and Well-being, the role of social workers in the Canadian mental health system was…
Nonfatal Occupational Falls Among U.S. Health Care Workers, 2008–2010
Yeoh, Han T.; Lockhart, Thurmon E.; Wu, Xuefang
The purpose of this study was to describe antecedents and characteristics of nonfatal fall-related injuries among health care workers in the United States. A special request was made for the Bureau of Labor Statistics to obtain nonfatal fall-related injury data from 2008 to 2010. Overall, workers in the nursing-related profession had the highest percentages of workplace fall-related injuries. Ninety-one percent of these injured workers were female, and more than 50% were between the ages of 45 and 64 years. More than 25% of fall injuries resulted in 31 or more workdays being lost. This study indicated that the most affected body parts were the lower extremities, with most injuries resulting in sprains, strains, and tears. Accordingly, this 3-year study revealed that a high number of fall injuries occurred at night for health care workers compared to other workers in the U.S. private sector. PMID:23281604
Job satisfaction, burnout, and turnover in health care social workers.
Siefert, K; Jayaratne, S; Chess, W A
The findings of two consecutive surveys of job satisfaction and burnout in national samples of health care social workers are presented. Between 1979 and 1989, there were significant increases in the proportion of social workers employed in private versus public agencies, in quantitative workload, and in social workers' perceptions of the challenges presented by their jobs. Role conflict and role ambiguity, lack of comfort, and dissatisfaction with financial rewards emerged as significant predictors of depersonalization and burnout. However, a significant increase in social workers' feelings of personal accomplishment also occurred, and high challenge emerged as a significant predictor of sense of effectiveness. PMID:1894206
Space age health care delivery
NASA Technical Reports Server (NTRS)
Jones, W. L.
Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.
Community Health Workers as Support for Sickle Cell Care.
Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly
Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care. PMID:27320471
Drinking, Drugs & Youth: Use and Abuse. Fostering Families. A Specialized Training Program Designed for Foster Care Workers & Foster Care Parents.
ERIC Educational Resources Information Center
Schatz, Mona Struhsaker; And Others
This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module examines substance abuse by children aged 10 years and above. The module's learning objectives address: (1) family rules and coping mechanisms relevant to substance-abusing youth; (2) characteristics of adolescent…
Observations of Group Care Worker-Child Interaction in Residential Youth Care: Pedagogical Interventions and Child Behavior
ERIC Educational Resources Information Center
Bastiaanssen, Inge L. W.; Delsing, Marc J. M. H.; Geijsen, Luuk; Kroes, Gert; Veerman, Jan W.; Engels, Rutger C. M. E.
Background: The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children. Objective: The aim of the current study was to observe the pedagogical interventions of group care workers within residential…
Social Workers in Home Care: The Israeli Case
ERIC Educational Resources Information Center
Ayalon, Liat; Baum, Nehami
In Israel, the government partially supports personal home care services (grooming, feeding, assistance with transfers) as a means to maintain frail individuals in their home environment for as long as possible. Social workers capture a prominent position in these arrangements as initiators and supervisors of personal home care services. This…
A Behavioral Approach to Training Day Care Workers
ERIC Educational Resources Information Center
Ivy, Jonathan W.; Schreck, Kimberly A.
Day care workers are not only responsible for meeting the needs of the children they care for but creating an enriched and friendly environment as well. Few daycare centers require any specific inservice training for their staff members. When provided, training typically occurs as a didactic workshop. For this study a multiple baseline design…
Understanding Nursing Home Worker Conceptualizations about Good Care
ERIC Educational Resources Information Center
Chung, Gawon
This study explored how direct care workers in nursing homes conceptualize good care and how their conceptualizations are influenced by external factors surrounding their work environment and the relational dynamics between them and residents. Study participants were drawn from a local service employees' union, and in-depth interviews were…
Child Care Workers' Knowledge about Reporting Suspected Child Sexual Abuse.
ERIC Educational Resources Information Center
Wurtele, Sandy K.; Schmitt, Ann
This study examined the knowledgeability of child care workers (n=97) regarding their rights and responsibilities in reporting suspected child sexual abuse. Day care personnel knew significantly less about procedures for reporting suspected abuse and their protection under the law (when compared to child sexual abuse experts). (Author/DB)
Risk factors of tuberculosis among health care workers in Sabah, Malaysia.
Jelip, Jenarun; Mathew, George G; Yusin, Tanrang; Dony, Jiloris F; Singh, Nirmal; Ashaari, Musa; Lajanin, Noitie; Shanmuga Ratnam, C; Yusof Ibrahim, Mohd; Gopinath, Deyer
Tuberculosis (TB) is one of the main public health problems in Sabah; 30% of the total number of TB cases reported in Malaysia every year occur in Sabah. The average incidence of TB among health care workers over the past 5 years is 280.4 per 100,000 population (1, Annual Report of Sabah State TB Control Programme, 1998). At present, there are no specific measures for the prevention of TB transmission in health care facilities. A case-control study was conducted among health care workers in Sabah in 2000-2001. Cases were health care workers with TB diagnosed between January 1990 and June 2000. Controls were health care workers without TB and working in the same facility as cases during the disease episode. The study attempted to identify risk factors for TB among the study population. Data were collected through structured interviews and review of patients' records. The notification rate of TB among health care workers was significantly higher than that to the general population (Z=4.893, p<0.01). The average notification rate of TB among health care workers over the last 5 years was two times higher than in the general population (280.4/100,000 compared to 153.9/100,000). Regression results showed that ethnicity, designation, family contact and TB related knowledge did not significantly contribute to the risk of contracting TB in this study. However, after controlling for the above factors, age, gender, history of TB contact outside the workplace (other than family contact), duration of service and failure to use respiratory protection when performing high-risk procedures, were the main risk factors of TB among health care workers. This study succeeded in identifying some of the risk factors of TB among health care workers. We managed to include the large ratio of controls to case (3:1) and those cases spanned over a period of 10 years. However, the findings from the study have to be applied with caution due to the limitations of this study, which include recall
Does Work Contribute to Successful Aging Outcomes in Older Workers?
ERIC Educational Resources Information Center
Sanders, Martha J.; McCready, Jack W.
Older workers are the fastest growing segment of the labor force, yet little is known about designing jobs for older workers that optimize their experiences relative to aging successfully. This study examined the contribution of workplace job design (opportunities for decision-making, skill variety, coworker support, supervisor support) to…
Measuring Worker Turnover in Long-Term Care: Lessons from the Better Jobs Better Care Demonstration
ERIC Educational Resources Information Center
Piercy, Kathleen Walsh, Ed.; Barry, Theresa; Kemper, Peter; Brannon, S. Diane
Purpose: Turnover among direct-care workers (DCWs) continues to be a challenge in long-term care. Both policy makers and provider organizations recognize this issue as a major concern and are designing efforts to reduce turnover among these workers. However, there is currently no standardized method of measuring turnover to define the scope of the…
Workplace Spanish for Health Care Workers.
ERIC Educational Resources Information Center
Garcia, Paula
This syllabus and curriculum guide were developed for a 12-week course in workplace Spanish for clinical workers at the Claretian Medical Center on the south side of Chicago. The purpose of the class was to provide basic communicative abilities in Spanish to the medical staff---registered nurses, triage nurses, and laboratory technologists--such…
A Time Series Study of Factors Associated with Retention and Attrition of Older Adult Child-Care Workers. Final Report.
ERIC Educational Resources Information Center
Newman, Sally; Engel, Rafael; Ward, Christopher; Karip, Emin; Faux, Robert
The work-related and personal factors associated with the willingness and ability of older adults to remain as child care workers and the factors associated with leaving child care work were studied in a time-series design. Subjects were 534 persons aged 50 years and older who were working for pay as child care providers. Of these, 341 replied to…
Professional Talk: How Middle Managers Frame Care Workers as Professionals.
Oldenhof, Lieke; Stoopendaal, Annemiek; Putters, Kim
This paper examines how middle managers in the long term care sector use the discourse of professionalism to create 'appropriate' work conduct of care workers. Using Watson's concept of professional talk, we study how managers in their daily work talk about professionalism of vocationally skilled care workers. Based on observations and recordings of mundane conversations by middle managers, we found four different professional talks that co-exist: (1) appropriate looks and conduct, (2) reflectivity about personal values and 'good' care, (3) methodical work methods, (4) competencies. Jointly, these professional talks constitute an important discursive resource for middle managers to facilitate change on the work floor. Change involves the reconfiguration of care work and different managerial-worker relations. Middle managers use professional talks in both enabling and disenabling ways vis-à-vis care workers. Based on these findings, we suggest a more nuanced portrayal of the relationship between managers and professionals. Rather than being based on an intrinsic opposition, i.e. 'managers versus professionals', this relationship is flexibly reconstructed via professional talk. PMID:24326776
Effects of a psycho-educational intervention on direct care workers' communicative behaviors with residents with dementia.
Barbosa, Ana; Marques, Alda; Sousa, Liliana; Nolan, Mike; Figueiredo, Daniela
This study assessed the effects of a person-centered care-based psycho-educational intervention on direct care workers' communicative behaviors with people with dementia living in aged-care facilities. An experimental study with a pretest-posttest control-group design was conducted in four aged-care facilities. Two experimental facilities received an 8-week psycho-educational intervention aiming to develop workers' knowledge about dementia, person-centered care competences, and tools for stress management. Control facilities received education only, with no support to deal with stress. In total, 332 morning care sessions, involving 56 direct care workers (female, mean age 44.72 ± 9.02 years), were video-recorded before and 2 weeks after the intervention. The frequency and duration of a list of verbal and nonverbal communicative behaviors were analyzed. Within the experimental group there was a positive change from pre- to posttest on the frequency of all workers' communicative behaviors. Significant treatment effects in favor of the experimental group were obtained for the frequency of inform (p < .01, η(2)partial = 0.09) and laugh (p < .01, η(2)partial = 0.18). Differences between groups emerged mainly in nonverbal communicative behaviors. The findings suggest that a person-centered care-based psycho-educational intervention can positively affect direct care workers' communicative behaviors with residents with dementia. Further research is required to determine the extent of the benefits of this approach. PMID:26400182
"Intent to stay" among paid home care workers in California.
Matthias, Ruth E; Benjamin, A E
The continuing shortage of entry-level healthcare workers highlights the need to understand worker retention and turnover. This study focuses on intent to stay among 618 paid home care workers in California, half from agencies, and half employed under a consumer-directed model that includes both relatives and non-relatives of the client. Most workers (63.3%) report that they will very likely be working as a caregiver in 12 months, but more family than non-family caregivers say so. Being related to the client, and having fewer clients, more training, more job satisfaction, and hopes for a raise, all predict intent to stay. However, when we analyze family caregivers separately, there are no significant predictors of intent to stay. PMID:16203689
Age and Workers' Perceptions of Workplace Safety: A Comparative Study
ERIC Educational Resources Information Center
Gyekye, Seth Ayim; Salminen, Simo
The study examined the relationship between age and I) safety perception; ii) job satisfaction; iii) compliance with safety management policies; and (iv) accident frequency. Participants were Ghanaian industrial workers (N = 320) categorized into 4 age groups: 19-29 years; 30-39 years; 40-50 years; and 51 years and above. Workplace safety…
Understanding Burnout in Child and Youth Care Workers
ERIC Educational Resources Information Center
Barford, Sean W.; Whelton, William J.
Burnout is a major concern in human service occupations as it has been linked to turnover, absenteeism, a reduction in the quality of services, numerous physical and psychological disorders, and a disruption in interpersonal relations (Maslach et al. "2001"). Child and youth care workers are especially susceptible to burnout as the inherent…
Job Satisfaction for Child and Youth Care Workers.
ERIC Educational Resources Information Center
Krueger, Mark A.
Job satisfaction, which can be defined as a feeling of fulfillment or pleasure associated with one's work, comes from many personal sources but can be nourished by supportive agency practices, daily interactions, and long-term goals. Job satisfaction is important for child and youth care workers because (1) job satisfaction and competence are…
Cultural Support Workers and Long Day Care Services
ERIC Educational Resources Information Center
Miller, Melinda G.; Knowles, Meg; Grieshaber, Susan
In Australia, eligible long day care services may apply for support at the state level to assist with the transition of children from culturally or linguistically diverse backgrounds into childcare settings. For staff in childcare services, this support comes in the form of a cultural support worker (CSW). The primary role of a CSW is to build…
Tracing patients exposed to health care workers with tuberculosis.
Zaza, S; Beck-Sagué, C M; Jarvis, W R
OBJECTIVES: Following an outbreak of tuberculosis (TB) among health care workers at a public hospital, the study was undertaken to (a) locate all exposed patients and administer tuberculin skin tests (TSTs) to them, (b) provide clinical treatment or prophylaxis to infected patients, and (c) ascertain the risk of M. tuberculosis transmission from health care workers to patients. METHODS: The authors identified all patients who had been hospitalized on floors where health care workers with symptomatic TB worked. The staff of the hospital's outpatient HIV/AIDS clinic notified and evaluated clinic patients who had been hospitalized on those floors. County health department personnel attempted to contact the remaining patients by letter and phone. RESULTS: The authors identified 586 patients hospitalized during the health care worker outbreak, of whom 503 were potentially susceptible. Of these, 172 (34.2%) could be contacted, and 138 (80.2%) completed tuberculin skin testing or other follow-up evaluation. Of 134 who completed testing, 28 (20.9%) had reactive TSTs. In all, 362 patients (72%) were lost to follow-up, including many HIV-positive and homeless patients, who are at high risk of developing active TB once infected with M. tuberculosis. CONCLUSIONS: The reemergence of TB as a public health threat and the emergence of other infectious diseases make it imperative to elicit accurate addresses and contact information from hospitalized patients and to develop better methods of contacting patients after hospital discharge. PMID:9071278
Direct Care Workers' Recommendations for Training and Continuing Education
ERIC Educational Resources Information Center
Menne, Heather L.; Ejaz, Farida K.; Noelker, Linda S.; Jones, James A.
Training of direct care workers (DCWs) varies depending upon the setting in which they work and the state in which they are trained. Evidence points to the importance of adequate training as critical to DCW job satisfaction and reduction in turnover. Several approaches have been taken to enhance the training of DCWs with the objective that as job…
Radiation safety for health care workers in the bronchoscopy suite.
Jain, P; Fleming, P; Mehta, A C
Increased use of fluoroscopy during flexible bronchoscopy has raised concerns about radiation safety of health care workers in the bronchoscopy suite. We review the potential health risks associated with occupational radiation exposure, the monitoring devices available, and discuss the measures to reduce radiation exposure during flexible bronchoscopy. PMID:10205715
V-TECS Guide for Child Care Worker.
ERIC Educational Resources Information Center
Elliott, Ronald T.; Benson, Robert T.
This guide is intended to assist teachers responsible for instructing future child care workers. The competency-based course outline provided covers the following topics: planning activities or programs for young children, performing child guidance activities, performing food service activities, performing housekeeping activities, and performing…
Working conditions in home care: a survey of Washington state's home care workers.
Hayashi, R; Gibson, J W; Weatherley, R A
Home care services make it possible for millions of older Americans to continue living in the community. Such services may enhance the recipients' quality of life while providing essential respite to family caregivers. But while there has been increasing recognition of the burden borne by the predominantly female family caregivers, there has been less attention to the plight of the home care workforce. With the growth of the home care industry, the burden of care has to some extent shifted from one category of female caregivers to another. This paper, based on a survey of 16 agencies and 1,900 workers, examines the employment conditions of home care workers in Washington state. The study reveals a pattern of harsh working conditions, low wages, and few benefits. The findings raise questions about the ethics and efficacy of government policies that are based on the exploitation of home care workers. PMID:10134029
Perceptions and employment intentions among aged care nurses and nursing assistants from diverse cultural backgrounds: A qualitative interview study.
Gao, Fengsong; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony; Newcombe, Peter
The residential aged care industry faces shortages and high turnover rates of direct care workers. This situation is further complicated by the increasing cultural diversity of residents and staff. To retain direct care workers, it is crucial to explore their perceptions of the rewards and difficulties of care work, and their employment intentions in multicultural environments. A qualitative descriptive study was used to understand perceptions of the rewards and difficulties of residential aged care work for core direct care workers (i.e. nurses and nursing assistants), how these were related to their intentions to stay or leave, and how these varied between nurses and nursing assistants, and between locally and overseas born workers. Individual interviews were conducted between June and September 2013 with 16 direct care workers in an Australian residential aged care facility with a specific focus on people from culturally and linguistically diverse backgrounds. It was found that direct care workers' employment intentions were related to their perceptions and management of the rewards and difficulties of care work. Their experiences of care work, the employment characteristics, and the organizational resources that fitted their personality, ability, expectations, and essential needs were viewed as rewards. Evaluating their jobs as meaningful was a shared perception for direct care workers who intended to stay. Individual workers' perceptions of the rewarding aspects of care work served to counterbalance the challenges of care work, and promoted their intentions to stay. Perceptions and employment intentions varied by occupational groups and by cultural backgrounds. Overseas born direct care workers are valuable resources in residential aged care facility rather than a limitation, but they do require organizational support, such as cultural awareness of the management, English language support, a sense of family, and appropriate job responsibility. The findings
Job Stress and Job Satisfaction: Home Care Workers in a Consumer-Directed Model of Care
Delp, Linda; Wallace, Steven P; Geiger-Brown, Jeanne; Muntaner, Carles
Objective To investigate determinants of job satisfaction among home care workers in a consumer-directed model. Data Sources/Setting Analysis of data collected from telephone interviews with 1,614 Los Angeles home care workers on the state payroll in 2003. Data Collection and Analysis Multivariate logistic regression analysis was used to determine the odds of job satisfaction using job stress model domains of demands, control, and support. Principal Findings Abuse from consumers, unpaid overtime hours, and caring for more than one consumer as well as work-health demands predict less satisfaction. Some physical and emotional demands of the dyadic care relationship are unexpectedly associated with greater job satisfaction. Social support and control, indicated by job security and union involvement, have a direct positive effect on job satisfaction. Conclusions Policies that enhance the relational component of care may improve workers' ability to transform the demands of their job into dignified and satisfying labor. Adequate benefits and sufficient authorized hours of care can minimize the stress of unpaid overtime work, caring for multiple consumers, job insecurity, and the financial constraints to seeking health care. Results have implications for the structure of consumer-directed models of care and efforts to retain long-term care workers. PMID:20403063
Individual and contextual antecedents of workplace aggression in aged care nurses and certified nursing assistants.
Rodwell, John; Demir, Defne; Gulyas, Andre
Employees in aged care are at high risk of workplace aggression. Research rarely examines the individual and contextual antecedents of aggression for specific types of workers within these settings, such as nurses and certified nursing assistants (CNAs). The study aimed to explore characteristics of the job demands-resources model (JD-R), negative affectivity (NA) and demographics related to workplace aggression for aged care workers. The survey study was based on 208 nurses and 83 CNAs working within aged care. Data from each group were analysed separately using ordinal regressions. Both aged care nurses and CNAs reported high rates of bullying, external emotional abuse, threat of assault and physical assault. Elements of the JD-R model and individual characteristics were related to aggression types for both groups. Characteristics of the JD-R model, NA and demographics are important in understanding the antecedents of aggression observed among aged care workers. PMID:26224217
Quarantine, Isolation, and Health Care Workers.
Webb, Adam
Although Ebola virus disease and other hemorrhagic fevers are not generally considered infectious diseases of the nervous system, neurologists may be asked to participate in the management of patients with these and other dangerous communicable illnesses, including possible bioterrorism agents. It is essential for all health professionals to understand the public health, legal, and ethical frameworks behind autonomy-limiting interventions such as quarantine and isolation. Health care professionals represent the front line of defense during public health emergencies. They are often disproportionately affected by the illnesses themselves as well as by the public health interventions intended to prevent spread. The global health crisis caused by the spread of Ebola virus disease has been instructional for examining these ethical issues. PMID:26633787
Working on reform. How workers' compensation medical care is affected by health care reform.
Himmelstein, J; Rest, K
The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies? Images p13-a p14-a p15-a p16-a p18-a p19-a p20-a p22-a p24-a PMID:8610187
Review of Pesticide Education Materials for Health Care Providers Providing Care to Agricultural Workers
ERIC Educational Resources Information Center
Hiott, Ann E.; Quandt, Sara A.; Early, Julie; Jackson, David S.; Arcury, Thomas A.
Context: Pesticide exposure is an important environmental and occupational health risk for agricultural workers and their families, but health care providers receive little training in it. Objective: To evaluate the medical resources available to providers caring for patients, particularly farmworkers, exposed to pesticides and to recommend a…
Is it racism? Skepticism and resistance towards ethnic minority care workers among older care recipients.
Jönson, Håkan
The study investigates the occurrence and character of skepticism and resistance towards ethnic minority care workers among older care recipients in a municipality in Sweden. Twelve representatives of caregiver organizations were interviewed about their experience of this phenomenon. Three additional interviews were conducted with ethnic minority care workers. Representatives described the problem as rare and mostly occurring as language difficulties or as a temporary problem characterized as a fear of the unknown among some care recipients. They tended to apply a pragmatic or pathologizing approach when talking about causes of and solutions to the problem. These approaches enabled care providers to comply with "potential racism" without challenging an official ideology of anti-racism. In contrast, staff of foreign descent described the problem as more frequent and severe, particularly for short-term employees who experience many first-time encounters with care recipients. PMID:17953063
Home Care Workers' Skills in the Context of Task Shifting: Complexities in Care Work.
Barken, Rachel; Denton, Margaret; Plenderleith, Jennifer; Zeytinoglu, Isik U; Brookman, Catherine
Task shifting, which involves the transfer of care work from regulated health-care professionals to home care workers (HCWs), is a strategy to ensure the efficient delivery of home care services in Canada and internationally. Using a feminist political economy approach, this paper explores the effects of task shifting on HCWs' skills. Task shifting may be understood as a form of downward substitution-and an effort to increase control over workers while minimizing costs-as some of health-care professionals' responsibilities are divided into simpler tasks and transferred to HCWs. Our interviews with 46 home health-care providers in Ontario, which focused explicitly on HCWs' role in care provision, problematize the belief that "low skilled" care workers have little control over their work. HCWs' skills become more complex when they do transferred tasks, and HCWs sometimes gain greater control over their work. This results in increased autonomy and mastery for many HCWs. In turn, this serves to reinforce the intrinsic rewards of care work, despite the fact that it is low paid and undervalued work. PMID:26286959
[Problems in Providing Care to Young Workers with Mental Health Disturbance - A Survey Using of the Cases of Workers Who Had Taken Sick Leave Due to Mental Health Disturbance].
Ikegami, Kazunori; Eguchi, Masafumi; Osaki, Yohei; Nakao, Tomo; Nakamoto, Kengo; Hiro, Hisanori
In this study we discuss the measures of providing care to young workers with mental health disturbance by analyzing the cases of workers who had taken sick leave due to mental health disturbance. We analyzed 36 cases, collected from 11 occupational physicians, of workers who had taken sick leave due to mental health disturbance, and discuss measures for providing care to such young workers. We organized and classified data containing the details of the care provided to the workers and analyzed the main aspects and problems in providing it. We compared two age groups of workers: a below age 30 group, and an age 30 and above group. We observed that occupational nurses were more frequently the primary persons who dealt with workplace consultations in the below age 30 group (before sick leave: 38.9%; during sick leave: 38.9%) compared to the age 30 and above group (before sick leave: 16.7%, during sick leave: 11.1%). Most of the case providers expressed the opinion that a support system is necessary to help the workers return to work and it is an important factor in providing care to workers who have taken sick leave due to mental health disturbance. Coordination with the families of the workers was also important in the below age 30 group. It might be difficult to assign young workers to suitable workplaces or duties because of their inadequate job skills, lack of sufficient experience, and influence of personal factors on mental health. Our results suggest that it is important to provide appropriate care for young workers with mental health disturbance, such as support by occupational nurses, and to strengthen the collaboration between their families and the workplace staff. PMID:27302732
Providing and financing aged care in Australia
Ergas, Henry; Paolucci, Francesco
This article focuses on the provision and financing of aged care in Australia. Demand for aged care will increase substantially as a result of population aging, with the number of Australians aged 85 and over projected to increase from 400,000 in 2010 to over 1.8 million in 2051. Meeting this demand will greatly strain the current system, and makes it important to exploit opportunities for increased efficiency. A move to greater beneficiary co-payments is also likely, though its extent may depend on whether aged care insurance and other forms of pre-payment can develop. PMID:22312229
Methicillin resistance of Staphylococcus species among health care and nonhealth care workers undergoing cataract surgery
Olson, Randall; Donnenfeld, Eric; Bucci, Frank A; Price, Francis W; Raizman, Michael; Solomon, Kerry; Devgan, Uday; Trattler, William; Dell, Steven; Wallace, R Bruce; Callegan, Michelle; Brown, Heather; McDonnell, Peter J; Conway, Taryn; Schiffman, Rhett M; Hollander, David A
Purpose: The purpose of this study is to characterize the bacterial flora of the ocular and periocular surface in cataract surgery patients and to determine the prevalence of methicillin resistance among staphylococcal isolates obtained from health care workers (HCWs) and non-HCWs. Methods: In this prospective, multicenter, case series study, eyelid and conjunctival cultures were obtained from the nonoperative eye of 399 consecutive cataract patients on the day of surgery prior to application of topical anesthetics, antibiotics, or antiseptics. Speciation and susceptibility testing were performed at the Dean A. McGee Eye Institute. Logistic regression was utilized to evaluate whether any factors were significant in predicting the presence of methicillin-resistant staphylococcal isolates. Results: Staphylococcus epidermidis (62.9%), followed by S. aureus (14.0%), was the most frequently isolated organism. Methicillin-resistant S. epidermidis accounted for 47.1% (178/378) of S. epidermidis isolates, and methicillin-resistant S. aureus accounted for 29.5% (26/88) of S. aureus isolates. Methicillin-resistant staphylococcal isolates were found in 157 of 399 (39.3%) patients, the majority (89.2%) of whom were non-HCWs. The likelihood of being colonized with methicillin-resistant organisms increased with age (odds ratio [OR], 1.27; 95% confidence interval [CI]: 1.02–1.58; P = 0.04) but decreased with diabetes (OR, 0.51; 95% CI: 0.29–0.89; P = 0.02). Being a HCW (OR, 1.25; 95% CI: 0.61–2.58; P = 0.54) was not a risk factor for colonization with methicillin-resistant organisms. Conclusion: Patients without exposure to health care environments are as likely as HCWs to be colonized with methicillin-resistant organisms. Increasing methicillin resistance with age may partially explain the increased risk of endophthalmitis reported with older age. PMID:21191448
Assessment of hand hygiene compliance after hand hygiene education among health care workers in Cambodia
Sansam, Sim; Yamamoto, Eiko; Srun, Sok; Sinath, Yin; Moniborin, Mey; Bun Sim, Kheang; Reyer, Joshua A.; Yoshida, Yoshitoku; Hamajima, Nobuyuki
ABSTRACT Health care-associated infection (HCAI) is the most frequent adverse event for hospitalized patients. Hand hygiene is a simple and effective solution to protect patients from HCAI. This study aimed to introduce hand hygiene to health care workers based on the World Health Organization guideline for reducing HCAI in Cambodia and to assess their behavioral patterns on hand hygiene. All health care workers at Kampong Cham provincial hospital had lectures and practice on hand hygiene in January 2012. The surveys for hand hygiene compliance (HHC) were performed after 6 months, 1 year and 2 years, respectively. The number of surgical site infections (SSI) was counted in 2011 and 2014. Our analysis used the data of 58 workers, who were observed at all three points, although 139 workers were observed during the study period. The average of HHC at 6 months, 1 year and 2 years were 62.37%, 85.76% and 80.36%, respectively. The improved group (HHC 2 years/1 year≧1) had 32 workers, whereas the worsened group (HHC 2 years/1 year<1) had 26. There was a significant difference in departments of the two groups (P=0.011) but not in sex, age or occupations. The improved group had more workers of General (31.2% vs. 19.2%), Surgical (25.0% vs. 11.5%) and Infection (21.9% vs. 11.5%) categories compared to the worsened group. The incidence of SSI was improved from 32.26% in 2011 to 0.97% in 2014. Our results suggest that the education and the survey on hand hygiene are effective for reducing HCAI in Cambodia. PMID:27303102
Assessment of hand hygiene compliance after hand hygiene education among health care workers in Cambodia.
Sansam, Sim; Yamamoto, Eiko; Srun, Sok; Sinath, Yin; Moniborin, Mey; Bun Sim, Kheang; Reyer, Joshua A; Yoshida, Yoshitoku; Hamajima, Nobuyuki
Health care-associated infection (HCAI) is the most frequent adverse event for hospitalized patients. Hand hygiene is a simple and effective solution to protect patients from HCAI. This study aimed to introduce hand hygiene to health care workers based on the World Health Organization guideline for reducing HCAI in Cambodia and to assess their behavioral patterns on hand hygiene. All health care workers at Kampong Cham provincial hospital had lectures and practice on hand hygiene in January 2012. The surveys for hand hygiene compliance (HHC) were performed after 6 months, 1 year and 2 years, respectively. The number of surgical site infections (SSI) was counted in 2011 and 2014. Our analysis used the data of 58 workers, who were observed at all three points, although 139 workers were observed during the study period. The average of HHC at 6 months, 1 year and 2 years were 62.37%, 85.76% and 80.36%, respectively. The improved group (HHC 2 years/1 year≧1) had 32 workers, whereas the worsened group (HHC 2 years/1 year<1) had 26. There was a significant difference in departments of the two groups (P=0.011) but not in sex, age or occupations. The improved group had more workers of General (31.2% vs. 19.2%), Surgical (25.0% vs. 11.5%) and Infection (21.9% vs. 11.5%) categories compared to the worsened group. The incidence of SSI was improved from 32.26% in 2011 to 0.97% in 2014. Our results suggest that the education and the survey on hand hygiene are effective for reducing HCAI in Cambodia. PMID:27303102
School Age Child Care: A Preliminary Report.
ERIC Educational Resources Information Center
Jacobs, Ellen; And Others
This paper examines on-site, school-age child care and the relationship between attendance at on-site, after-school child care programs and familial, environmental, and developmental factors. Topics discussed include: (1) the quality of school-based environments in kindergarten and child care; (2) the socioeconomic status and size of families of…
Interactions and relationships in long term care: photography and narratives by direct care workers.
Shenk, Dena
The challenge of hiring and retaining well-trained caregivers for the growing numbers of elders in need of care is a global concern. This study was designed to understand the views of direct care workers and included 15 nurse aides and med techs working in an assisted living and special care assisted living community for people with dementia. Each participant was provided with a digital camera and asked to take photographs "to show what caregiving means to you." Analysis is based on group discussions about the full set of photographs created by the direct care workers and individual written and oral narratives about four photographs chosen by each participant. The categories generated from these data represent the direct care workers' perceptions of the approaches to quality caregiving and the relationships involved in doing their jobs well. By focusing on the essential relationships and interactions, rather than primarily on the required care, we can begin to imagine the caregiving experience in terms of a communal rather than an institutional experience. We can then productively turn our focus to the people involved rather than emphasize their roles as providers or recipients of care. PMID:22539061
Nurse-managed care for health care workers in southern Africa.
Mamba, P; Dlamini, M; Mallinson, R K; Williams, V
In Swaziland, the health care system is experiencing severe scarcity of health care workers (HCWs) due to difficult working conditions, migration and the human immunodeficiency virus (HIV) pandemic. Nurses and other HCWs in Swaziland are personally as affected by communicable diseases as the general population. High levels of HIV and TB co-infection bring added complexity to care. The loss of skilled staff in key positions has had a particularly negative impact on the quality of care and service delivery. The Swaziland Nurses Association (SNA) has established a Centre for Comprehensive Wellness for HCWs in the public and private sector and their immediate families to support the health workforce. PMID:24020598
Occupational HIV risk for health care workers: risk factor and the risk of infection in the course of professional activities
Wyżgowski, Przemysław; Rosiek, Anna; Grzela, Tomasz; Leksowski, Krzysztof
Virtually created panic among health care workers about pandemic acquired immune deficiency syndrome prompted us to review the scientific literature to investigate the risk of human immunodeficiency virus (HIV) transmission in the daily works of health care workers, especially surgeons and anesthesiologists. In this review, we report worldwide valuations of the number of HIV infections that may occur from unsafe daily work in health care. We also present how to minimize the risk of infection by taking precautions and how to utilize postexposure prophylaxis in accordance with the latest reports of the Centers for Disease Control and Prevention. HIV-infected patients will be aging, and most of them will become the candidates for procedures such as major vascular reconstruction and artery bypass grafting, where the risks of blood contact and staff injury are high. For these reasons, all health care workers need to know how to prevent, and fight following the accidental exposure to HIV. PMID:27366077
Improving occupational health care for construction workers: a process evaluation
Background To evaluate the process of a job-specific workers' health surveillance (WHS) in improving occupational health care for construction workers. Methods From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0–10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received. Results Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation. Conclusions Programme implementation was acceptable. Low reach, limited protocol adherence and
Risk factors for nosocomial tuberculosis transmission among health care workers.
Ito, Yutaka; Nagao, Miki; Iinuma, Yoshitsugu; Matsumura, Yasufumi; Yamamoto, Masaki; Takakura, Shunji; Igawa, Junko; Yamanaka, Hiroe; Hashimoto, Akiko; Hirai, Toyohiro; Niimi, Akio; Ichiyama, Satoshi; Mishima, Michiaki
We conducted hospital-based contact investigations of 55 serial sputum smear-positive tuberculosis (TB) patients and 771 health care workers (HCWs) from 2006-2013. HCWs who made contact with TB patients in the absence of appropriate airborne precautions were evaluated using interferon gamma release assays to identify TB infection. Twenty-nine HCWs (3.8%) were newly diagnosed with TB infection. The 10 TB patients responsible for transmission had a duration of contact of >7 days by multivariate analysis. PMID:26777287
Age-differences in work motivation and job satisfaction. The influence of age on the relationships between work characteristics and workers' outcomes.
Boumans, Nicolle P G; de Jong, Ad H J; Janssen, Sara M
This study investigated the influence of age on the relationship between work characteristics and workers' work motivation and job satisfaction. In total, 1036 workers of a Dutch division of a multinational organization participated. Data were collected by a digital questionnaire. Two interaction terms in the regression on work motivation were significant. The first interaction showed that the positive correlation between Motivating Potential Score (MPS) and motivation was much stronger for older than for younger employees. So, to remain motivated, older employees seem more in need of intrinsic challenging and fulfilling jobs. The second significant interaction indicated that the positive association between career opportunities and motivation was much stronger for younger employees than for older employees. This means that, especially, younger workers' motivation increases as they are offered more career opportunities. Careful career mentoring by the supervisor as part of an aging policy can contribute to the maintenance of workers of any age. PMID:22474915
Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.
Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita
The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia. PMID:25935206
Primary Care Clinician Expectations Regarding Aging
ERIC Educational Resources Information Center
Davis, Melinda M.; Bond, Lynne A.; Howard, Alan; Sarkisian, Catherine A.
Purpose: Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians' age expectations likely influence patients' expectations and care delivery patterns; yet, limited research has explored clinicians' age expectations. The Expectations Regarding Aging…
8 CFR 212.15 - Certificates for foreign health care workers.
Code of Federal Regulations, 2010 CFR
... Authorization to Issue Certification for Health Care Workers, with the appropriate fee contained in 8 CFR 103.7... occupational therapy or physical therapy. (ii) Registered nurses and other health care workers requiring the... perform labor in another health care occupation requiring a baccalaureate degree (other than...
Exposure of health workers in primary health care to glutaraldehyde
Background In order to avoid proliferation of microorganisms, cleaning, disinfection and sterilisation in health centres is of utmost importance hence reducing exposure of workers to biological agents and of clients that attend these health centres to potential infections. One of the most commonly-used chemical is glutaraldehyde. The effects of its exposure are well known in the hospital setting; however there is very little information available with regards to the primary health care domain. Objective To determine and measure the exposure of health workers in Primary Health Care Centres. Environmental to glutaraldehyde and staff concentration will be measured and compared with regulated Occupational Exposure Limits. Methods/Design Observational, cross-sectional and multi-centre study. The study population will be composed of any health professionals in contact with the chemical substance that work in the Primary Health Care Centres in the areas of Barcelonès Nord, Maresme, and Barcelona city belonging to the Catalan Institute of Health. Data will be collected from 1) Glutaraldhyde consumption from the previous 4 years in the health centres under study. 2) Semi-structured interviews and key informants to gather information related to glutaraldehyde exposure. 3) Sampling of the substance in the processes considered to be high exposure. Discussion Although glutaraldehyde is extensively used in health centres, scientific literature only deals with certain occupational hazards in the hospital setting. This study attempts to take an in-depth look into the risk factors and environmental conditions that exist in the primary care workplace with exposure to glutaraldehyde. PMID:24180250
Managing HIV/hepatitis positive patients: present approach of dental health care workers and students.
Shinde, Nagesh; Baad, Rajendra; Nagpal, Deepak Kumar J; Prabhu, Prashant R; Surekha, L Chavan; Karande, Prasad
People with HIV/HBsAg in India frequently encounter discrimination while seeking and receiving health care services. The knowledge and attitudes of health care workers (HCWs) influences the willingness and ability of people with HIV/HBsAg to access care, and the quality of the care they receive. The objective of this study was to asses HIV/HBsAg-related knowledge, attitudes and risk perception among students and dental HCWs. A cross-sectional survey was conducted on 250 students and 120 dental HCWs in the form of objective questionnaire. Information was gathered regarding demographic details (age, sex, duration of employment, job category); HIV/ HBsAg-related knowledge and attitudes; risk perception; and previous experience caring for HIV-positive patients. The HCWs in this study generally had a positive attitude to care for the people with HIV/HBsAg. However, this was tempered by substantial concerns about providing care, and the fear of occupational infection with HIV/HBsAg. A continuing dental education program was conducted to resolve all the queries found interfering to provide care to HIV/HBsAg patients. But even after the queries were resolved the care providing capability was not attained. These findings show that even with advanced knowledge and facilities the attitude of dental HCWs and students require more strategic training with regards to the ethics and moral stigma associated with the dreaded infectious diseases (HIV/HBsAg). PMID:23404020
Healthcare organization-education partnerships and career ladder programs for health care workers.
Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C
Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. PMID:25441318
Dental Care Knowledge and Practice of a Group of Health Workers in Benin City, Nigeria
Amuh, VO; Okojie, OH; Ehizele, AO
Background: The correlation between knowledge of dental care knowledge and its practice varies among the different health professionals. Aim: The aim of the following study is to assess the knowledge and practice of health workers in a private medical health facility on dental care. Subjects and Methods: A descriptive cross-sectional study was carried out on the health workers in Faith Medical Center, Benin City, Nigeria. A self-administered questionnaire, containing 31 open and closed questions was used for data collection to assess their knowledge and practice of dental care. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago, IL, USA) and WIN PEPI software version 11.15. Results: None of the respondents had a poor knowledge of dental care, but majority had poor practice. The pattern of distribution of knowledge and practice of dental care observed in this study was not significantly affected by age, gender, occupation and working experience. The entire respondents knew that bleeding from the gum is not normal and 96.2% (75/78) gave correct causes of bleeding gums. Majority 88.5% (69/78) also knew that tooth decay is not normal, but fewer 66.6% (52/78) knew the correct causes of tooth decay. Only 37.2% (29/75) of the respondents took correct action after experiencing a toothache (i.e., consulting a dentist for proper management) and majority 80.8% (63/78) and 76.1% (60/78) still make use of toothpicks, which is considered as potentially harmful and frequently consume cariogenic diet respectively. Conclusion: There is a good knowledge of dental care, but poor oral health practices among the studied health workers. Oral health education to correct their improper practices is therefore highly advocated. PMID:25364607
Process of precocious functional aging in workers of laundries.
Mafra, Simone Caldas Tavares; Carlos, Celina Angélica Lisboa Valente; Silva, Vania Eugênia da
The World Health Organization (WHO), as well as researchers of the whole world, it has been demonstrating concern with the subject of the aging related to the work and it recognizes that modifications in the several systems of the human body take to the gradual decrease in the effectiveness of each one of them, because the aging caused by the work advances apprenticeships of the cycle of the man's life, not respecting the natural state of that process. In this sense, it was aimed at with this research to investigate the relative aspects to the capacity for the work and to the workers' with responsibility to realize the work in the laundries service, verifying if they present signs of precocious functional aging. PMID:22316746
Care of Aging Parents by Adult Offspring.
ERIC Educational Resources Information Center
Ames, Barbara D.
A prevailing myth holds that modern families, characterized by high mobility and individualistic life styles, do not care for their aging members. To assess the quantity and characteristics of the care of noninstitutionalized elderly parents by their adult children, parents and adult child pairs (N=50) responded to interviews. Specific research…
Implementing the role of the primary care mental health worker: a qualitative study
England, Elizabeth; Lester, Helen
Background Primary care mental health workers are a new role recently introduced into primary care in England to help manage patients with common mental health problems. Aim To explore the views of GPs, primary care teams and patients on the value and development of the new role of primary care mental health workers in practice. Design of study Qualitative study. Setting The Heart of Birmingham Primary Care Teaching Trust in the West Midlands, UK. Method Thirty-seven semi-structured interviews involving seven primary care mental health workers, 21 patients and 11 focus groups involving 38 members of primary care teams were held with six teams with a worker. Two teams asked for the worker to be removed. Six practice managers also took part in the study. Results A number of different approaches were used to implement this new role. Strategies that incorporated the views of primary care trust senior management, primary care teams and workers' views appeared most successful. Rapid access to a healthcare professional at times of stress and the befriending role of the worker were also highly valued. Workers felt that their role left them professionally isolated at times. A number of workers described tension around ownership of the role. Conclusion Primary care mental health workers appear to provide a range of skills valued by patients and the primary care teams and can increase patient access and choice in this area of health care. Successful implementation strategies highlighted in this study may be generalisable to other new roles in primary care. PMID:17359607
Work-Life Differences and Outcomes for Agency and Consumer-Directed Home-Care Workers
ERIC Educational Resources Information Center
Benjamin, A.E.; Matthias, Ruth E.
Purpose. Research on home-care outcomes has highlighted the promise of consumer-directed models that rely on recipients rather than agencies to arrange and direct services. However, there has been little research on workers employed directly by recipients. This study examined differences in work-life and worker outcomes between workers in…
What Do Direct Care Workers Say Would Improve Their Jobs? Differences across Settings
ERIC Educational Resources Information Center
Kemper, Peter; Heier, Brigitt; Barry, Teta; Brannon, Diane; Angelelli, Joe; Vasey, Joe; Anderson-Knott, Mindy
Purpose: The study's goals were to understand what changes in management practices would most improve the jobs of frontline workers from the perspective of workers themselves and to analyze differences across settings. Design and Methods: The baseline survey of direct care workers (N = 3,468) conducted as part of the National Study of the Better…
[Overview of sharps injuries among health-care workers].
Gopar-Nieto, Rodrigo; Juárez-Pérez, Cuauhtémoc Arturo; Cabello-López, Alejandro; Haro-García, Luis Cuauhtémoc; Aguilar-Madrid, Guadalupe
Sharps injuries are one of the most frequent health-care related accidents. It is estimated globally that 35 million workers are at risk; in Mexico there is no data available for this type of injuries. They are associated with lack of training, instrument and procedure risk, fatigue and stress. The occupational distribution is nurses 45 %, technicians 20 %, doctors 20 % and maintenance workers 5 %. The most commonly associated procedures are injection, venipuncture, suture, and insertion and manipulation of IV catheters. Hepatitis B is the most commonly transmitted agent. Emotional distress is huge as well as the cost of prophylaxis and follow-up. More than half of the injuries are not notified. The most common reasons for not reporting are: the belief that the exposure has low risk of infection, the lack of knowledge of reporting systems and the assumption that it is difficult to notify. Many strategies have been created to reduce the incidence of sharps injuries, such as: identifying the risk of blood exposure, the creation of politics to minimize the risk, the education and training to create a safe workplace, the enhancing of the reporting system, the use of double-gloving and using safety-engineered sharps devices. In many countries these politics have reduced the incidence of sharps injuries as well as the economic burden. PMID:25984621
What Makes Migrant Live-in Home Care Workers in Elder Care Be Satisfied with Their Job?
ERIC Educational Resources Information Center
Iecovich, Esther
Purpose: The study aims to examine job satisfaction of migrant live-in home care workers who provide care to frail older adults and to examine the extent to which quality of relationships between the care provider and care recipient and workplace characteristics is associated with job satisfaction. Design and Methods: A convenience sample that…
Health Care Workers Skipped Hand Washing One-Third of The Time
... nlm.nih.gov/medlineplus/news/fullstory_158291.html Health Care Workers Skipped Hand Washing One-Third of the ... 13, 2016 (HealthDay News) -- Staff at many outpatient health care facilities in New Mexico failed to follow recommendations ...
Psychosocial work environment factors and weight change: a prospective study among Danish health care workers
Background Lifestyle variables may serve as important intermediate factors between psychosocial work environment and health outcomes. Previous studies, focussing on work stress models have shown mixed and weak results in relation to weight change. This study aims to investigate psychosocial factors outside the classical work stress models as potential predictors of change in body mass index (BMI) in a population of health care workers. Methods A cohort study, with three years follow-up, was conducted among Danish health care workers (3982 women and 152 men). Logistic regression analyses examined change in BMI (more than +/− 2 kg/m2) as predicted by baseline psychosocial work factors (work pace, workload, quality of leadership, influence at work, meaning of work, predictability, commitment, role clarity, and role conflicts) and five covariates (age, cohabitation, physical work demands, type of work position and seniority). Results Among women, high role conflicts predicted weight gain, while high role clarity predicted both weight gain and weight loss. Living alone also predicted weight gain among women, while older age decreased the odds of weight gain. High leadership quality predicted weight loss among men. Associations were generally weak, with the exception of quality of leadership, age, and cohabitation. Conclusion This study of a single occupational group suggested a few new risk factors for weight change outside the traditional work stress models. PMID:23327287
Study of the Physical Condition of Middle-aged Office and Field Workers Aged 50 and Older.
Yoo, ChanUk; Park, SooHee; Yang, DongJoo; Park, YunHee; Kim, DeokJu; Yang, YeongAe
[Purpose] We investigated the physical condition of middle-aged workers in Korea by job category (office job vs. production job). [Subjects] In total, 3,650 middle-aged workers (production job, n = 2,615; office job, n = 1,035) ≥50 years of age from eight geographical areas were evaluated from 2007 to 2008. [Methods] The subjects' subjective physical condition, exercise status, smoking status, and drinking status were investigated, and precise physical measurements, cardiovascular endurance, muscular strength, muscular endurance, flexibility, reflexes, and reactions were measured. [Results] Subjectively, the physical condition and exercise status of those with office jobs were superior to those of production job workers. Office workers exhibited a higher rate of drinking than production workers, and also had better cardiovascular endurance, muscular strength, muscular endurance, reflexes, and reactions. However, production workers were more flexible than office workers. [Conclusion] Middle-aged production job workers in Korea have poorer overall physical condition than middle-aged office job workers. The physical condition of middle-aged and elderly workers must be managed through various health management programs to secure a productive aging society. PMID:25364116
Study of the Physical Condition of Middle-aged Office and Field Workers Aged 50 and Older
Yoo, ChanUk; Park, SooHee; Yang, DongJoo; Park, YunHee; Kim, DeokJu; Yang, YeongAe
[Purpose] We investigated the physical condition of middle-aged workers in Korea by job category (office job vs. production job). [Subjects] In total, 3,650 middle-aged workers (production job, n = 2,615; office job, n = 1,035) ≥50 years of age from eight geographical areas were evaluated from 2007 to 2008. [Methods] The subjects' subjective physical condition, exercise status, smoking status, and drinking status were investigated, and precise physical measurements, cardiovascular endurance, muscular strength, muscular endurance, flexibility, reflexes, and reactions were measured. [Results] Subjectively, the physical condition and exercise status of those with office jobs were superior to those of production job workers. Office workers exhibited a higher rate of drinking than production workers, and also had better cardiovascular endurance, muscular strength, muscular endurance, reflexes, and reactions. However, production workers were more flexible than office workers. [Conclusion] Middle-aged production job workers in Korea have poorer overall physical condition than middle-aged office job workers. The physical condition of middle-aged and elderly workers must be managed through various health management programs to secure a productive aging society. PMID:25364116
Learning to Facilitate Advance Care Planning: The Novice Social Worker's Experience
ERIC Educational Resources Information Center
Washington, Karla; Bowland, Sharon; Mueggenburg, Kay; Pederson, Margaret; Otten, Sheila; Renn, Tanya
Professional leaders have identified clear roles for social workers involved in advance care planning (ACP), a facilitated process whereby individuals identify their preferences for future medical care; yet information about effective teaching practices in this area is scant. This study reports on the experiences of 14 social workers who…
Social Workers' Participation in the Resolution of Ethical Dilemmas in Hospice Care
ERIC Educational Resources Information Center
Csikai, Ellen L.
Ethical dilemmas are inherent in every health care setting. A sample of hospice social workers with no direct access to a hospice ethics committee (N = 110) was surveyed regarding ethical issues in hospice care, how the issues were managed, and the extent to which social workers participated in resolution of ethical dilemmas. Common issues…
A Challenging Job: Physical and Sexual Violence towards Group Workers in Youth Residential Care
ERIC Educational Resources Information Center
Alink, Lenneke R. A.; Euser, Saskia; Bakermans-Kranenburg, Marian J.; van IJzendoorn, Marinus H.
Background: Residential or group care social workers appear to be at increased risk for experiencing physical violence at work. However, little is known about "sexual harassment" in addition to physical victimization of social workers in "youth" residential or group care. Objective We investigated the prevalence of physical and…
Primary Care Clinician Expectations Regarding Aging
Davis, Melinda M.; Bond, Lynne A.; Howard, Alan; Sarkisian, Catherine A.
Purpose: Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians' age expectations likely influence patients' expectations and care delivery patterns; yet, limited research has explored clinicians' age expectations. The Expectations Regarding Aging Survey (ERA-12) was used to assess (a) age expectations in a sample of primary care clinicians practicing in the United States and (b) clinician characteristics associated with ERA-12 scores. Design and Methods: This study was a cross-sectional survey of primary care clinicians affiliated with 5 practice-based research networks, October 2008 to June 2009. A total of 374 of the 1,510 distributed surveys were returned (24.8% response rate); 357 analyzed. Mean respondent age was 48.6 years (SD = 11.6; range 23–87 years); 88.0% physicians, 96.0% family medicine, 94.9% White, and 61.9% male. Results: Female clinicians reported higher ERA-12 scores; clinicians' age expectations decreased with greater years in practice. Among the clinicians, higher ERA-12 scores were associated with higher clinician ratings of the importance of and personal skill in administering preventive counseling and the importance of delivering preventive services. Agreement with individual ERA-12 items varied widely. Implications: Unrealistically high or low ERA could negatively influence the quality of care provided to patients and patients' own age expectations. Research should examine the etiology of clinicians' age expectations and their association with older adult diagnoses and treatment. Medical education must incorporate strategies to promote clinician attitudes that facilitate successful patient aging. PMID:21430129
Older Workers' Perspectives on Training and Retention of Older Workers: National Finance Sector Survey. Support Document
ERIC Educational Resources Information Center
Lundberg, David; Marshallsay, Zaniah
Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…
Front-line worker engagement: greening health care, improving worker and patient health, and building better jobs.
Chenven, Laura; Copeland, Danielle
Frontline workers have a great deal to contribute to improving environmental sustainability of their employers and the health of workers and patients. This article discusses a national project of the Healthcare Career Advancement Program, funded by the U.S. Department of Labor to support green jobs development. Implementation was accomplished through a labor/management collaboration between union locals and 11 employers in four regions throughout the United States. The project developed and implemented a model of training and education for environmental service workers and other frontline health-care workers in hospital settings that supported systems change and built new roles for these workers. It empowered them to contribute to triple bottom line outcomes in support of People (patients, workers, the community), Planet (environmental sustainability and a lower carbon footprint), and Profit (cost savings for the institutions). In the process workers more clearly articulated their important role as a part of the healthcare team and learned how they could contribute to improved patient and worker health and safety. PMID:23896075
Live-in Care Workers in Sheltered Housing for Older Adults in Israel: The New Sheltered Housing Law.
Iecovich, Esther
Supportive housing schemes were historically aimed to provide group accommodation for older adults. With the aging of residents, facilities were required to enable them to receive care services in order to allow them to age in place. Thus, different countries and different facilities developed different models of housing with care, reflecting cultural and policy diversities. Despite all of the different models, there are many commonalities among the supportive housing schemes across countries. These include provision of dwelling units and care services provided by either the facility or by external agencies. The aims of this article are threefold: to describe the historical development of the ever-evolving supportive care housing phenomena; to point at variations in models of housing and care within the international context; and to present a new Israeli model that enables residents to privately hire live-in care workers to meet their care needs. This is a unique model in the international context that has not been reported before. The article describes the main ideas of the new model and discusses the challenges that it raises and pinpoints the unresolved issues associated with the presence of live-in care workers employed by residents of sheltered housing that should be addressed. PMID:26959294
Assessing the skills of home care workers in helping older people take their prescribed medications.
Smyth, Elizabeth E J
The Southern Health and Social Care Trust in Northern Ireland applied a modified version of the Objective Structured Clinical Examination (OSCE) to assess the skills of home care workers in assisting older people taking prescribed medications. In Northern Ireland, home care workers are care workers employed by health and social care trusts or private agencies. The application of the model has developed the skills of this staff group, improved the relationship between the commissioner and provider, significantly reduced the time spent by community nurses in individual training and assessment, and enhanced the patient experience for those taking medication. Overall, the application of this model has provided assurances to the Trust board, the executive director of nursing, and operational directors that home care workers are competent in assisting older people in this high-risk activity. PMID:26252238
Unemployment in the Postindustrial Age: Counseling Redundant Workers.
ERIC Educational Resources Information Center
Rundle, Jaclyn; DeBlassie, Richard R.
Focuses on counseling workers who are left jobless when manufacturing plants close. Identifies settings in which redundancy counseling could take place, discussing goals of such counseling, and the special characteristics and counseling needs of displaced workers. (RC)
The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.
ERIC Educational Resources Information Center
Older Women's League, Washington, DC.
Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…
Supporting Children's Transition to School Age Care
ERIC Educational Resources Information Center
Dockett, Sue; Perry, Bob
While a great deal of research has focused on children's experiences as they start school, less attention has been directed to their experiences--and those of their families and educators--as they start school age care. This paper draws from a recent research project investigating practices that promote positive transitions to school and school…
School Age Child Care Staff Training Evaluation.
ERIC Educational Resources Information Center
Gore, Jane S.; And Others
A formative and summative evaluation was made of eight school-age child care (SACC) training workshops conducted in 1989-90 for 190 participants in upstate New York. (The focus of the SACC workshops was to "train the trainers," as well as to provide trainees with quality materials and instruction for future training with their staff members.) All…
Keeping up! Older workers' adaptation in the workplace after age 55.
Ng, Eddy S W; Law, Alan
How do older workers keep up and adapt to a changing workplace after age 55? In exploring that question, this study specifically examined how age-related changes affect workers, how older workers deal with a loss of resources, how they engage in life management, and why some are more successful than others. An in-depth analysis was undertaken using 32 semi-structured interviews conducted with workers aged 55 to 64. Findings revealed that older workers use various strategies to adapt to a change in resources, and that these strategies help them cope and maintain their functioning in the workplace. Because older workers require different types of employer support, this study offers an understanding of how employers can provide that support to encourage older workers to remain in the workforce longer. Several avenues for future research are suggested, including an exploration of the role played by internal sources of support. PMID:24345532
Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units
da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis
Objective To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. Methods This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. Results The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Conclusion Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome. PMID:26340152
Intention to leave the job among live-in foreign home care workers in Israel.
Ayalon, Liat
In Israel, almost all around-the-clock home care services are provided by foreign workers. Despite the fact that these workers are considered temporary, the Israeli government has acknowledged the need for consistency in care and now allows workers to stay in the country for as long as their care recipient is alive. Nonetheless, there have been increasing concerns about the tendency of foreign home care workers to view Israel as a temporary station on their way to more attractive destinations, such as Canada or England. Using the job rewards and concerns model, this article evaluates determinants of foreign home care workers' intentions to leave their job. This study was a cross-sectional analysis of 178 Filipino home care workers in Israel. Only 15 workers (8.4%) reported that they would be likely or very likely to leave their job within the next 3 months. The final model suggested that negative experiences within the home/work environment as well as within Israeli society at large contribute to depression and posttraumatic stress symptoms. However, caring for an older adult with dementia was the only predictor of intention to leave the job. The majority of workers do not report an intention to leave their job. Nonetheless, greater supervision of this caregiving arrangement in an attempt to protect the rights of foreign home care workers within the home/work environment is an important step, which has to be followed up by attitudinal changes within society at large. Specific training in dementia care is also warranted. PMID:20544459
Interprofessional collaboration and integration as experienced by social workers in health care.
Glaser, Brooklyn; Suter, Esther
Interprofessional collaboration in health care is gaining popularity. This secondary analysis focuses on social workers' experiences on interprofessional teams. The data revealed that social workers perceived overall collaboration as positive. However, concerns were made apparent regarding not having the opportunity to work to full scope and a lack of understanding of social work ideology from other professionals. Both factors seem to impede integration of and collaboration with social workers on health care teams. This study confirms the need to encourage and support health care providers to more fully understand the foundation, role, and efficacy of social work on interprofessional teams. PMID:27007283
Role of health-care workers in the future delivery of health care.
Kaiser, L R
There is no logical, linear way to approach a future in which knowledge and technology explode and new opportunities go hand-in-hand with rapid obsolescence. Teams and task groups will replace the vertical command structures of the past, making teamwork, flexibility, and imagination more important that absolute knowledge. Maximum downward task delegation and decentralization will empower workers at all levels while challenging the assumptions of licensure. As the health-care organization grows more ephemeral, management will become an increasingly subtle art. Visionary skills are essential in a dynamic, rapidly changing society where the past is no longer a guide for the future. PMID:1958819
Community Health Workers as a Component of the Health Care Team.
Johnson, Sheri L; Gunn, Veronica L
In restructuring the delivery of primary care to improve the wellness of a community, every community must review its own circumstances for factors such as resources and capacities, health concerns, social and political perspectives, and competing priorities. Strengthening the health care team with community health workers to create a patient-centered medical home can enhance health care access and outcomes. Community health workers can serve as critical connectors between health systems and communities; they facilitate access to and improve quality and culturally sensitive medical care, emphasizing preventive and primary care. PMID:26318954
Oral health care in residential aged care services: barriers to engaging health-care providers.
Hearn, Lydia; Slack-Smith, Linda
The oral health of older people living in residential aged care facilities has been widely recognised as inadequate. The aim of this paper is to identify barriers to effective engagement of health-care providers in oral care in residential aged care facilities. A literature review was conducted using MEDline, CINAHL, Web of Science, Academic Search Complete and PsychInfo between 2000 and 2013, with a grey literature search of government and non-government organisation policy papers, conference proceedings and theses. Keywords included: dental/oral care, residential aged care, health-care providers, barriers, constraints, and limitations. A thematic framework was used to synthesise the literature according to a series of oral health-care provision barriers, health-care provider barriers, and cross-sector collaborative barriers. A range of system, service and practitioner level barriers were identified that could impede effective communication/collaboration between different health-care providers, residents and carers regarding oral care, and these were further impeded by internal barriers at each level. Findings indicated several areas for investigation and consideration regarding policy and practice improvements. While further research is required, some key areas should be addressed if oral health care in residential aged care services is to be improved. PMID:25155109
Job satisfaction of health-care workers at health centers in Vientiane Capital and Bolikhamsai Province, Lao PDR.
Khamlub, Senbounsou; Harun-Or-Rashid, Md; Sarker, Mohammad Abul Bashar; Hirosawa, Tomoya; Outavong, Phathammavong; Sakamoto, Junichi
The aim of this study was to assess job satisfaction levels among health-care workers and factors correlated with their overall job satisfaction. This cross-sectional study was conducted from July to September 2011 with 164 health-care workers using self-administered questionnaires on a six-point Likert scale. Categorical variables were reported using frequencies and median (interquartile range), while continuous data were using means and standard deviations. Spearman rho coefficients were computed to correlate the overall job satisfaction for each factor, Kruskal-Wallis and Mann-Whitney U tests were used to evaluate the differences between demographic characteristics on overall job satisfaction. Of the 164 respondents, the majority were females (65.85%). Other dominant variables were married (76.83%), age > or =41 years old (44.51%), certified heath professional level (96.30%), nurse profession (59.10%), and working experience < or =5 years (55.49%). Participants were satisfied with 17 factors, but dissatisfied with salary levels at a mean score of (3.25). The highest satisfaction reported was for the freedom to choose the method of working with a mean score of 4.99, followed by the amount of variety on the job (4.96), amount of responsibility (4.90), and relationships with co-workers (4.90). The correlation coefficient between overall job satisfaction and main factors for job satisfaction-conflict resolution at work, relationships with co-workers, and organizational structure were (0.79), (0.76), and (0.71), respectively. There were statistically significant differences in age group, working experience and position (P<0.05). In conclusion, health-care workers at health centers in Lao PDR were generally satisfied with their job except for their salary. The main factors that correlate with their overall job satisfaction were conflict resolutions at work, relationships with other co-workers, and organizational structure. PMID:24640179
Health services research in workers' compensation medical care: policy issues and research opportunities.
Himmelstein, J; Buchanan, J L; Dembe, A E; Stevens, B
OBJECTIVE: To describe some of the unique aspects of medical care offered under workers' compensation insurance systems and discuss the major policy considerations relevant to health services researchers undertaking investigations in this area. BACKGROUND AND FINDINGS: State-based workers' compensation (WC) insurance systems requiring employers to pay for medical care and wage replacement for workplace injuries and illnesses were first developed between 1910 and 1920 in the United States. Employers are generally required to purchase state-regulated workers' compensation insurance that includes first-dollar payment for all medical and rehabilitative services and payment of lost wages to workers with work-related illness or injury. Injured workers have variable but usually limited latitude in choosing their health care provider. Employers and workers' compensation insurers have incentives for controlling both the cost of medical care and lost wages. CONCLUSION: The major policy issues in WC medical care--the effect of patient choice of provider and delivery system structure, the ensuring of high-quality care, the effect of integrating benefits, and investigation of the interrelationships between work, health, and productivity--can be informed by current studies in health services research and by targeted future studies of workers' compensation populations. These studies must consider the extent of patient choice of physician, the regulatory environment, the unique role of the workplace as a risk and modifying factor, and the complex interaction between health and disability insurance benefits. PMID:10199686
Attitudes and perceptions of health care workers in Northeastern Germany about multidrug-resistant organisms.
Marschall, P; Hübner, N-O; Maletzki, S; Wilke, F; Dittmann, K; Kramer, A
There were 256 health care workers in 39 facilities who were interviewed about their perceptions of the quality of care of patients with and without multidrug-resistant organisms based on a standardized questionnaire. There are remarkable differences in the responses between facility types (acute care hospitals, long-term care hospitals, rehabilitation hospitals, and home care services). Hygiene management must be specifically tailored to the requirements of each facility. PMID:26897700
Evaluation Results & Final Report for the Preservice Training for Child Care Workers Project.
ERIC Educational Resources Information Center
Anderson, Sarah L.; Gramann, Jacqueline A.
Recent changes such as declining economic status of families and large-scale employment of women have resulted in increased utilization of child care services and the need for qualified child care providers. This study evaluated the Preservice Training for Child Care Workers programs' ability to meet the training needs of rural Texas child care…
8 CFR 1212.15 - Certificates for foreign health care workers.
Code of Federal Regulations, 2010 CFR
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Certificates for foreign health care... CERTAIN INADMISSIBLE ALIENS; PAROLE § 1212.15 Certificates for foreign health care workers. (a... coming to the United States for the primary purpose of performing labor in a health care...
Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers.
Mæstad, Ottar; Mwisongo, Aziza
Informal payments for health services are common in many transitional and developing countries. The aim of this paper is to investigate the nature of informal payments in the health sector of Tanzania and to identify mechanisms through which informal payments may affect the quality of health care. Our focus is on the effect of informal payments on health worker behaviours, in particular the interpersonal dynamics among health workers at their workplaces. We organised eight focus groups with 58 health workers representing different cadres and levels of care in one rural and one urban district in Tanzania. We found that health workers at all levels receive informal payments in a number of different contexts. Health workers sometimes share the payments received, but only partially, and more rarely within the cadre than across cadres. Our findings indicate that health workers are involved in 'rent-seeking' activities, such as creating artificial shortages and deliberately lowering the quality of service, in order to extract extra payments from patients or to bargain for a higher share of the payments received by their colleagues. The discussions revealed that many health workers think that the distribution of informal payments is grossly unfair. The findings suggest that informal payments can impact negatively on the quality of health care through rent-seeking behaviours and through frustrations created by the unfair allocation of payments. Interestingly, the presence of corruption may also induce non-corrupt workers to reduce the quality of care. Positive impacts can occur because informal payments may induce health workers to increase their efforts, and maybe more so if there is competition among health workers about receiving the payments. Moreover, informal payments add to health workers' incomes and might thus contribute to retention of health workers within the health sector. PMID:20709420
Quality of care provided by mid-level health workers: systematic review and meta-analysis
Lassi, Zohra S; Cometto, Giorgio; Huicho, Luis
Abstract Objective To assess the effectiveness of care provided by mid-level health workers. Methods Experimental and observational studies comparing mid-level health workers and higher level health workers were identified by a systematic review of the scientific literature. The quality of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation criteria and data were analysed using Review Manager. Findings Fifty-three studies, mostly from high-income countries and conducted at tertiary care facilities, were identified. In general, there was no difference between the effectiveness of care provided by mid-level health workers in the areas of maternal and child health and communicable and noncommunicable diseases and that provided by higher level health workers. However, the rates of episiotomy and analgesia use were significantly lower in women giving birth who received care from midwives alone than in those who received care from doctors working in teams with midwives, and women were significantly more satisfied with care from midwives. Overall, the quality of the evidence was low or very low. The search also identified six observational studies, all from Africa, that compared care from clinical officers, surgical technicians or non-physician clinicians with care from doctors. Outcomes were generally similar. Conclusion No difference between the effectiveness of care provided by mid-level health workers and that provided by higher level health workers was found. However, the quality of the evidence was low. There is a need for studies with a high methodological quality, particularly in Africa – the region with the greatest shortage of health workers. PMID:24347706
Family Day Care and the School-Age Child.
ERIC Educational Resources Information Center
Seltzer, Michelle Seligson
This paper provides portions of a workshop discussion at the Wheelock Conference on School-Age Child Care concerning the role of family day care for school-age children. The workshop participants included family day care providers affiliated with the day care system in the Greater Boston area, administrators of a family day care system which also…
An outbreak of hepatitis A among health care workers: risk factors for transmission.
Doebbeling, B N; Li, N; Wenzel, R P
OBJECTIVES. The purpose of this study was to investigate a nosocomial outbreak of hepatitis A that occurred in the burn treatment center of a referral hospital. METHODS. Retrospective cohort and case-control studies were performed to determine acquisition rates and risk factors for transmission. Adjusted infection rates were calculated by week of exposure. A case-control study was conducted to determine potential mechanisms for nosocomial acquisition. Recently infected health care workers were defined as case patients; exposed, serosusceptible health care workers without infection served as controls. RESULTS. The outbreak of hepatitis A affected 11 health care workers and 1 other burn patient (1 secondary patient case). All 11 health care workers became ill after the admission of a man and his 8-month-old son who developed hepatitis A while in the hospital. The cumulative incidence risk ratio was elevated for health care workers caring for either the infant or the father during the same week of exposure. The case-control study implicated the behavior of eating on the hospital ward as the single most important risk factor for infection. CONCLUSION. Inadequate hand-washing and subsequent oral contamination appear responsible for the outbreak. Hospitals may witness other institutional outbreaks if health care workers regularly eat on the wards. PMID:8259794
A Survey of the Asthma Knowledge and Practices of Child Care Workers.
ERIC Educational Resources Information Center
Ramm, John; And Others
Investigated the asthma knowledge and practices of 247 child-care workers in southwestern Sydney. Two hundred and twelve (86 percent) correctly identified a persistent cough as the predominant symptom of childhood asthma, with wheezing (98 percent) being the response chosen most often. Nearly 50 percent of workers had used a nebulizer and/or a…
Violence against Primary Health Care Workers in Al-Hassa, Saudi Arabia
ERIC Educational Resources Information Center
El-Gilany, Abdel-Hady; El-Wehady, Adel; Amr, Mostafa
This self-report questionnaire study was carried out in Al-Hassa, Saudi Arabia to highlight the magnitude, predictors, and circumstances of workplace violence against primary health care (PHC) workers. A total of 1,091 workers completed a self-administered questionnaire. About 28% were exposed to at least one violent event during the past year.…
Compassion Fatigue and Compassion Satisfaction among Residential Child Care Workers: The Role of Personality Resources
ERIC Educational Resources Information Center
Zerach, Gadi
This study assessed compassion fatigue (CF) and compassion satisfaction (CS) among Israeli residential child-care workers (RCWs) working in residential treatment facilities for children and youth at risk (N = 147) as compared to educational boarding schools workers (BSWs; N = 74). Furthermore, we assessed the relationship of potential…
Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers
ERIC Educational Resources Information Center
Sears, Jeanne M.; Wickizer, Thomas M.; Franklin, Gary M.; Cheadle, Allen D.; Berkowitz, Bobbie
Context: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending…
Providing care for migrant farm worker families in their unique sociocultural context and environment.
Connor, Ann; Layne, Laura; Thomisee, Karen
This article highlights the Farm Worker Family Health Program's (FWFHP) strategies for providing care to migrant farm workers residing within a unique social and cultural context. The care provided by health professions students from a variety of disciplines extends and augments the work of the local migrant farm worker clinic that is pushed beyond capacity during peak growing and harvest times. Nursing's social responsibility to care for underserved populations is a guiding principle of the FWFHP and shapes how the work is translated into action. The FWFHP is a community-academic partnership that began in the rural southeastern United States in 1993. Challenges facing migrant farm worker families include access to health care, language, health literacy, housing and sanitation, family and community integrity, and workplace safety. The nursing practice strategies used to address these health challenges may be adapted to strengthen health programs serving other populations who live in poverty or reside in low-resource settings. PMID:20301816
Structural barriers to receiving health care services for female sex workers in Russia.
King, Elizabeth J; Maman, Suzanne
Female sex workers in Russia have been particularly vulnerable to recent social, political, and economic changes. In this article, we describe the facilitators and barriers for sex workers receiving health care services in St. Petersburg, Russia. We conducted observations at medical institutions and nongovernmental organizations and in-depth interviews with 29 female sex workers. We identified the following barriers: poverty, not having documents, lack of anonymity in testing, and the official registration system. We identified the following facilitators: intervention by family members, social connections within the health care system, and referral services from a nongovernmental organization. Our findings indicate a need for reassessing policies and designing programs that better facilitate the use of health care services for the most vulnerable populations. This should include the expansion of support systems and outreach services designed to help female sex workers navigate the health care system. PMID:23774627
Creating Better School-Age Care Jobs: Model Work Standards.
ERIC Educational Resources Information Center
Haack, Peggy
Built on the premise that good school-age care jobs are the cornerstone of high-quality services for school-age youth and their families, this guide presents model work standards for school-age care providers. The guide begins with a description of the strengths and challenges of the school-age care profession. The model work standards are…
The Aging Worker: Insights into the Massachusetts Problem.
ERIC Educational Resources Information Center
John F. Kennedy Family Service Center, Inc., Charlestown, MA.
The report discusses the problems of the older worker (those 45 and older) in obtaining and maintaining employment in the state of Massachusetts. It also assesses the feasibility of redirecting and reactivating the older worker toward employment with the aid of job counseling and placement, job development, and comprehensive supportive services…
Systematic Review of Control Measures to Reduce Hazardous Drug Exposure for Health Care Workers.
Crickman, Rachael; Finnell, Deborah
Because of their involvement in the transport, handling, preparation, administration, or disposal of hazardous medications, health care workers across multiple settings are at risk for adverse health consequences from exposure to these drugs. This review presents evidence-based strategies to mitigate the harmful exposures. These include engineering controls, full use of personal protective equipment, medical and environmental monitoring, hazard identification, and the need for a comprehensive hazardous drug control program that includes education and training for health care workers. PMID:26417920
Occupational hazards to health care workers: Diverse, ill-defined, and not fully appreciated
Moore, R.M. Jr.; Kaczmarek, R.G. )
Health care workers are challenged by an imposing group of occupational hazards. These hazards include exposure to ionizing radiation, stress, injury, infectious agents, and chemicals. The magnitude and diversity of these hazards are not fully appreciated. The acquired immunodeficiency syndrome epidemic has created additional occupational hazards and has focused attention on the problem of occupational hazards to health care workers. Concern over the nosocomial transmission of the human immunodeficiency virus has contributed to efforts to implement universal infection control precautions and to decrease needlestick injuries. Health care organizations and providers, who have prompted health and safety campaigns for the general public, should not overlook the dangers associated with the health care setting.
Incentives and barriers regarding immunization against influenza and hepatitis of health care workers.
FitzSimons, David; Hendrickx, Greet; Lernout, Tinne; Badur, Selim; Vorsters, Alex; Van Damme, Pierre
A meeting of the Viral Hepatitis Prevention Board in Barcelona in November 2012 brought together health care professionals concerned with viral hepatitis and those concerned with other vaccine-preventable diseases (especially influenza) in order to share experiences and find ways to increase the protection of health care workers through vaccination. Despite the existence of numerous intergovernmental and national resolutions, recommendations or published guidelines, vaccine uptake rates in health care workers are often shockingly low and campaigns to increase those rates have been generally unsuccessful. Participants reviewed the numerous incentives and barriers to vaccine uptake. Reasons for low uptake range from lack of commitment by senior management of health facilities and unclear policies to lack of knowledge, and denial of risk. Positive factors included leadership, involvement of all concerned parties, reminders and peer pressure. Innovative approaches, including the use of social media, are needed. It was concluded that strategies should be modified appropriately to reach specific health care worker populations at risk and that policies for preventing infection of health care workers could include obligatory health checks to determine vaccination status or immunity. Further, mandatory vaccination of health care workers may be the only effective means in order to achieve high vaccination coverage rates. Suggested possible future activities included: refurbishment of the image of the occupation health profession; resolving the logistical problems of administering vaccine; elaborating policy on managing health care workers who have been vaccinated against hepatitis B at birth or in early childhood and who are now starting to work in the health professions; and embedding and applying policies on vaccination against vaccine-preventable diseases in all health care facilities and training institutions. Above all, national action plans need to be written, with the
75 FR 5147 - Corning, Inc. Including On-Site Leased Workers From Adecco, Pro Unlimited, Piedmont Prime Care...
Federal Register 2010, 2011, 2012, 2013, 2014
... Employment and Training Administration Corning, Inc. Including On-Site Leased Workers From Adecco, Pro..., Inc., including on-site leased workers from Adecco, Pro Unlimited, Piedmont Prime Care, and Computer... follows: All workers of Corning, Inc., including on-site leased workers from Adecco, Pro...
Predictors of Ethical Stress, Moral Action and Job Satisfaction in Health Care Social Workers
O'Donnell, Patricia; Farrar, Adrienne; BrintzenhofeSzoc, Karlynn; Conrad, Ann Patrick; Danis, Marion; Grady, Christine; Taylor, Carol; Ulrich, Connie M.
Value conflicts can be a source of ethical stress for social workers in health care settings. That stress, unless mediated by the availability of ethical resource services, can lead to social workers' dissatisfaction with their positions and careers, and possibly result in needed professionals leaving the field. This study explored social workers' experiences in dealing with ethical issues in health care settings. Findings showed the inter-relationship between selected individual and organizational factors and overall ethical stress, the ability to take moral actions, the impact of ethical stress on job satisfaction, and the intent to leave position. PMID:18551828
Parallel payers and preferred access: how Canada's Workers' Compensation Boards expedite care for injured and ill workers.
Hurley, Jeremiah; Pasic, Dianna; Lavis, John N; Culyer, Anthony J; Mustard, Cameron; Gnam, William
Canada's workers' compensation boards (WCBs) finance healthcare for injured and ill workers in parallel with provincial health insurance plans. Parallel systems of healthcare finance can create preferred access for some. WCBs have in recent years pursued a number of strategies to expedite or improve the quality of care for injured or ill workers, including in-house provision in WCB-owned facilities; contracting with private, for-profit clinics; contracting with publicly funded hospitals and clinics for use of facilities "off-hours"; and supporting specialized clinics within publicly funded hospitals. Many of these strategies incorporate incentive payments to physicians and facilities for treating WCB cases more quickly than patients covered by provincial plans. In this paper we document the development of these strategies and discuss their implications for physicians, patients, government and the provincial public insurance plans. PMID:18493170
The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi
Lancaster, Kathryn Elizabeth; Powers, Kimberly A.; Lungu, Thandie; Mmodzi, Pearson; Hosseinipour, Mina C.; Chadwick, Katy; Go, Vivian F.; Pence, Brian W.; Hoffman, Irving F.; Miller, William C.
Objective The HIV care continuum among female sex workers (FSW), a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi. Methods From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome. Results HIV seroprevalence was 69% (n = 138). Among all FSW the median age was 24 years (IQR: 22–28). Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3–17). The majority (69%) of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes. Conclusions FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered. PMID:26808043
The experiences of risk managers in providing emotional support for health care workers after adverse events.
Edrees, Hanan; Brock, Douglas M; Wu, Albert W; McCotter, Patricia I; Hofeldt, Ron; Shannon, Sarah E; Gallagher, Thomas H; White, Andrew A
Risk managers often meet with health care workers who are emotionally traumatized following adverse events. We surveyed members of the American Society for Health care Risk Management (ASHRM) about their training, experience, competence, and comfort with providing emotional support to health care workers. Although risk managers reported feeling comfortable and competent in providing support, nearly all respondents prefer to receive additional training. Risk managers who were comfortable listening to and supporting health care workers were more likely to report prior training. Health care organizations implementing second victim support programs should not rely solely on risk managers to provide support, rather engage and train interested risk managers and provide them with opportunities to practice. PMID:27088771
Older Workers' Perspectives on Training and Retention of Older Workers: South Australian Construction Industry Study. Support Document
ERIC Educational Resources Information Center
Lundberg, David; Marshallsay, Zariah
Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. This support document includes a national survey of…
Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers
Lankford, Mary G.; Zembower, Teresa R.; Trick, William E.; Hacek, Donna M.; Noskin, Gary A.
We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital. Hand-hygiene compliance was significantly better in the old hospital (161/304; 53%) compared to the new hospital (97/417; 23.3%) (p<0.001). Health-care workers in a room with a senior (e.g., higher ranking) medical staff person or peer who did not wash hands were significantly less likely to wash their own hands (odds ratio 0.2; confidence interval 0.1 to 0.5); p<0.001). Our results suggest that health-care worker hand-hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance. PMID:12603993
Approaches to School-Age Child Care. ERIC Digest.
ERIC Educational Resources Information Center
Seligson, Michelle; Coltin, Lillian
This ERIC Digest provides basic information about school-age day care programs. Discussion focuses briefly on options available to families with school-age children, developmental needs of school-age children, characteristics of high quality school-age programs, supportive services for self-care, and ways of improving school-age child care…
The First Identification of Encephalitozoon cuniculi Infection in an Animal Care Worker in Turkey
CARHAN, Ahmet; OZKAN, Ozcan; OZKAYA, Ethem
Background: As a zoonotic pathogen, Encephalitozoon cuniculi is a cause of serious disease in animals and people. The present study was to evaluate the health status examination of this seropositive animal care worker in our previous study. Methods: Blood samples were taken from five workers. CIA test was applied to detect antibodies against E. cuniculi in blood serum. The indirect immunofluorescence antibody test was used as confirmation test. Seropositive worker had a complete medical examination. Results: Only one worker was found to be seropositive according to the results of the serological test. Sera positive to E. cuniculi was confirmed with IFAT and spores were detected in the urine sample of the worker. The worker was treated with albendazole. Conclusion: Rabbits should be examined routinely for the presence of anti-E. cuniculi antibody. People working with laboratory animal should avoid contact with urine and faeces of infected or pay attention to personal hygiene. PMID:26246827
Public sector antiretroviral treatment programme in South Africa: health care workers' attention to mental health problems.
Pappin, Michele; Wouters, Edwin; Booysen, Frederik L R; Lund, Crick
Although there is a high prevalence of anxiety and depression amongst people receiving antiretroviral treatment (ART), many patients are not screened, diagnosed or referred for mental health problems. This study aims to determine whether public sector health care workers in South Africa observe, screen, diagnose and refer ART patients that show symptoms of common mental disorders. It also aims to ascertain the extent of mental health training received by public sector health care workers working in ART. The study was cross-sectional in design. Self-administered questionnaires were completed by 40 nurses and structured interviews were conducted with 23 lay workers across the five districts in the Free State between July 2009 and October 2009. STATA version 12 was used to perform statistical data analysis. The health care workers reported observing a high frequency of symptoms of common mental disorders among public sector ART patients. While 70% of nurses screened and diagnosed, only 40% of lay workers screened and diagnosed patients on ART for a mental disorder. Health care workers who had received training in mental health were more likely to screen or diagnose a mental disorder, but only 14% of the workers had received such training. We recommend that health care workers should receive task-specific training to screen and/or diagnose patients on ART for common mental disorders using the guidelines of the South African HIV Clinicians Society. A positive diagnosis should be referred to a health care practitioner for appropriate evidence-based treatment in the form of medication or psychotherapy. PMID:25317991
Does age affect the relationship between control at work and sleep disturbance for shift workers?
Loudoun, Rebecca Jane; Muurlink, Olav; Peetz, David; Murray, Georgina
Among miners, shift work, aging and lack of control at work may be factors leading to increased sleep problems. Such risk factors may also operate in interaction, resulting in an even increased harm for sleep disruption. The present study aims at evaluating these relationships drawing on a sample of Australian mine and energy workers and their partners. The workers were mainly men. All performed shift work that included either nights (95%) or multiple shifts (92%), usually both (87%), while 36% were aged 50 years or above. The results show that low latitude over work activities is associated with higher sleep disturbances across the sample, though the effects are clearer amongst younger workers. By contrast, for younger workers, control over shift scheduling is not associated with sleep disturbances but for workers aged 50 or more, low control results in more sleep disturbance. Misalignment between shift workers and partner work schedules, and partner dissatisfaction with shift worker's employment and shift worker's work-life balance, are also associated with more sleep disturbances amongst shift workers. PMID:25231503
Effects of aging on morningness-eveningness and sleep habits in Korean and Japanese workers.
Park, Y M; Matsumoto, K; Seo, Y J; Shinkoda, H; Park, K P
The Morningness-Eveningness Questionnaire and Life Habits Inventory were given to Korean and Japanese workers. The distributions of scores on the questionnaire for these two groups were normal and its mean slightly moved to the Morning type with aging. It is noteworthy, however, that the mean scores of Korean workers was lower than those of the Japanese workers. The self-reported waking times and bedtimes for the two groups gradually became earlier with aging. From these results it could be said that aging was an factor that led to the difference of circadian phase. PMID:9628176
Slip, trip, and fall injuries among nursing care facility workers.
Bell, Jennifer L; Collins, James W; Tiesman, Hope M; Ridenour, Marilyn; Konda, Srinivas; Wolf, Laurie; Evanoff, Bradley
The objective of this research was to describe the slip, trip, and fall injury experience and trends in a population of nursing home workers, identify risk factors for slip, trip, and fall injuries, and develop prevention strategies for slip, trip, and fall hazards. Workers' compensation injury claims data and payroll data from 1996 through 2003 were obtained from six nursing homes and used to calculate injury incidence rates. Narrative information was used to describe details of slip, trip, and fall events. A total of 86 slip, trip, and fall-related workers' compensation claims were filed during the 8-year period. Slip, trip, and fall claim rates showed a nonsignificant increase during the 8-year period. Most slips, trips, and falls were attributed to hazards that can be mitigated (e.g., water on the floor or loose cords in a walkway). Nursing home workers experience more slip, trip, and fall-related injury claims than workers in other industries. Preventive programs should be implemented and evaluated in this industry. PMID:23521142
HIV/AIDS knowledge and occupational risk in primary care health workers from Chile
Valdés, Baltica Cabieses; Lagunas, Lilian Ferrer; Villarroel, Luis Antonio; Acosta, Rosina Cianelli; Miner, Sarah; Silva, Margarita Bernales
Objective To explore the relationship between knowledge level and occupational risk exposure to HIV/AIDS in primary care health workers. Methodology Analytical cross-sectional study. 720 health workers from Santiago answered a survey about HIV/AIDS that included: knowledge level (appropriate, inappropriate), occupational risk (with or without risk), and control variables (age, gender, health center, education and marital status). Descriptive and association analysis were performed. Odds Ratio (OR) was estimated through simple and multiple regressions logistics. Results 58.7% of the participants reported HIV occupational risk. 63.8% of the participants from the exposed group reported an appropriate level of knowledge, versus 36.1% of the non-exposed group (Adjusted OR of 3.1, IC95%OR: 2.0-4.8, p<0.0001). Technicians and cleaning staff reported a lower proportion of appropriate level of knowledge compared to the employees with college education (p<0.0001). Conclusion The level of HIV/AID occupational risk is directly associated with the level of knowledge of the disease. PMID:25284913
Assessing Interventions To Improve Influenza Vaccine Uptake Among Health Care Workers.
Rashid, Harunor; Yin, Jiehui Kevin; Ward, Kirsten; King, Catherine; Seale, Holly; Booy, Robert
Despite official recommendations for health care workers to receive the influenza vaccine, uptake remains low. This systematic review of randomized controlled trials was conducted to understand the evidence about interventions to improve influenza vaccine uptake among health care workers. We identified twelve randomized controlled trials that, collectively, assessed six major categories of interventions involving 193,924 health care workers in high-income countries. The categories were educational materials and training sessions, improved access to the vaccine, rewards following vaccination, organized efforts to raise vaccine awareness, reminders to get vaccinated, and the use of lead advocates for vaccination. Only one of the four studies that evaluated the effect of a single intervention in isolation demonstrated a significantly higher vaccine uptake rate in the intervention group, compared to controls. However, five of the eight studies that evaluated a combination of strategies showed significantly higher vaccine uptake. Despite the low quality of the studies identified, the data suggest that combined interventions can moderately increase vaccine uptake among health care workers. Further methodologically appropriate trials of combined interventions tailored to individual health care settings and incorporating less-studied strategies would enhance the evidence about interventions to improve immunization uptake among health care workers. PMID:26858382
Who's Minding the Child Care Workers? A Look at Staff Burn-out.
ERIC Educational Resources Information Center
Whitebook, Marcy; Howes, Carollee
This study investigates "burn-out" and turnover among workers in child care settings. A total of 95 persons working in 32 child care centers in San Francisco were interviewed by telephone. One-fifth of the centers in the city were represented and both public and private centers were included. Each category of center was proportinately represented…
A Health Care Worker with Ebola Virus Disease and Adverse Prognostic Factors Treated in Sierra Leone.
O'Shea, Matthew K; Clay, Katherine A; Craig, Darren G; Moore, Alastair J; Lewis, Stephen; Espina, Melanie; Praught, Jeff; Horne, Simon; Kao, Raymond; Johnston, Andrew M
We describe the management of a Sierra Leonean health care worker with severe Ebola virus disease complicated by diarrhea, significant electrolyte disturbances, and falciparum malaria coinfection. With additional resources and staffing, high quality care can be provided to patients with Ebola infection and adverse prognostic factors in west Africa. PMID:26903609
The Impact of Stress and Support on Direct Care Workers' Job Satisfaction
ERIC Educational Resources Information Center
Ejaz, Farida K.; Noelker, Linda S.; Menne, Heather L.; Bagaka's, Joshua G.
Purpose: This research applies a stress and support conceptual model to investigate the effects of background characteristics, personal and job-related stressors, and workplace support on direct care workers' (DCW) job satisfaction. Design and Methods: Researchers collected survey data from 644 DCWs in 49 long-term care (LTC) organizations. The…
Orientation Manual for Child Care Centres Involved in the Recognition of Overseas Trained Workers.
ERIC Educational Resources Information Center
l'Anson, Christine, Comp.; Harris, Liz, Comp.
This manual has been primarily developed to assist child care center staff who are involved in the process of the recognition of the qualifications of overseas workers within the child care industry in Western Australia. The information and practical exercises provided aim to increase staff's level of awareness and acceptance of cultural…
Effects of Age Expectations on Oncology Social Workers' Clinical Judgment
ERIC Educational Resources Information Center
Conlon, Annemarie; Choi, Namkee G.
Objective: This study examined the influence of oncology social workers' expectations regarding aging (ERA) and ERA with cancer (ERAC) on their clinical judgment. Methods: Oncology social workers (N = 322) were randomly assigned to one of four vignettes describing a patient with lung cancer. The vignettes were identical except for the…
Stamatiou, Konstantinos; Margariti, Maria; Nousi, Eftichia; Mistrioti, Dimitra; Lacroix, Richard; Saridi, Maria
Purpose: The main aim of this study is to investigate the occurrence and severity of FSD in women working in tertiary hospitals. Material and methods: The study sample was drawn from health care women between the ages of 20 and 65 years, working in two hospitals in Greece. This descriptive study used a structured Greek questionnaire and sexual function screener and quality of life sectors were consisted of rated scale questions. Eighty eight questionnaires were returned properly completed. The statistical analysis used the SPSS statistical program. Results: Female sexual dysfunction is a highly prevalent health issue whose exact incidence is not well defined. Factors that can contribute to female sexual dysfunction may be psychogenic, physical, mixed or unknown. Each of these factors consists of individual components that influence the sexual response; however their precise impact in FSD development and progression is unknown. Moreover, the role of circadian rhythm disorders (especially that of shift work sleep disorder) to the development and progression of FSD has been poorly investigated. Conclusion: Working environment and patterns of work schedules may play a role in FSD however it has been difficult to specify in what extent they contribute to FSD development. PMID:27482157
Health care strategy for ensuring work ability in an aging Korea.
Park, Jungsun; Park, Jong-Tae; Kim, Soo Geun; Yoo, Cheol-In; Son, Junseok; Yim, Jun; Kim, Dae-Seong; Rhee, Kyung Young; Kim, Yangho
The rapid aging trend in South Korea will cause a growing shortage of labor and decreasing quality of the labor force. The purpose of this commentary is to recommend a health care strategy to maintain and promote the work ability of employees in an aging Korea. Strategies to promote the work ability require the collaboration of governmental agencies at the central and local levels. First, the common goal should be the reinforcement of follow-up measure in general medical examinations and the promotion of healthy lifestyles for workers. Second, collaborating activities should be performed among the Worker's Health Center, the Health Promotion Center, and community health centers. In conclusion, health care strategies for ensuring the work ability in an aging Korea require the collaboration of governmental agencies at the central and local levels. PMID:27610236
Gender, aging, and work: aging workers' strategies to confront the demands of production in maquiladora plants in nogales, Mexico.
Adarga, Mireya Scarone; Becerril, Leonor Cedillo; Champion, Catalina Denman
This work is part of a qualitative socio-cultural investigation with a group of men and women 40 years and older in the maquila export industry in Nogales, Sonora, Mexico. In 1994, as a result of the North American Free Trade Agreement, maquila plants combined traditional intensive work methods with new "just in time" production norms that impacted work and health conditions, particularly in older, or aging, workers. The workers that were interviewed for this study show a reduction in their functional ability to work starting at 40 years of age. Work organization demands, general health conditions, and a decrease in physical abilities brings these 40-year-old workers to prematurely construct an image of themselves as aging workers and to develop coping strategies that vary by gender. PMID:21342871
Assessing the implementation of performance management of health care workers in Uganda
Background The performance management concept is relatively new to the Ugandan health sector. Uganda has been implementing health sector reforms for nearly two decades. The reforms included the introduction of the results-oriented management in the public sector and the decentralisation of the management of health care workers from central to local governments. This study examined the implementation of performance management of health care workers in order to propose strategies for improvement. Methods The study was a descriptive survey carried out in the Kumi, Mbale, Sironko and Tororo districts and utilising mixed research methodology. A self-administered questionnaire was used to collect quantitative data from the health care workers. A semi-structured interview guide was used to collect qualitative data from the health service managers. The sample for the quantitative method was selected using stratified random sampling. Purposive sampling was used to select health service managers. Quantitative data were analysed using Statistical Package for Social Sciences (version 18.0). Qualitative data were categorised according to the themes and analysed manually. Results The findings show that to some extent performance management is implemented in the health sector; however, there were loopholes in its implementation. There were inadequacies in setting performance targets and performance management planning was hardly done. Although many health care workers had job descriptions, the performance indicators and standards were not clearly defined and known to all workers and managers. Additionally the schedules for performance assessments were not always adhered to. There were limited prospects for career progression, inadequate performance feedback and poor rewarding mechanisms. Conclusions Performance management of health care workers is inadequately done in the districts. Performance management is a key component of attempts to improve health sector outcomes. As a
Quits and Job Changes among Home Care Workers in Maine: The Role of Wages, Hours, and Benefits
ERIC Educational Resources Information Center
Morris, Lisa
Purpose: Figuring out how to make home care jobs more attractive has become a top policy priority. This study investigates the impact of wages, hours, and benefits on the retention of home care workers. Design and Methods: Using a 2-wave survey design and a sample of home care workers from Maine, the factors associated with turnover intentions,…
Professional competencies and training needs of professional social workers in integrated behavioral health in primary care.
Horevitz, Elizabeth; Manoleas, Peter
The Affordable Care Act has led to a widespread movement to integrate behavioral health services into primary care settings. Integrated behavioral health (IBH) holds promise for treating mild to moderate psychiatric disorders in a manner that more fully addresses the biopsychosocial spectrum of needs of individuals and families in primary care, and for reducing disparities in accessing behavioral health care. For behavioral health practitioners, IBH requires a shift to a brief, outcome-driven, and team-based model of care. Despite the fact that social workers comprise the majority of behavioral health providers in IBH settings, little research has been done to assess the extent to which social workers are prepared for effective practice in fast-paced primary care. We conducted a survey of social workers (N = 84) in IBH settings to assess the following: (1) Key competency areas for social work practice in IBH settings and (2) Self-rated preparedness for effective practice in IBH settings. Online snowball sampling methods were used over a period of 1 month. Results indicate that social workers feel prepared for general practice in IBH settings, but would benefit from additional training in IBH-specific competency areas identified in the survey. Findings can help guide social work training to improve workforce preparedness for practice in IBH settings in the wake of health care reform. PMID:24028739
Work-Family Conflict, Psychological Distress and Sleep Deficiency Among Patient Care Workers
Jacobsen, Henrik Børsting; Reme, Silje Endresen; Sembajwe, Grace; Hopcia, Karen; Stoddard, Anne M.; Kenwood, Christopher; Stiles, Tore C.; Sorensen, Glorian; Buxton, Orfeu M.
Objectives There is a well-established link between psychological distress, work-related stress and sleep. The aim of this study was to test the hypothesis that work-family conflict was associated with sleep deficiency both cross-sectionally and longitudinally while controlling for potential covariates. Methods In this two-phase study, a workplace health survey was collected from a cohort of patient care workers (n=1,572) at two large hospitals. Follow-up was collected nearly two years later in a subsample (n=102). Self-reported measures included work-family conflict, socio-demographics, workplace factors, psychological distress, and outcomes of sleep duration, sleep insufficiency, and sleep maintenance. Bivariate associations (P<0.2) from the baseline sample were used to build multivariable logistic regression models. Results The participants were 90 % women with a mean age of 41 (±11.7) years. At baseline, after adjusting for covariates, higher levels of work-family conflict were significantly associated with sleep deficiency, short sleep duration and perceived sleep insufficiency, but not with sleep maintenance problems. Higher levels of work-family conflict also predicted sleep insufficiency at follow-up nearly two years later. None of the other variables were associated with sleep outcomes longitudinally. Conclusion This is the first study to determine the predictive and cross-sectional associations of work-family conflict on sleep deficiency, also controlling for other measures of job stress and psychological distress. The results indicate that future interventions on sleep deficiency in patient care workers should include a specific focus on work-family conflict. PMID:25000547
Staff Development of Direct Care Workers in Pennsylvania: The Relationship between Organizational Structure and Culture and Best-Practices in Training
ERIC Educational Resources Information Center
Kemeny, M. Elizabeth
Using the conceptual model of social structure and personality framework (House, 1981) as a theoretical guide, this cross sectional mixed-method design examined how organizational structure and culture relate to practices for training direct care workers in 328 aging and disability network service provider organizations in Pennsylvania. To…
Oral health knowledge of health care workers in special children's center
Wyne, Amjad; Hammad, Nouf; Splieth, Christian
Objective: To determine the oral health knowledge of health care workers in special children's center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to "wait till there is some pain in case of a dental cavity" before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of "gum disease". Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers' response in relation to their specific job. Conclusion: The special health care workers in the disabled children's center generally had satisfactory oral health knowledge and practices. PMID:25878636
Knowledge of Maternal and Newborn Care Among Primary Level Health Workers in Kapilvastu District of Nepal
Acharya, D; Paudel, R; Gautam, K; Gautam, S; Upadhyaya, T
Background: Higher maternal and neonatal deaths are common in low- and middle-income countries; due to less access to skilled help. Adequate knowledge and skills on maternal and newborn care (MNC) of community health workers can improve maternal and newborn health. Aims: To identify the knowledge of primary level health workers on some components of MNC. Subjects and Methods: Respondents were selected using simple random sampling method. For collecting the data, enumerators visited health institutions for 2 months from 1st October to 31st November 2012, and structured interview schedule was used to gather the information. A cross-sectional study was conducted in a total of one hundred and thirty-seven primary level health workers in Kapilvastu district, Nepal. The Chi-square test was employed to examine the association between the knowledge of health workers on MNC and designation and work experience. Data were analyzed using SPSS version 17. Results: In a total of 137 primary level health workers, more than half 53.2% (73/137) were senior auxiliary health workers/health assistant. Health workers having correct knowledge on contents of MNC were-registration 32.1% (44/137), major components of antenatal care 57.7% (79/137), danger signs of pregnancy 39.4% (54/137), five cleans 59.1% (81/137), postnatal health problems 54.0% (74/137), majority to health action to newborn care, newborn bath and meaning of exclusive breastfeeding. There was a statistical association between designation of health workers and above-mentioned components of MNC (P < 0.05). Conclusions: The differentials in the knowledge of MNC among primary level health suggest improving knowledge of the grass root level health workers with appropriate training and development programs. PMID:27144073
Overcoming Barriers to Eye Care: Patient Response to a Medical Social Worker in a Glaucoma Service.
Fudemberg, Scott J; Amarasekera, Dilru C; Silverstein, Marlee H; Linder, Kathryn M; Heffner, Paul; Hark, Lisa A; Waisbourd, Michael
This paper investigates the patient response to a medical social worker in a glaucoma clinic. The literature suggests that medical social workers are effective in a variety of health care settings, yet the efficacy of a medical social worker in an adult ophthalmic setting has not been studied. We present the results of a retrospective chart review of 50 patients with glaucoma referred to a medical social worker between January 5, 2015 and June 31, 2015 in an outpatient clinic of an urban eye hospital. Clinical and demographic data, as well as the data from a quality of care questionnaire, were collected for each patient. Patients rated their interaction with the medical social worker as highly positive (mean = 4.75, 5-point Likert scale), and nearly 90 % of patients expressed interest in future contact with the social worker. Additionally, most patients reported that the social worker resolved the issues they were facing (61.1 %), supported them in seeing their ophthalmologist (70.6 %), and helped them to manage their glaucoma (69.7 %). Reported barriers to glaucoma care were emotional distress; cost of office visits and medications; lack of medical insurance; transportation; poor medication adherence; impairment of daily activities; follow-up adherence; and language. As vision loss from glaucoma is irreversible, it is important to detect and treat patients at early stages of the disease. Therefore, it is imperative for patients to regularly visit their eye care providers and adhere to treatment and follow-up recommendations. This study suggests that a medical social worker could play a pivotal role in helping patients with glaucoma overcome barriers to treatment and facilitate disease management. PMID:26860278
Risks to health care workers from nano-enabled medical products.
Murashov, Vladimir; Howard, John
Nanotechnology is rapidly expanding into the health care industry. However, occupational safety and health risks of nano-enabled medical products have not been thoroughly assessed. This manuscript highlights occupational risk mitigation practices for nano-enabled medical products throughout their life cycle for all major workplace settings including (1) medical research laboratories, (2) pharmaceutical manufacturing facilities, (3) clinical dispensing pharmacies, (4) health care delivery facilities, (5) home health care, (6) health care support, and (7) medical waste management. It further identifies critical research needs for ensuring worker protection in the health care industry. PMID:25950806
[Ways of improving health care of industrial workers of Kazakhstan].
Petrov, P P; Asylbekova, G O; Zhakashov, N Zh; Kul'zhanov, M K
The health of industrial workers should be considered from the point of view of broad social positions and primarily from the working and living conditions and the state of health services. Environmental factors should also be taken into consideration. Periodic medical check-ups of industrial workers indicate that their health is improving. Despite the success achieved, this problem in Kazakhstan is not being adequately solved, there are only 61 health units. Hospital beds in these institutions do not have necessary specialization corresponding to the profile of industrial enterprises. Numerous industrial enterprises, oil-and-gas extracting works pollute the environment, which has been confirmed by respective examples. The authors provide evidence for the necessity of economic education for the population. Preliminary results of experimental introduction of a new economic mechanism and medical insurance in Kazakhstan are being considered as factors contributing to the improvement of public health financing resources. PMID:1470989
How decentralisation influences the retention of primary health care workers in rural Nigeria
Abimbola, Seye; Olanipekun, Titilope; Igbokwe, Uchenna; Negin, Joel; Jan, Stephen; Martiniuk, Alexandra; Ihebuzor, Nnenna; Aina, Muyi
Background In Nigeria, the shortage of health workers is worst at the primary health care (PHC) level, especially in rural communities. And the responsibility for PHC – usually the only form of formal health service available in rural communities – is shared among the three tiers of government (federal, state, and local governments). In addition, the responsibility for community engagement in PHC is delegated to community health committees. Objective This study examines how the decentralisation of health system governance influences retention of health workers in rural communities in Nigeria from the perspective of health managers, health workers, and people living in rural communities. Design The study adopted a qualitative approach, and data were collected using semi-structured in-depth interviews and focus group discussions. The multi-stakeholder data were analysed for themes related to health system decentralisation. Results The results showed that decentralisation influences the retention of rural health workers in two ways: 1) The salary of PHC workers is often delayed and irregular as a result of delays in transfer of funds from the national to sub-national governments and because one tier of government can blame failure on another tier of government. Further, the primary responsibility for PHC is often left to the weakest tier of government (local governments). And the result is that rural PHC workers are attracted to working at levels of care where salaries are higher and more regular – in secondary care (run by state governments) and tertiary care (run by the federal government), which are also usually in urban areas. 2) Through community health committees, rural communities influence the retention of health workers by working to increase the uptake of PHC services. Community efforts to retain health workers also include providing social, financial, and accommodation support to health workers. To encourage health workers to stay, communities also
Evaluating a Hygiene Education Program for Child Care Workers.
ERIC Educational Resources Information Center
Petri, Cynthia J.; Winnail, Scott D.; Geiger, Brian F.; Artz, Lynn M.; Mason, J. W.
Children, parents, and child caregivers are vulnerable to several infectious diseases as a result of contact with child care centers. This pilot program, implemented in a rural county in a southeastern state, was designed to enhance knowledge and skills related to improved hygiene practices in a child care setting. The target audience for the…
Improving Adherence to Hand Hygiene among Health Care Workers
ERIC Educational Resources Information Center
Maskerine, Courtney; Loeb, Mark
Increased adherence to hand hygiene is widely acknowledged to be the most important way of reducing infections in health care facilities. Despite evidence of benefit, adherence to hand hygiene among health care professionals remains low. Several behavioral and organizational theories have been proposed to explain this. As a whole, the success of…
The HIV-positive dentist: balancing the rights of the health care worker and the patient.
Gardam, M A; Flanagan, W F; Salit, I E
We describe a hypothetical case of an HIV-positive dentist without cognitive impairment who uses proper infection control procedures. The dentist's physician notifies the medical officer of health without the dentist's consent. Although HIV-positive health care workers, including dentists, have been identified in the past, proven HIV transmission to patients is very rare. Most authorities recommend that an HIV-positive health care worker be monitored by an expert panel, which could then, if necessary, refer to the regulatory body to revoke or restrict the person's license to practice. Mandatory HIV testing is not required for health care workers because they generally do not pose a risk for infecting their patients; they are, however, ethically and legally obligated to report their HIV status to their profession's regulatory body. PMID:11450216
Responding to the Affordable Care Act: a leadership opportunity for social workers in employee assistance programs.
Frauenholtz, Susan
Until recently, estimates indicated that more than half of Americans obtain health insurance through their employers. Yet the employer-based system leaves many vulnerable populations, such as low-wage and part-time workers, without coverage. The changes authorized by the Affordable Care Act (2010), and in particular the Health Insurance Marketplace (also known as health insurance exchanges), which became operational in 2014, are projected to have a substantial impact on the provision of employer-based health care coverage. Because health insurance is so intricately woven with employment, social workers in employee assistance programs (EAPs) are positioned to assume an active leadership role in guiding and developing the needed changes to employer-based health care that will occur as the result of health care reform. This article describes the key features and functions of the Health Insurance Marketplace and proposes an innovative role for EAP social workers in implementing the exchanges within their respective workplaces and communities. How EAP social workers can act as educators, advocates, and brokers of the exchanges, and the challenges they may face in their new roles, are discussed, and the next steps EAP social workers can take to prepare for health reform-related workplace changes are delineated. PMID:25095628
Gene expression differences in relation to age and social environment in queen and worker bumble bees.
Lockett, Gabrielle A; Almond, Edward J; Huggins, Timothy J; Parker, Joel D; Bourke, Andrew F G
Eusocial insects provide special insights into the genetic pathways influencing aging because of their long-lived queens and flexible aging schedules. Using qRT-PCR in the primitively eusocial bumble bee Bombus terrestris (Linnaeus), we investigated expression levels of four candidate genes associated with taxonomically widespread age-related pathways (coenzyme Q biosynthesis protein 7, COQ7; DNA methyltransferase 3, Dnmt3; foraging, for; and vitellogenin, vg). In Experiment 1, we tested how expression changes with queen relative age and productivity. We found a significant age-related increase in COQ7 expression in queen ovary. In brain, all four genes showed higher expression with increasing female (queen plus worker) production, with this relationship strengthening as queen age increased, suggesting a link with the positive association of fecundity and longevity found in eusocial insect queens. In Experiment 2, we tested effects of relative age and social environment (worker removal) in foundress queens and effects of age and reproductive status in workers. In this experiment, workerless queens showed significantly higher for expression in brain, as predicted if downregulation of for is associated with the cessation of foraging by foundress queens following worker emergence. Workers showed a significant age-related increase in Dnmt3 expression in fat body, suggesting a novel association between aging and methylation in B. terrestris. Ovary activation was associated with significantly higher vg expression in fat body and, in younger workers, in brain, consistent with vitellogenin's ancestral role in regulating egg production. Overall, our findings reveal a mixture of novel and conserved features in age-related genetic pathways under primitive eusociality. PMID:26883339
Parenting the Poorly Attached Teenager. Fostering Families. A Specialized Training Program Designed for Foster Care Workers & Foster Care Parents.
ERIC Educational Resources Information Center
Schatz, Mona Struhsaker; Faust, Timothy Philip
This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module explores the attachment process and the long-term effects of attachment difficulties in the first years of a child's life. The module's learning objectives address: (1) ways of identifying the basic concepts…
Intentions to Quit Work among Care Staff Working in the Aged Care Sector
ERIC Educational Resources Information Center
Karantzas, Gery C.; Mellor, David; McCabe, Marita P.; Davison, Tanya E.; Beaton, Paul; Mrkic, Dejan
Purpose of the Study: The aged care industry experiences high rates of staff turnover. Staff turnover has significant implications for the quality of care provided to care recipients and the financial costs to care agencies. In this study, we applied a model of intention to quit to identify the contextual and personal factors that shape aged care…
Ethical Behaviours in Clinical Practice Among Mexican Health Care Workers
Valdez-Martínez, Edith; Lavielle, Pilar; Bedolla, Miguel; Squires, Allison
The objective of this study was to describe the cultural domain of ethical behaviours in clinical practice as defined by health care providers in Mexico. Structured interviews were carried out with 500 health professionals employed at the Mexican Institute of Social Security in Mexico City. The Smith Salience Index was used to evaluate the relevance of concepts gathered from the free listings of the interviewees. Cluster analysis and factor analysis facilitated construction of the conceptual categories, which the authors refer to as 'dimensions of ethical practice'. Six dimensions emerged from the analysis to define the qualities that comprise ethical clinical practice for Mexican health care providers: overall quality of clinical performance; working conditions that favour quality of care; use of ethical considerations as prerequisites for any health care intervention; values favouring teamwork in the health professional–patient relationship; patient satisfaction scores; and communication between health care providers and patients. The findings suggest that improved working conditions and management practices that promote the values identified by the study's participants would help to improve quality of care. PMID:18849364
Communicating for Quality in School Age Care Services
ERIC Educational Resources Information Center
Cartmel, Jennifer; Grieshaber, Susan
School Age Care (SAC) services have existed in Australia for over 100 years but they have tended to take a back seat when compared with provision for school-aged children and those under school age using early childhood education and care (ECEC) services. Many SAC services are housed in shared premises and many children attending preparatory or…
School-Age Child Care Trend Report: Part 2
ERIC Educational Resources Information Center
Neugebauer, Roger
According to the author, school-age care is the fastest growing segment of the early childhood arena and possibly the least visible. While programs have been serving school-age children in out-of-school hours since the turn of the century, it is only in recent years that professionals have started to view school-age care as a distinct discipline…
Burnout as a clinical entity--its importance in health care workers.
Felton, J S
Burnout, viewed as the exhaustion of physical or emotional strength as a result of prolonged stress or frustration, was added to the mental health lexicon in the 1970s, and has been detected in a wide variety of health care providers. A study of 600 American workers indicated that burnout resulted in lowered production, and increases in absenteeism, health care costs, and personnel turnover. Many employees are vulnerable, particularly as the American job scene changes through industrial downsizing, corporate buyouts and mergers, and lengthened work time. Burnout produces both physical and behavioural changes, in some instances leading to chemical abuse. The health professionals at risk include physicians, nurses, social workers, dentists, care providers in oncology and AIDS-patient care personnel, emergency service staff members, mental health workers, and speech and language pathologists, among others. Early identification of this emotional slippage is needed to prevent the depersonalization of the provider-patient relationship. Prevention and treatment are essentially parallel efforts, including greater job control by the individual worker, group meetings, better up-and-down communication, more recognition of individual worth, job redesign, flexible work hours, full orientation to job requirements, available employee assistance programmes, and adjuvant activity. Burnout is a health care professional's occupational disease which must be recognized early and treated. PMID:9800422
Decolonization of patients and health care workers to control nosocomial spread of methicillin-resistant Staphylococcus aureus: a simulation study
Background Control of methicillin-resistant Staphylococcus aureus (MRSA) transmission has been unsuccessful in many hospitals. Recommended control measures include isolation of colonized patients, rather than decolonization of carriage among patients and/or health care workers. Yet, the potential effects of such measures are poorly understood. Methods We use a stochastic simulation model in which health care workers can transmit MRSA through short-lived hand contamination, or through persistent colonization. Hand hygiene interrupts the first mode, decolonization strategies the latter. We quantified the effectiveness of decolonization of patients and health care workers, relative to patient isolation in settings where MRSA carriage is endemic (rather than sporadic outbreaks in non-endemic settings caused by health care workers). Results Patient decolonization is the most effective intervention and outperforms patient isolation, even with low decolonization efficacy and when decolonization is not achieved immediately. The potential role of persistently colonized health care workers in MRSA transmission depends on the proportion of persistently colonized health care workers and the likelihood per colonized health care worker to transmit. As stand-alone intervention, universal screening and decolonization of persistently colonized health care workers is generally the least effective intervention, especially in high endemicity settings. When added to patient isolation, such a strategy would have maximum benefits if few health care workers cause a large proportion of the acquisitions. Conclusions In high-endemicity settings regular screening of health care workers followed by decolonization of MRSA-carriers is unlikely to reduce nosocomial spread of MRSA unless there are few persistently colonized health care workers who are responsible for a large fraction of the MRSA acquisitions by patients. In contrast, decolonization of patients can be very effective. PMID:23151152
Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea
Nam, Seung-Joo; Chun, Hoon Jai; Moon, Jeong Seop; Park, Sung Chul; Hwang, Young-Jae; Yoo, In Kyung; Lee, Jae Min; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Kim, Chang Duck
Background/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea. Methods: We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction. Results: Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R2=0.340, p<0.001). Conclusions: An endoscopy unit is composed of a heterogeneous group of health-care professionals (i.e., nurses, fellows, and professors), and job stress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit. PMID:26898513
Aging in poverty: making the case for comprehensive care management.
Judd, Rebecca G; Moore, Brenda A
A model for holistic care management that would enhance outcomes for economically vulnerable older adults who receive an array of disjointed services administered through the older Americans Act (OAA) and local Area Agencies on Aging (AAA) is proposed. Fragmented service delivery is typically wasteful and ineffectual, but comprehensive care management that includes an autonomous care manager, a single interagency plan of care and ongoing monitoring that is client-centered may protect those aging in poverty from negative health outcomes. PMID:21967136
Older Workers' Perspectives on Training and Retention of Older Workers. A National Vocational Education and Training Research and Evaluation Program Report
ERIC Educational Resources Information Center
Lundberg, David; Marshallsay, Zaniah
Older workers' perspectives are examined in a national survey of the finance sector and case studies of aged care and construction workers. The majority of older workers intend to work beyond retirement age, to achieve a better lifestyle. With training, older workers could mentor younger workers. (Contains 30 tables.) [This work has been produced…
A Multidisciplinary Work-Related Low Back Pain Predictor Questionnaire: Psychometric Evaluation of Iranian Patient-Care Workers
Sarallah, Shojaei; Jamshidi, Ahmad Reza; Joan, Wagner
Study Design Psychometric evaluation design. Purpose Psychometric evaluation of a multidisciplinary work-related low back pain predictor questionnaire (MWRLBPPQ) of Iranians patient-care workers based on the social cognitive theory. Overview of Literature Healthcare is one of the professions in which work-related musculoskeletal disorders are prevalent. The chronic low back pain experienced by patient caregivers can negatively impact their professional performance, and patient handling in a hospital is the main cause of low back pain in this population. Methods This was a cross-sectional study carried out in Qom, Iran from July 2014 to November 2014. A MWRLBPPQ based on nine concepts of the social cognitive theory and existing literature regarding chronic low back pain was developed. Ten patient-care workers first completed the questionnaire as a pilot test, allowing the ambiguities of the instrument to be resolved. Exploratory factor analysis was used to confirm construct validity. This questionnaire was distributed among 452 patient-care workers in hospitals located in different geographically areas in Qom, Iran. Cronbach's Alpha was calculated to assess reliability. Results In all, 452 caregivers of patients with mean age of 37.71 (standard deviation=8.3) years participated in the study. An exploratory factor analysis loaded seven concepts of self-efficacy, knowledge, outcome perception, self-control, emotional coping, and self-efficacy in overcoming impediments and challenges in the environment. All concepts were jointly accounted for 50.08% of variance of behavior change. The Cronbach's alpha coefficient showed favorable internal consistency (alpha=0.83), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MWRLBPPQ. Conclusions The MWRLBPPQ is a reliable and valid theory-based instrument that can be used to predict factors influencing work-related low back pain among workers who lift and transfer patients in hospitals
Prevalence of measles antibodies among health care workers in Catalonia (Spain) in the elimination era
Background Interruption of measles transmission was achieved in Catalonia (Spain) in 2000. Six years later, a measles outbreak occurred between August 2006 and June 2007 with 381 cases, 11 of whom were health care workers (HCW). The objective was to estimate susceptibility to measles in HCW and related demographic and occupational characteristics. Methods A measles seroprevalence study was carried out in 639 HCW from six public tertiary hospitals and five primary healthcare areas. Antibodies were tested using the Vircell Measles ELISA IgG Kit. Data were analyzed according to age, sex, type of HCW, type of centre and vaccination history. The odds ratios (OR) and their 95% CI were calculated to determine the variables associated with antibody prevalence. OR were adjusted using logistic regression. Positive predictive values (PPV) and the 95% confidence intervals (CI) of having two documented doses of a measles containing vaccine (MCV) for the presence of measles antibodies and of reporting a history of measles infection were calculated. Results The prevalence of measles antibodies in HCW was 98% (95% CI 96.6-98.9), and was lower in HCW born in 1981 or later, after the introduction of systematic paediatric vaccination (94.4%; 95% CI 86.4-98.5) and higher in HCW born between 1965 and 1980 (99.0%; 95% CI 97.0-99.8). Significant differences were found for HCW born in 1965–1980 with respect to those born in 1981 and after (adjusted OR of 5.67; 95% CI: 1.24-25.91). A total of 187 HCW reported being vaccinated: the proportion of vaccinated HCW decreased with age. Of HCW who reported being vaccinated, vaccination was confirmed by the vaccination card in 49%. Vaccination with 2 doses was documented in only 50 HCW, of whom 48 had measles antibodies. 311 HCW reported a history of measles. The PPV of having received two documented doses of MCV was 96% (95% CI 86.3-99.5) and the PPV of reporting a history of measles was 98.7% (95% CI 96.7-99.6). Conclusions Screening to detect
Substance abuse intervention for health care workers: a preliminary report.
Lapham, S C; Chang, I; Gregory, C
The Workplace Managed Care Cooperative Agreement project targets 3,300 health care professionals in hospital, specialty clinic, and primary care settings located in metropolitan New Mexico communities. This project will evaluate whether enhancements to existing substance abuse prevention/early intervention programs can prevent the onset of risky drinking, reduce prevalence of risky drinking, better identify employees who abuse alcohol and drugs, and improve employee wellness. This article describes one such enhancement (Project WISE [Workplace Initiative in Substance Education]), implemented at Lovelace Health Systems. Project WISE includes relatively low-cost elements such as substance abuse awareness training, information on how to reduce drinking, and brief motivational counseling. Evaluation will consist of baseline comparisons of the intervention and comparison sites, a process evaluation, a qualitative analysis using focus groups, and an outcome evaluation using health and work records. Methodological challenges, solutions, and implications for researchers undertaking similar projects are presented. PMID:10795124
Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study
Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors. PMID:22551645
Linking Emotional Labor, Public Service Motivation, and Job Satisfaction: Social Workers in Health Care Settings.
Roh, Chul-Young; Moon, M Jae; Yang, Seung-Bum; Jung, Kwangho
This study examines the determinants of emotional laborers'--social workers in health care organizations--job satisfaction and their public service motivation in using a structural equation model and provides empirical evidence regarding what contributes to job satisfaction or burnout in these workers. Among several latent variables, this study confirmed that false face significantly decreases the job satisfaction of social worker and is positively associated with burnout. In addition, commitment to public interest increases social workers' job satisfaction significantly. This study has implications for the management of emotional labor. By educating emotional laborers to reappraise situations to increase their job satisfaction and avoid burnout, reappraisal training and education are expected to result in increases in positive emotions and decreases in negative emotions, and to improve employees' performance in their organizations. PMID:26720584
Peer support workers: an untapped resource in primary mental health care.
Tellez, Juan J; Perez, Juan; Kidd, Jacquie
The treatment of moderate to severe mental illness in a primary health care setting is an area under development and can be contentious. The capacity, capability, resourcing and willingness of staff and organisations all feature in the discussions among specialist services and primary health care providers about the opportunities and barriers associated with primary mental health care. This paper presents the peer support worker as an untapped resource that has the potential to support the patient, primary health care staff, and general practitioner in the care of people who fall outside the current understanding of "mild" mental health problems, but who would nonetheless benefit from receiving their care in a primary health care setting. PMID:25770722
Promoting the role of patients in improving hand hygiene compliance amongst health care workers
Ahmed Awaji, Maryam; Al-Surimi, Khaled
Hand hygiene is one of the fundamental measures necessary for reducing healthcare-associated infections. The adherence of health care workers to safe hand hygiene practices is low worldwide, despite evidence showing compliance with hand hygiene guidelines decreases infection rate. This project focuses on the role of patients in promoting healthcare workers' compliance with hand hygiene practices. Several plan-do-study-act (PDSA) cycles were conducted to test interventions which aimed to empower patients and increase staff members' adherence to hand hygiene practices. The initial findings presented on the run chart demonstrate that compliance among healthcare workers increased with the interventions; there was an increase of 15% compliance during the 10 days of project testing. We will need to collect more data to show continued and sustained improvement. Patients can play an important role in promoting safe care and hand hygiene practices. PMID:27493752
Promoting the role of patients in improving hand hygiene compliance amongst health care workers.
Ahmed Awaji, Maryam; Al-Surimi, Khaled
Hand hygiene is one of the fundamental measures necessary for reducing healthcare-associated infections. The adherence of health care workers to safe hand hygiene practices is low worldwide, despite evidence showing compliance with hand hygiene guidelines decreases infection rate. This project focuses on the role of patients in promoting healthcare workers' compliance with hand hygiene practices. Several plan-do-study-act (PDSA) cycles were conducted to test interventions which aimed to empower patients and increase staff members' adherence to hand hygiene practices. The initial findings presented on the run chart demonstrate that compliance among healthcare workers increased with the interventions; there was an increase of 15% compliance during the 10 days of project testing. We will need to collect more data to show continued and sustained improvement. Patients can play an important role in promoting safe care and hand hygiene practices. PMID:27493752
Child Care Training Needs Assessment: A Report on the Training Needs of Child Care Workers in Seventeen Agencies in the SUNYA Catchment Area.
ERIC Educational Resources Information Center
Armstrong, Mary; And Others
An assessment study was conducted to compile a comprehensive view of the training needs of child care workers in eastern upstate New York. A Needs Assessment Questionnaire was distributed to 539 child care workers, and 65% were returned. The questionnaires concerned demographic, specific job-related, and training-related information. In addition,…
Health and Safety Resources for Child Care Workers.
ERIC Educational Resources Information Center
Child Care Employee Project, Berkeley, CA.
Organized into three sections, these resource materials provide basic information for child caregivers about occupational hazards associated with child care work; personnel policies, staff burnout and environmental stressors; and employee rights. Contents of the first section include a general discussion of health and safety hazards in child care…
Home care workers: injury prevention through risk factor reduction.
Jarrell, R B
Home health care professionals work in a nonstandard and unpredictable environment for which few controls are available. The professional must cope with a residence's existing access, cleanliness, facilities, and other occupants (including pets), among other factors, and these vary between homes. This chapter suggests interventions that can reduce risks to employees, patients, and family members. PMID:9353822
Effects of Training Programme on HIV/AIDS Prevention among Primary Health Care Workers in Oyo State, Nigeria
ERIC Educational Resources Information Center
Ajuwon, Ademola; Funmilayo, Fawole; Oladepo, Oladimeji; Osungbade, Kayode; Asuzu, Michael
Purpose: The purpose of this paper is to train primary health care workers to be trainers and implementers of community-based AIDS prevention activities in Oyo State, Nigeria, by describing an evaluation of the project. Design/methodology/approach: A total of 148 primary health care workers recruited from the 33 local government areas (LGA) of the…
Influences of Age and Gender on Workers' Goals for Retirement
ERIC Educational Resources Information Center
Hershey, Douglas A.; Jacobs-Lawson, Joy M.; Neukam, Kirstan A.
Having clear goals for retirement is a critical determinant of life satisfaction and adjustment during the post-employment transition period. The purpose of the present study was to explore individuals' goals for retirement and determine whether age and gender differences exist among those goals. A sample of 55 working adults (aged 20-67) were…
Suicidal and depressive symptoms in Filipino home care workers in Israel.
Ayalon, Liat
The study consisted of a cross sectional sample of 178 Filipino home care workers who completed the Paykel Suicide Scale and the Patient Health Questionnaire-9. Respondents also completed questionnaires about exposure to abuse and perceived social support. Overall, 35% of the sample reported exposure to some type of abuse within their home/work environment. For those reporting low levels of satisfaction with care recipient, higher exposure to major lifetime discrimination was associated with higher SIA, whereas for those reporting high levels of satisfaction with care recipient, there was no relationship between exposure to major lifetime discrimination and SIA. Abuse within the home/work environment was the only predictor of depressive symptoms, with greater abuse being associated with higher levels of depressive symptoms. Filipino home care workers in Israel likely are exposed to moderate levels of abuse and discrimination within the home/work environment as well as within society at large. Because live-in home care workers spend the majority of their time within the home/work environment, their relationship with their care recipients have protective qualities that can serve as a buffer against discrimination. Nevertheless, abusive working conditions within their home/work environment have detrimental effects on their mental health. PMID:22124622
Prevalence of Burnout Syndrome of Greek Child Care Workers and Kindergarten Teachers
ERIC Educational Resources Information Center
Rentzou, Konstantina
The present study, employing the Maslach Burnout Inventory-Educators Survey, aims to compare and explore possible differences to the levels of burnout reported by the two main professional groups working in the early childhood education and care sector in Greece, that is kindergarten teachers and childcare workers. The correlation between the…
Compassion Fatigue Risk and Self-Care Practices among Residential Treatment Center Childcare Workers
ERIC Educational Resources Information Center
Eastwood, Callum D.; Ecklund, Kathryn
Exploration of the presence of risk for compassion fatigue among residential childcare workers (RCW) at residential treatment facilities and the relationship between self-care practices and compassion fatigue were explored. Using the Professional Quality of Life Survey (ProQOL-R III) to assess compassion fatigue, burnout, and compassion…
Teaching the Principles of Applied Behavior Modification to Direct-Care Workers in Mental Retardation.
ERIC Educational Resources Information Center
Brautman, Edwin Jay
Intended for direct care workers at institutions for severely and profoundly retarded persons, the curriculum focuses on behavior modification skill instruction. Eight lesson plans are presented, with information on topic, content, and teaching methods. Topics include the following (sample subtopics in parentheses): 1) introduction; 2) observing…
Fear of Severe Acute Respiratory Syndrome (SARS) among Health Care Workers
ERIC Educational Resources Information Center
Ho, Samuel M. Y.; Kwong-Lo, Rosalie S. Y.; Mak, Christine W. Y.; Wong, Joe S.
In this study, the authors examined fear related to severe acute respiratory syndrome (SARS) among 2 samples of hospital staff in Hong Kong. Sample 1 included health care workers (n = 82) and was assessed during the peak of the SARS epidemic. Sample 2 included hospital staff who recovered from SARS (n = 97). The results show that participants in…
Modeling Dental Health Care Workers' Risk of Occupational Infection from Bloodborne Pathogens.
ERIC Educational Resources Information Center
Capilouto, Eli; And Others
The brief paper offers a model which permits quantification of the dental health care workers' risk of occupationally acquiring infection from bloodborne pathogens such as human immunodeficiency virus and hepatitis B virus. The model incorporates five parameters such as the probability that any individual patient is infected and number of patients…
Optimism of health care workers during a disaster: a review of the literature
Boldor, Noga; Bar-Dayan, Yosefa; Rosenbloom, Tova; Shemer, Joshua; Bar-Dayan, Yaron
Optimism has several orientations. One such outlook is a general tendency to regard the world as a positive place, accepting difficulties as mere challenges instead of impassable barriers. Among health care workers, optimism improves their level of functioning, their patients' satisfaction, and their therapeutic results. Optimistic staff members report feeling less pressure, use fewer avoidance strategies, focus on practical problem solutions, seek social support, and have more trust in people and organizations. The aim of this article is to provide a review of the literature concerning the role of optimism, both in daily life and in crisis situations. An attempt was made to find the linkage between optimism among health care workers during disasters and their active response, with special emphasis on the relationship between optimism and knowledge, feelings or behavior. Based on the literature, optimism was found to be helpful both in daily medical work and in cases of medical emergencies. Optimism was also revealed one of the key components of resilience and self-efficacy. Therefore, it is recommended to consider strengthening the optimism through initiative programs. Obtaining optimism can be included in toolkit preparedness for health care workers in order to confront the complications in the aftermath of disaster. These programs, together with appropriate information, social support, professional trust, and leaders modeling behavior, will raise the well-being and enhance coping skills of the health care workers during and aftermath of disaster scenarios. PMID:22461847
8 CFR 1245.14 - Adjustment of status of certain health care workers.
Code of Federal Regulations, 2013 CFR
... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Adjustment of status of certain health care workers. 1245.14 Section 1245.14 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.14 Adjustment of status...
22 CFR 40.53 - Uncertified foreign health-care workers.
Code of Federal Regulations, 2014 CFR
... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Uncertified foreign health-care workers. 40.53 Section 40.53 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Labor Certification and Qualification for Certain Immigrants §...
8 CFR 1245.14 - Adjustment of status of certain health care workers.
Code of Federal Regulations, 2011 CFR
... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Adjustment of status of certain health care workers. 1245.14 Section 1245.14 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.14 Adjustment of status...
Work Stress, Burnout, and Social and Personal Resources among Direct Care Workers
ERIC Educational Resources Information Center
Gray-Stanley, Jennifer A.; Muramatsu, Naoko
Work stress is endemic among direct care workers (DCWs) who serve people with intellectual and developmental disabilities. Social resources, such as work social support, and personal resources, such as an internal locus of control, may help DCWs perceive work overload and other work-related stressors as less threatening and galvanize them to cope…
Transfer of Learning: A Guide for Strengthening the Performance of Health Care Workers.
ERIC Educational Resources Information Center
Nelson, David, Ed.; Dufour, Wendy, Ed.
This document shares strategies and techniques that can facilitate transfer of learning among health care workers. The guide begins with a discussion of reasons why "good" training fails and lists possible interventions for addressing the following performance factors: job expectations; performance feedback; physical environment and tools;…
When the Job Has Lost Its Appeal: Intentions to Quit among Direct Care Workers
ERIC Educational Resources Information Center
Gray, Jennifer A.; Muramatsu, Naoko
Background: Previous research indicates that work stress contributes to intentions to quit among direct care workers (DCWs) who provide services to people with intellectual and developmental disability (IDD). Though resources can help DCWs cope and remain in a job, little is known about how various dimensions of work stress and resources (social…
The Critical Role of Social Workers in Home Based Primary Care
Reckrey, Jennifer M.; Gettenberg, Gabrielle; Ross, Helena; Kopke, Victoria; Soriano, Theresa; Ornstein, Katherine
The growing homebound population has many complex biomedical and psychosocial needs and requires a team based approach to care (Smith, Ornstein, Soriano, Muller, & Boal, 2006). The [XX] Visiting Doctors Program (MSVD), a large interdisciplinary home based primary care program in [XX], has a vibrant social work program that is integrated into the routine care of homebound patients. We describe the assessment process used by MSVD social workers, highlight examples of successful social work care, and discuss why social workers' individualized care plans are essential for keeping patients with chronic illness living safely in the community. Despite barriers to widespread implementation, such social work involvement within similar home based clinical programs is essential in the interdisciplinary care of our most needy patients. PMID:24717182
Social-cognitive determinants of hoist usage among health care workers.
Rickett, Bridgette; Orbell, Sheina; Sheeran, Paschal
Injuries caused by unsafe manual handling of patients are a major source of ill health in health care workers. The present study evaluated the ability of 4 classes of variable to predict use of a hoist when moving a heavily dependent patient. Variables examined were occupational role characteristics, such as hours of work and type of shift worked; biographics, including age and height; aspects of occupational context, such as number of hoists available and number of patients; and motivational variables specified by the theory of planned behavior (Ajzen, 1985) and protection motivation theory (Rogers, 1983). Regression analyses showed that background and social-cognitive variables were able to account for 59% of variance in intention to use a hoist and 41% of variance in use of the hoist assessed 6 weeks later. Height, hoist availability, coworker injunctive norm, perceived behavioral control, response cost, response benefits, and social and physical costs of not using the hoist each explained independent variance in motivation to use a hoist at work. PMID:16649851
Health Care Workers' Beliefs and Practices Around Pap Screening for Adolescents Seeking Contraception.
Gabzdyl, Elizabeth; Engstrom, Janet L; McFarlin, Barbara L
Adolescents often avoid seeing a health care provider to obtain contraception because they do not want to undergo a pelvic exam and Pap screening for fear of stress, pain or embarrassment. The purpose of this quality improvement project was to study health care workers, attitudes and beliefs about Pap screening and to educate them on the latest evidence-based guidelines, with the hope of ultimately decreasing unnecessary screening. Results showed a modest reduction in the frequency of Pap screening; however, many adolescents continued to undergo unnecessary Pap screening. The reluctance of health care workers to change their practice demonstrates the need for better methods of translating evidence-based guidelines into practice. PMID:26058904
Workforce Development Innovations with Direct Care Workers: Better Jobs, Better Services, Better Business.
Dailey, Wayne F; Morris, John A; Hoge, Michael A
This study describes findings from a national search to identify innovative workforce practices designed to improve the lives of direct care workers serving individuals with mental health and substance use conditions, while simultaneously improving client care, and the business vitality of the employer. The search process, conducted by The Annapolis Coalition on the Behavioral Health Workforce, resulted in the selection of five programs to receive the Pacesetter Award from among 51 nominations received. Awardees understood the value of investing in direct care workers, who constitute an essential, but often overlooked, group within the behavioral health workforce. A review of these innovations yielded six cross-cutting principles that should inform future workforce efforts (a) supporting educational and career development (b) increasing wages and benefits PMID:25535046
School's Out! Group Day Care for the School Age Child.
ERIC Educational Resources Information Center
Prescott, Elizabeth; Milich, Cynthia
This report on group day care is designed to: (1) examine the kinds of group programs for school-age children which exist in Los Angeles County, (2) describe the conditions necessary for program operation, and (3) consider the issue of quality as it relates to community expansion of day care services for children of school age. The report is…
[Guidelines for the prevention and control of tuberculosis in health care workers].
Casas, Irma; Dominguez, Jose; Rodríguez, Soledad; Matllo, Joan; Altet, Neus
Tuberculosis remains one of the communicable diseases that cause increased morbidity and mortality worldwide. With an incidence rate of 13,04 per 100,000 population, Spain ranks third among the most affected European countries. These data show a tendency to decrease meaning that it may go unnoticed with the potential to miss the appropriate preventive measures in a suspected case. In centers where patients are treated with tuberculosis, health care worker presents risk of transmission. This risk is higher in some areas or work units. The Occupational health physicians' services, which monitorize the health of health care workers, use different strategies in order to prevent and detect tuberculosis infection. The national guidelines include the tuberculin skin test as a screening test for tuberculosis infection with mention of new diagnostic tests based on the in vitro detection of gamma interferon (IGRA) for certain cases. The purpose of this guide is to establish common criteria for IGRA tests, as a supplementary aid to the tuberculin skin test in health care workers, from the evidence available today. Recommendations for its use have been adapted to the different situations faced by the professionals involved in monitoring the health of health workers. PMID:26520610
We care don't we? Social workers, the profession and HIV/AIDS.
Hall, Nigel
The HIV/AIDS epidemic has impacted all levels of society from the individual to the macro-economic. The continuing spread of infection around the world means that traditional methods of care and support are put under extreme pressure and many families lose their capacity to cope. Social workers are involved in providing care, counseling and support to those affected, and in developing programmes and other interventions to prevent the spread of the disease. Prevention and behaviour change are vital, but access to treatment is an ethical imperative, particularly in developing countries where the epidemic is most prevalent. Social work is a profession uniquely situated to demonstrate leadership in multi-sectoral collaboration in responding to this pandemic. Consequently this paper briefly reviews the scale and current nature of the epidemic and then considers how social workers can help build more compassionate policies at an international level. Social workers can help to create awareness of the negative effects of poverty, tackle gender inequity, help build more effective coalitions and partnerships, and work with other concerned groups and organisations to end stigma and discrimination. Using case examples the paper considers how social workers can help develop caring strategies that improve the lives of those living with HIV and AIDS. PMID:17521984
Evaluation of a stroke family care worker: results of a randomised controlled trial.
Dennis, M.; O'Rourke, S.; Slattery, J.; Staniforth, T.; Warlow, C.
OBJECTIVE: To examine the effect of contact with a stroke family care worker on the physical, social, and psychological status of stroke patients and their carers. DESIGN: Randomised controlled trial with broad entry criteria and blinded outcome assessment six months after randomisation. SETTING: A well organised stroke service in an Edinburgh teaching hospital. SUBJECTS: 417 patients with an acute stroke in the previous 30 days randomly allocated to be contacted by a stroke family care worker (210) or to receive standard care (207). The patients represented 67% of all stroke patients assessed at the hospital during the study period. MAIN OUTCOME MEASURES: Patient completed Barthel index, Frenchay activities index, general health questionnaire, hospital anxiety and depression scale, social adjustment scale, mental adjustment to stroke scale, and patient satisfaction questionnaire; carer completed Frenchay activities index, general health questionnaire, hospital anxiety and depression scale, social adjustment scale, caregiving bassles scale, and carer satisfaction questionnaire. RESULTS: The groups were balanced for all important baseline variables. There were no significant differences in physical outcomes in patients or carers, though patients in the treatment group were possibly more helpless less well adjusted socially, and more depressed, whereas carers in the treatment group were possibly less hassled and anxious. However, both patients and carers in the group contacted by the stroke family care worker expressed significantly greater satisfaction with certain aspects of their care, in particular those related to communication and support. CONCLUSIONS: The introduction of a stroke family care worker improved patients' and their carers' satisfaction with services and may have had some effect on psychological and social outcomes but did not improve measures of patients' physical wellbeing. PMID:9133884
Influence of Worker Age on the Infestation of Resistant and Susceptible Honey Bees (Apis mellifera) with Tracheal Mites (Acarapis woodi)*
Technology Transfer Automated Retrieval System (TEKTRAN)
In an earlier study, resistant and susceptible workers exposed to tracheal mites one, two, three or four days post-emergence showed a decline in infestation. I further investigated the combined effects of worker age and of strain on infestation with tracheal mites. In four separate tests, workers we...
Medicaid eligibility workers discuss Medicaid estate planning for nursing home care.
Walker, L; Gruman, C; Robison, J
This study was part of a multiphase project examining the perceptions of elder law attorneys, certified financial planners, and Medicaid eligibility workers regarding Medicaid estate planning (MEP) for nursing home care. Focus group methodology (5 groups, N = 32 participants) was used to explore the perspectives and experiences of Medicaid eligibility workers, who are responsible for interpreting, administering, and enforcing federal and state regulations. Findings describe factors influencing MEP, enforcement of regulations, and potential policy responses to MEP. Participants identified numerous impediments to effective implementation of current regulations. Recommendations for improved policy include redefinition of spousal assessment policies, other valuable consideration determinations, and penalty period formulas. PMID:10224716
Semelparous Penna Ageing Model with Parental Care
NASA Astrophysics Data System (ADS)
Fehsenfeld, K. M.; Sá Martins, J. S.; de Oliveira, S. Moss; Bernardes, A. T.
In this paper we study the importance of parental care for the survival of semelparous species, that reproduce only once in life. We perform our simulations for sexual and asexual reproductions and show that catastrophic senescence (death soon after reproduction) is delayed if parental care is considered.
Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project.
Wickizer, T M; Franklin, G; Plaeger-Brockway, R; Mootz, R D
This article has summarized research and policy activities undertaken in Washington State over the past several years to identify the key problems that result in poor quality and excessive disability among injured workers, and the types of system and delivery changes that could best address these problems in order to improve the quality of occupational health care provided through the workers' compensation system. Our investigations have consistently pointed to the lack of coordination and integration of occupational health services as having major adverse effects on quality and health outcomes for workers' compensation. The Managed Care Pilot Project, a delivery system intervention, focused on making changes in how care is organized and delivered to injured workers. That project demonstrated robust improvements in disability reduction; however, worker satisfaction suffered. Our current quality improvement initiative, developed through the Occupational Health Services Project, synthesizes what was learned from the MCP and other pilot studies to make delivery system improvements. This initiative seeks to develop provider incentives and clinical management processes that will improve outcomes and reduce the burden of disability on injured workers. Fundamental to this approach are simultaneously preserving workers' right to choose their own physician and maintaining flexibility in the provision of individualized care based on clinical need and progress. The OHS project then will be a "real world" test to determine if aligning provider incentives and giving physicians the tools they need to optimize occupational health delivery can demonstrate sustainable reduction in disability and improvements in patient and employer satisfaction. Critical to the success of this initiative will be our ability to: (1) enhance the occupational health care management skills and expertise of physicians who treat injured workers by establishing community-based Centers of Occupational
Predicting Health Care Utilization in Marginalized Populations: Black, Female, Street-based Sex Workers
Varga, Leah M.; Surratt, Hilary L.
Background Patterns of social and structural factors experienced by vulnerable populations may negatively affect willingness and ability to seek out health care services, and ultimately, their health. Methods The outcome variable was utilization of health care services in the previous 12 months. Using Andersen's Behavioral Model for Vulnerable Populations, we examined self-reported data on utilization of health care services among a sample of 546 Black, street-based female sex workers in Miami, Florida. To evaluate the impact of each domain of the model on predicting health care utilization, domains were included in the logistic regression analysis by blocks using the traditional variables first and then adding the vulnerable domain variables. Findings The most consistent variables predicting health care utilization were having a regular source of care and self-rated health. The model that included only enabling variables was the most efficient model in predicting health care utilization. Conclusions Any type of resource, link, or connection to or with an institution, or any consistent point of care contributes significantly to health care utilization behaviors. A consistent and reliable source for health care may increase health care utilization and subsequently decrease health disparities among vulnerable and marginalized populations, as well as contribute to public health efforts that encourage preventive health. PMID:24657047
Traditional health practitioners as primary health care workers.
Hoff, W
The author conducted a field study in 1993 to evaluate the effectiveness of four projects that were training traditional health practitioners (THPs) to provide primary health care (PHC) services in Ghana, Mexico, and Bangladesh. The study, funded by a grant from the World Health Organization, Division of Strengthening Health Services, concluded that incorporating trained THPs in PHC programmes can be cost effective in providing essential and culturally relevant health services to communities. The main objective of the study was to evaluate how effective the training projects were and to determine what impacts they might have upon the communities served. A qualitative field evaluation was performed using data collected from project documents, observations, and field interviews with a selection of health agency staff, THPs, and community members. A summary of results is presented from the four field studies. For details refer to the full report. PMID:9204727
A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities.
Conway, Jane; Dilworth, Sophie; Hullick, Carolyn; Hewitt, Jacqueline; Turner, Catherine; Higgins, Isabel
This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person. PMID:25981903
Prevalence of latent tuberculosis infection among health care workers in a hospital for pulmonary diseases
Schablon, Anja; Beckmann, Gudrun; Harling, Melanie; Diel, Roland; Nienhaus, Albert
Background Little is known about the prevalence of latent tuberculosis infections (LTBI) in health care workers (HCW) in low-incidence countries especially in hospitals for pulmonary diseases. With Interferon-gamma release assays (IGRA), a new method for diagnosis of LTBI is available which is more specific than the tuberculin skin test (TST). Objectives The study was designed to estimate prevalence of LTBI among 270 HCW in a Hospital of Pulmonary Diseases routinely screened for TB. Methods LTBI was assessed by the QuantiFERON-Gold In Tube (QFT-IT). Information on gender, age, workplace, job title, BCG vaccination and history of both TB and TST were collected using a standardised questionnaire. Adjusted odds ratios for potential risk factors for LTBI were calculated. Results The prevalence of LTBI was 7.2%. In HCW younger than 30 years LTBI prevalence was 3.5% and in those older than 50 years 22%. Physicians and nurses showed a higher prevalence rate than other professions (10.8% to 4.5%). The putative risk factors for LTBI were age (>50 year OR 9.3, 95%CI 2.5–33.7), working as physicians/nurses (OR 3. 95%CI 1.2–10.4) and no previous TST in medical history (OR 4.4, 95%CI 1.01–18.9) when compared to those with a negative TST. Conclusion Prevalence of LTBI assessed by QFT-IT is low, this indicates a low infection risk even in hospitals for pulmonary diseases. No statement can be made regarding the occupational risk as compared to the general population because there are no LTBI prevalence data from Germany available. The higher LTBI prevalence rate in older HCWs might be due to the cohort effect or the longer time at risk. PMID:19134168
Musculoskeletal Symptoms and Risk of Burnout in Child Care Workers — A Cross-Sectional Study
Koch, Peter; Stranzinger, Johanna; Nienhaus, Albert; Kozak, Agnessa
Objectives German child care workers' job satisfaction is influenced by the consequences of unfavourable underlying conditions. Child care workers tend to suffer from psychosocial stress, as they feel that their work is undervalued. The objective of the present study is to investigate how the psychosocial factors of the effort-reward imbalance (ERI) model influence musculoskeletal symptoms (MS) and the risk of burnout. To our knowledge this is the first study investigating the association between the factors of the ERI model and MS in child care workers. Methods and Findings Data from 199 child care workers were examined in a cross-sectional study. Psychosocial factors were recorded with the ERI questionnaire. MS was recorded with the Nordic Questionnaire and risk of burnout with the Personal Burnout scale of the Copenhagen Burnout Inventory. Multivariate analysis was performed using linear and logistic regression models. The response rate was 57%. In most of the sample (65%), an effort-reward imbalance was observed. 56% of the child care workers were at risk of burnout and 58% reported MS. Factors associated with risk of burnout were subjective noise exposure (OR: 4.4, 95%CI: 1.55–12.29) and overcommitment (OR: 3.4; 95%CI: 1.46–7.75). There were statistically significant associations between MS and overcommitment (low back pain—OR: 2.2, 95%CI: 1.04–4.51), low control (overall MS OR: 3.8; 95%CI: 1.68–3.37) and risk of burnout (overall MS OR: 2.3, 95%CI: 1.01–5.28). For ERI no statistically significant associations were found with reference to risk of burnout or MS. Conclusion Overcommitment in child care workers is related to MS and risk of burnout. There is also evidence that low control is associated with MS and subjective noise exposure with risk of burnout. Effort-reward imbalance is not related to either outcome. This occupational health risk assessment identifies changeable working factors in different types of facilities. PMID:26488770
Risk and management of blood-borne infections in health care workers.
Beltrami, E M; Williams, I T; Shapiro, C N; Chamberland, M E
Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it. PMID:10885983
Push, pull, and reverse: self-interest, responsibility, and the global health care worker shortage.
Kirby, Katherine E; Siplon, Patricia
The world is suffering from a dearth of health care workers, and sub-Saharan Africa, an area of great need, is experiencing the worst shortage. Developed countries are making the problem worse by luring health care workers away from the countries that need them most, while developing countries do not have the resources to stem the flow or even replace those lost. Postmodern philosopher Emmanuel Levinas offers a unique ethical framework that is helpful in assessing both the irresponsibility inherent in the current global health care situation and the responsibility and obligation held by the stakeholders involved in this global crisis. Drawing on Levinas' exploration of individual freedom and self-pursuit, infinite responsibility for the Other, and the potential emergence of a just community, we demonstrate its effectiveness in explaining the health care worker crisis, and we argue in favor of a variety of policy and development assistance measures that are grounded in an orientation of non-indifference toward Others. PMID:21744290
Risk and Management of Blood-Borne Infections in Health Care Workers
Beltrami, Elise M.; Williams, Ian T.; Shapiro, Craig N.; Chamberland, Mary E.
Exposure to blood-borne pathogens poses a serious risk to health care workers (HCWs). We review the risk and management of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in HCWs and also discuss current methods for preventing exposures and recommendations for postexposure prophylaxis. In the health care setting, blood-borne pathogen transmission occurs predominantly by percutaneous or mucosal exposure of workers to the blood or body fluids of infected patients. Prospective studies of HCWs have estimated that the average risk for HIV transmission after a percutaneous exposure is approximately 0.3%, the risk of HBV transmission is 6 to 30%, and the risk of HCV transmission is approximately 1.8%. To minimize the risk of blood-borne pathogen transmission from HCWs to patients, all HCWs should adhere to standard precautions, including the appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments. Employers should have in place a system that includes written protocols for prompt reporting, evaluation, counseling, treatment, and follow-up of occupational exposures that may place a worker at risk of blood-borne pathogen infection. A sustained commitment to the occupational health of all HCWs will ensure maximum protection for HCWs and patients and the availability of optimal medical care for all who need it. PMID:10885983
Assessment of genotoxic risks in Croatian health care workers occupationally exposed to cytotoxic drugs: a multi-biomarker approach.
Kopjar, Nevenka; Garaj-Vrhovac, Verica; Kasuba, Vilena; Rozgaj, Ruzica; Ramić, Snjezana; Pavlica, Vesna; Zeljezić, Davor
The aim of the present study was to evaluate genome damage induced in peripheral blood lymphocytes of Croatian health care workers occupationally exposed to cytotoxic drugs. A comprehensive multi-biomarker approach using the alkaline comet assay and cytogenetic endpoints (analysis of structural chromosome aberrations, SCE assay, lymphocyte proliferation kinetics and cytokinesis-block micronucleus assay) was employed. The study included two populations of subjects: 50 health care workers occupationally exposed to cytotoxic drugs and 50 control subjects matched in age, gender and smoking habit. An investigation regarding the handling practice with cytotoxic drugs was conducted in parallel. Results obtained indicate high exposure levels at workplace that should be reduced. The values recorded among the occupationally exposed subjects were as follows: mean comet tail length: 17.46+/-0.08 microm; the incidence of long-tailed nuclei: 54.68+/-3.93%; 4.48+/-0.33 structural chromosome aberrations per 200 cells; 5.81+/-0.04 SCE per 50 cells; 29.28+/-2.21% of high-frequency cells; proliferation rate index: 1.97+/-0.12; and 16.32+/-0.85 micronuclei per 1000 binuclear cells. All these values indicated higher levels of DNA and cytogenetic damage compared to the general population. Obtained results also confirmed that the frequency of long-tailed nuclei in the alkaline comet assay represents a helpful complement to other well-established comet parameters. The age of subjects and smoking habit significantly influenced the values of both comet and cytogenetic endpoints. Overall results of this study confirmed that handling cytotoxic drugs without appropriate safety precautions involves a potential genotoxic risk for exposed subjects. Before a strict monitoring of exposure levels on each workplace becomes a standard practice in Croatian hospitals, cytogenetic surveillance of exposed workers is also recommended, at least in cases of accidental exposure. PMID:19049854
Pre-event Smallpox Vaccination for Healthcare Workers Revisited – the Need for a Carefully Screened Multidisciplinary Cadre
Malone, JD D.
Abstract As healthcare institutions are a focus of smallpox transmission early in an epidemic, several mathematical models support pre-event smallpox vaccination of healthcare workers (HCWs). The deciding factor for HCW voluntary vaccination is the risk of disease exposure versus the risk of vaccine adverse events. In a United States military population, with careful screening to exclude atopic dermatitis/eczema and immunosuppression, over 1 million vaccinia vaccinations were delivered with 1 fatality attributed to vaccination. Among 37,901 U.S. civilian volunteer healthcare workers vaccinated, 100 serious adverse events were reported including 10 ischemic cardiac episodes and six myocardial infarctions – 2 were fatal. This older population had a higher rate of adverse events due to age related coronary artery disease. T-cell mediated inflammatory processes, induced by live vaccinia vaccination, may have a role in the observed acute coronary artery events. With exclusion of individuals at risk for coronary artery disease, atopic dermatitis/eczema, and immunosuppression, HCWs can be smallpox vaccinated with minimal risk. A smallpox pre-vaccinated multidisciplinary cadre (physician, nurse, infection control practitioner, technician) will supply leadership to deal with fear and uncertainty while limiting spread and initial mortality of smallpox. Stochastic – from the Greek meaning "skillful in aiming" – is currently interpreted as arising from chance and involving probability. This issue's article "Containing a large bioterrorist smallpox attack: a computer simulation approach" by Longini et al. is a discrete time, stochastic computer simulation model that offers additional planning guidance for a smallpox (variola virus) outbreak (1). Although interpretation of the model's information may differ, Longini's article concludes "Given that surveillance and containment measures are in place, preemptive vaccination of hospital workers would further
Socioeconomic Status, Occupational Characteristics, and Sleep Duration in African/Caribbean Immigrants and US White Health Care Workers
Ertel, Karen A.; Berkman, Lisa F.; Buxton, Orfeu M.
Study Objectives: o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant–white difference in sleep duration. Design: Cross sectional Setting: Four extended care facilities in Massachusetts, United States Participants: 340 employees in extended care facilities Measurements and Results: Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: −81.0, −47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (−69.2, −32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (−57.8, −17.6). Conclusions: his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant–white difference in sleep duration in the United States, especially among health care workers. Citation: Ertel KA; Berkman LF; Buxton OM. Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immi grants and US white health care workers. SLEEP 2011; 34(4):509-518. PMID:21461330
Test of the Fishbein and Ajzen models as predictors of health care workers' glove use.
Levin, P F
The aim of this study was to identify predictors of health care workers' glove use when there is a potential for blood exposure. The study hypothesis was that an extension of the theory of planned behavior would explain more of the variance in glove use behavior than the theory of reasoned action or theory of planned behavior. A random sample of nurses and laboratory workers (N = 527) completed a 26-item questionnaire with acceptable content validity and reliability estimates. Using structural equation modeling techniques, intention, attitude, and perceived risk were significant predictors of behavior. Perceived control and attitude were the significant determinants of intention. The theory of reasoned action was the most parsimonious model, explaining 70% of the variance in glove use behavior. The theory of planned behavior extension was a viable model to study behavior related to glove use and reducing workers' risks to bloodborne diseases. PMID:10435547
Perceptions of health and risk management among home care workers in Sweden
Larsson, A; Karlqvist, L; Westerberg, M; Gard, G
Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers' perceptions of health, risks, working conditions, and risk management within their organization. Method: The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides (n = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations. PMID:24078781
Work stress, sleep deficiency and predicted 10-year cardiometabolic risk in a female patient care worker population
Jacobsen, Henrik Børsting; Reme, Silje Endresen; Sembajwe, Grace; Hopcia, Karen; Stiles, Tore C.; Sorensen, Glorian; Porter, James H.; Marino, Miguel; Buxton, Orfeu M.
Objectives The aim of this study was to investigate the longitudinal effect of work-related stress, sleep deficiency and physical activity on 10-year cardiometabolic risk among an all-female worker population. Methods Data on patient care workers (n=99) was collected two years apart. Baseline measures included: job stress, physical activity, night work and sleep deficiency. Biomarkers and objective measurements were used to estimate 10-year cardiometabolic risk at follow-up. Significant associations (P<0.05) from baseline analyses were used to build a multivariable linear regression model. Results The participants were mostly white nurses with a mean age of 41 years. Adjusted linear regression showed that having sleep maintenance problems, a different occupation than nurse, and/or not exercising at recommended levels at baseline increased the 10-year cardiometabolic risk at follow-up. Conclusions In female workers prone to work-related stress and sleep deficiency, maintaining sleep and exercise patterns had a strong impact on modifiable 10-year cardiometabolic risk. PMID:24809311
Mature Age Workers: Are They a Disadvantaged Group in the Labour Market?
ERIC Educational Resources Information Center
VandenHeuvel, Adriana
Although a majority work full time, many mature-age workers (45 and older) are clearly at a disadvantage in the Australian labor market. Average unemployment duration is long, many unwillingly work part time or are underemployed, and their likelihood of unemployment is very high, especially for older women. (JOW)
Modernization and Age Management in France: French Older Workers and Employment.
ERIC Educational Resources Information Center
Gaullier, Xavier; Thomas, Charles
In the new context of economic recovery, employment creation, new technologies, and labor shortages in some sectors, France cannot sustain a systematic policy of rejecting aging workers. This policy has led gradually to the recognition that early retirement was merely an easy way out of the problem that has many substantially adverse effects on…
Understanding informal payments in health care: motivation of health workers in Tanzania
Stringhini, Silvia; Thomas, Steve; Bidwell, Posy; Mtui, Tina; Mwisongo, Aziza
Background There is growing evidence that informal payments for health care are fairly common in many low- and middle-income countries. Informal payments are reported to have a negative consequence on equity and quality of care; it has been suggested, however, that they may contribute to health worker motivation and retention. Given the significance of motivation and retention issues in human resources for health, a better understanding of the relationships between the two phenomena is needed. This study attempts to assess whether and in what ways informal payments occur in Kibaha, Tanzania. Moreover, it aims to assess how informal earnings might help boost health worker motivation and retention. Methods Nine focus groups were conducted in three health facilities of different levels in the health system. In total, 64 health workers participated in the focus group discussions (81% female, 19% male) and where possible, focus groups were divided by cadre. All data were processed and analysed by means of the NVivo software package. Results The use of informal payments in the study area was confirmed by this study. Furthermore, a negative relationship between informal payments and job satisfaction and better motivation is suggested. Participants mentioned that they felt enslaved by patients as a result of being bribed and this resulted in loss of self-esteem. Furthermore, fear of detection was a main demotivating factor. These factors seem to counterbalance the positive effect of financial incentives. Moreover, informal payments were not found to be related to retention of health workers in the public health system. Other factors such as job security seemed to be more relevant for retention. Conclusion This study suggests that the practice of informal payments contributes to the general demotivation of health workers and negatively affects access to health care services and quality of the health system. Policy action is needed that not only provides better financial
The "brain drain" of health care workers: causes, solutions and the example of Jamaica.
Lofters, Aisha K
Despite much media attention being given to the physician shortage in Canada in recent years, this shortage pales in comparison to that seen in many middle- and low-income countries. A major cause of the shortage in these countries is the migration of health care workers from developing to developed nations, a phenomenon known as the "brain drain". The loss of these workers is having devastating impacts globally, particularly in Sub-Saharan Africa and the Caribbean. Causes of the "brain drain" are numerous and include poor working conditions in poorer countries and active recruitment by richer countries. Jamaica has been one of the countries in the Caribbean hardest hit by mass migration of health care workers. The multiple dimensions of Jamaica's health worker "brain drain" illustrate both the complexity of the issues reviewed in this commentary, and the net loss for low- and middle-income countries. Creative and sustainable solutions to the problem are actively being sought globally, but will require commitment and support from all nations as well as from international funding bodies if meaningful impacts on health are to be realized. PMID:23617992
Outsourcing Elderly Care to Migrant Workers: The Impact of Gender and Class on the Experience of Male Employers
Gallo, Ester; Scrinzi, Francesca
This article, based on semi-structured interviews, addresses masculinity in the international division of reproductive labour through an analysis of the impact of gender and class on the outsourcing of elderly care services to migrant care workers. In the Italian context, characterised by a limited provision of long-term care services and by cash-for-care benefits, the strategies of men as employers of migrant care workers are shaped by class and gender. The outsourcing of care to migrant workers reproduces hegemonic masculinity in so far as male employers are able to withdraw from the 'dirty work'. At the same time, men engage with tasks which are, in principle, kept at a distance. The employers' family status, combined with their class background, are crucial factors in shaping the heterogeneity of men's experiences as employers and managers of care labour, and the ways in which they make sense of their masculinity. PMID:27041775
Data on the migration of health-care workers: sources, uses, and challenges.
Diallo, Khassoum
The migration of health workers within and between countries is a growing concern worldwide because of its impact on health systems in developing and developed countries alike. Policy decisions need to be made at the national, regional and international levels to manage more effectively this phenomenon, but those decisions will be effective and correctly implemented and evaluated only if they are based on adequate statistical data. Most statistics on the migration of health-care workers are neither complete nor fully comparable, and they are often underused, limited (because they often give only a broad description of the phenomena) and not as timely as required. There is also a conflict between the wide range of potential sources of data and the poor statistical evidence on the migration of health personnel. There are two major problems facing researchers who wish to provide evidence on this migration: the problems commonly faced when studying migration in general, such as definitional and comparability problems of "worker migrations" and those related to the specific movements of the health workforce. This paper presents information on the uses of statistics and those who use them, the strengths and limitations of the main data sources, and other challenges that need to be met to obtain good evidence on the migration of health workers. This paper also proposes methods to improve the collection, analysis, sharing, and use of statistics on the migration of health workers. PMID:15375450
The Role of the Work Context in Multiple Wellness Outcomes for Hospital Patient Care Workers
Sorensen, Glorian; Stoddard, Anne M.; Stoffel, Sonja; Buxton, Orfeu; Sembajwe, Grace; Hashimoto, Dean; Dennerlein, Jack T.; Hopcia, Karen
Objective To examine the relationships among low back pain (LBP), inadequate physical activity, and sleep deficiency among patient care workers, and of these outcomes to work context. Methods A cross-sectional survey of patient care workers (N=1572, response rate=79%). Results 53% reported LBP, 46%, inadequate physical activity, and 59%, sleep deficiency. Inadequate physical activity and sleep deficiency were associated (p=0.02), but LBP was not significantly related to either. Increased risk of LBP was significantly related to job demands, harassment at work, decreased supervisor support, and job title. Inadequate physical activity was significantly associated with low decision latitude. Sleep deficiency was significantly related to low supervisor support, harassment at work, low ergonomic practices, people-oriented culture, and job title. Conclusions These findings point to shared pathways in the work environment that jointly influence multiple health and wellbeing outcomes. PMID:21775897
Home-Based Direct Care Workers: Their Reported Injuries and Perceived Training Knowledge.
Hamadi, Hanadi; Probst, Janice C; Khan, M Mahmud; Bellinger, Jessica; Porter, Candace
The objectives of the study were to profile occupational injury patterns across home health and hospice care (HHC), organization characteristics, and home health aides' (HHAs) individual characteristics, and examine how worker training affects HHAs' risk of reporting an injury using the model of human factors of health care in the home. The authors measured training knowledge using an 11-item scale and conducted univariate and bivariate analyses to describe injury patterns across individual, occupational, and organizational factors using STATA 12.0. The researchers found that work-related injuries and type of injury were associated with increased likelihood of reporting one or more injuries, full-time employment, high hourly pay, and working in an inpatient or mixed setting. Overall, HHAs perceived that they received "excellent" and "good" training on key topics that promoted safety and job knowledge. Furthermore, the results suggested linkages between worker's complex personal, occupational, and organizational characteristics. PMID:27026275
The challenges in providing services to clients with mental illness: managed care, burnout and somatic symptoms among social workers.
Acker, Gila M
This study examined the relationship between social workers' experiences when interfacing with managed care organizations and burnout. A total of 591 social workers completed questionnaires that included several measures: Self-perceived competence in the context of managed care, professional involvement with clients with severe mental illness, and burnout. Results showed that self-perceived competence in the context of managed care had statistically significant correlations with burnout dimensions. The author discusses the role of social work schools in preparing students for the realistic aspects of mental health work, and recommends a partnership between managed care organizations and professionals for best care giving. PMID:19946797
Factors affecting uptake of recommended immunizations among health care workers in South Australia.
Tuckerman, Jane L; Collins, Joanne E; Marshall, Helen S
Despite the benefits of vaccination for health care workers (HCWs), uptake of recommended vaccinations is low, particularly for seasonal influenza and pertussis. In addition, there is variation in uptake within hospitals. While all vaccinations recommended for HCWs are important, vaccination against influenza and pertussis are particularly imperative, given HCWs are at risk of occupationally acquired influenza and pertussis, and may be asymptomatic, acting as a reservoir to vulnerable patients in their care. This study aimed to determine predictors of uptake of these vaccinations and explore the reasons for variation in uptake by HCWs working in different hospital wards. HCWs from wards with high and low influenza vaccine uptake in a tertiary pediatric and obstetric hospital completed a questionnaire to assess knowledge of HCW recommended immunizations. Multiple logistic regression was used to determine predictors of influenza and pertussis vaccination uptake. Of 92 HCWs who responded, 9.8% were able to identify correctly the vaccines recommended for HCWs. Overall 80% of respondents reported they had previously received influenza vaccine and 50.5% had received pertussis vaccine. Independent predictors of pertussis vaccination included length of time employed in health sector (P < 0.001), previously receiving hepatitis B/MMR (measles, mumps, rubella) vaccine (P < 0.001), and a respondent being aware influenza infections could be severe in infants (p = 0.023). Independent predictors of seasonal influenza vaccination included younger age (P < 0.001), English as first language (P < 0.001), considering it important to be vaccinated to protect themselves (P < 0.001), protect patients (p = 0.012) or awareness influenza could be serious in immunocompromised patients (p = 0.030). Independent predictors for receiving both influenza and pertussis vaccinations included younger age (P < 0.001), time in area of work (P = 0.020), previously receiving hepatitis B vaccine (P = 0
Factors affecting uptake of recommended immunizations among health care workers in South Australia
Tuckerman, Jane L; Collins, Joanne E; Marshall, Helen S
Despite the benefits of vaccination for health care workers (HCWs), uptake of recommended vaccinations is low, particularly for seasonal influenza and pertussis. In addition, there is variation in uptake within hospitals. While all vaccinations recommended for HCWs are important, vaccination against influenza and pertussis are particularly imperative, given HCWs are at risk of occupationally acquired influenza and pertussis, and may be asymptomatic, acting as a reservoir to vulnerable patients in their care. This study aimed to determine predictors of uptake of these vaccinations and explore the reasons for variation in uptake by HCWs working in different hospital wards. HCWs from wards with high and low influenza vaccine uptake in a tertiary pediatric and obstetric hospital completed a questionnaire to assess knowledge of HCW recommended immunizations. Multiple logistic regression was used to determine predictors of influenza and pertussis vaccination uptake. Of 92 HCWs who responded, 9.8% were able to identify correctly the vaccines recommended for HCWs. Overall 80% of respondents reported they had previously received influenza vaccine and 50.5% had received pertussis vaccine. Independent predictors of pertussis vaccination included length of time employed in health sector (P < 0.001), previously receiving hepatitis B/MMR (measles, mumps, rubella) vaccine (P < 0.001), and a respondent being aware influenza infections could be severe in infants (p = 0.023). Independent predictors of seasonal influenza vaccination included younger age (P < 0.001), English as first language (P < 0.001), considering it important to be vaccinated to protect themselves (P < 0.001), protect patients (p = 0.012) or awareness influenza could be serious in immunocompromised patients (p = 0.030). Independent predictors for receiving both influenza and pertussis vaccinations included younger age (P < 0.001), time in area of work (P = 0.020), previously receiving hepatitis B vaccine (P = 0
Challenges of Transcultural Caring Among Health Workers in Mashhad-Iran: A Qualitative Study
Amiri, Rana; Heydari, Abbas; Dehghan-Nayeri, Nahid; Vedadhir, Abou Ali; Kareshki, Hosein
Background: One of the consequences of migration is cultural diversity in various communities. This has created challenges for healthcare systems. Objectives: The aim of this study is to explore the health care staffs' experience of caring for Immigrants in Mashhad- Iran. Setting: This study is done in Tollab area (wherein most immigrants live) of Mashhad. Clinics and hospitals that immigrants had more referral were selected. Participants: Data were collected through in-depth interviews with medical and nursing staffs. 15 participants (7 Doctors and 8 Nurses) who worked in the more referred immigrants' clinics and hospitals were entered to the study. Design: This is a qualitative study with content analysis approach. Sampling method was purposive. The accuracy and consistency of data were confirmed. Interviews were conducted until no new data were emerged. Data were analyzed by using latent qualitative content analysis. Results: The data analysis consisted of four main categories; (1) communication barrier, (2) irregular follow- up, (3) lack of trust, (4) cultural- personal trait. Conclusion: Result revealed that health workers are confronting with some trans- cultural issues in caring of immigrants. Some of these issues are related to immigration status and some related to cultural difference between health workers and immigrants. These issues indicate that there is transcultural care challenges in care of immigrants among health workers. Due to the fact that Iran is the context of various cultures, it is necessary to consider the transcultural care in medical staffs. The study indicates that training and development in the area of cultural competence is necessary. PMID:26925887
Knowledge of community care workers about key family practices in a rural community in South Africa
van Zyl, Marjorie; Eygelaar, Johanna
Background Interventions by community care workers within the context of community-based integrated management of childhood illness (CIMCI) may have a positive effect on child health if the health workers have adequate knowledge about key family practices. Setting The study was conducted in rural areas of the West Coast district in the Western Cape, South Africa. Objectives The objective of this study was to determine the knowledge of community care workers about five of the 16 key family practices of CIMCI. Methods A descriptive survey collected a self-administered questionnaire from 257 community care workers out of a possible total of 270 (95.2% response rate). Descriptive and inferential statistical analysis was applied. Results Only 25 of the respondents (10%) obtained a score higher than 70% on the knowledge-based items of the questionnaire. Less than 25% of respondents answered questions in these key areas correctly (pneumonia [17%], tuberculosis [13%], HIV/AIDS [9%] immunisation [3%] and recommendations for a child with fever [21%]). Statistically significant correlations were found between the total score a respondent achieved and the highest level of education obtained (p < 0.01), the level of in-service training (p < 0.01), attendance of a CIMCI five-day training course (p < 0.01), and completing a subsequent refresher course (p < 0.01). Conclusion The knowledge of CCWs was inadequate to provide safe, quality CIMCI. CIMCI refresher courses should be offered annually to improve CCWs' knowledge and the quality of care that they render. Regular update courses could contribute to building competence. PMID:26842523
Adoption and Usage of mHealth Technology on Quality and Experience of Care Provided by Frontline Workers: Observations From Rural India
Chaturvedi, Sharad; Chaudhuri, Indrajit; Krishnan, Ram; Lesh, Neal
Background mHealth apps are deployed with the aim of improving access, quality, and experience of health care. It is possible that any mHealth intervention can yield differential impacts for different types of users. Mediating and determining factors, including personal and socioeconomic factors, affect technology adoption, the way health workers leverage and use the technology, and subsequently the quality and experience of care they provide. Objective To develop a framework to assess whether mHealth platforms affect the quality and experience of care provided by frontline workers, and whether these effects on quality and experience are different depending on the level of technology adoption and individual characteristics of the health worker. Literacy, education, age, and previous mobile experience are identified as individual factors that affect technology adoption and use, as well as factors that affect the quality and experience of care directly and via the technology. Methods Formative research was conducted with 15 community health workers (CHWs) using CommCare, an mHealth app for maternal and newborn care, in Bihar, India. CHWs were first classified on the level of CommCare adoption using data from CommCareHQ and were then shadowed on home visits to evaluate their levels of technology proficiency, and the quality and experience of care provided. Regression techniques were employed to test the relationships. Out of all the CHWs, 2 of them refused to participate in the home visits, however, we did have information on their levels of technology adoption and background characteristics, which were included in the analysis as relevant. Results Level of technology adoption was important for both quality and experience of care. The quality score for high users of CommCare was higher by 33.4% (P=.04), on average, compared to low users of CommCare. Those who scored higher on CommCare proficiency also provided significantly higher quality and experience of care, where
[Blood-borne infections and the pregnant health care worker. Risks and preventive measures].
Wicker, S; Rabenau, H F; Haberl, A E; Bühren, A; Bechstein, W O; Sarrazin, C M
Due to the increasing proportion of women in health care, as well as changes in working conditions (implementation of safety devices, minimally invasive/endoscopic procedures) the question arises whether the applicable laws and regulations for the protection of working mothers are outdated and should be updated.Individual risk analysis, as well as the inclusion of the pregnant health care worker in the decision-making process with regard to continuation or modification of the work practice serves as a protection of the expectant mother and unborn child and allows a continuation of the occupational activities. PMID:21901466
Social Capital Theory: Another Lens for School Social Workers to Use to Support Students Living in Foster Care
ERIC Educational Resources Information Center
Fram, Maryah Stella; Altshuler, Sandra J.
Schools have a wide range of connections with the child welfare system, with common interests in the care, well-being, and future life opportunities of children living in foster care. Children in foster care are often the most vulnerable students in the school system, and school social workers often serve as important resources for these children.…
Proceedings of the Annual National Conference for Child Care Workers (2nd, Valley Forge, PA, October 9-12, 1980).
ERIC Educational Resources Information Center
Powell, Norman W., Jr., Ed.
The speeches, papers, and workshops descriptions presented at the second annual National Conference for Child Care Workers are presented. Several issues relating to child care supervision, child care work, and child development are considered along with the management of group living environments and various aspects of supervision. Job…
Field experiment of a very brief worksite intervention to improve nutrition among health care workers.
Armitage, Christopher J
Despite the potential of worksite interventions to boost productivity and save insurance costs, they tend to be costly and tested in nonrandomized trials. The aim of the present study was to test the ability of a very brief worksite intervention based on implementation intentions to improve nutrition among health care workers. Seventy-nine health care workers were randomly allocated to a control condition or to form implementation intentions using standard instructions or with a supporting tool. Fruit intake and metacognitive processing (operationalized as awareness of standards, self-monitoring and self-regulatory effort) were measured at baseline and follow-up. Participants who formed implementation intentions ate significantly more fruit and engaged in significantly more metacognitive processing at follow-up than did participants in the control condition (ds > .70). The findings support the efficacy of implementation intentions for increasing fruit intake in health care workers and preliminary support for the utility of a tool to support implementation intention formation. PMID:25822117
Gamma delta T cell responses associated with the development of tuberculosis in health care workers.
Ordway, Diane J; Pinto, Luisa; Costa, Leonor; Martins, Marta; Leandro, Clara; Viveiros, Miguel; Amaral, Leonard; Arroz, Maria J; Ventura, Fernando A; Dockrell, Hazel M
This study evaluated T cell immune responses to purified protein derivative (PPD) and Mycobacterium tuberculosis (Mtb) in health care workers who remained free of active tuberculosis (HCWs w/o TB), health care workers who went on to develop active TB (HCWs w/TB), non-health care workers who were TB free (Non-HCWs) and tuberculosis patients presenting with minimal (Min TB) or advanced (Adv TB) disease. Peripheral blood mononuclear cells (PBMC) were stimulated with Mtb and PPD and the expression of T cell activation markers CD25+ and HLA-DR+, intracellular IL-4 and IFN-gamma production and cytotoxic responses were evaluated. PBMC from HCWs who developed TB showed decreased percentages of cells expressing CD8+CD25+ in comparison to HCWs who remained healthy. HCWs who developed TB showed increased gammadelta TCR+ cell cytotoxicity and decreased CD3+gammadelta TCR- cell cytotoxicity in comparison to HCWs who remained healthy. PBMC from TB patients with advanced disease showed decreased percentages of CD25+CD4+ and CD25+CD8+ T cells that were associated with increased IL-4 production in CD8+ and gammadelta TCR+ phenotypes, in comparison with TB patients presenting minimal disease. TB patients with advanced disease showed increased gammadelta TCR+ cytotoxicity and reduced CD3+gammadelta TCR- cell cytotoxicity. Our results suggest that HCWs who developed TB show an early compensatory mechanism involving an increase in lytic responses of gammadelta TCR+ cells which did not prevent TB. PMID:15708307
Preparing for an epidemic: cancer care in an aging population.
Shih, Ya-Chen Tina; Hurria, Arti
The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer. PMID:24857069
Does informal care reduce public care expenditure on elderly care? Estimates based on Finland's Age Study
Background To formulate sustainable long-term care policies, it is critical first to understand the relationship between informal care and formal care expenditure. The aim of this paper is to examine to what extent informal care reduces public expenditure on elderly care. Methods Data from a geriatric rehabilitation program conducted in Finland (Age Study, n = 732) were used to estimate the annual public care expenditure on elderly care. We first constructed hierarchical multilevel regression models to determine the factors associated with elderly care expenditure. Second, we calculated the adjusted mean costs of care in four care patterns: 1) informal care only for elderly living alone; 2) informal care only from a co-resident family member; 3) a combination of formal and informal care; and 4) formal care only. We included functional independence and health-related quality of life (15D score) measures into our models. This method standardizes the care needs of a heterogeneous subject group and enabled us to compare expenditure among various care categories even when differences were observed in the subjects' physical health. Results Elder care that consisted of formal care only had the highest expenditure at 25,300 Euros annually. The combination of formal and informal care had an annual expenditure of 22,300 Euros. If a person received mainly informal care from a co-resident family member, then the annual expenditure was only 4,900 Euros and just 6,000 Euros for a person living alone and receiving informal care. Conclusions Our analysis of a frail elderly Finnish population shows that the availability of informal care considerably reduces public care expenditure. Therefore, informal care should be taken into account when formulating policies for long-term care. The process whereby families choose to provide care for their elderly relatives has a significant impact on long-term care expenditure. PMID:23947622
How to Select Anti-Aging Skin Care Products
... zone Video library Find a dermatologist How to select anti-aging skin care products Dermatologists share their ... make a noticeable difference. When shopping for sunscreen, select one that offers all of the following: Broad ...
Surviving the Silver Tsunami: Training a Health Care Workforce to Care for North Carolina's Aging Population.
Heflin, Mitchell T
North Carolina's aging population will require a health care workforce prepared to meet patients' complex care needs. The keys to training this workforce include continuing to mobilize the state's educational infrastructure to provide interprofessional, community-based experiences and maximizing exposure to new models of care. PMID:26961830
Community Care Workers, Poor Referral Networks and Consumption of Personal Resources in Rural South Africa
Sips, Ilona; Haeri Mazanderani, Ahmad; Schneider, Helen; Greeff, Minrie; Barten, Francoise; Moshabela, Mosa
Although home-based care (HBC) programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs), in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs). An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data – CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25%) of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers. PMID:24781696
Community care workers, poor referral networks and consumption of personal resources in rural South Africa.
Sips, Ilona; Haeri Mazanderani, Ahmad; Schneider, Helen; Greeff, Minrie; Barten, Francoise; Moshabela, Mosa
Although home-based care (HBC) programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs), in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs). An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data - CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25%) of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers. PMID:24781696
Occupational traumatic injuries among workers in health care facilities - United States, 2012-2014.
Gomaa, Ahmed E; Tapp, Loren C; Luckhaupt, Sara E; Vanoli, Kelly; Sarmiento, Raymond Francis; Raudabaugh, William M; Nowlin, Susan; Sprigg, Susan M
In 2013, one in five reported nonfatal occupational injuries occurred among workers in the health care and social assistance industry, the highest number of such injuries reported for all private industries. In 2011, U.S. health care personnel experienced seven times the national rate of musculoskeletal disorders compared with all other private sector workers. To reduce the number of preventable injuries among health care personnel, CDC's National Institute for Occupational Safety and Health (NIOSH), with collaborating partners, created the Occupational Health Safety Network (OHSN) to collect detailed injury data to help target prevention efforts. OHSN, a free, voluntary surveillance system for health care facilities, enables prompt and secure tracking of occupational injuries by type, occupation, location, and risk factors. This report describes OHSN and reports on current findings for three types of injuries. A total of 112 U.S. facilities reported 10,680 OSHA-recordable* patient handling and movement (4,674 injuries); slips, trips, and falls (3,972 injuries); and workplace violence (2,034 injuries) injuries occurring from January 1, 2012-September 30, 2014. Incidence rates for patient handling; slips, trips, and falls; and workplace violence were 11.3, 9.6, and 4.9 incidents per 10,000 worker-months,† respectively. Nurse assistants and nurses had the highest injury rates of all occupations examined. Focused interventions could mitigate some injuries. Data analyzed through OHSN identify where resources, such as lifting equipment and training, can be directed to potentially reduce patient handling injuries. Using OHSN can guide institutional and national interventions to protect health care personnel from common, disabling, preventable injuries. PMID:25905893
Health protection of health care workers from the prospective of ethics, science and good medical practice. Opinions from stakeholders in health care settings.
Porru, S; Cannatelli, P; Cerioli, Beloyanna; Flor, L; Gramegna, Maria; Polato, R; Rodriguez, D
Fitness for work (FFW) in health care workers poses multidisciplinary challenges because of management problems scientific and ethical implications and the implementation of preventive interventions in health care settings. All the relevant stakeholders, including the General Manager, Medical Director, worker's representative, the person responsible for prevention and protection, forensic medicine expert, the person responsible for prevention and health safety at public administration level, commented on: danger to third parties; FFW formulation; human resource management; stress; professional independence; role of the person responsible for prevention and protection and of the person responsible for prevention at public administration level; professional responsibilities. Opinions are reported regarding the main problems related to the role of the Occupational Physician in FFW formulation, such as the difficult balance between autonomy and independence, limited turnover and aging of workforce, need of confidentiality and respect for professional status of the HCW prevalence of susceptibility conditions, rights and duties of stakeholders. The most significant result was the request by the Lombardy Region for more quality in risk assessment and health surveillance; to maintain uniform conduct over all the local health authorities, to allow the board in charge of examining appeals against FFW to fully cooperate with the occupational physician; due attention to the person/worker; the opportunity to convene referral boards for complex FFW management; the challenge of stress management and the need for an observatory for psychological discomforts; the importance of the ICOH Code of Ethics and avoidance of conflicts of interests; the need for individual risk assessment and risk management; the concept of sharing responsibilities and of a real multidisciplinary approach. PMID:22838299
School-Age Child Care. Fastback 454.
ERIC Educational Resources Information Center
LeBuffe, James R.; Hargreaves, Sherran A.
Currently at least 5 million children--some estimates are as high as 15 million--are left unsupervised before or after school for 3 or more hours a day. In response to the problems of these latchkey children, many public schools are now developing some form of school-based or school-related before- and after-school child care programs. The purpose…
Age at exposure to ionising radiation and cancer mortality among Hanford workers: follow up through 1994
Wing, S; Richardson, D
Background: Studies of workers at the plutonium production factory in Hanford, WA have led to conflicting conclusions about the role of age at exposure as a modifier of associations between ionising radiation and cancer. Aims: To evaluate the influence of age at exposure on radiation risk estimates in an updated follow up of Hanford workers. Methods: A cohort of 26 389 workers hired between 1944 and 1978 was followed through 1994 to ascertain vital status and causes of death. External radiation dose estimates were derived from personal dosimeters. Poisson regression was used to estimate associations between mortality and cumulative external radiation dose at all ages, and in specific age ranges. Results: A total of 8153 deaths were identified, 2265 of which included cancer as an underlying or contributory cause. Estimates of the excess relative risk per Sievert (ERR/Sv) for cumulative radiation doses at all ages combined were negative for all cause and leukaemia and positive for all cancer and lung cancer. Cumulative doses accrued at ages below 35, 35–44, and 45–54 showed little association with mortality. For cumulative dose accrued at ages 55 and above (10 year lag), the estimated ERR/Sv for all cancers was 3.24 (90% CI: 0.80 to 6.17), primarily due to an association with lung cancer (ERR/Sv: 9.05, 90% CI: 2.96 to 17.92). Conclusions: Associations between radiation and cancer mortality in this cohort are primarily a function of doses at older ages and deaths from lung cancer. The association of older age radiation exposures and cancer mortality is similar to observations from several other occupational studies. PMID:15961623
Resident Satisfaction and Its Components in Residential Aged Care
ERIC Educational Resources Information Center
Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.
Purpose: The purpose of this study was to assess the direction and magnitude of the effects among the components of resident satisfaction in residential aged care and to examine if the relationships among satisfaction components vary according to facility type (i.e., nursing home and hostel). Briefly, a hostel is a low-care facility in which…
Schools Out! Family Day Care for the School Age Child.
ERIC Educational Resources Information Center
Prescott, Elizabeth; Milich, Cynthia
This paper presents a study of family day care services for school age children. The study involved telephone and home interviews concerning services provided by a sample of 247 family day care mothers from the Los Angeles area. The paper is divided into two parts. Part I describes the results of the interviews in numerical form and includes short…
Inverse roles of emotional labour on health and job satisfaction among long-term care workers in Japan.
Tsukamoto, Erika; Abe, Takeru; Ono, Michikazu
Emotional labour increases among long-term care workers because providing care and services to impaired elders causes conflicting interpersonal emotions. Thus, we investigated the associations between emotional labour, general health and job satisfaction among long-term care workers. We conducted a cross-sectional study among 132 established, private day care centres in Tokyo using a mail survey. The outcome variables included two health-related variables and four job satisfaction variables: physical and psychological health, satisfaction with wages, interpersonal relationships, work environment and job satisfaction. We performed multiple regression analyses to identify significant factors. Directors from 36 facilities agreed to participate. A total of 123 responses from long-term care workers were analysed. Greater emotional dissonance was associated with better physical and psychological health and worse work environment satisfaction (partial regression coefficient: -2.93, p = .0389; -3.32, p = .0299; -1.92, p = .0314, respectively). Fewer negative emotions were associated with more job satisfaction (partial regression coefficient: -1.87, p = .0163). We found that emotional labour was significantly inversely associated with health and job satisfaction. Our findings indicated that the emotional labour of long-term care workers has a negative and positive influence on health and workplace satisfaction, and suggests that care quality and stable employment among long-term care workers might affect their emotional labour. Therefore, we think a programme to support emotional labour among long-term care workers in an organized manner and a self-care programme to educate workers regarding emotional labour would be beneficial. PMID:25263457
Racial disparities in job strain among American and immigrant long-term care workers
Hurtado, David A.; Sabbath, Erika L.; Ertel, Karen A.; Buxton, Orfeu M.; Berkman, Lisa F.; Cabot, Thomas D.
Background Nursing homes are occupational settings, with an increasing minority and immigrant workforce where several psychosocial stressors intersect. Aim To examine racial/ethnic differences in job strain between Black (n=127) and White (n=110) immigrant and American direct-care workers at nursing homes (total n=237). Methods Cross-sectional study with data collected at four nursing homes in Massachusetts, during 2006-2007. We contrasted Black and White workers within higher-skilled occupations such as Registered Nurses (RNs) or Licensed Practical Nurses (LPNs, n=82) and lower-skilled staff such as Certified Nursing Assistants (CNAs, n=155). Results Almost all Black workers (96 percent) were immigrants. After adjusting for demographic and occupational characteristics, Black employees were more likely to report job strain, compared to Whites (Relative Risk [RR]: 2.9, 95% CI 1.3 to 6.6). Analyses stratified by occupation showed that Black CNAs were more likely to report job strain, compared to White CNAs (RR: 3.1, 95% CI: 1.0 to 9.4). Black workers were also more likely to report low control (RR: 2.1, 95% CI: 1.1 to 4.0). Additionally, Black workers earned $2.58 less per hour and worked 7.1 more hours per week on average, controlling for potential confounders. Conclusion Black immigrant workers were 2.9 times more likely to report job strain than Whites, with greater differences among CNAs. These differences may reflect organizational and job characteristics, individual characteristics, or potentially interpersonal or institutional racial or ethnic discrimination. Further research should consider the role of race/ethnicity in shaping patterns of occupational stress. PMID:22591096
The 2030 Problem: Caring for Aging Baby Boomers
Knickman, James R; Snell, Emily K
Objective To assess the coming challenges of caring for large numbers of frail elderly as the Baby Boom generation ages. Study Setting A review of economic and demographic data as well as simulations of projected socioeconomic and demographic patterns in the year 2030 form the basis of a review of the challenges related to caring for seniors that need to be faced by society. Study Design A series of analyses are used to consider the challenges related to caring for elders in the year 2030: (1) measures of macroeconomic burden are developed and analyzed, (2) the literatures on trends in disability, payment approaches for long-term care, healthy aging, and cultural views of aging are analyzed and synthesized, and(3)simulations of future income and assets patterns of the Baby Boom generation are developed. Principal Findings The economic burden of aging in 2030 should be no greater than the economic burden associated with raising large numbers of baby boom children in the 1960s. The real challenges of caring for the elderly in 2030 will involve: (1) making sure society develops payment and insurance systems for long-term care that work better than existing ones, (2) taking advantage of advances in medicine and behavioral health to keep the elderly as healthy and active as possible, (3) changing the way society organizes community services so that care is more accessible, and (4) altering the cultural view of aging to make sure all ages are integrated into the fabric of community life. Conclusions To meet the long-term care needs of Baby Boomers, social and public policy changes must begin soon. Meeting the financial and social service burdens of growing numbers of elders will not be a daunting task if necessary changes are made now rather than when Baby Boomers actually need long-term care. PMID:12236388
Mother, daughter, patient, nurse: women's emotion work in aged care.
Gattuso, S; Bevan, C
This paper examines emotion work within the predominantly female environment of aged-care nursing, identifying phenomena which must be accounted for in a theory of emotional labour. These phenomena include the blurring of public and private in women's experiences and maternal models of care. Initial findings demonstrate the high levels of stress experienced by staff, related to emotional labour and to conflicts around the erosion of care standards. Sixteen women, from rural Australia, participated in the first stage of the research. The oldest was in her sixties, the youngest in her thirties. Length of aged-care experience ranged from 2 to 33 years. Although most of the women expected to still be in aged care in 5 years' time, they were negative in their attitudes to personal ageing, suggesting an ambivalence in their feelings about working in aged care. Three women nurses are the particular focus of this paper. Their narratives illustrate the intersection of private and public caring in nurses' lives and the implications of this for emotional labour. Phenomena such as dual caring, conflicts in insider-outsider roles, and transference are revealed in their narratives. We argue that the welfare of the recipient of gerontic nursing is linked to the well-being of the nurse-carer but that a cultural change is needed so as to recognize and value emotion work. However, endorsing Staden, we agree that such a change is dependent on the politicization of 'caring'. There is also need for further and broader research concerning the nature of emotional labour and the ethics of care. PMID:10759986
In-hospital contact investigation among health care workers after exposure to smear-negative tuberculosis
Ringshausen, Felix C; Schlösser, Stephan; Nienhaus, Albert; Schablon, Anja; Schultze-Werninghaus, Gerhard; Rohde, Gernot
Background Smear-negative pulmonary tuberculosis (TB) accounts for a considerable proportion of TB transmission, which especially endangers health care workers (HCW). Novel Mycobacterium-tuberculosis-specific interferon-γ release assays (IGRAs) may offer the chance to define the burden of TB in HCW more accurately than the Mantoux tuberculin skin test (TST), but the data that is available regarding their performance in tracing smear-negative TB in the low-incidence, in-hospital setting, is limited. We conducted a large-scale, in-hospital contact investigation among HCW of a German university hospital after exposure to a single case of extensive smear-negative, culture-positive TB with pulmonary involvement. The objective of the present study was to evaluate an IGRA in comparison to the TST and to identify risk factors for test positivity. Methods Contacts were prospectively enrolled, evaluated using a standardized questionnaire, the IGRA QuantiFERON®-TB Gold in Tube (QFT-GIT) and the TST, and followed-up for two years. Active TB was ruled out by chest x-ray in QFT-GIT-positive subjects. Independent predictors of test positivity were established through the use of logistic regression analysis. Results Out of the 143 subjects analyzed, 82 (57.3%) had close contact, but only four (2.8%) experienced cumulative exposure to the index case >40 hours. QFT-GIT results were positive in 13 subjects (9.1%), while TST results were positive in 40 subjects (28.0%) at an induration >5 mm. Overall agreement was poor between both tests (kappa = 0.15). Age was the only predictor of QFT-GIT-positivity (Odds ratio 2.7, 95% confidence interval 1.32–5.46), while TST-positivity was significantly related to Bacillus Calmette-Guérin vaccination and foreign origin. Logistic regression analysis showed no relation between test results and exposure. No secondary cases of active TB were detected over an observational period of two years. Conclusion Our findings suggest a low contagiosity of
A Time and Place: The Role of Social Workers in Improving End-of-Life Care.
Peres, Judith
Americans are living longer, but dying after a prolonged period of management of multiple chronic illnesses and functional disabilities. Despite waves of public and professional activity targeted toward improving care for the dying and supporting the families, gaps in care and challenges in end-of-life care persist. Contentious issues such as the so-called "death panels" or physician payment for discussion of advance directives and care wishes at the end of life; aid in dying; and regarding individuals who actively choose death (case of Brittney Maynard) are continually debated in the public media. Progress toward improvement in the experience of dying remains incremental and change has been slow. With the release of a second Institute of Medicine ( 2014 ) report devoted to what it means to die in America in the 21st century, momentum and opportunity for change may increase. If this is to happen, social workers will need to deliver the range of biopsychosocial care that patients and families so desperately need. However, holistic care of the individual will only improve, if the nation also addresses ongoing systemic problems in financing, policy, and service delivery in end-of-life care. PMID:27462948
Age in Relation to Worker Compensation Costs in the Construction Industry
Schwatka, Natalie V.; Butler, Lesley M.; Rosecrance, John C.
Background A better understanding of how workers' compensation (WC) costs are affected by an aging US workforce is needed, especially for physically demanding industries, such as construction. Methods The relationship between age and injury type on claim costs was evaluated using a database of 107,064 Colorado WC claims filed between 1998 and 2008 among construction workers. Results Mean WC costs increased with increasing age for total cost (P < 0.0001), medical costs (P < 0.0001), and indemnity costs (P < 0.0001). For each one-year increase in age, indemnity, and medical costs increased by 3.5% and 1.1%, respectively. For specific injury types, such as strains and contusions, the association between age and indemnity costs was higher among claimants aged ≥65 compared to claimants aged 18–24. Conclusions Our findings suggest that specific injury types may be partially responsible for the higher indemnity costs among older construction workers, compared with their younger coworkers. PMID:22782837
Training primary health care workers about drugs: a national survey of UK trainers' perceptions towards training.
Albery, I P; Heuston, J; Durand, M A; Groves, P; Gossop, M; Strang, J
Reports have consistently shown that non-specialist drug workers (whose working role is not specifically concentrated on dealing with drug-related issues) are reluctant to work with drug users. A number of explanations have been offered to account for this unwillingness including attitudinal factors, occupational constraints and a lack of motivation to learn about drug-related issues. Previously, it has been shown that training affects commitment to working with substance misusers, although failure to attract particular professional groups (e.g. general practitioners) into training courses has also been reported. No previous research has examined the views of trainers about training primary health care and health-related workers. This study of a (non-probability) sample of UK drug trainers (n = 145) assessed training activity for different health care workers, and trainers' differential perceptions of training needs and methods. GPs were the group least likely to become trained about drug issues. Training in attitudes towards drug using individuals was perceived to be more important than either skills or knowledge training for GPs, practice nurses, other nurses and probation officers. Experiential training methods were perceived to be more important than a didactic approach for training all health groups except GPs for whom lecture type instruction was believed to be equally appropriate. Seventy-nine percent of subjects reported providing training across drugs in alcohol or drugs, alcohol and tobacco. Most trainers who stated that certain professions required independent training believed that GPs should be trained separately from other groups. PMID:16203392
Old age, disability and care in public health.
Giacomin, Karla Cristina; Firmo, Josélia Oliveira Araújo
Aging of the population profoundly changes the scope of action of public health, altering the profile of morbidity-mortality and increasing the demand for chronic care. In the aging population, disability serves as an indicator of health and a guideline for actions and policies. This enquiry, with a qualitative approach, based on interpretative anthropology and the emic perspective, aims to understand the way of thinking and acting of old people in the face of 'old age with disability' and their relationships with public health. Individual interviews were held at the subject's homes, using a semi-structured script, with 57 old people living in the city, including participants from the cohort of Bambuí. Collection and analysis of the data was oriented by the methodology of Signs, Meanings and Actions, making possible anthropological investigation of the representations and concrete behaviors associated with disability in old age in the local culture. Two categories relating to the relationships between old age, disability and public healthcare emerged from the analysis: (i) experience of care in old age with disability; and (ii) the fear of lack of care. The results reveal that public health needs to review its concepts about disability in old age and incorporate disability into the agenda of the functional dimension of health and care for old age. PMID:26691789
The ELDER expansion project: building cultural competence among long term home care workers.
Lange, Jean W; Mager, Diana R; Andrews, Nancy
This study aimed to improve communication and care provision in five home or long term care settings by raising staff awareness about health beliefs and patterns among varied cultures. Lack of cultural competence is linked to ethnocentric attitudes that can lead to inappropriate communication and ineffective interventions. Understanding the culturally imbedded belief systems of patients and providers is an integral part of effective communication skills that are foundational to optimal team functioning. Participants included five home or long term care agencies in an underserved region of New England. Seventy-four nurses, aids and allied health professionals participated in 10-12 small group interactive sessions. Comparison of pre and post cultural self efficacy scores revealed that participant confidence regarding their knowledge and skills when interacting with other cultures improved interactions with patients and co-workers. Journal exemplars supported the ability of attendees to apply content to the workplace. PMID:23265680
Diabetes Connect: Developing a Mobile Health Intervention to Link Diabetes Community Health Workers With Primary Care.
Cherrington, Andrea L; Agne, April A; Lampkin, Yolanda; Birl, Annie; Shelton, Tanya C; Guzman, Alfredo; Willig, James H
Community health worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the health care team and enhance care. We tested a model for the integration of a CHW-delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using the mHealth tool. This project partnered an academic institution, a safety-net clinic, and African American churches. The integration of mHealth technology into CHW programs was successfully achieved and readily accepted. PMID:26353025
Responding to vulnerability in old age: patient-centred care.
Abley, Clare
Patient-centred care is a term widely used in health policy and is familiar to staff as a principle or commonly agreed approach to care. However, nursing and multidisciplinary teams often do not agree how it should be provided for older patients. This article outlines three different models of patient-centred care applicable to the care of older people. The article also explores the concept of vulnerability in old age, highlighting differences between the perspectives of older people and those of professionals and how clinical practice can be improved to achieve a more patient-centred approach. The links between patient-centred care and vulnerability in old age are considered along with the implications of this for clinical practice. PMID:23240515
Who knows, who cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia.
Robinson, Andrew; Eccleston, Claire; Annear, Michael; Elliott, Kate-Ellen; Andrews, Sharon; Stirling, Christine; Ashby, Michael; Donohue, Catherine; Banks, Susan; Toye, Christine; McInerney, Fran
The number of people with dementia is increasing rapidly worldwide. Commensurate with population ageing, the use of nursing homes in Australia (known as residential aged care facilities) for individuals with dementia is growing. As a terminal condition, dementia is best managed by instituting a palliative approach to care. A good knowledge of dementia, including its progression and management, among staff and families of people living with dementia is essential for clear decision making and the provision of appropriate care. Yet there is limited information regarding relative levels of dementia knowledge. This paper reports the results of a study that assessed dementia knowledge among these two cohorts using the Dementia Knowledge Assessment Tool; the study surveyed 279 staff members and 164 family members of residents with dementia. Dementia knowledge deficits were evident in both cohorts across a range of areas. It is critical that dementia knowledge deficits are identified and addressed in order to support evidence-based dementia care. PMID:25265739
Uchendu, O.C.; Ilesanmi, O.S.; Olumide, A.E.
Background: There is increasing interest in the choice of health care providing facility in Nigeria. Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local government staff. Methods: A cross sectional survey of all 312 workers in a Local Government Secretariat in South West Nigeria was done. Chi Square and logistic regression analysis was done. Results: The mean age was 38.6 ± 7.5 years, 55% were females and 71.7% had tertiary education. The median monthly family income of the respondents was N 28, 000 (N3,000 – N500,000), with 24.4% earning a monthly income of N21, 000 to N30, 000. Many (72.3%) utilized public health facilities attributing the choice to the low cost of services. Respondents who are satisfied with their usual care providing facilities are 12.2 times more likely to have used public facilities than private facilities (95%, CI 3.431 – 43.114). Respondents who described the quality with ease of getting care/short waiting times as being good are 3.9 times more likely to have private facilities as their chosen health care providing facility (95%, CI 1.755 – 8.742). Cost/payment for service is 2.9 times more likely to predict the use of public health facility as the usual health care provider. Conclusion: Private facilities though costlier do not appear to be providing better services than public facilities. To increase access to health care the cost of services and the waiting time are important factors to address. PMID:25161426
Demographics, Management, Preventive Health Care and Disease in Aged Horses.
Ireland, Joanne L
Gerontology has become increasingly important in equine veterinary medicine, with aged animals representing a significant proportion of the equine population. Horses are defined as geriatric or aged from age 15 years onwards but can have a life span of more than 40 years. Despite a high level of owner concern for the well-being of their geriatric animal, provision of preventive health care may be suboptimal. Owners seem to under-recognize some of the most prevalent diseases identified in geriatric horses. This review focuses on the demographic characteristics of the equine geriatric population and management and preventive care practices of older horses. PMID:27449388
Migration of health-care workers from developing countries: strategic approaches to its management.
Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario
Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449
Health Care Workers in the Dominican Republic: Self-perceived role in smoking cessation
Ossip-Klein, Deborah J.; Diaz, Sergio; Sierra, Essie; Quiñones, Zahira; Armstrong, Latoya; Chin, Nancy P.; McIntosh, Scott
A Dominican Republic (DR) based multi-community trial of smoking cessation viewed health care workers (HCWs) as potential interventionists. Effectively engaging them, requires a clear understanding of their attitudes and practices regarding smoking. A Rapid Assessment Procedure, conducted among HCWs in six economically disadvantaged communities, included physicians, nurses, other health professionals, paraprofessionals and lay workers. Attitudes and practices about smoking were consistent across the 82 HCWs and mostly reflected community views. HCWs lacked proactiveness related to smoking cessation and had a limited view of their role, attributing clients' quitting successes to personal will. Prior cessation training was limited although interest was generally high. Material resources about smoking cessation were virtually absent. DR HCWs' views represented features both distinct from and common to HCWs elsewhere. Any intervention with HCWs must first raise awareness before addressing their role in smoking cessation, discussing implementation barriers and include training and materials about risks and effective interventions. PMID:19448160
Migration of health-care workers from developing countries: strategic approaches to its management.
Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario
Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449
Utilization of village health workers within a primary health care programme in The Gambia.
Menon, A
The utilization of Village Health Workers (VHWs) was studied in a rural area of The Gambia 3 years after the introduction of a village-based Primary Health Care (PHC) programme. Of 23 children who died from conditions treatable at village level, only five were first seen by the VHW. Fourteen were seen elsewhere in the region by staff more qualified than the first tier workers. The implications of this pattern of utilization on the lack of impact of VHWs on mortality are discussed. Only half of the non-fatal illnesses were attended to by VHWs. Reasons for this included such factors as lack of knowledge of services available, shortages of money, absence of the VHW at critical periods and social or political disputes with VHWs. Attempts must be made to tackle these fundamental problems if VHWs are to be successfully incorporated into the health services. PMID:1880830
Development and evaluation of an aged care specific Advance Care Plan
Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie
Objectives To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. Design An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. Participants and setting 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Results Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Conclusions Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector. PMID:23626906
Phenomenological perspectives on self-care in aging
Söderhamn, Olle
Self-care is a central concept in health care and may be considered as a means to maintain, restore, and improve one's health and well-being. When performed effectively, self-care contributes not only to human functioning but also to human structural integrity and human development (ie, to a dynamic and holistic state of health). Self-care as a clinical concept is relevant for health care professionals, and it should be meaningful to investigate it at a philosophical level and to further elaborate upon this concept. The aim of this article is to discuss and elaborate upon a phenomenological perspective on self-care in aging that is relevant for the health sciences. Self-care may be preliminarily regarded as a fundamental perspective for the conscious older individual, and as a way of being in the world with both the objective body and with the lived body. The lived body is the personal center of perception and the field of action, and it is also the center of self-care. The potentiality or ability for self-care activity and self-care activity itself are structures given to perception, with self-care ability as an integral part of the lived body. The actualization of self-care ability comes about through a certain meaning, which can be regarded as an important driving force. It is constituted by communication, a healthy lifestyle, and by building meaning and socializing. Successful self-care involves having contacts with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and others, as well as being satisfied, positive, and being able to look forward. One fundamental cornerstone is serenity on behalf of the individual. Self-care can facilitate transitions, and it may also be an outcome of transitions. PMID:23807842
Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection.
Peterson, Kristina; Rogers, Bonnie M E; Brosseau, Lisa M; Payne, Julianne; Cooney, Jennifer; Joe, Lauren; Novak, Debra
This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices. PMID:27056750
The facilitators of communication with people with dementia in a care setting: an interview study with healthcare workers
Stanyon, Miriam Ruth; Griffiths, Amanda; Thomas, Shirley A.; Gordon, Adam Lee
Objectives: to describe the views of healthcare workers on the facilitators of communication with people with dementia in a care setting. Design: thematic analysis of semi-structured interviews. Setting: all participants were interviewed in their place of work. Participants: sixteen healthcare workers whose daily work involves interacting with people with dementia. Results: four overarching categories of themes were identified from the interviews that impact on communication: the attributes of a care worker, communication strategies used, organisational factors and the physical characteristics of the care environment. Conclusion: many strategies used by healthcare workers to facilitate communication have not yet been studied in the research literature. Participants' views on training should be incorporated into future dementia training programmes. PMID:26764403
The free health care initiative: how has it affected health workers in Sierra Leone?
Witter, Sophie; Wurie, Haja; Bertone, Maria Paola
There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers. Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just 'business as normal'. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis. PMID:25797469
The free health care initiative: how has it affected health workers in Sierra Leone?
Witter, Sophie; Wurie, Haja; Bertone, Maria Paola
There is an acknowledged gap in the literature on the impact of fee exemption policies on health staff, and, conversely, the implications of staffing for fee exemption. This article draws from five research tools used to analyse changing health worker policies and incentives in post-war Sierra Leone to document the effects of the Free Health Care Initiative (FHCI) of 2010 on health workers.Data were collected through document review (57 documents fully reviewed, published and grey); key informant interviews (23 with government, donors, NGO staff and consultants); analysis of human resource data held by the MoHS; in-depth interviews with health workers (23 doctors, nurses, mid-wives and community health officers); and a health worker survey (312 participants, including all main cadres). The article traces the HR reforms which were triggered by the FHCI and evidence of their effects, which include substantial increases in number and pay (particularly for higher cadres), as well as a reported reduction in absenteeism and attrition, and an increase (at least for some areas, where data is available) in outputs per health worker. The findings highlight how a flagship policy, combined with high profile support and financial and technical resources, can galvanize systemic changes. In this regard, the story of Sierra Leone differs from many countries introducing fee exemptions, where fee exemption has been a stand-alone programme, unconnected to wider health system reforms. The challenge will be sustaining the momentum and the attention to delivering results as the FHCI ceases to be an initiative and becomes just 'business as normal'. The health system in Sierra Leone was fragile and conflict-affected prior to the FHCI and still faces significant challenges, both in human resources for health and more widely, as vividly evidenced by the current Ebola crisis. PMID:25797469
Health-care worker engagement in HIV-related quality improvement in Dar es Salaam, Tanzania
Garcia, Maria E.; Li, Michelle S.; Siril, Hellen; Hawkins, Claudia; Kaaya, Sylvia; Ismail, Shabbir; Chalamilla, Guerino; Mdingi, Sarah Geoffrey; Hirschhorn, Lisa R.
Objective To assess health-care worker (HCW) awareness, interest and engagement in quality improvement (QI) in HIV care sites in Tanzania. Design Cross-sectional survey distributed in May 2009. Setting Sixteen urban HIV care sites in Dar es Salaam, Tanzania, 1 year after the introduction of a quality management program. Participants Two hundred seventy-nine HCWs (direct care, clinical support staff and management). Main Outcome Measures HCW perceptions of care delivered, rates of engagement, knowledge and interest in QI. HCW-identified barriers to and facilitators of the delivery of quality HIV care. Results Two hundred seventy-nine (73%) of 382 HCWs responded to the survey. Most (86%) felt able to meet clients' needs. HCW-identified facilitators of quality included: teamwork (88%), staff communication (79%), positive work environment (75%) and trainings (84%). Perceived barriers included: problems in patients' lives (73%) and too few staff or too high patient volumes (52%). Many HCWs knew about specific QI activities (52%) or had been asked for input on QI (63%), but fewer (40.5%) had participated in activities and only 20.1% were currently QI team members. Managers were more likely to report QI involvement than direct care or clinical support staff (P < 0.01). No difference in QI involvement was seen based on patient load or site type. Conclusions HCWs can provide important insights into barriers and facilitators of providing quality care and can be effectively engaged in QI activities. HCW participation in efforts to improve services will ensure that HIV/AIDS quality of care is achieved and maintained as countries strive for universal antiretroviral access. PMID:21441571
Health worker migration and universal health care in Sub-Saharan Africa.
Sieleunou, Isidore
There is a more and more emerging consensus claiming universal access to health care in order to achieve the desired Millennium Development Goals related to health in Africa. Unfortunately, the debate of the universal coverage has focussed so far mainly on financial affordability, while it is also a human resource matter. Many countries in sub-Saharan Africa are experiencing severe shortages of skilled health care workers. There are several causes, the importance of which varies by country, but one of the most significant factors is brain drain. In those countries, scarcity of doctors increases the distance between a doctor and patients, and bridging that increased distance implies costs, both time and money. Adequate number of qualified health personnel is then vital to increase coverage and improve the quality of care. In as much as access to health services is also determined by access to qualified health workers, any reflection on the universal health coverage has to also consider the inequities in qualified health personnel distribution throughout the world. PMID:22384301
Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.
Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos
Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306
'We are despised in the hospitals': sex workers' experiences of accessing health care in four African countries.
Scorgie, Fiona; Nakato, Daisy; Harper, Eric; Richter, Marlise; Maseko, Sian; Nare, Prince; Smit, Jenni; Chersich, Matthew
Sex workers in east and southern Africa are exposed to multiple occupational health and safety risks. Detailed understanding of barriers to accessing care would optimise design of improved services for this population. In this study, trained sex workers conducted 55 in-depth interviews and 12 focus group discussions with 106 female, 26 male and 4 transgender sex workers across 6 urban sites in Kenya, Zimbabwe, Uganda and South Africa. Data were analysed thematically, following an interpretive framework. Participants cited numerous unmet health needs, including diagnosis and treatment for sexually transmitted infections and insufficient access to condoms and lubricant. Denial of treatment for injuries following physical assault or rape and general hostility from public-sector providers was common. Resources permitting, many sex workers attended private services, citing higher quality and respect for dignity and confidentiality. Sex workers in southern Africa accessed specialised sex worker clinics, reporting mostly positive experiences. Across sites, participants called for additional targeted services, but also sensitisation and training of public-sector providers. Criminalisation of sex workers and associated stigmatisation, particularly of transgender and male sex workers, hinder HIV-prevention efforts and render access to mainstream healthcare precarious. Alongside law reform, sex worker-led peer outreach work should be strengthened and calls by sex workers for additional targeted services heeded. PMID:23414116
Complex routes into HIV care for migrant workers: a qualitative study from north India
Rai, Tanvi; Lambert, Helen S.; Ward, Helen
ABSTRACT Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment
Complex routes into HIV care for migrant workers: a qualitative study from north India.
Rai, Tanvi; Lambert, Helen S; Ward, Helen
Migrant workers are designated a bridge population in the spread of HIV and therefore if infected, should be diagnosed and treated early. This study examined pathways to HIV diagnosis and access to care for rural-to-urban circular migrant workers and partners of migrants in northern India, identifying structural, social and individual level factors that shaped their journeys into care. We conducted a qualitative study using in-depth interviews with HIV-positive men (n = 20) and women (n = 13) with a history of circular migration, recruited from an antiretroviral therapy centre in one district of Uttar Pradesh, north India. Migrants and partners of migrants faced a complex series of obstacles to accessing HIV testing and care. Employment insecurity, lack of entitlement to sick pay or subsidised healthcare at destination and the household's economic reliance on their migration-based livelihood led many men to continue working until they became incapacitated by HIV-related morbidity. During periods of deteriorating health they often exhausted their savings on private treatments focused on symptom management, and sought HIV testing and treatment at a public hospital only following a medical or financial emergency. Wives of migrants had generally been diagnosed following their husbands' diagnosis or death, with access to testing and treatment mediated via family members. For some, a delay in disclosure of husband's HIV status led to delays in their own testing. Diagnosing and treating HIV infection early is important in slowing down the spread of the epidemic and targeting those at greatest risk should be a priority. However, despite targeted campaigns, circumstances associated with migration may prevent migrant workers and their partners from accessing testing and treatment until they become sick. The insecurity of migrant work, the dominance of private healthcare and gender differences in health-seeking behaviour delay early diagnosis and treatment initiation
Violence toward health care workers in emergency departments in Denizli, Turkey.
Boz, Bora; Acar, Kemalettin; Ergin, Ahmet; Erdur, Bulent; Kurtulus, Ayse; Turkcuer, Ibrahim; Ergin, Nesrin
This study sought to determine the frequency and types of violence that occurred during the previous year against health care workers in emergency departments in Denizli, Turkey, and to discern the views of workers on the prevention of such aggressive behavior. This study was conducted from March 1 to April 15, 2003, and included a group of 79 health care workers from the emergency departments of 3 hospitals in Denizli, namely, the Hospital of Pamukkale University Medical Faculty, the City Hospital of Denizli, and the Hospital of the Social Insurance Foundation. Data were collected from a self-administered questionnaire. In all, 88.6% of participants had been subjected to or had witnessed verbal violence, and 49.4% of them had been subjected to or had witnessed physical violence during the previous year. The most frequent reason (31.4%) for violence was abuse of alcohol and drugs by perpetrators. The second most frequent reason (24.7%) was the long waiting times typical of emergency departments. The most common type of violence was loud shouting; swearing, threatening, and hitting were the next most frequent violent behaviors. In all, 36.1% of subjects who had experienced violence reported that they developed psychological problems after the incident. Most participants commented on the insufficiency of currently available security systems within emergency departments and on the need for further training about violence. All health care personnel within emergency departments should be aware of the risk of violence and should be prepared for unpredictable conditions and events; in addition, security systems should be updated so that violence within emergency departments can be prevented. PMID:16751169
[The Relationship Between Burnout Symptoms and Work Satisfaction Among Child Welfare Workers in Residential Care].
Steinlin, Célia; Dölitzsch, Claudia; Fischer, Sophia; Schmeck, Klaus; Fegert, Jörg M; Schmid, Marc
Working in residential care is associated with high demands and high stress. As a result, employees may develop symptoms of burnout. These symptoms lead to absence from work and have a negative effect on the continuity and quality of the residential care. Until now, little is known about burnout risks in child welfare workers, although children and adolescents are especially dependent on continuous relationships and healthy caregivers. A better understanding of the relationship between burnout symptoms and work satisfaction may help to identify starting points for prevention and intervention. The present study assessed symptoms of burnout in a sample of 319 social education workers in residential care in Switzerland using the burnout-screening-scales (BOSS). Work satisfaction was assessed with a newly developed questionnaire based on concepts of trauma-sensitive care. The questionnaire was tested for reliability and factorial validity in the present study. In order to estimate the relationship between burnout symptoms and work satisfaction, correlations and relative risks were calculated. Almost one fifth (18 %) of the sample showed a risk of burnout. The principal component analysis of the questionnaire on work satisfaction revealed four factors: support by superiors, participation and transparency; communication and support within the team; gratification in the work; and institutional structures and resources. All four factors as well as the total score showed significant correlations with burnout symptoms. Among employees with a comparably lower work satisfaction, the risk of burnout was 5.4 times higher than among employees with a comparably higher work satisfaction. It is discussed how work satisfaction could be promoted and how, as a result, the quality and continuity of care for the children and adolescents could be improved. PMID:26947529
Assault and abuse of health care workers in a large teaching hospital.
Yassi, A
OBJECTIVES: To determine the nature, extent and costs of injuries to health care workers caused by physical abuse. DESIGN: Retrospective study. SETTING: Large acute and tertiary care teaching hospital in Winnipeg. PARTICIPANTS: All health care workers at the hospital who filed reports of abuse-related injuries and of verbal abuse and threatening behaviour from Apr. 1, 1991, to Mar. 31, 1993. OUTCOME MEASURES: Frequency of physical and verbal abuse of hospital personnel according to job category, type of injury, hours of staff time lost and estimates of costs compensated for abuse-related injuries. RESULTS: Of the 242 reported abuse-related injuries 194 (80.2%) occurred among the nursing personnel. The nurses in the medical units filed most (33.1%) of the reports. Although the psychiatric nurses filed fewer reports (35 [14.5%]) they had the highest rate of injuries per 100,000 paid hours among the nursing staff. Not surprisingly, the security officers were at highest risk, 53.5% having reported an abuse-related injury for a rate of 16.8 such injuries per 100,000 paid hours. Male staff members had a higher injury rate than their female counterparts in all occupational groups. Bruising or crushing was the most frequent type of injury (in 126 cases); the next most frequent were cuts and lacerations (in 47) and human bites and exposures to blood or body fluids (in 23). However, the 36 sprains and strains resulted in the largest amount of time lost. In all, over 8000 hours were lost due to abuse-related injuries, and over $76,000 was paid in workers' compensation benefits. Concurrently, 646 incidents of verbal abuse and threatening behaviour were reported. Only three abuse-related injuries and two incidents of verbal abuse were reported by physicians. CONCLUSIONS: Abuse-related injuries to health care workers in an urban hospital are prevalent, serious and can be costly in terms of time off work and compensation. Underreporting is likely, especially among physicians
Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya
Background The World Health Organization (WHO) and the Government of Kenya alike identify a well-performing health workforce as key to attaining better health. Nevertheless, the motivation and retention of health care workers (HCWs) persist as challenges. This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi. Methods A cross-sectional cluster sample design was used to select 59 health facilities that yielded interviews with 404 health care workers, grouped into 10 different types of service providers. Data were collected in November 2011 using structured questionnaires and a Focus Group Discussion guide. Findings were analyzed using bivariate and multivariate methods of the associations and determinants of health worker motivation and retention. Results The levels of education and gender factors were lowest in Turkana with female HCWs representing only 30% of the workers against a national average of 53%. A smaller proportion of HCWs in Turkana feel that they have adequate training for their jobs. Overall, 13% of the HCWs indicated that they had changed their job in the last 12 months and 20% indicated that they could leave their current job within the next two years. In terms of work environment, inadequate access to electricity, equipment, transport, housing, and the physical state of the health facility were cited as most critical, particularly in Turkana. The working environment is rated as better in private facilities. Adequate training, job security, salary, supervisor support, and manageable workload were identified as critical satisfaction factors. Family health care, salary, and terminal benefits were rated as important compensatory factors. Conclusions There are distinct motivational and retention factors that affect
Caring for Children and Youth Who Have Been Sexually Abused: A Training Manual for Child and Youth Care Workers and Foster Parents. Second Edition.
ERIC Educational Resources Information Center
Croll, Linda
This manual, which incorporates a developmental perspective, targets child and youth care workers and foster parents who are ready to enhance their practical skills in providing care and treatment for young people who have been sexually abused. Users of this manual should have some previous understanding in human growth and development, effective…
Factors Influencing Childcare Workers' Promotion of Physical Activity in Children Aged 0-4 Years: A Qualitative Study
ERIC Educational Resources Information Center
Wilke, Sarah; Opdenakker, Claudia; Kremers, Stef P. J; Gubbels, Jessica S
The present study examined the factors influencing childcare workers' promotion of physical activity (PA) among children aged 0-4?years, a particularly interesting context because of the increasing number of children attending childcare. Twenty Dutch childcare workers were interviewed. The interviews revealed some important barriers to the…
Age-Differences in Work Motivation and Job Satisfaction. The Influence of Age on the Relationships between Work Characteristics and Workers' Outcomes
ERIC Educational Resources Information Center
Boumans, Nicolle P. G.; de Jong, Ad H. J.; Janssen, Sara M.
This study investigated the influence of age on the relationship between work characteristics and workers' work motivation and job satisfaction. In total, 1036 workers of a Dutch division of a multinational organization participated. Data were collected by a digital questionnaire. Two interaction terms in the regression on work motivation were…
Social workers' roles in addressing the complex end-of-life care needs of elders with advanced chronic disease.
Kramer, Betty J
This study examined social workers' roles in caring for low-income elders with advanced chronic disease in an innovative, community-based managed care program, from the perspective of elders, family, team members, and social workers. The results are drawn from a larger longitudinal, multimethod case study. Sources of data include survey reports of needs addressed by social workers for 120 deceased elders, five focus groups with interdisciplinary team members, and in-depth interviews with 14 elders and 10 of their family caregivers. A thematic conceptual matrix was developed to detail 32 distinctive social work roles that address divergent needs of elders, family, and team members. Distinctive perceptions of social workers' roles were identified for the different stakeholder groups (i.e., elders, family caregivers, team members, and social workers). Findings from this study may inform supervisors and educators regarding training needs of those preparing to enter the rapidly growing workforce of gerontological social workers who may be called upon to care for elders at the end of life. Training is particularly warranted to help social workers gain the skills needed to more successfully treat symptom management, depression, anxiety, agitation, grief, funeral planning, and spiritual needs that are common to the end of life. PMID:24295099
Primary healthcare worker knowledge related to prenatal and immediate newborn care: a cross sectional study in Masindi, Uganda
Background Global neonatal mortality remains unacceptably high. Health workers who attend to prenatal and postnatal mothers need to be knowledgeable in preventive and curative care for pregnant women and their newborn babies. This study aimed to determine the level of knowledge related to prenatal and immediate newborn care among primary healthcare workers in Masindi, Uganda. Methods A cross-sectional study was conducted. Interviews comprised of 25 multiple-choice questions were administered to health workers who were deployed to offer prenatal and postnatal care in Masindi in November 2011. Questions were related to four domains of knowledge: prenatal care, immediate newborn care, management of neonatal infections and identifying and stabilizing Low-Birth Weight (LBW) babies. Corresponding composite variables were derived; level of knowledge among health workers dichotomized as 'adequate' or 'inadequate'. The chi-square statistic test was used to examine associations with independent variables including level of training (nursing assistant, general nurse or midwife), level of care (hospital/health centre level IV or health centre level III/II) and years of service (five years or less, six years or more). Results 183 health workers were interviewed: general nurses (39.3%), midwives (21.9%) and nursing assistants (38.8%). Respectively, 53.6%, 46.5%, 7.1% and 56.3% were considered to have adequate knowledge in prenatal care, newborn care, management of neonatal infections and identifying/stabilizing LBW babies. Being a general nurse was significantly associated with having adequate knowledge in identifying and stabilizing LBW babies (p < 0.001) compared to being a nursing assistant. Level of care being hospital/health centre level IV was not significantly associated with having adequate knowledge in prenatal or newborn care with reference to health centres of level III/II. Conclusion Knowledge regarding prenatal and newborn care among primary healthcare
Principles for communicating with aging health-care consumers.
Schewe, C D; Spotts, H E
The health-care marketplace is aging by leaps and bounds and bringing with it new and different medical needs. As costs soar and public assistance programs dwindle in impact, health-care providers will need better marketing strategies to bring treatments to patients/consumers. This article looks at the research findings of behavioral scientists and offers guidelines for effective communication with aging audiences. Health-care providers can use these findings to design more effective advertising, promotional brochures, newsletters, and a host of other communication tools targeted at an older market. Health-care managers and other professionals should find the guidelines useful in their daily interactions with patients and colleagues. PMID:10107270
Emami Moghadam, Zahra; Emami Zeydi, Amir; Mazlom, Seyed Reza; Abadi, Fatemeh Sardar; Pour, Parastoo Majidi; Davoudi, Malihe; Banafsheh, Elahe
Introduction: The vulnerability of children under 5 years old requires paying more attention to the health of this group. In the Iranian health care system, health workers are the first line of human resources for health care in rural areas. Because most health workers begin working in conditions with minimal facilities, their clinical qualifications are crucial. The aim of this study was to determine the number of repetitions of child care skills, required for health worker students to achieve proficiency based on the learning curve. Methods: A time series research design was used. Participants in this study were first year health worker students enrolled in three health schools in 2011. Data were collected using a questionnaire consisting of demographic information and a checklist evaluating the health worker students' clinical skills proficiency for child care. Data were analyzed using SPSS version 16.0 software (SPSS Inc., Chicago, IL) using descriptive and inferential statistics including Kruskal-Wallis and Pearson correlation coefficient tests. Results: Learning curve patterns in child care skills acquisition showed that for less than 20 and between 20 to 29 times, the level of skill acquisition had an upward slope. Between 30- 39 the learning curve was descending, however the slope became ascending once more and then it leveled off (with change of less than 5%). Conclusion: It seems that 40 repetitions of child care skills are sufficient for health worker students to achieve proficiency. This suggests that time, resources and additional costs for training health worker students' trainees can be saved by this level of repetition. PMID:26622199
[Aging and work ability of workers of a university hospital's cleaning and hygiene service].
Andrade, Cristiane Batista; Monteiro, Maria Inês
This study was conducted with the cleaning personnel of a university hospital in the city of Campinas, State of São Paulo. These are public employees whose work is mainly physical: cleaning is a job that requires heavy physical work; in addition, workers are also exposed to chemical products. The objective of this survey was to evaluate the work ability of cleaners from different age groups, for which was used the Work Ability Index, an instrument developed by Finnish researchers. The sample was comprised of 69 workers who answered the questionnaire: 21.7% have excellent work ability; 31.9% good; 31.9% moderate; and 14.5% poor. The most frequently reported diseases with medical diagnosis were: lesion due to accidents, musculoskeletal disorders, and cardiovascular diseases. The members of the older group ranked lower in the Work Ability Index and reported a larger number of diseases, which therefore affected their work ability. PMID:17722389
Knowledge of Evidence-Based Urinary Catheter Care Practice Recommendations Among Healthcare Workers in Nursing Homes
Mody, Lona; Saint, Sanjay; Galecki, Andrzej; Chen, Shu; Krein, Sarah L.
Objectives This study assessed the knowledge of recommended urinary catheter care practices among nursing home (NH) healthcare workers (HCWs) in Southeast Michigan. Design A self-administered survey. Setting Seven nursing homes in Southeast Michigan. Participants Three hundred and fifty-six healthcare workers. Methods An anonymous, self-administered survey of HCWs (nurses & nurse aides) in seven NHs in 2006. The survey included questions about respondent characteristics and knowledge about indications, care, and personal hygiene pertaining to urinary catheters. The association of knowledge measures with occupation (nurses vs. aides) was assessed using generalized estimating equations. Results A total of 356 of 440 HCWs (81%) responded. Over 90% of HCWs were aware of measures such as cleaning around the catheter daily, glove use, and hand hygiene with catheter manipulation. They were less aware of research-proven recommendations of not disconnecting the catheter from its bag (59% nurses vs. 30% aides, P < .001), not routinely irrigating the catheter (48% nurses vs. 8% aides, P < .001), and hand hygiene even after casual contact (60% nurses vs. 69% aides, P = .07). HCWs were also unaware of recommendations regarding alcohol-based handrub (27% nurses & 32% aides with correct responses, P = .38). HCWs reported sources, both informal (such as nurse supervisors) and formal (in-services), of knowledge about catheter care. Conclusion Wide discrepancies remain between research-proven recommendations pertaining to urinary catheter care and HCWs' knowledge. Nurses and aides differ in their knowledge of recommendations against harmful practices, such as disconnecting the catheter from the bag and routinely irrigating catheters. Further research should focus on strategies to enhance dissemination of proven infection control practices in NHs. PMID:20662957
Patient Age Influences Perceptions About Health Care Communication
DeVoe, Jennifer E.; Wallace, Lorraine S.; Fryer, George E.
Objective The study's objective was to determine if a patient's age is independently associated with how he/she perceives interactions with health care providers Methods We used a secondary, cross-sectional analysis of nationally representative data from the 2002 Medical Expenditure Panel Survey (MEPS). We measured the independent association between patient age and six outcomes pertaining to communication and decision-making autonomy, while simultaneously controlling for gender, race, ethnicity, family income, educational attainment, census region, rural residence, insurance status, and usual source of care. Results Compared to patients ≥ 65 years, patients ages 18–64 were less likely to report that their provider "always" listened to them, "always" showed respect for what they had to say, and "always" spent enough time with them. Discussion Patient perceptions of health care interactions vary by age. A better understanding of how and why age is associated with patient-provider communication could be useful to design practice-level interventions that enhance services and also to develop national policies that improve health care delivery and health outcomes. PMID:19184691
Information needs of health care workers in developing countries: a literature review with a focus on Africa
Pakenham-Walsh, Neil; Bukachi, Frederick
Health care workers in developing countries continue to lack access to basic, practical information to enable them to deliver safe, effective care. This paper provides the first phase of a broader literature review of the information and learning needs of health care providers in developing countries. A Medline search revealed 1762 papers, of which 149 were identified as potentially relevant to the review. Thirty-five of these were found to be highly relevant. Eight of the 35 studies looked at information needs as perceived by health workers, patients and family/community members; 14 studies assessed the knowledge of health workers; and 8 looked at health care practice. The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage common diseases, going right across the health workforce and often associated with suboptimal, ineffective and dangerous health care practices. If this level of knowledge and practice is representative, as it appears to be, it indicates that modern medicine, even at a basic level, has largely failed the majority of the world's population. The information and learning needs of family caregivers and primary and district health workers have been ignored for too long. Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide. PMID:19356239
Are Nurses and Auxiliary Healthcare Workers Equally Effective in Delivering Smoking Cessation Support in Primary Care?
Faulkner, Kathryn; Sutton, Stephen; Jamison, James; Sloan, Melanie; Boase, Sue
Introduction: Smoking cessation support is increasingly delivered in primary care by auxiliary healthcare workers in place of healthcare professionals. However, it is unknown whether this shift might affect the quality and impact of the support delivered. Methods: Data from the iQuit in Practice randomized control trial of cessation support in General Practice was used (N = 602). Analyses assessed whether cessation advisor type (nurse or healthcare assistant [HCA]) was associated with abstinence (primary outcome: self-reported 2-week point prevalence abstinence at 8 weeks follow-up), the advice delivered during the initial consultation, pharmacotherapies prescribed, patient satisfaction, initial consultation length, and the number and type of interim contacts. Results: There were no statistically significant differences in abstinence for support delivered by HCAs versus nurses at 8 weeks (HCAs 42.8%, nurses 42.6%; unadjusted odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.73 to 1.40), or at 4 weeks or 6 months follow-up. There were no statistically significant differences in advice delivered, the types of pharmacotherapies prescribed or patient satisfaction. Compared with nurses, HCA consultations were longer on average (HCAs 23.6 minutes, nurses 20.8 minutes; P = .002) and they undertook more interim contacts (HCAs median 2, nurses median 1; P < .001), with contact more likely to be face-to-face than phone call (HCAs 91.2%, nurses 70.9%; OR = 4.23, 95% CI = 2.86 to 6.26). Conclusions: HCAs appear equally effective as nurses in supporting smoking cessation, although they do this with greater patient contact. Using auxiliary practitioners to deliver cessation support could free up nurse time and reduce costs. Implications: This study found that primary care patients receiving smoking cessation support from auxiliary healthcare workers were just as likely to be abstinent up to 6 months later as those patients seen by nurses. While the auxiliary healthcare
Oral health related knowledge, attitude and practices among the primary health care workers of a district in India
Bhoopathi, Praveen Haricharan; Reddy, Peddi Reddy Parthasarthi; Kotha, Arpitha; Mancherla, Monica; Boinapalli, Prathibha; Samba, Amit
Aim: To assess the knowledge, attitude, and practices of the primary health care workers in our country. Materials and Methods: Data was gathered by means of a closed-ended questionnaire form. A total of 30 primary health centers (PHCs) and 60 subcenters (SCs) were included in the study. Frequency distribution was used together with Chi-square tests and analysis of variance (ANOVA) in this study. A P value of < 0.05 was considered significant. Results: Only 40% of the primary health care workers knew that dental caries is multifactorial, majority of them could not identify the symptoms of gum diseases, a meager number of the primary health care workers (28%) knew about the oral health aspects of a pregnant lady, and with the exception of doctors, the other health care workers were not sure of the etiology of oral cancer. Conclusion: About one-tenth of the primary care workers had high knowledge regarding oral health, only one-tenth of them had highly favorable oral health attitudes, and 9% of them had highly favorable oral health practices. PMID:25452921
Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital
Costa, Dayane de Melo; Kipnis, André; Leão-Vasconcelos, Lara Stefânia Netto de Oliveira; Rocha-Vilefort, Larissa Oliveira; Telles, Sheila Araújo; André, Maria Cláudia Dantas Porfírio Borges; Tipple, Anaclara Ferreira Veiga; Lima, Ana Beatriz Mori; Ribeiro, Nádia Ferreira Gonçalves; Pereira, Mayara Regina; Prado-Palos, Marinésia Aparecida
The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03), habit of nail biting (p = 0.04) and preparation and administration of antimicrobial (p = 0.04) were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking. PMID:25477910
Professional and educational needs of hospice and palliative care social workers.
Weisenfluh, Sherri M; Csikai, Ellen L
In the past decade much growth has occurred in the numbers of patients and families served by hospices and palliative care services. Thus, not surprisingly, these services have also been subject to increasing regulation by governmental and accrediting entities. In order to stay up-to-date in this ever-changing environment and to continue to provide effective interventions, social workers must stay engaged in the professional community and continuing education. In this quantitative study, 1,169 practicing hospice and palliative care social workers provided information about their practice activities and agency characteristics, professional affiliations and certification, and ongoing educational needs. About one-half of respondents carried a caseload of 21-50 and were most engaged in communicating the psychosocial needs of the patient and family to other members of the team and assessing for grief and bereavement issues. The most important educational needs pertained to the psychological and social needs of patients and families and psychosocial interventions. Most were members of professional organizations and three-quarters were members of NASW. Although many were aware of the joint NASW-NHPCO social work hospice specialty certification, few held this certification yet. The results of this survey can be utilized in the design of continuing education programs and advocacy for programmatic and policy change within agencies and the industry. PMID:23438645
Burnout and Workload Among Health Care Workers: The Moderating Role of Job Control
Portoghese, Igor; Galletta, Maura; Coppola, Rosa Cristina; Finco, Gabriele; Campagna, Marcello
Background As health care workers face a wide range of psychosocial stressors, they are at a high risk of developing burnout syndrome, which in turn may affect hospital outcomes such as the quality and safety of provided care. The purpose of the present study was to investigate the moderating effect of job control on the relationship between workload and burnout. Methods A total of 352 hospital workers from five Italian public hospitals completed a self-administered questionnaire that was used to measure exhaustion, cynicism, job control, and workload. Data were collected in 2013. Results In contrast to previous studies, the results of this study supported the moderation effect of job control on the relationship between workload and exhaustion. Furthermore, the results found support for the sequential link from exhaustion to cynicism. Conclusion This study showed the importance for hospital managers to carry out management practices that promote job control and provide employees with job resources, in order to reduce the burnout risk. PMID:25379330
Health workers' perceptions of Italian female adolescents: a qualitative study about sexuality, contraception, and caring practices in family health centers.
Olivari, Maria Giulia; Santoro, Elena; Stagni Brenca, Elisa; Confalonieri, Emanuela; Di Blasio, Paola
Our aim was to explore health workers' perceptions of providing sexuality and contraception care for female adolescents within family health centers. We interviewed 26 volunteer health workers and analyzed the interviews using thematic analysis. We identified three main themes: (a) "adolescents and sexuality," with the subthemes "initiation rite," "me like the others," and "just for fun"; (b) "adolescents and contraception," with the subthemes "omnipotent adolescents," "aware adolescents," and "women's responsibility"; and PMID:26167812
Community Health Workers and Health Care Delivery: Evaluation of a Women's Reproductive Health Care Project in a Developing Country
Wajid, Abdul; White, Franklin; Karim, Mehtab S.
Background As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. Methods A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. Results The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Conclusions Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a
Enhancing hardiness among health-care workers: the perceptions of senior managers.
Hague, Ann; Leggat, Sandra G
The purpose of this exploratory study was to understand 'hardiness' as defined and operationalized by senior health executives, and to explore the options for increasing the hardiness of the health-care workforce. Previous research has shown that hardiness is important in the workplace as a means to reduce or avoid the negative impact of stress, which then has an association with the maintenance of individual health. Hardiness has been thought to play an important role in assisting health-care workers deal with emotional and stressful work environments. In depth interviews were conducted with senior managers in a Victorian health service to explore hardiness and determine whether the senior executives had identified hardiness as a factor related to performance, how they recognized it within their staff and how hardiness might be enhanced within the organization. The senior managers were able to identify hardy members of their staff, whom they largely described as high performers. We argue that there is opportunity to strengthen health-care organizations by identifying and supporting hardy staff members. Our findings suggest that health-care organizations can teach the concept of hardiness, select hardy employees and develop strategies to assist employees to increase their levels of hardiness in the workplace. PMID:20424272
The Aging Brain Care Medical Home: Preliminary Data.
LaMantia, Michael A; Alder, Catherine A; Callahan, Christopher M; Gao, Sujuan; French, Dustin D; Austrom, Mary G; Boustany, Karim; Livin, Lee; Bynagari, Bharath; Boustani, Malaz A
The Aging Brain Care (ABC) Medical Home aims to improve the care, health outcomes, and medical costs of Medicare beneficiaries with dementia or depression across central Indiana. This population health management program, funded by the Centers for Medicare and Medicaid Services Innovation Center, expanded an existing collaborative dementia and depression care program to serve 1,650 older adults in a local safety-net hospital system. During the first year, 20 full-time clinical staff were hired, trained, and deployed to deliver a collaborative care intervention. In the first 18 months, an average of 13 visits was provided per person. Thirty percent of the sample had a diagnosis of dementia, and 77% had a diagnosis of depression. Sixty-six percent of participants with high depression scores (Patient Health Questionnaire-9 score ≥14) had at least a 50% reduction in their depressive symptoms. Fifty-one percent of caregivers of individuals with dementia had at least a 50% reduction in caregiver stress symptoms (measured by the Healthy Aging Brain Care Monitor-Caregiver Version). After 18 months, the ABC Medical Home has demonstrated progress toward improving the health of older adults with dementia and depression. Scalable and practical models like this show initial promise for answering the challenges posed by the nation's rapidly aging population. PMID:26096394
Factors Influencing Residents' Satisfaction in Residential Aged Care
ERIC Educational Resources Information Center
Chou, Shu-Chiung; Boldy, Duncan P.; Lee, Andy H.
Purpose: The aim of this study was to identify the important factors influencing residents' satisfaction in residential aged care and to provide a better understanding of their interrelationships. Design and Methods: A cross-sectional survey design was used to collect the required information, including resident satisfaction, resident dependency…
School-Age Child Care: Innovative Public School Programs.
ERIC Educational Resources Information Center
ERS Spectrum, 1992
Innovative school-age day care programs include Tennessee's Extended School Program; Hawaii's After-School Plus program; San Antonio's Kid's Involvement Network (offering middle school supervision); Aurora, Colorado's state-licensed Year-Round School Recreation Plan; and Pomona, California's Child Development Program. These public school programs…
Optimising nutrition in residential aged care: A narrative review.
Agarwal, Ekta; Marshall, Skye; Miller, Michelle; Isenring, Elisabeth
In developed countries the prevalence of protein-energy malnutrition increases with age and multi-morbidities increase nutritional risk in aged care residents in particular. This paper presents a narrative review of the current literature on the identification, prevalence, associated risk factors, consequences, and management of malnutrition in the residential aged care (RAC) setting. We performed searches of English-language publications on Medline, PubMed, Ovid and the Cochrane Library from January 1, 1990 to November 25, 2015. We found that, on average, half of all residents in aged care are malnourished as a result of factors affecting appetite, dietary intake and nutrient absorption. Malnutrition is associated with a multitude of adverse outcomes, including increased risk of infections, falls, pressure ulcers and hospital admissions, all of which can lead to increased health care costs and poorer quality of life. A number of food and nutrition strategies have demonstrated positive nutritional and clinical outcomes in the RAC setting. These strategies extend beyond simply enhancing the nutritional value of foods and hence necessitate the involvement of a range of committed stakeholders. Implementing a nutritional protocol in RAC facilities that comprises routine nutrition screening, assessment, appropriate nutrition intervention, including attention to food service systems, and monitoring by a multidisciplinary team can help prevent decline in residents' nutritional status. Food and nutritional issues should be identified early and managed on admission and regularly in the RAC setting. PMID:27621242
Baby Boom Caregivers: Care in the Age of Individualization
ERIC Educational Resources Information Center
Guberman, Nancy; Lavoie, Jean-Pierre; Blein, Laure; Olazabal, Ignace
Purpose: Many Baby Boomers are faced with the care of aging parents, as well as that of disabled or ill spouses or children. This study examines how Baby Boomers in Quebec, Canada, perceive and play their role as caregivers and how this might differ from their parents' generation. Design and methods: This was a qualitative and empirical study…
Latchkey Children and School-Age Child Care. ERIC Digest.
ERIC Educational Resources Information Center
Seligson, Michelle; Fink, Dale B.
This ERIC Digest provides an overview of school-age child care (SACC) programs and suggests reasons for their growth. Discussion points out that escalating interest in SACC has paralleled the raising numbers of children left on their own, and that educators are only the latest in a parade of civic and professional groups which have gone on record…
School Age Child Care in Virginia: 1993 Survey Results.
ERIC Educational Resources Information Center
Council on Child Day Care and Early Childhood Programs, Richmond, VA.
School-age child care (SACC) programs based on-site in Virginia elementary schools were surveyed to determine the scope of such programs across the commonwealth, and to look more comprehensively at existing programs in terms of operators, activities, affordability, and other issues. In January 1993, the survey was sent to school superintendents in…
Process Evaluation of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis.
van Vilsteren, M; Boot, C R L; Voskuyl, A E; Steenbeek, R; van Schaardenburg, D; Anema, J R
Purpose To perform a process evaluation of the implementation of a workplace integrated care intervention for workers with rheumatoid arthritis to maintain and improve work productivity. The intervention consisted of integrated care and a participatory workplace intervention with the aim to make adaptations at the workplace. Methods The implementation of the workplace integrated care intervention was evaluated with the framework of Linnan and Steckler. We used the concepts recruitment, reach, dose delivered, dose received, fidelity and satisfaction with the intervention. Data collection occurred through patient questionnaires and medical records. Results Participants were recruited by sending a letter including a reply card from their own rheumatologist. In total, we invited 1973 patients to participate. We received 1184 reply cards, and of these, 150 patients eventually participated in the study. Integrated care was delivered according to protocol for 46.7 %, while the participatory workplace intervention was delivered for 80.6 %. Dose received was nearly 70 %, which means that participants implemented 70 % of the workplace adaptations proposed during the participatory workplace intervention. The fidelity score for both integrated care and the participatory workplace intervention was sufficient, although communication between members of the multidisciplinary team was limited. Participants were generally satisfied with the intervention. Conclusions This process evaluation shows that our intervention was not entirely implemented as intended. The integrated care was not delivered to enough participants, but for the intervention components that were delivered, the fidelity was good. Communication between members of the multidisciplinary team was limited. However, the participatory workplace intervention was implemented successfully, and participants indicated that they were satisfied with the intervention. PMID:26811171
It is not their war: the impact of military operations on Philippine migrant care workers for elderly people in Israel
Ron, Pnina
Objective A majority of work immigrants from the Philippines came to Israel to fill positions involving personal and nursing care. Most of them were in Israel during the Second Lebanon War, the Cast Lead operation, and the Protective Edge Operation. These migrant care workers experienced these events no differently than did the Israeli population. The goal of this study was to examine the connections between the Philippine migrant care workers' exposure to the military operations and the levels of post-traumatic stress disorder (PTSD), death anxiety, and burnout among them. Methods A random sample of 147 Philippine migrant care workers was recruited through four agencies that employ migrant care workers. Participants completed a self-report questionnaire. Results Philippine migrant care workers reported high levels of PTSD, high levels of death anxiety, and low levels of burnout. Levels of exposure were positively associated with levels of PTSD, death anxiety, and negatively with burnout. A significant inverse relationship was found between interpersonal variables (self-esteem and sense of mastery) and the PTSD, death anxiety, and burnout levels reported by the participants. PMID:26170643
"When Things Are Really Complicated, We Call the Social Worker": Post-Hip-Fracture Care Transitions for Older People.
Sims-Gould, Joanie; Byrne, Kerry; Hicks, Elisabeth; Franke, Thea; Stolee, Paul
Social workers play a key role in the delivery of interdisciplinary health care. However, in the past decade, concerns have been raised about social work's sustainability and contributions in a changing health care sector. These changes come at a time when older patients are more complex and vulnerable than ever before. In this article, using a strengths-based approach, the authors examine the key contributions made by social workers working with older patients with hip fracture as they strive to achieve successful care transitions. Twenty-five interviews with health care professionals (HCPs) were conducted and then analyzed using an analytical coding framework. Although social workers are vital, they are often underused and overlooked in the care of hip fracture patients. The authors sketch the important contributions that social workers make to care transitions after hip fracture, specifically informational continuity; patient-HCP relational continuity; conflict resolution; mediation among family, patient, and HCP (for example, doctors and nurses); collaboration with family caregivers and community supports; and relocation counseling. PMID:26638501
Symptoms of posttraumatic stress disorder among health care workers in earthquake-affected areas in southwest China.
Wang, Li; Zhang, Jianxin; Zhou, Mingjie; Shi, Zhanbiao; Liu, Ping
The symptoms of posttraumatic stress disorder and associated risk factors were investigated among health care workers in earthquake-affected areas in southwest China. 343 health care workers completed the Chinese version of the Impact of Event Scale-Revised 3 mo. after the Wenchuan Earthquake. The prevalence of probable PTSD was 19%. The significant risk factors identified for PTSD severity included being female, being bereaved, being injured, and higher intensity of initial fear. These findings suggest that PTSD is a common mental health problem among health care workers in earthquake-affected areas. The present information can be useful in directing, strengthening, and evaluating disaster-related mental health needs and interventions after an earthquake. PMID:20524558
Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs.
Boiano, James M; Steege, Andrea L; Sweeney, Marie H
The toxicity of antineoplastic drugs is well documented. Many are known or suspected human carcinogens where no safe exposure level exists. Authoritative guidelines developed by professional practice organizations and federal agencies for the safe handling of these hazardous drugs have been available for nearly three decades. As a means of evaluating the extent of use of primary prevention practices such as engineering, administrative and work practice controls, personal protective equipment (PPE), and barriers to using PPE, the National Institute for Safety and Health (NIOSH) conducted a web survey of health care workers in 2011. The study population primarily included members of professional practice organizations representing health care occupations which routinely use or come in contact with selected chemical agents. All respondents who indicated that they administered antineoplastic drugs in the past week were eligible to complete a hazard module addressing self-reported health and safety practices on this topic. Most (98%) of the 2069 respondents of this module were nurses. Working primarily in hospitals, outpatient care centers, and physician offices, respondents reported that they had collectively administered over 90 specific antineoplastic drugs in the past week, with carboplatin, cyclophosphamide, and paclitaxel the most common. Examples of activities which increase exposure risk, expressed as percent of respondents, included: failure to wear nonabsorbent gown with closed front and tight cuffs (42%); intravenous (I.V.) tubing primed with antineoplastic drug by respondent (6%) or by pharmacy (12%); potentially contaminated clothing taken home (12%); spill or leak of antineoplastic drug during administration (12%); failure to wear chemotherapy gloves (12%); and lack of hazard awareness training (4%). The most common reason for not wearing gloves or gowns was "skin exposure was minimal"; 4% of respondents, however, reported skin contact during handling and
Caring for Aging Chinese: Lessons Learned From the United States
After two birth peaks and the "one child per family" policy, China is facing unprecedented challenges with regard to its aging population. This article analyzes the problems associated with three traditional ways of caring for older Chinese, the current health care system, and social supports available to older Chinese. The "4-2-1" family structure and the "empty nest" undermine family support, the prevalence of chronic illnesses and lack of money reduce older adults'selfcare abilities, and insufficient care facilities threaten social support. Lessons learned from the United States show that community-based nursing models, nursing curriculum reforms with a gerontology focus, and reformed health care systems are pivotal for addressing China's crisis. PMID:18239066
Ageing with telecare: care or coercion in austerity?
Mort, Maggie; Roberts, Celia; Callén, Blanca
In recent years images of independence, active ageing and staying at home have come to characterise a successful old age in western societies. 'Telecare' technologies are heavily promoted to assist ageing-in-place and a nexus of demographic ageing, shrinking healthcare and social care budgets and technological ambition has come to promote the 'telehome' as the solution to the problem of the 'age dependency ratio'. Through the adoption of a range of monitoring and telecare devices, it seems that the normative vision of independence will also be achieved. But with falling incomes and pressure for economies of scale, what kind of independence is experienced in the telehome? In this article we engage with the concepts of 'technogenarians' and 'shared work' to illuminate our analysis of telecare in use. Drawing on European-funded research we argue that home-monitoring based telecare has the potential to coerce older people unless we are able to recognise and respect a range of responses including non-use and 'misuse' in daily practice. We propose that re-imagining the aims of telecare and redesigning systems to allow for creative engagement with technologies and the co-production of care relations would help to avoid the application of coercive forms of care technology in times of austerity. PMID:23094945
Preventive dental health care experiences of preschool-age children with special health care needs
Huebner, Colleen E.; Chi, Donald L.; Masterson, Erin; Milgrom, Peter
Purpose This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Methods Study methods included 90 parent interviews and dental examinations of their preschool-age children. Results Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37 percent experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Conclusions Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. PMID:25082666
What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?
Background In countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers' satisfaction can help determine where resources should be focused. Although there is a growing body of research assessing health worker satisfaction in hospitals, less is known about health worker satisfaction in rural, primary health clinics. This study explores the workplace satisfaction of health workers in primary health clinics in rural Tanzania. Methods Overall, 70 health workers in rural Tanzania participated in a self-administered job satisfaction survey. We calculated mean ratings for 17 aspects of the work environment. We used principal components analysis (PCA) to identify groupings of these variables. We then examined the bivariate associations between health workers demographics and clinic characteristics and each of the satisfaction scales. Results Results showed that 73.9% of health workers strongly agreed that they were satisfied with their job; however, only 11.6% strongly agreed that they were satisfied with their level of pay and 2.9% with the availability of equipment and supplies. Two categories of factors emerged from the PCA: the tools and infrastructure to provide care, and supportive interpersonal environment. Nurses and medical attendants (compared to clinical officers) and older health workers had higher satisfaction scale ratings. Conclusions Two dimensions of health workers' work environment, namely infrastructure and supportive interpersonal work environment, explained much of the variation in satisfaction among rural Tanzanian health workers in primary health clinics. Health workers were generally more satisfied with supportive interpersonal relationships than with the infrastructure. Human resource policies should consider how to
City Initiatives in School-Age Child Care. SACC Action Research Paper No. 1. School-Age Child Project.
ERIC Educational Resources Information Center
Gannett, Ellen
Features contributing to the success of six city-wide, comprehensive school-age program models are highlighted. Models are Seattle, Washington's Community Partnerships for School-Age Child Care; Madison, Wisconsin's School-Age Child Care Project; Irvine, California's Irvine Child Care Project; Houston, Texas' After-School Partnership; Los Angeles,…
Seroprevalence study of B. pertussis infection in health care workers in Catalonia, Spain
Urbiztondo, Luis; Broner, Sonia; Costa, Josep; Rocamora, Laura; Bayas, José M; Campins, Magda; Esteve, Maria; Borras, Eva; Domínguez, Angela; for the Study of the Immune Status in Health Care, the Working Group
Pertussis is a re-emerging infection in countries with high infant immunization coverage. Healthcare workers (HCW) are exposed and can transmit the infection to especially-vulnerable patients. Therefore, pertussis vaccination of HCW is recommended. Between June 2008 and December 2010, 460 HCW from hospital and primary healthcare centers were recruited to determine susceptibility to pertussis. IgG antibodies against pertussis (anti-pertussis ab) were measured, using a routine technique that detects antibodies against pertussis including pertussis toxin (PT) and filamentous hemagglutinin (FHA). Positive results were confirmed with a more-specific technique that only assesses anti-PT IgG antibodies. The median age was 42 years (range, 21–65), 77.3% were female. 172 were nurses, 133 physicians, 60 other clinical workers and 95 non-clinical workers. None had received pertussis vaccination since childhood. The overall prevalence of anti-pertussis antibodies was 51.7%, (95% CI 47.1–56.4). Anti-PT antibodies were determined in the 220 HCW with positive anti-pertussis antibodies: 4 (1.8%) were negative and 33 (15%) had a high titer (≥ 45 IU/mL). No significant differences between the prevalence of anti-pertussis antibodies or anti-TP antibodies were found according to age, type of occupation or type of center. Our study confirms the need for vaccination of HCW because at least half are susceptible to pertussis. High anti-PT titers found in 15% of seropositive HCW showed that they had had recent contact with B. pertussis. PMID:25483549
A framework for outcome-level evaluation of in-service training of health care workers
Background In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President's Emergency Plan for AIDS Relief's Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results of that project. Methods A general inductive methodology was used for the conceptualization and development of the framework. Fifteen key informant interviews were conducted to explore contextual factors, perceived needs, barriers and facilitators affecting the evaluation of training outcomes. In addition, a thematic analysis of 70 published articles reporting health care worker training outcomes identified key themes and categories. These were integrated, synthesized and compared to several existing training evaluation models. This formed an overall typology which was used to draft a new framework. Finally, the framework was refined and validated through an iterative process of feedback, pilot testing and revision. Results The inductive process resulted in identification of themes and categories, as well as relationships among several levels and types of outcomes. The resulting framework includes nine distinct types of outcomes that can be evaluated, which are organized within three nested levels: individual, organizational and health system/population. The outcome types are: (1) individual knowledge, attitudes and skills; (2) individual performance; (3) individual patient health; (4) organizational systems; (5) organizational performance; (6) organizational-level patient health; (7) health systems; (8) population-level performance; and (9) population-level health. The framework also addresses contextual factors which may influence the outcomes of training, as well as the
Engagement with HIV Prevention Treatment and Care among Female Sex Workers in Zimbabwe: a Respondent Driven Sampling Survey
Cowan, Frances M.; Mtetwa, Sibongile; Davey, Calum; Fearon, Elizabeth; Dirawo, Jeffrey; Wong-Gruenwald, Ramona; Ndikudze, Theresa; Chidiya, Samson; Benedikt, Clemens; Busza, Joanna; Hargreaves, James R.
Objective(S) To determine the HIV prevalence and extent of engagement with HIV prevention and care among a representative sample of Zimbabwean sex workers working in Victoria Falls, Hwange and Mutare. Design Respondent driven sampling (RDS) surveys conducted at each site. Methods Sex workers were recruited using respondent driven sampling with each respondent limited to recruiting 2 peers. Participants completed an interviewer-administered questionnaire and provided a finger prick blood sample for HIV antibody testing. Statistical analysis took account of sampling method. Results 870 women were recruited from the three sites. HIV prevalence was between 50 and 70%. Around half of those confirmed HIV positive were aware of their HIV status and of those 50-70% reported being enrolled in HIV care programmes. Overall only 25-35% of those with laboratory-confirmed HIV were accessing antiretroviral therapy. Among those reporting they were HIV negative, 21-28% reported having an HIV test in the last 6 months. Of those tested HIV negative, most (65-82%) were unaware of their status. Around two-thirds of sex workers reported consistent condom use with their clients. As in other settings, sex workers reported high rates of gender based violence and police harassment. Conclusions This survey suggests that prevalence of HIV is high among sex workers in Zimbabwe and that their engagement with prevention, treatment and care is sub-optimal. Intensifying prevention and care interventions for sex workers has the potential to markedly reduce HIV and social risks for sex workers, their clients and the general population in Zimbabwe and elsewhere in the region. PMID:24143203
The impact of an aging population on palliative care.
O'Brien, Tony
By 2050, it is predicted that 26% of the population will be aged 80 and over. Although older people have much to contribute, one challenging aspect of an aging population is the increasing rate of dementia. Palliative care is now included as part of the care pathway of a wide variety of nonmalignant diseases. The European Association for Palliative Care (EAPC) and the European Union Geriatric Medicine Society (EUGMS) have jointly called for every older citizen with chronic disease to be offered the best possible palliative care approach wherever they are cared for. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:24303834
Ending neglect: providing effective childhood tuberculosis training for health care workers in Tanzania
Olotu, R.; Talbot, E. A.; Cronin, B. J.; Christopher, R.; Mkomwa, Z.
Setting: Health care facilities in Dar es Salaam, Pwani, and Arusha, Tanzania. Objective: To assess health care worker (HCW) knowledge and practices 1 year after specialized training in childhood tuberculosis (TB). Design: Using a standardized survey, we interviewed a convenience sample of HCWs providing both general and specialized care to children. Results: We interviewed 117 HCWs in TB clinics, maternal and child health clinics, human immunodeficiency virus (HIV) clinics, out-patient departments, and pediatric in-patient wards at 12 facilities. A total of 81 HCWs (62% of nurses, 74% of clinicians) reported having attended the national childhood TB training course. Most HCWs responded correctly to questions on childhood TB diagnosis, treatment, and TB-HIV co-management, regardless of training history. Most HCWs reported that they routinely obtain chest radiographs, HIV testing, and a TB contact history when evaluating children for TB. Less than half of HCWs reported routinely obtaining sputum for mycobacterial culture or performing a tuberculin skin test. Three times as many trained as untrained HCWs reported having ever prescribed isoniazid preventive therapy (IPT) to a child (P < 0.05). Conclusion: In general, levels of childhood TB knowledge were high and practices were in accordance with national guidance. Specific gaps in diagnosis, treatment and use of IPT were identified for future focused training. PMID:26400701
Health care worker disability due to latex allergy and asthma: a cost analysis.
Phillips, V L; Goodrich, M A; Sullivan, T J
OBJECTIVES: The reported prevalence of occupational allergy to natural rubber latex is 8% to 17%, and that of latex-induced occupational asthma is 2.5% to 6%. Conversion of medical facilities to "latex-safe" can reduce employee sensitization, impairment, and disability. The purpose of this study was to determine the cost of a latex-safe approach, compared with that of continued latex glove use, and to identify the level of worker disability required to make the latex-safe approach financially preferable to a health care institution. METHODS: The costs of 2 strategies--latex-safe vs the status quo--were calculated from the perspective of 3 health care institutions. A break-even point was calculated for each facility. RESULTS: In all facilities, the cost of using nonlatex gloves exceeded the cost of using latex gloves. In all 3 facilities, however, 1% or fewer of those at risk would have to become fully disabled or fewer than 2% would have to become partially disabled for the continued use of latex gloves to exceed the cost of the latex-safe approach. CONCLUSION: Health care facilities, regardless of size, are likely to benefit financially from becoming latex-safe even if latex-related disability levels are extremely low. PMID:10394310
Exposure of laboratory animal care workers to airborne mouse and rat allergens.
Glueck, Joshua T; Huneke, Richard B; Perez, Hernando; Burstyn, Igor
Urine of rats and mice is the main source of allergenic proteins that can enter the respiratory tract of laboratory animal care workers. Little is known about the levels and determinants of these exposures in the United States. We investigated the relationship between activities in animal facilities and levels of personal exposure to allergen by collecting personal breathing zone dust samples from 7 caretakers during full workdays for 1 wk. Mice and rat urinary allergens in inhalable dust were quantified via immunoassay. The activities of the sampled workers were observed, and the methods of preventing exposure to allergens were recorded. Mouse urinary allergen was detected in 20 of 39 measurements, yielding a geometric mean of 0.8 ng/m(3) with a maximum of 24 ng/m(3). Washing and cleaning cages and the number of mice handled daily were the most important determinants of personal exposure to mouse urinary allergen, as identified by using multiple linear regressions that explained 51% of total variance. Personal exposures to mouse urinary allergen were associated with day-to-day variation of tasks rather than characteristics of workers. Where potential for personal exposure is the highest, protective measures (N95 masks and cage dumping stations) appeared to be used, as is appropriate. Rat urinary allergen was detected in 4 of 39 measurements; detectable concentrations were between 0.8 and 39 ng/m(3). Only persons who handled rats were exposed to rat urinary allergen. The current findings are valuable for establishing exposure levels against which comparisons of improvement or deterioration of personal exposures can be made. PMID:23312083
Family medicine model in Turkey: a qualitative assessment from the perspectives of primary care workers
Background A person-list-based family medicine model was introduced in Turkey during health care reforms. This study aimed to explore from primary care workers' perspectives whether this model could achieve the cardinal functions of primary care and have an integrative position in the health care system. Methods Four groups of primary care workers were included in this exploratory-descriptive study. The first two groups were family physicians (FP) (n = 51) and their ancillary personnel (n = 22). The other two groups were physicians (n = 44) and midwives/nurses (n = 11) working in community health centres. Participants were selected for maximum variation and 102 in-depth interviews and six focus groups were conducted using a semi-structured form. Results Data analysis yielded five themes: accessibility, first-contact care, longitudinality, comprehensiveness, and coordination. Most participants stated that many people are not registered with any FP and that the majority of these belong to the most disadvantaged groups in society. FPs reported that 40-60% of patients on their lists have never received a service from them and the majority of those who use their services do not use FPs as the first point of contact. According to most participants, the list-based system improved the longitudinality of the relationship between FPs and patients. However, based on other statements, this improvement only applies to one quarter of the population. Whereas there was an improvement limited to a quantitative increase in services (immunisation, monitoring of pregnant women and infants) included in the performance-based contracting system, participants stated that services not among the performance targets, such as family planning, postpartum follow-ups, and chronic disease management, could be neglected. FPs admitted not being able to keep informed of services their patients had received at other health institutions. Half of the participants stated that the list
Factors associated with establishment-based female sex workers accessing health care services in Shanghai.
Pan, Rong; Mao, Limin; He, Na; Zhang, Jing; Chen, Kun; Liao, Cuiqin; Tang, Xian; Gong, Xiangzhen; Blaxland, Megan; de Wit, John
Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18-52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32-4.93; p < 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84-7.38; p < 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21-0.80; p < 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20-0.79; p < 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05-0.91; p < 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds
Field study of age-differentiated strain for assembly line workers in the automotive industry.
Börner, Kerstin; Scherf, Christian; Leitner-Mai, Bianca; Spanner-Ulmer, Birgit
A field study in an automotive supply industry company was conducted to explore age-differentiated strain of assembly line workers. Subjective and objective data from 23 female workers aged between 27 and 57 years were collected at the workplace belt buckle assembly during morning shifts. Subjects with medication or chronic diseases affecting heart rate and breath rate were excluded. For subjective data generation different questionnaires were used. Before the Work Ability Index and the Munich Chronotype Questionnaire were completed by the subjects. Short questionnaires (strain-ratings, NASA-TLX) directly at begin and end of the work were used for obtaining shift-related data. During the whole shift (6 a.m. - 2.45 p.m.) bodily functions were logged with a wireless chest strap. In addition, the motion of the hand-arm-system was recorded for 30 times, 3 minutes each after a fixed time-schedule. First results show that younger subjects need significant less time for assembly (mean = 14.940 s) compared to older subjects (mean = 17.040 s; t(472.026) = -9.278 , p < 0.01). PMID:22317519
Evaluating Knowledge, Attitude and Practice of Health-Care Workers Regarding Patient Education in Iran.
Garshasbi, Sima; Khazaeipour, Zahra; Fakhraei, Nahid; Naghdi, Maryam
The objective of the study was to evaluate the position of patient education measuring knowledge, attitude, and practice (KAP) among health care workers (HCWs). It is also aimed to emphasize the need for a real position for patient education. This survey was performed among a group of HCWs in Iran. The scores had an acceptable level. However, nurses, females and younger people received higher scores. The staff was already aware of patient education necessity and considered it as the duty of all medical team. Often HCWs cannot include patient education in their routine due to time shortage, lack of staff's financial motivation, fatigue, and loads of work, etc. There is still need for a real training in the educational curriculum. Additionally, the various HCWs-related obstacles should be taken into account. PMID:26853292
Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals.
Costello, Susan
Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. PMID:26719732
Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy.
Bhatt, Aditi; Mittal, Sourabh; Gopinath, K S
The combined modality treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained worldwide acceptance for management of selected patients with peritoneal metastases from various cancers. Cytoreductive surgery is performed with the goal of removing all macroscopic disease and is coupled with perioperative chemotherapy (POC) in the form of HIPEC with or without EPIC (early postoperative intraperitoneal chemotherapy) to deal with the microscopic residual disease. These treatments entail the use of cytotoxic drugs in the operation theatre or in the intensive care unit where they are not commonly used and put the healthcare workers participating in the treatment at risk of exposure. CRS is performed with high voltage electrocautery generating a large amount of surgical smoke which is inhaled by the involved personnel and has potential health hazards. This article outlines the safety measures to be taken while performing CRS and POC. PMID:27065717
Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals
Costello, Susan
Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. PMID:26719732
CLMA position on HIV/HBV testing of health-care workers. Clinical Laboratory Management Association.
In February 1991, CLMA's National Affairs Committee (NAC) developed a proposed position statement on mandatory HIV/HBV testing of health-care workers. The proposed statement was submitted to the 24-member National Affairs Reactor Panel and, based on their input, appropriate revisions were made. In May 1991, CLMA surveyed the full membership, and, as a result, the following position was adopted. Ninety-six percent of the members responding agreed with principles 1, 2, and 3; 88% agreed with 4, 5, and 6. NAC members include Royal A. Crystal, Chair; Linda D. Bielitzki, J.D., Vice Chair; Michael G. Bissell, M.D., Ph.D.; Earl C. Buck; Michael A. Maffetone, D. A.; Timothy Murray; Laurence J. Peterson; Marianne C. Watters; and Martha A. Feichter, National Affairs Analyst. PMID:10128723
Knowledge and understanding of AIDS among health-care workers in Jamaica.
Orrett, F A; Prabhakar, P
Six hundred and fifty questionnaires were sent to Health-care Workers (HCW) in four hospitals to assess the knowledge and understanding on HIV transmission and isolation precautions to be instituted for control and also to ascertain whether any differences in knowledge existed between HCW of teaching and nonteaching hospitals. Five hundred and nine questionnaires were returned, a response rate of 79%. Questions on HIV transmission via blood transfusion and sexual intercourse and proper disposal of sharp instruments received the highest scores (85-100), embracing all groups of teaching and non-teaching hospitals. The greatest area of misconception and misunderstanding was reflected in responses obtained on isolation precautions (less than 30) for both teaching and non-teaching hospitals. Our study emphasizes an urgent need for a comprehensive, continuous education of HCW on prevention and control of HIV infections in Jamaica. PMID:2623847
Attitudes of influenza‐vaccinated health care workers toward masks to prevent nosocomial transmission of influenza
Brandt, Christian; Rabenau, Holger F.; Wicker, Sabine
Please cite this paper as: Brandt et al. (2010) Attitudes of influenza‐vaccinated health care workers toward masks to prevent nosocomial transmission of influenza. . Influenza and Other Respiratory Viruses 5(1), 61–66. Background Influenza viruses are highly contagious. Health care workers (HCWs) are at risk of occupational exposure to influenza and may transmit the infection to their patients and coworkers. Objectives The aim of the study was to characterize the attitudes of HCWs regarding the use of surgical masks to prevent nosocomial influenza transmission. Furthermore, we assessed the informational needs of HCWs with regard to infection control measures. Methods A survey was conducted among HCWs, using an anonymous questionnaire, at a German University Hospital during an influenza vaccination campaign. Results Overall, 40·5% of the HCWs were vaccinated against seasonal influenza, and 35·2% were vaccinated against Influenza A/H1N1 ("swine flu"). In total, 1445 vaccinees completed the anonymous questionnaire. Of all respondents, 70·5% stated that the infection control recommendation "wearing a surgical" mask was appropriate to avoid influenza transmission. The percentage of HCWs who would like to have had more information about the infection control measures was 67·5%. Conclusions Appropriate interventions ought to be taken to reduce the risk of exposure to influenza viruses among HCWs. Adherence to recommendations for the use of masks among HCWs needs to be evaluated. Further work is required to highlight the informational needs of HCWs to gain an appreciation of infection control measures. PMID:21138542
Investigating attitudes towards caring for people with HIV/AIDS among hospital care workers in Ibadan, Nigeria: the role of self-efficacy.
Olley, B O
Fear of HIV infection and its consequences may affect the willingness and capacity of health care workers to provide good quality care for people with HIV/AIDS (PWHAs). The study was founded on the proposition that self-efficacy may mediate the attitudinal disposition of health care workers related to provision of care to PWHAs. Two hundred and ten physicians (n = 103) and nurses (n = 107) sampled from the University College Hospital, Ibadan, Nigeria, responded (48% response rate) to a questionnaire which addressed self-efficacy relating to HIV/AIDS, knowledge about HIV/AIDS and treatment of and attitudes towards HIV/AIDS patients. Attitude questions included items on fear of HIV infection, futility in providing care for HIV patients, distress in caring for the patient who is likely to die and willingness to care for PWHAs. The major finding was a significant association between reported high selfefficacy and less fear of acquiring HIV, less futility in providing care for PWHAs and increased willingness to provide such care. More years of education was associated with higher willingness to care, less fear associated with care as well as lower perceived futility related to the care of PWHAs. Female gender was significantly related to the perception of futility related to the care of PWHAs. There was no significant relationship between self-efficacy and knowledge about HIV/AIDS. The findings have significant implications for hospital care for PWHAs and suggest that self-efficacy, rather than knowledge about HIV/AIDS may be important in mediating attitudes towards PWHAs and also in developing intervention programmes aimed at helping health care providers to reframe their attitudes. PMID:25871939
HIV Testing and Engagement in Care among Highly Vulnerable Female Sex Workers: Implications for Treatment as Prevention Models
Surratt, Hilary L.; O'Grady, Catherine; Kurtz, Steven P.; Buttram, Mance E.; Levi-Minzi, Maria A.
Background Although emerging Treatment as Prevention models can be effective in reducing HIV incidence among high-risk populations, many HIV infected individuals remain undiagnosed or fail to engage in HIV care. Methods This study examined the factors associated with HIV testing and care among a population of substance using female sex workers. Results Recent HIV testing was associated with higher education level, having a regular health care provider or clinic, recent crack use, and higher sexual risk behaviors; HIV treatment utilization was associated with higher levels of social support, having a regular health care provider or clinic, housing stability and insurance coverage. Qualitative data revealed HIV-related stigma, denial, social isolation, and substance use as barriers to HIV testing and treatment; social support and accessibility of services were key enablers. Conclusions Improving HIV testing and linkage to treatment among female sex workers will require structural initiatives to reduce stigma and increase service seeking support. PMID:25130245
Work-related Neck Pain Among Desk Job Workers of Tertiary Care Hospital in New Delhi, India: Burden and Determinants
Darivemula, Surendra Babu; Goswami, Kiran; Gupta, Sanjeev Kumar; Salve, Harshal; Singh, Upinder; Goswami, Anil Kumar
Background: Work-related Neck Pain (WRNP) is a leading cause of disability and absenteeism. There is dearth of information about burden and determinants of WRNP in health facility setting in India. Materials and Methods: A cross-sectional study was carried out at tertiary care hospital in New Delhi. All Group C desk job workers involved in the administrative work were included in the study. Participants were screened for WRNP by using pretested semi-structured questionnaire. Detailed information on probable risk factors was collected among patients with WRNP. Neck examination by trained investigator was done. Work place assessment was done by using observation check-list using the recommendations of the ISO Standard (Ergonomic requirements for office work with visual display terminals). Crude and adjusted odds ratio was calculated with 95% confidence interval to understand the determinants of WRNP. Results: In total, 441 participants were included in the study. Of them, 58% were males. Majority of participants aged between31-50 years. One-year prevalence of neck pain and WRNP was reported as 43.3%, (95% CI 38.7%-47.9%) and 28.3%, (95% CI 24.3%-32.7%) respectively. On multivariate analysis, female gender (OR-2.0 95% CI) and poor perception of breaks during working hours (OR-2.4 95% CI), along with work place related factors such as posture (OR-5.4 95% CI) and height of the screen (<10 cms) (OR-2.6) were identified as independent determinants of WRNP. Conclusion: High one-year prevalence of WRNP was reported among desk job workers. Burden of WRNP was reported more among females as compared to males. Most common factor identified was Computer use for more than 4-6 hours was most important predictor of WRNP followed by work related factors such as height of screen and posture are associated with WRNP. PMID:26917874
Health care and social issues of immigrant rescue and recovery workers at the World Trade Center site.
de la Hoz, Rafael E; Hill, Scottie; Chasan, Rachel; Bienenfeld, Laura A; Afilaka, Aboaba A; Wilk-Rivard, Elizabeth; Herbert, Robin
This article reviews the experience of a unique occupational group of World Trade Center (WTC) workers: immigrant workers. This group is comprised largely of men, laborers, who are first-generation immigrants. The majority of these workers are from Latin America (predominantly from Ecuador and Colombia) or from Eastern Europe (predominantly from Poland). Our data shows that the disease profile observed in these workers was what we have previously reported for WTC working population as a whole. Recent reports have begun to document the disproportionate burden of occupational hazards, injuries, and illnesses experienced by immigrant workers in the United States. The WTC experience of immigrants exemplified this burden but, additionally, highlighted that this burden is exacerbated by limitations in access to appropriate health care, disability and compensation benefits, and vocational rehabilitation services. A clinical program that was designed to address the complex medical and psychosocial needs of these workers in a comprehensive manner was successfully established. Full justice for these workers depends on larger societal changes. PMID:19092486
Knowledge and Practice on Injection Safety among Primary Health Care Workers in Kaski District, Western Nepal
Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kc, Vikash Kumar; Jha, Nisha; Sharma, Damodar
Background Unsafe injection practice can transmit various blood borne infections. The aim of this study was to assess the knowledge and practice of injection safety among injection providers, to obtain information about disposal of injectable devices, and to compare the knowledge and practices of urban and rural injection providers. Methods The study was conducted with injection providers working at primary health care facilities within Kaski district, Nepal. Ninety-six health care workers from 69 primary health care facilities were studied and 132 injection events observed. A semi-structured checklist was used for observing injection practice and a questionnaire for the survey. Respondents were interviewed to complete the questionnaire and obtain possible explanations for certain observed behaviors. Results All injection providers knew of at least one pathogen transmitted through use/re-use of unsterile syringes. Proportion of injection providers naming hepatitis/jaundice as one of the diseases transmitted by unsafe injection practice was significantly higher in urban (75.6%) than in rural (39.2%) area. However, compared to urban respondents (13.3%), a significantly higher proportion of rural respondents (37.3%) named Hepatitis B specifically as one of the diseases transmitted. Median (inter-quartile range) number of therapeutic injection and injectable vaccine administered per day by the injection providers were 2 (1) and 1 (1), respectively. Two handed recapping by injection providers was significantly higher in urban area (33.3%) than in rural areas (21.6%). Most providers were not aware of the post exposure prophylaxis guideline. Conclusion The knowledge of the injection providers about safe injection practice was acceptable. The use of safe injection practice by providers in urban and rural health care facilities was almost similar. The deficiencies noted in the practice must be addressed. PMID:27540325
Meeting Community Health Worker Needs for Maternal Health Care Service Delivery Using Appropriate Mobile Technologies in Ethiopia
Little, Alex; Medhanyie, Araya; Yebyo, Henock; Spigt, Mark; Dinant, Geert-Jan; Blanco, Roman
Background Mobile health applications are complex interventions that essentially require changes to the behavior of health care professionals who will use them and changes to systems or processes in delivery of care. Our aim has been to meet the technical needs of Health Extension Workers (HEWs) and midwives for maternal health using appropriate mobile technologies tools. Methods We have developed and evaluated a set of appropriate smartphone health applications using open source components, including a local language adapted data collection tool, health worker and manager user-friendly dashboard analytics and maternal-newborn protocols. This is an eighteen month follow-up of an ongoing observational research study in the northern of Ethiopia involving two districts, twenty HEWs, and twelve midwives. Results Most health workers rapidly learned how to use and became comfortable with the touch screen devices so only limited technical support was needed. Unrestricted use of smartphones generated a strong sense of ownership and empowerment among the health workers. Ownership of the phones was a strong motivator for the health workers, who recognised the value and usefulness of the devices, so took care to look after them. A low level of smartphones breakage (8.3%,3 from 36) and loss (2.7%) were reported. Each health worker made an average of 160 mins of voice calls and downloaded 27Mb of data per month, however, we found very low usage of short message service (less than 3 per month). Conclusions Although it is too early to show a direct link between mobile technologies and health outcomes, mobile technologies allow health managers to more quickly and reliably have access to data which can help identify where there issues in the service delivery. Achieving a strong sense of ownership and empowerment among health workers is a prerequisite for a successful introduction of any mobile health program. PMID:24204872
A Configurational Approach to the Relationship between High-Performance Work Practices and Frontline Health Care Worker Outcomes
Chuang, Emmeline; Dill, Janette; Morgan, Jennifer Craft; Konrad, Thomas R
Objective To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care. Methods Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis. Principal Findings Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers. Conclusions High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices. PMID:22224858
Utilization of the QuantiFERON-TB Gold Test in a Two-Step Process with the Tuberculin Skin Test To Evaluate Health Care Workers for Latent Tuberculosis▿
Abdalhamid, Baha; Hinrichs, Steven H.; Garrett, Jodi L.; O'Neill, Jean M.; Hansen-Cain, Kristine M.; Armbrust, Amy A.; Iwen, Peter C.
A cost analysis of combining a tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT-GT) to detect latent tuberculosis in newly hired health care workers was performed. An approximately 50% reduction in the cost of additional care was realized when workers with positive TST results were subsequently screened using the QFT-GT. PMID:20573876
Apartment residents' and day care workers' exposures to tetrachloroethylene and deficits in visual contrast sensitivity.
Schreiber, Judith S; Hudnell, H Kenneth; Geller, Andrew M; House, Dennis E; Aldous, Kenneth M; Force, Michael S; Langguth, Karyn; Prohonic, Elizabeth J; Parker, Jean C
Tetrachloroethylene (also called perchloroethylene, or perc), a volatile organic compound, has been the predominant solvent used by the dry-cleaning industry for many years. The U.S. Environmental Protection Agency (EPA) classified perc as a hazardous air pollutant because of its potential adverse impact on human health. Several occupational studies have indicated that chronic, airborne perc exposure adversely affects neurobehavioral functions in workers, particularly visual color discrimination and tasks dependent on rapid visual-information processing. A 1995 study by Altmann and colleagues extended these findings, indicating that environmental perc exposure at a mean level of 4,980 microg/m(3) (median=1,360 microg/m(3)) alters neurobehavioral functions in residents living near dry-cleaning facilities. Although the U.S. EPA has not yet set a reference concentration guideline level for environmental exposure to airborne perc, the New York State Department of Health set an air quality guideline of 100 microg/m(3). In the current residential study, we investigated the potential for perc exposure and neurologic effects, using a battery of visual-system function tests, among healthy members of six families living in two apartment buildings in New York City that contained dry-cleaning facilities on the ground floors. In addition, a day care investigation assessed the potential for perc exposure and effects among workers at a day care center located in the same one-story building as a dry-cleaning facility. Results from the residential study showed a mean exposure level of 778 microg/m(3) perc in indoor air for a mean of 5.8 years, and that perc levels in breath, blood, and urine were 1-2 orders of magnitude in excess of background values. Group-mean visual contrast sensitivity (VCS), a measure of the ability to detect visual patterns, was significantly reduced in the 17 exposed study participants relative to unexposed matched-control participants. The groups did not
Caring for Children and Youth Who Have Been Sexually Abused: A Training Manual for Child and Youth Care Workers and Foster Parents. Facilitator's Guide.
ERIC Educational Resources Information Center
Croll, Linda
This facilitator's guide is part of an overall program developed as a resource for child and youth care workers and foster parents. Those using the facilitator's guide must possess considerable knowledge and training in the areas of child abuse, child welfare, child laws, human development, and group and family dynamics. Facilitators must be able…
Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial
ERIC Educational Resources Information Center
Babamoto, Kenneth S.; Sey, Kwa A.; Camilleri, Angela J.; Karlan, Vicki J.; Catalasan, Joana; Morisky, Donald E.
The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative…
75 FR 65515 - NRC Corporation, USPS Help Desk of Customer Care Center, Including On-Site Leased Workers of Volt...
Federal Register 2010, 2011, 2012, 2013, 2014
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration NRC Corporation, USPS Help Desk of Customer Care Center, Including On... September 3, 2010 (75 FR 54187). The workers supply information technology support services and are...
Words from the Heart Speak to the Heart: A Study of Deep Acting, Faking, and Hiding among Child Care Workers
ERIC Educational Resources Information Center
Lee, Raymond T.; Brotheridge, Celeste M.
Purpose: The purpose of this paper is to understand, from the child care worker's perspective, how work experience, display rules, and affectivity are related to emotional labor. It also examines the utility of separating surface acting into its two components: the hiding and faking of emotions. Design/methodology/approach: This study is based on…
[In the aftermath of medical error: caring for patients, family, and the healthcare workers involved].
Schwappach, David L B
Medical errors, in particular those resulting in harm, pose a serious situation for patients ("first victims") and the healthcare workers involved ("second victims") and can have long-lasting and distressing consequences. To prevent a second traumatization, appropriate and empathic interaction with all persons involved is essential besides error analysis. Patients share a nearly universal, broad preference for a complete disclosure of incidents, regardless of age, gender, or education. This includes the personal, timely and unambiguous disclosure of the adverse event, information relating to the event, its causes and consequences, and an apology and sincere expression of regret. While the majority of healthcare professionals generally support and honest and open disclosure of adverse events, they also face various barriers which impede the disclosure (e.g., fear of legal consequences). Despite its essential importance, disclosure of adverse events in practice occurs in ways that are rarely acceptable to patients and their families. The staff involved often experiences acute distress and an intense emotional response to the event, which may become chronic and increase the risk of depression, burnout and post-traumatic stress disorders. Communication with peers is vital for people to be able to cope constructively and protectively with harmful errors. Survey studies among healthcare workers show, however, that they often do not receive sufficient individual and institutional support. Healthcare organizations should prepare for medical errors and harmful events and implement a communication plan and a support system that covers the requirements and different needs of patients and the staff involved. PMID:25410745
Latent Tuberculosis Infection and Associated Factors among Health Care Workers in Kigali, Rwanda
Rutanga, Claude; Lowrance, David W.; Oeltmann, John E.; Mutembayire, Grace; Willis, Matt; Uwizeye, Claude Bernard; Hinda, Ruton; Bassirou, Chitou; Gutreuter, Steve; Gasana, Michel
Introduction Data are limited regarding tuberculosis (TB) and latent TB infection prevalence in Rwandan health facilities. Methods We conducted a cross-sectional survey among healthcare workers (HCWs) in Kigali during 2010. We purposively selected the public referral hospital, both district hospitals, and randomly selected 7 of 17 health centers. School workers (SWs) from the nearest willing public schools served as a local reference group. We tested for latent TB infection (LTBI) using tuberculin skin testing (TST) and asked about past TB disease. We assessed risk of LTBI and past history of TB disease associated with hospital employment. Among HCWs, we assessed risk associated with facility type (district hospital, referral hospital, health center), work setting (inpatient, outpatient), and occupation. Results Age, gender, and HIV status was similar between the enrolled 1,131 HCWs and 381 SWs. LTBI was more prevalent among HCWs (62%) than SWs (39%). Adjusted odds of a positive TST result were 2.71 (95% CI 2.01–3.67) times greater among HCWs than SWs. Among HCWs, there was no detectable difference between prevalence of LTBI according to facility type, work setting, or occupation. Conclusion HCWs are at greater risk of LTBI, regardless of facility type, work setting, or occupation. The current status of TB infection control practices should be evaluated in the entire workforce in all Rwandan healthcare facilities. PMID:25919759
Physical violence against health care workers: A nationwide study from Iran
Fallahi-Khoshknab, Masoud; Oskouie, Fatemeh; Najafi, Fereshteh; Ghazanfari, Nahid; Tamizi, Zahra; Afshani, Shahla
Background: Workplace violence is a serious and problematic phenomenon in health care settings. Research shows that health care workers are at the highest risk of such violence. The aim of this study was to address the frequency of physical violence against Iranian health personnel, their response to such violence, as well as the contributing factors to physical violence. Materials and Methods: A cross-sectional study was conducted in 2011, in which 6500 out of 57,000 health personnel working in some teaching hospitals were selected using multi-stage random sampling. Data were collected using the questionnaire of "Workplace Violence in the Health Sector" developed by the International Labor Organization, the International Council of Nurses, the World Health Organization, and the Public Services International. Results: The findings revealed that 23.5% of the participants were exposed to physical violence in the 12 months prior to the study. Nurses were the main victims of physical violence (78%) and patients' families were the main perpetrators of violence (56%). The most common reaction of victims to physical violence was asking the aggressor to stop violence (45%). Lack of people's knowledge of employees' tasks was the most common contributing factor to physical violence (49.2%). Conclusions: Based on the results, legislating appropriate laws in order to prevent and control violence in the workplace is necessary. Moreover, developing educational programs to manage the incidence of physical violence should be on health centers' agenda. PMID:27186199
The best of intentions: patients' intentions to request health care workers cleanse hands before examinations.
Treise, Debbie; Weigold, Michael F; Birnbrauer, Kristina; Schain, Denise
The Centers for Disease Control and Prevention (CDC) recommends that patients ask health care providers to cleanse their hands in the patients' presence for each examination. This study investigates the utility of the recommendation in light of potential challenges stemming from norms in the provider-patient relationship. In addition, we investigate the role of individual differences that may make such a discussion especially difficult (e.g., interaction anxiety) or seem inappropriate (e.g., authoritarianism). We also seek to identify how well-known predictors of behavioral intentions (i.e., attitudes, subjective norms, efficacy, outcome benefits and costs) affect intentions to perform this specific behavior. In total, 250 hospitalized, postsurgical patients were asked about their own likelihood of following the CDC recommendation. They were also asked to view and respond to video depictions of a doctor and patient interaction that varied the presence of a patient request and a doctor's cleansing. Results of the study suggest the CDC recommendation, without additional considerations, is unlikely to reduce dangers posed by health care worker transmission of infectious disease. PMID:26362713
Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural Taiwan.
Chao, Ming-Che; Jou, Rong-Chang; Liao, Cing-Chu; Kuo, Chung-Wei
Workplace stress (WS) has been found to affect job satisfaction (JS), performance, and turnover intentions (TIs) in developed countries, but there is little evidence from other countries and especially rural areas. In rural Taiwan, especially, there is an insufficient health care workforce, and the situation is getting worse. To demonstrate the relationship, we used a cross-sectional structured questionnaire, and data from 344 licensed professionals in 1 rural regional hospital were analyzed using the structural equation model. The results showed that WS had a positive effect on both TI and job performance (JP) but a negative effect on satisfaction. JS did improve performance. For the staff with an external locus of control, stress affected JP and satisfaction significantly. For the staff with lower perceived job characteristics, JS affected performance significantly. The strategies to decrease stress relating to work load, role conflict, family factors, and working environment should be focused and implemented urgently to lower the turnover rate of health care workers in rural Taiwan. PMID:24174390
Latent Tuberculosis in Health Care Workers Exposed to Active Tuberculosis in a Tertiary Care Hospital in Oman
Khamis, Faryal; Al-Lawati, Adil; Al-Zakwani, Ibrahim; Al-Abri, Seif; Al-Naamani, Jaleelah; Al-Harthi, Harith; Al-Jardani, Amina; Al-Harthi, Aliya
Objectives Data on the prevalence of tuberculosis (TB) in healthcare workers (HCW) in Oman and the Arabian Gulf is scarce. The aim of this study was to estimate the prevalence of latent tuberculosis (LTB) among HCW exposed to active TB in one of the tertiary care hospitals in Muscat. Methods Exposed HCW were screened for LTB from January to June 2012 using skin tuberculin and serum interferon tests. Candidates were followed-up for a total of nine months. Descriptive statistics were used to summarize the data. Results A total of 371 exposed HCW were involved in the study. The incidence of LTB in exposed HCW was 33.2% (n = 123). Almost 54% (66/123) of the HCW started treatment and only 42.4% (28/66) completed the full nine-month treatment course. Conclusions The high prevalence of LTBI in exposed HCW merits further evaluation of the screening and treatment programs in the country. Future countrywide studies are warranted to provide more precise statistics on the prevalence and management of this public health issue. PMID:27403243
Nasal carriage of Methicillin- and Mupirocin-resistant S. aureus among health care workers in a tertiary care hospital
Agarwal, Loveleena; Singh, Amit Kumar; Sengupta, Chandrim; Agarwal, Amitabh
Objective: Methicillin-resistant Staphylococcus aureus (MRSA) ranks top among the nosocomial pathogens. Nasal formulation of mupirocin is found to eradicate MRSA from colonized individuals, but the emergence of resistant strains is a matter of concern. Methods: Nasal swabs were collected from 200 health care workers (HCWs) who were screened for MRSA. Kirby–Bauer disc diffusion method was used to perform antibiotic susceptibility test. MRSA detection was done using a cefoxitin 30 µg disc and interpreted according to the Clinical and Laboratory Standards Institute guidelines. Determination of mupirocin resistance was performed using Epsilometer test (E-test). Findings: About 14% of HCWs showed nasal carriage of MRSA. Nursing orderlies were the predominant carriers. E-test showed four mupirocin resistant isolates. The antibiogram of the MRSA isolates revealed the higher resistance to antibiotics as compared to methicillin-sensitive Staphylococcus aureus. All the MRSA isolates were sensitive to linezolid. Conclusion: HCWs in our hospital showed high nasal carriage rate of MRSA, particularly the nursing orderlies which is statistically significant. It is advisable to detect mupirocin resistance among the isolates obtained from the HCWs so that in case of resistance, alternative treatment should be sought. PMID:26645023
Does Raising the Early Retirement Age Increase Employment of Older Workers?
Staubli, Stefan; Zweimüller, Josef
Two pension reforms in Austria increased the early retirement age (ERA) from 60 to 62 for men and from 55 to 58.25 for women. We find that raising the ERA increased employment by 9.75 percentage points among affected men and by 11 percentage points among affected women. The reforms had large spillover effects on the unemployment insurance program but negligible effects on disability insurance claims. Specifically, unemployment increased by 12.5 percentage points among men and by 11.8 percentage points among women. The employment response was largest among high-wage and healthy workers, while low-wage and less healthy workers either continued to retire early via disability benefits or bridged the gap to the ERA via unemployment benefits. Taking spillover effects and additional tax revenues into account, we find that for a typical birth-year cohort a one year increase in the ERA resulted in a reduction of net government expenditures of 107 million euros for men and of 122 million euros for women. PMID:24319299
Early aging in Chernobyl clean-up workers: long-term study.
Krasnov, V; Kryukov, V; Samedova, E; Emelianova, I; Ryzhova, I
This paper represents data of long-term open prospective study. 312 male clean-up workers, who participated in elimination of the Chernobyl disaster consequences in 1986-87, were observed and examined in Moscow Research Institute of Psychiatry. The average age of patients was 57,0 ± 6,8 years. All patients were diagnosed with psychoorganic syndrome, caused by combination of different factors, which led to early cerebrovascular pathology, which was confirmed by clinical, neuropsychological, and instrumental examination. Anamnesis and the level of social adaptation were also assayed. Clinical estimation was done with the use of specially developed Clinical Psychopathological Chart. All the symptoms were divided into 4 groups (asthenic, psychovegetative, dysthymic, and cognitive symptom-complexes). No pronounced signs of dementia were observed. The control group included 44 clean-up workers without mental disorders. Predomination of various exogenous factors before and after accident was noted. Therapy included different vasotropic remedies, as well as family therapy, art therapy, and cognitive training. The possibilities of the reverse development of symptoms were statistically proved. The results allow making a conclusion that these disorders could not be explained either by radiation effects or by PTSD but connected with cerebrovascular pathology. PMID:25692150
Early Aging in Chernobyl Clean-Up Workers: Long-Term Study
Krasnov, V.; Kryukov, V.; Samedova, E.; Emelianova, I.; Ryzhova, I.
This paper represents data of long-term open prospective study. 312 male clean-up workers, who participated in elimination of the Chernobyl disaster consequences in 1986-87, were observed and examined in Moscow Research Institute of Psychiatry. The average age of patients was 57,0 ± 6,8 years. All patients were diagnosed with psychoorganic syndrome, caused by combination of different factors, which led to early cerebrovascular pathology, which was confirmed by clinical, neuropsychological, and instrumental examination. Anamnesis and the level of social adaptation were also assayed. Clinical estimation was done with the use of specially developed Clinical Psychopathological Chart. All the symptoms were divided into 4 groups (asthenic, psychovegetative, dysthymic, and cognitive symptom-complexes). No pronounced signs of dementia were observed. The control group included 44 clean-up workers without mental disorders. Predomination of various exogenous factors before and after accident was noted. Therapy included different vasotropic remedies, as well as family therapy, art therapy, and cognitive training. The possibilities of the reverse development of symptoms were statistically proved. The results allow making a conclusion that these disorders could not be explained either by radiation effects or by PTSD but connected with cerebrovascular pathology. PMID:25692150
Does Raising the Early Retirement Age Increase Employment of Older Workers?*
Staubli, Stefan; Zweimüller, Josef
Two pension reforms in Austria increased the early retirement age (ERA) from 60 to 62 for men and from 55 to 58.25 for women. We find that raising the ERA increased employment by 9.75 percentage points among affected men and by 11 percentage points among affected women. The reforms had large spillover effects on the unemployment insurance program but negligible effects on disability insurance claims. Specifically, unemployment increased by 12.5 percentage points among men and by 11.8 percentage points among women. The employment response was largest among high-wage and healthy workers, while low-wage and less healthy workers either continued to retire early via disability benefits or bridged the gap to the ERA via unemployment benefits. Taking spillover effects and additional tax revenues into account, we find that for a typical birth-year cohort a one year increase in the ERA resulted in a reduction of net government expenditures of 107 million euros for men and of 122 million euros for women. PMID:24319299
Complexities of short-term mobility for sex work and migration among sex workers: violence and sexual risks, barriers to care, and enhanced social and economic opportunities.
Goldenberg, Shira M; Chettiar, Jill; Nguyen, Paul; Dobrer, Sabina; Montaner, Julio; Shannon, Kate
Despite research on the health and safety of mobile and migrant populations in the formal and informal sectors globally, limited information is available regarding the working conditions, health, and safety of sex workers who engage in short-term mobility and migration. The objective of this study was to longitudinally examine work environment, health, and safety experiences linked to short-term mobility/migration (i.e., worked or lived in another city, province, or country) among sex workers in Vancouver, Canada, over a 2.5-year study period (2010-2012). We examined longitudinal correlates of short-term mobility/migration (i.e., worked or lived in another city, province, or country over the 3-year follow-up period) among 646 street and off-street sex workers in a longitudinal community-based study (AESHA). Of 646 sex workers, 10.84 % (n = 70) worked or lived in another city, province, or country during the study. In a multivariate generalized estimating equations (GEE) model, short-term mobility/migration was independently correlated with older age (adjusted odds ratio (AOR) 0.95, 95 % confidence interval (CI) 0.92-0.98), soliciting clients in indoor (in-call) establishments (AOR 2.25, 95 % CI 1.27-3.96), intimate partner condom refusal (AOR 3.00, 1.02-8.84), and barriers to health care (AOR 1.77, 95 % CI 1.08-2.89). In a second multivariate GEE model, short-term mobility for sex work (i.e., worked in another city, province, or country) was correlated with client physical/sexual violence (AOR 1.92, 95 % CI 1.02-3.61). In this study, mobile/migrant sex workers were more likely to be younger, work in indoor sex work establishments, and earn higher income, suggesting that short-term mobility for sex work and migration increase social and economic opportunities. However, mobility and migration also correlated with reduced control over sexual negotiation with intimate partners and reduced health care access, and mobility for sex work was associated with
Work Stress, Burnout, and Social and Personal Resources among Direct Care Workers
Gray-Stanley, Jennifer A.; Muramatsu, Naoko
Work stress is endemic among direct care workers (DCWs) who serve people with intellectual and developmental disabilities. Social resources, such as work social support, and personal resources, such as an internal locus of control, may help DCWs perceive work overload and other work-related stressors as less threatening and galvanize them to cope more effectively to prevent burnout. However, little is known about what resources are effective for coping with what types of work stress. Thus, we examined how work stress and social and personal resources are associated with burnout for DCWs. We conducted a survey of DCWs (n = 323) from five community-based organizations that provide residential, vocational, and personal care services for adults with intellectual and developmental disabilities. Participants completed a self-administered survey about their perceptions of work stress, work social support, locus of control, and burnout relative to their daily work routine. We conducted multiple regression analysis to test both the main and interaction effects of work stress and resources with respect to burnout. Work stress, specifically work overload, limited participation decision-making, and client disability care was positively associated with burnout (p < .001). The association between work social support and burnout depended on the levels of work overload (p < .05), and the association between locus of control and burnout depended on the levels of work overload (p < .05) and participation in decision-making (p < .05). Whether work social support and locus of control make a difference depends on the kinds and the levels of work stressors. The findings underscore the importance of strong work-based social support networks and stress management resources for DCWs. PMID:21316918
Is the existing knowledge and skills of health workers regarding eye care in children sufficient to meet needs?
Kishiki, Elizabeth; Hogeweg, Margreet; Dieleman, Marjolein; Lewallen, Susan; Courtright, Paul
Although uncommon, childhood blindness is a major contributor to blind-person years in Africa. Children with vision-related problems need urgent referral, but existing evidence suggests that there is delay in presentation. A pilot study in a random selection of government dispensaries in two districts of Kilimanjaro Region, Tanzania, was conducted to assess the knowledge and skills of primary healthcare workers regarding eye care needs of children. Questionnaires were administered to 16 healthcare workers, and in-depth interviews were conducted with 9 health workers and 2 key informants. Overall, 88% of workers recognised cataract in a picture, 63% knew that it required surgery but only 50% realised surgery was urgent. Only 38% recognised squint as needing referral and none considered this urgent. Moreover, 38% could correctly suggest a cause of a large corneal scar and 44% of workers believed that children with albinism need to attend schools for the blind. Poor knowledge of referral and treatment guidelines are likely due to a number of factors, including inadequate training and the rarity of childhood blindness. Primary eye care manuals should be reviewed to ensure that information regarding childhood blindness is adequate and appropriate. Referral pathways should also be revised. PMID:24029677
Quality of Life of the Health Care Workers in the Pre-Retirement Period from the Private Sector of the Primary Health Care from the Skopje Region
Mujchin, Iskra Gerazova
BACKGROUND: The quality of life (QOL) of the workers in the pre-retirement period is an important line in their functioning, as well as in the process of their preparing for retirement. AIM: To assess the QOL of the health care workers - HCW (doctors and nurses/medical technicians) in the pre-retirement period from the private sector of the Primary Health Care (PHC). MATERIAL AND METHODS: We performed a cross-sectional, questionnaire-based study including 200 HCW in their pre-retirement period from the PHC from the Skopje region divided in two groups. The examined group (EG) included 100 HCW working in the private sector, whereas the control group (CG) consisted of 100 HCW employed in the public sector, matched to EG by age and duration of employment at the actual workplace. The QOL of the examinees was assessed by the World Health Organization Quality of Life - Bref questionnaire (WHOQOL - BREF). RESULTS: Examinees from both group assessed their QOL as good, i.e. there was no significant difference between the mean scores of EG and CG in regard to assessment of their QOL (3.7 vs. 3.6; p = 0.274). Regarding the satisfaction with their health, we found that examinees from EG are significantly more satisfied with their health than the examinees of CG as it was expressed by the obtained mean scores (3.9 vs. 3.6; p = 0.017). The mean scores of the domain assessing physical health and environment did not differ significantly between EG and CG (23.4 vs. 22.9; p = 0.187 and 25.7 vs. 24.9; p = 0.290, respectively). We found significant difference between EG and CG in regard to the mean scores assessing the psychological health (23.1 vs. 21.5; p = 0.003) and social life (11.6 vs. 10.1; p < 0.001). CONCLUSION: HCW from EG evaluated their QOL slightly better and they were more satisfied with their health than HCW from CG. In addition, HCW from EG assessed better their psychological health and social life than HCW from CG, whereas regarding the assessment of the physical
Need or right: Sexual expression and intimacy in aged care.
Rowntree, Margaret R; Zufferey, Carole
This paper explores how the residential aged care sector could engage with residents' sexual expression and intimacy. It is informed by a study of 19 aged care staff members and 23 community members, and initially designed on the principles of Appreciative Inquiry methodology. The data were collected through focus groups and interviews and analyzed using discourse analysis. We found that staff members mainly conceptualize sexual expression as a need to be met, while community members (current and prospective residents) understand it as a right to be exercised. We conclude that the way in which sexual expression is conceptualized has critical implications for the sector's engagement with this topic. A 'needs' discourse informs policies, procedures and practices that enable staff to meet residents' needs, while a 'rights' discourse shapes policies, practices and physical designs that improve residents' privacy and autonomy, shifting the balance of power towards them. The former approach fits with a nursing home medical model of care, and the latter with a social model of service provision and consumption. PMID:26568211
Outreach services to improve access to health care in South Africa: lessons from three community health worker programmes
Nxumalo, Nonhlanhla; Goudge, Jane; Thomas, Liz
Introduction In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-related barriers to health care. Methods The comparative case studies, located in Eastern Cape and Gauteng, were investigated using qualitative methods. Thematic analysis was used to identify factors that constrain and enable outreach services to improve access to care. Results The local satellite (of a national NGO), successful in addressing multi-dimensional barriers to care, provided CHWs with continuous training focused on the social determinants of ill-health, regular context-related supervision, and resources such as travel and cell-phone allowances. These workers engaged with, and linked their clients to, agencies in a wide range of sectors. Relationships with participatory structures at community level stimulated coordinated responses from service providers. In contrast, an absence of these elements curtailed the ability of CHWs in the small NGO and government-initiated service to provide effective outreach services or to improve access to care. Conclusion Significant investment in resources, training, and support can enable CHWs to address barriers to care by negotiating with poorly functioning government services and community participation structures. PMID:23364101
"I Get Along With Most of Them": Direct Care Workers' Relationships With Residents' Families in Assisted Living
Kemp, Candace L.; Ball, Mary M.; Perkins, Molly M.; Hollingsworth, Carole; Lepore, Michael J.
Purpose: The purpose of this article was to explore staff–family relationships in assisted living facilities (ALFs) as they are experienced by care staff and perceived by administrators. We identify factors that influence relationships and explore how interactions with residents' families affect care staff's caregiving experiences. Design and Methods: The data are drawn from a statewide study involving 45 ALFs in Georgia. Using grounded theory methods, we analyze qualitative data from in-depth interviews with 41 care staff and 43 administrators, and survey data from 370 care staff. Results: Care workers characterized their relationships with most family members as "good" or "pretty good" and aspired to develop relationships that offered personal and professional affirmation. The presence or absence of affirmation was central to understanding how these relationships influenced care staffs' on-the-job experiences. Community, facility, and individual factors influenced the development of relationships and corresponding experiences. Insofar as interactions with family members were rewarding or frustrating, relationships exerted positive or negative influences on workers' caregiving experiences. Implications: Findings suggest the need to create environments—through policy and practice—where both parties are empathetic of one another and view themselves as partners. Doing so would have positive outcomes for care workers, family members, and residents. PMID:19363017
HIV prevention and care services for female sex workers: efficacy of a targeted community-based intervention in Burkina Faso
Traore, Isidore T; Meda, Nicolas; Hema, Noelie M; Ouedraogo, Djeneba; Some, Felicien; Some, Roselyne; Niessougou, Josiane; Sanon, Anselme; Konate, Issouf; Van De Perre, Philippe; Mayaud, Philippe; Nagot, Nicolas
Introduction Although interventions to control HIV among high-risk groups such as female sex workers (FSW) are highly recommended in Africa, the contents and efficacy of these interventions are unclear. We therefore designed a comprehensive dedicated intervention targeting young FSW and assessed its impact on HIV incidence in Burkina Faso. Methods Between September 2009 and September 2011 we conducted a prospective, interventional cohort study of FSW aged 18 to 25 years in Ouagadougou, with quarterly follow-up for a maximum of 21 months. The intervention combined prevention and care within the same setting, consisting of peer-led education sessions, psychological support, sexually transmitted infections and HIV care, general routine health care and reproductive health services. At each visit, behavioural characteristics were collected and HIV, HSV-2 and pregnancy were tested. We compared the cohort HIV incidence with a modelled expected incidence in the study population in the absence of intervention, using data collected at the same time from FSW clients. Results The 321 HIV-uninfected FSW enrolled in the cohort completed 409 person-years of follow-up. No participant seroconverted for HIV during the study (0/409 person-years), whereas the expected modelled number of HIV infections were 5.05/409 person-years (95% CI, 5.01–5.08) or 1.23 infections per 100 person-years (p=0.005). This null incidence was related to a reduction in the number of regular partners and regular clients, and by an increase in consistent condom use with casual clients (adjusted odds ratio (aOR)=2.19; 95% CI, 1.16–4.14, p=0.01) and with regular clients (aOR=2.18; 95% CI, 1.26–3.76, p=0.005). Conclusions Combining peer-based prevention and care within the same setting markedly reduced the HIV incidence among young FSW in Burkina Faso, through reduced risky behaviours. PMID:26374604
Listening to Chinese Immigrant Restaurant Workers in the Midwest: Application of the Culture-Centered Approach (CCA) to Explore Perceptions of Health and Health Care.
Gao, Haijuan; Dutta, Mohan; Okoror, Titilayo
This study engages with the culture-centered approach (CCA) to explore Chinese immigrant restaurant workers' perception of the U.S. health care system and their interactions with the health care system in interpreting meanings of health. Chinese restaurant workers are marginalized because of their struggles on the job, their immigrant identity, and their negotiations with the structural contexts of occupation, migration status, and culture. In-depth interviews were conducted with 18 Chinese immigrant restaurant workers that lasted an average of 1.5 hours each, and were audiotaped. Interviews with participants highlighted critical issues in access to health care and the struggles experienced by restaurant workers in securing access to health, understood in the context of work. Critical to the workers' discourse is the acknowledgment of structural constraints such as lack of insurance coverage, immigration status, and lack of understanding of how the U.S. health care system works. PMID:26575110
Elder Care, Multiple Role Involvement, and Well-Being Among Middle-Aged Men and Women in Japan.
Kikuzawa, Saeko
Japan's population is aging at an unprecedented rate. Combined with the tradition of family responsibility for elder care, this rapid population aging has resulted in middle-aged Japanese people being much more likely today than in past decades to face the responsibility of caring for their elderly parents alongside their other major roles. Using nationally representative Japanese data, this study assessed the individual and combined implications of caregiving and other role involvements for the well-being of middle-aged men and women. Some evidence was found for deleterious psychological consequences of the caregiver role. However, in contrast to expectations, the interaction between the roles of caregiver and worker was positively associated with well-being among both men and women. The results suggest the importance of middle-aged adults being able to keep working when they have to care for their aging parents. Another important finding was significant gender differences in the psychological consequences of holding multiple family- and work-related roles and in combining these with the caregiver role. Further analysis showed that the spousal role was also negatively associated with depressive symptoms and positively associated with satisfaction for men but not for women. Gender differences in the findings appear to reflect the significant gender asymmetry in role experiences in Japan. PMID:26467034
Aging and its modulation in a long-lived worker caste of the honey bee.
Münch, Daniel; Kreibich, Claus D; Amdam, Gro V
Highly social animals provide alternative aging models in which vastly different lifespan patterns are flexible, and linked to social caste. Research in these species aims to reveal how environment, including social cues, can shape the transition between short-lived and extremely long-lived phenotypes with negligible senescence. Among honey bee workers, short to intermediate lifespans are typical for summer castes, while the winter caste can live up to 10 times longer. For summer castes, experimental interventions could predictably accelerate, slow or revert functional senescence. In contrast, little is known about the partic ular conditions under which periods of negligible senescence in winter castes can be disrupted or sustained. We asked how manipulation of social environment in colonies with long-lived winter bees might alter the pace of functional senescence, measured as learning performance, as well as of cellular senescence, measured as lipofuscin accumulation. We show that behavioral senescence becomes rapidly detectable when the winter state is disrupted, and changes in social task behaviors and social environment (brood) are induced. Likewise, we found that cellular senescence was induced by such social intervention. However, cellular senescence showed marked regional differences, suggesting that particular brain regions age slower than others. Finally, by preventing post-winter colonies from brood rearing, behavioral senescence became undetectable, even after transition to the usually short-lived phenotypes had occurred. We envision that social regulation of negligible functional senescence and highly dynamic accumulation of a universal symptom of cellular aging (lipofuscin) offers rewarding perspectives to target proximate mechanisms of slowed aging. PMID:23596282
Planning Manual for School-Age Child Care in New Mexico.
ERIC Educational Resources Information Center
Rainhart, Dolly
This manual was designed to assist concerned individuals and organizations within communities in New Mexico to develop and plan effective school-age child care programs. Emphasized are the first steps in initiating and implementing school-age child care in a community. Chapter I discusses the need for school-age child care programs and the…
Determinants of "return to work in good health" among workers with back pain who consult in primary care settings: a 2-year prospective study
Bourbonnais, Renée; Frémont, Pierre; Rossignol, Michel; Stock, Susan R.; Nouwen, Arie; Larocque, Isabelle; Demers, Eric
Many factors have been linked to return to work after a back pain episode, but our understanding of this phenomenon is limited and cross-sectional dichotomous indices of return to work are not valid measures of this construct. To describe the course of "return to work in good health" (RWGH—a composite index of back pain outcome) among workers who consulted in primary care settings for back pain and identify its determinants, a 2-year prospective study was conducted. Subjects (n = 1,007, 68.4%) were workers who consulted in primary care settings of the Quebec City area for a nonspecific back pain. They completed five telephone interviews over 2 years (follow-up = 86%). Analyses linking baseline variables with 2-year outcome were conducted with polytomous logistic regression. The proportion of "success" in RWGH increased from 18% at 6 weeks to 57% at 2 years. In women, persistent pain, pain radiating to extremities, increasing job seniority, not having a unionized job, feeling that the physician did listen carefully and increasing fear-avoidance beliefs towards work and activity were determinants of "failure" in RWGH. In men, decreasing age, cigarette smoking, poor self-reported health status, pain in the thoracic area, previous back surgeries, a non-compensated injury, high pain levels, belief that job is below qualifications, likelihood of losing job, job status, satisfaction with health services and fear-avoidance beliefs towards work were all significant. RWGH among workers with back pain receives multiple influences, especially among men. In both genders, however, fear-avoidance beliefs about work are associated with failure and high self-efficacy is associated with success. PMID:16868783
Where Caring Is Sharing: Evolving Ethical Considerations in Tuberculosis Prevention Among Healthcare Workers.
Boulanger, Renaud F; Hunt, Matthew R; Benatar, Solomon R
In many settings, the dedication of healthcare workers (HCWs) to the treatment of tuberculosis exposes them to serious risks. Current ethical considerations related to tuberculosis prevention in HCWs involve the threat posed by comorbidities, issues of power and space, the implications of intersectoral collaborations, (de)professionalization, just remuneration, the duty to care, and involvement in research. Emerging ethical considerations include mandatory vaccination and the use of geolocalization services and information technologies. The following exploration of these various ethical considerations demonstrates that the language of ethics can fruitfully be deployed to shed new light on policies that have repercussions on the lives of HCWs in underresourced settings. The language of ethics can help responsible parties get a clearer sense of what they owe HCWs, particularly when these individuals are poorly compensated, and it shows that it is essential that HCWs' contribution be acknowledged through a shared commitment to alleviate ethically problematic aspects of the environments within which they provide care. For this reason, there is a strong case for the community of bioethicists to continue to take greater interest both in the micro-level (eg, patient-provider interactions) and macro-level (eg, injustices that occur as a result of the world order) issues that put HCWs working in areas with high tuberculosis prevalence in ethically untenable positions. Ultimately, appropriate responses to the various ethical considerations explored here must vary based on the setting, but, as this article shows, they require thoughtful reflection and courageous action on the part of governments, policy makers, and managers responsible for national responses to the tuberculosis epidemic. PMID:27118857
Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study
Kruse, Gina R; Chapula, Bushimbwa Tambatamba; Ikeda, Scott; Nkhoma, Mavis; Quiterio, Nicole; Pankratz, Debra; Mataka, Kaluba; Chi, Benjamin H; Bond, Virginia; Reid, Stewart E
Background Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results Some 483 active clinical staff completed the questionnaire (84% response rate), 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2–1.6) and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3–2.2). Reasons for co-worker attrition included: better pay (40%), feeling overworked or stressed (21%), moving away (16%), death (8%) and illness (5%). When asked about HIV testing, 370 of 456 (81%) reported having tested; 240 (50%) tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability. PMID:19594917
Latex allergy and occupational asthma in health care workers: adverse outcomes.
Amr, Sania; Suk, William A
The prevalence of natural rubber latex (NRL) allergy has been estimated to be 5-18% in health care workers, and latex exposure has been one of the leading causes of occupational asthma in the last several years. We present the cases of two nurses who developed sensitivity to NRL, both with dermatologic symptoms and respiratory symptoms that included asthma. They were referred to the University of Maryland for evaluation of their allergies, then for occupational and environmental consults. The patients' allergy to NRL was confirmed on the basis of clinical history, a positive skin test to latex, and the presence of latex-specific immunoglobulin E (IgE) serology by radioallergosorbent test (RAST). Both patients worked in the same community hospital for approximately 20 years; one was an endoscopy nurse and the other worked in the emergency department. Following the diagnosis of allergy to latex, both patients avoided direct skin contact with latex, but they continued to work in the same respective environments, where powdered latex gloves and other potentially sensitizing chemicals were used. Instead of improving, the clinical condition of the patients worsened and they remained symptomatic, even after they were removed from their workplace. Their airways reacted to low levels of a variety of sensitizers and irritants in the environment, and they became depressed. Both nurses were referred for vocational rehabilitation. PMID:14998756
Stigma in HIV-infected health care workers in Kenya: a mixed-method approach.
Opollo, Jackline G; Gray, Jennifer
HIV-related stigma decreases access to HIV testing, prevention, and treatment services. Our mixed methods study explored stigma as perceived, experienced, and managed in a sample of 76 HIV-infected health care workers in Kisumu, Kenya. Stigma was quantitatively measured using the HIV/AIDS Stigma Instrument for People Living with AIDS (HASI-P). Overall, subjects experienced low stigma levels (mean = 7.88, SD = 12.90; range = 0-61), and none of the sociodemographic variables were predictive of stigma. Transcript analysis of 20 qualitative interviews revealed two negative themes (blame, lack of knowledge) and five positive themes (living positively, optimism, empathy, support, changes over time). Three themes emerged on reducing stigma (normalizing, empowerment, leading by example). Disclosure, access to treatment, stigma reduction training, workplace support groups, and awareness of an HIV workplace policy may have contributed to low stigma scores. Qualitative findings corroborated quantitative findings and corresponded to the six domains of the HASI-P. PMID:25769752
Health care workers' knowledge, attitudes and practices on tobacco use in economically disadvantaged dominican republic communities.
Prucha, Michael G; Fisher, Susan G; McIntosh, Scott; Grable, John C; Holderness, Heather; Thevenet-Morrison, Kelly; de Monegro, Zahíra Quiñones; Sánchez, José Javier; Bautista, Arisleyda; Díaz, Sergio; Ossip, Deborah J
Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR. PMID:25872018
Clinical treatment adherence of health care workers and students exposed to potentially infectious biological material.
Almeida, Maria Cristina Mendes de; Canini, Silvia Rita Marin da Silva; Reis, Renata Karina; Toffano, Silmara Elaine Malaguti; Pereira, Fernanda Maria Vieira; Gir, Elucir
OBJECTIVE To assess adherence to clinical appointments by health care workers (HCW) and students who suffered accidents with potentially infectious biological material. METHOD A retrospective cross-sectional study that assessed clinical records of accidents involving biological material between 2005 and 2010 in a specialized unit. RESULTS A total of 461 individuals exposed to biological material were treated, of which 389 (84.4%) were HCWs and 72 (15.6%) students. Of the 461 exposed individuals, 307 (66.6%) attended a follow-up appointment. Individuals who had suffered an accident with a known source patient were 29 times more likely to show up to their scheduled follow-up appointments (OR: 29.98; CI95%: 16.09-55.83). CONCLUSION The predictor in both univariate and multivariate analyses for adherence to clinical follow-up appointment was having a known source patient with nonreactive serology for the human immunodeficiency virus and/or hepatitis B and C. PMID:25992825
Factors Associated with Acceptability of HIV Self-Testing Among Health Care Workers in Kenya
Kalibala, Samuel; Tun, Waimar; Cherutich, Peter; Nganga, Anne; Oweya, Erick; Oluoch, Patricia
Health care workers (HCWs) in sub-Saharan Africa are at a high risk of HIV infection from both sexual and occupational exposures. However, many do not seek HIV testing. This paper examines the acceptability of an unsupervised facility-based HIV self-testing (HIV-ST) intervention among HCWs and their partners and factors associated with uptake of HIVST among HCWs. HCWs in seven large Kenyan hospitals were invited to participate in pre-HIVST information sessions during which they were offered HIVST kits to take home for self-testing. A post-intervention survey was conducted among 765 HCWs. Forty-one percent attended the information session; of those, 89 % took the HIVST kits and of those, 85 % self-tested. Thirty-four percent of surveyed HCWs used the HIVST to test themselves. Of those who took the HIVST kit and had partners, 73 % gave the kit to their partner and 86 % of them indicated their partner self-tested. Factors positively associated with use of the HIVST on self were being female, being single, and being a HCW from Homa Bay Hospital (located in a high HIV prevalence area). HIVST is acceptable to HCWs and their partners. However, strategies are needed to increase HCWs attendance at pre-implementation information sessions. PMID:24974123
[Empowering leadership style among health care workers. A study on the nurse manager].
Bobbio, A; Manganelli Rattazzi, A M; Muraro, M
The aim of the study is to supply a contribution to the validity analysis of the Empowering Leadership Questionnaire (ELQ) in the Italian context. The ELQ has been developed in order to measure empowering leadership style in organizational contexts and, in the present work, has been administered to a group of health care workers in order to evaluate the Nurse Manager's leadership style. Three hundred and eleven individuals from an important Local Health Unit of the Veneto Region participated in the study, filling out a self-administered structured questionnaires. Correlations between ELQ, task-oriented, relationship-oriented and transformational leadership stile are addressed. Moreover, the relationships between ELQ, organizational commitment, job burnout, turnover intentions and job satisfaction are analyzed. Exploratory, confirmatory, reliability analyses and path analyses techniques are applied. Results support the main results obtained by the authors of the scale. In addition, with regards to ELQ predictive validity, the selected dependent variables (turnover intentions and job satisfaction) are significantly influenced by some of the ELQ dimensions, via the mediation of affective commitment and job burnout, supporting the value of the ELQ measures in the healthcare context. PMID:17650741
Quality of advance care planning policy and practice in residential aged care facilities in Australia
Silvester, William; Fullam, Rachael S; Parslow, Ruth A; Lewis, Virginia J; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Gilchrist, Jane
Objectives To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. Design Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. Setting 19 selected RACFs in Victoria. Participants 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. Results Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and procedures for ACP; however, none of the ACP-related documents submitted covered all information required to meet ACP best practice. Surveyed staff had limited experience of ACP, and discrepancies between self reported comfort, and levels of knowledge and confidence to undertake ACP-related activities, indicated a need for training and ongoing organisational support. Conclusions Surveyed organisations â policies and procedures related to ACP were limited and the quality of existing documentation was poor. RACF staff had relatively limited experience in developing advance care plans with facility residents, although attitudes were positive. A systematic approach to the implementation of ACP in residential aged care settings is required to ensure best practice is implemented and sustained. PMID:24644755
Health care workers' mobile phones: a potential cause of microbial cross-contamination between hospitals and community.
Ustun, Cemal; Cihangiroglu, Mustafa
This study evaluated the microbial contamination of health care workers' (HCWs) mobile phones. The study was conducted at a secondary referral hospital in July 2010. Samples were taken from all surfaces of the mobile phones using a sterile swab, and incubated on Brain Heart Infusion agar at 37.5°C for 24 hr. Any isolated microorganisms were grown aerobically on 5% sheep blood agar and eosin methylene-blue agar medium at 37.5°C for 24-48 hr. The Sceptor microdilution system was used to identify the microorganisms, together with conventional methods. The oxacillin disc diffusion test and double-disc synergy test were used to identify methicillin-resistant Staphylococcus aureus (MRSA) and expanded-spectrum beta-lactamase (ESBL)-producing Gram-negative bacilli, respectively. The mobile phones were also categorized according to whether the HCWs used them in the intensive care unit (ICU). Overall, 183 mobile phones were screened: 94 (51.4%) from nurses, 32 (17.5%) from laboratory workers, and 57 (31.1%) from health care staff. In total, 179 (97.8%) culture-positive specimens were isolated from the 183 mobile phones, including 17 (9.5%) MRSA and 20 (11.2%) ESBL-producing Escherichia coli, which can cause nosocomial infections. No statistical difference was observed in the recovery of MRSA (p = 0.3) and ESBL-producing E. coli (p = 0.6) between the HCW groups. Forty-four (24.6%) of the 179 specimens were isolated from mobile phones of ICU workers, including two MRSA and nine ESBL-producing E. coli. A significant (p = 0.02) difference was detected in the isolation of ESBL-producing E. coli between ICU workers and non-ICU workers. HCWs' mobile phones are potential vectors for transferring nosocomial pathogens between HCWs, patients, and the community. PMID:22793671
Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada
Socías, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate
Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers' experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers' Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). Results In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10–1.94), workplace- (AOR = 1.31, 95% CI 1.05–1.63), and community-level violence (AOR = 1.41, 95% CI 1.04–1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03–1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34–2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59–7.57) emerged as independent correlates of institutional barriers to health services. Discussion Despite Canada's UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care
The job satisfaction and burnout levels of primary care health workers in the province of Malatya in Turkey
Cagan, Ozlem; Gunay, Osman
Objective: The objective was to determine the job satisfaction and burnout levels of primary care health workers in Malatya in Turkey. Methods: The sample of the study included 186 physicians, 126 midwives and 106 nurses working in primary health care. The Minnesota Job Satisfaction Scale and the Maslach Burnout Scale were used in the study. Results: The general, internal and external job satisfaction score medians of the study group were 3.35, 3.50 and 3.12 respectively, while the median of the Maslach Personal accomplishment score was 23.00, the Emotional Burnout score median was 15.00, and the Depersonalisation score median was found to be 3.00. Conclusions: The manner of their employment in the departments where they work, their perception of their economic circumstances and their satisfaction of the department where they work have an impact on the job satisfaction and burnout levels of workers. PMID:26150840
Sexual and reproductive health needs of HIV-positive women in Botswana - a study of health care worker's views.
Schaan, Michelle M; Taylor, Myra; Puvimanasinghe, John; Busang, Lesego; Keapoletswe, Koona; Marlink, Richard
Botswana's HIV prevalence is one of the highest in the world at 31.8% in the 15-49 years antenatal population. Being HIV-positive for a woman presents unique challenges with regard to sexuality, child bearing, and partner relations. To ensure optimal sexual and reproductive health (SRH) of HIV-positive women, it is important to understand how health care workers (HCWs) are prepared to address SRH issues such as contraception, fertility desires, and partner violence. This study reports on a knowledge, attitudes, and practices (KAP) questionnaire completed by 98 HCWs from clinics located in and nearby Gaborone and analyzed using descriptive and nonparametric statistics. The majority of participants were nurses (43%), health educators (27%), and lay counselors (19%), 82% female, median age of 35 (Interquartile Range (IQR): 29.25-43.75). General HIV/AIDS knowledge was high with a median score of 8.0/9 (89%) (IQR: 8-9). However, the median SRH knowledge score was much lower at 6.0/10 (60%) (IQR: 4-7). Of the three groups, the SRH knowledge scores of lay counselors were significantly lower than nurses (p=0.024). The attitude scores pertaining to issues such as family planning, sexual violence, the health system's ability to offer SRH services, and personal ability to offer SRH services were moderately positive with a median score of 75% (IQR: 69-81%); although nearly 25% of respondents felt that it is irresponsible for an HIV-positive woman to want to have a child. When presented with a case study of an abused, HIV-positive pregnant woman, most respondents indicated they would offer supportive care without judgment; however 28% of respondents indicated they would express disapproval or disappointment for becoming pregnant when she knows she is HIV-positive. The low SRH knowledge scores together with discriminatory attitudes and practices emphasize the need for increased and ongoing training in SRH issues for all HCWs who provide care for HIV-positive women. PMID:22568549
[Scarcity in health care, age as selection criterion and the value of old age. Current discussion].
Naafs, J
There is a growing attention for setting limits in health care. Contemporary medical scarcity makes choices necessary, but what are the arguments? Only medical criteria for selection are accepted in the Netherlands, but that does not mean at all that age is an unimportant criterion. In this article the discussion on age as criterion for selection is reviewed. It seems that arguments are based on different basic (moral) assumptions and that age and aging can be appreciated from different points of view. There is among other things the principle of justice and the idea of a natural life-span (Daniels), the norm of a worthwhile life-time (the fair-innings argument of Harris) and the idea of old age as a period of its own (Callahan). The different starting points can lead to the same way of thinking about age as a criterion for selection. Daniels, Harris, and Callahan justify this kind of selection. The Dunning-committee however does not accept it, from the point of a fundamental equality of people, the protection of life and the principle of solidarity in our society. It seems that not only the different arguments lead towards different conclusions but also the different views on the value of old age by different groups or by society as a whole. PMID:8328008
Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review
Mwai, Grace W; Mburu, Gitau; Torpey, Kwasi; Frost, Peter; Ford, Nathan; Seeley, Janet
Introduction The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). Methodology A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the following databases: PubMed, PsychINFO, Embase, Web of Science, JSTOR, WHOLIS, Google Scholar and SAGE journals online. Bibliographies of included articles were also searched. A narrative synthesis approach was used to analyze common emerging themes on the role and outcomes of CHWs in HIV care in sub-Saharan Africa. Results In total, 21 studies met the inclusion criteria, documenting a range of tasks performed by CHWs. These included patient support (counselling, home-based care, education, adherence support and livelihood support) and health service support (screening, referral and health service organization and surveillance). CHWs were reported to enhance the reach, uptake and quality of HIV services, as well as the dignity, quality of life and retention in care of people living with HIV. The presence of CHWs in clinics was reported to reduce waiting times, streamline patient flow and reduce the workload of health workers. Clinical outcomes appeared not to be compromised, with no differences in virologic failure and mortality comparing patients under community-based and those under facility-based care. Despite these benefits, CHWs faced challenges related to lack of recognition, remuneration and involvement in decision making. Conclusions CHWs can clearly contribute to HIV services delivery and strengthen human resource capacity in sub-Saharan Africa. For their contribution to be sustained, CHWs need to be recognized, remunerated and integrated in wider health systems. Further
Perspectives of Parents and Health Care Workers on Early Infant Male Circumcision Conducted Using Devices: Qualitative Findings From Harare, Zimbabwe
Mavhu, Webster; Hatzold, Karin; Ncube, Getrude; Fernando, Shamiso; Mangenah, Collin; Chatora, Kumbirai; Mugurungi, Owen; Ticklay, Ismail; Cowan, Frances M
ABSTRACT Background: The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend early infant male circumcision (EIMC) for prevention of HIV. Here, we present findings from a qualitative study in Zimbabwe that assessed parental and health care workers' perspectives of EIMC conducted using devices. Methods: This qualitative study was nested within a trial of EIMC devices. Between January and May 2013, we held 4 focus group discussions (FGDs) and 12 in-depth interviews with parents and 12 in-depth interviews with clinicians (7 trial clinicians and 5 non-trial clinicians). We also conducted 95 short telephone interviews with parents who had arranged to bring their sons for EIMC but then defaulted. Results: Parents who had adopted EIMC spoke of their initial anxieties about the procedure. Additionally, they commented on both the procedure and outcome. Parents who decided against EIMC cited fear of harm, specifically the infant's death, penile injury, and excessive pain. Misperceptions about male circumcision in general and EIMC specifically were a significant barrier to EIMC adoption and were prevalent among health care workers as well as parents. In particular, the findings suggest strong parental concerns about the fate of the discarded foreskin. Parents who chose EIMC for their newborn sons felt that the procedure was safe and expressed satisfaction with the outcome. For their part, health care workers largely thought that EIMC was safe and that the outcome was aesthetically pleasing. They also felt that it would be feasible to offer wide-scale EIMC for HIV prevention in the public sector; they recommended strategies to increase EIMC uptake, in addition to highlighting a few concerns. Conclusions: The qualitative study enables us to better understand parental and health care workers' perspectives of EIMC conducted using devices, especially their perspectives on EIMC safety, feasibility, acceptability, and barriers. These findings
Identification of nasal colonization with β-lactamase-producing Enterobacteriaceae in patients, health care workers and students in Madagascar
Micheel, Volker; Hogan, Benedikt; Rakotoarivelo, Rivo Andry; Rakotozandrindrainy, Raphael; Razafimanatsoa, Fetra; Razafindrabe, Tsiriniaina; Rakotondrainiarivelo, Jean Philibert; Crusius, Sabine; Poppert, Sven; Schwarz, Norbert Georg; May, Jürgen; Hagen, Ralf Matthias
This study assesses the nasal occurrence of β-lactamase-producing Enterobacteriaceae both in patients in a hospital department of infectious diseases at admission and in healthy Madagascan students and health care workers. Nasal swabs from 681 students, 824 health care workers, and 169 patients were obtained in Antananarivo, Madagascar, and transferred to Germany. Screening for β-lactamase (ESBL, ampC) producing Enterobacteriaceae was performed by cultural and molecular approaches, comprising Brilliance ESBL agar, E-testing, ABCD-testing, and commercial hyplex ESBL and SuperBug ID PCR. Regarding ESBL-positive strains and strains with resistance against at least three out of the four tested bactericidal antibiotic drugs, 0.3% (five out of 1541) of the students and health care workers group showed nasal colonization, whereas colonization was observed in 7.1% (12 out of 169) of the hospitalized patients at admission. No appreciably reduced detection rates after sample storage and intercontinental transport were observed. A considerable proportion of nasal colonization with cephalosporin-resistant Enterobacteriaceae was demonstrated in Madagascan hospital patients at admission, posing a risk of developing future endogenous infections. The nasal colonization of healthy individuals was negligible. Good storage and transport stability of Enterobacteriaceae will allow for future studies even in areas difficult to access. PMID:25908994
Identification of nasal colonization with β-lactamase-producing Enterobacteriaceae in patients, health care workers and students in Madagascar.
Micheel, Volker; Hogan, Benedikt; Rakotoarivelo, Rivo Andry; Rakotozandrindrainy, Raphael; Razafimanatsoa, Fetra; Razafindrabe, Tsiriniaina; Rakotondrainiarivelo, Jean Philibert; Crusius, Sabine; Poppert, Sven; Schwarz, Norbert Georg; May, Jürgen; Frickmann, Hagen; Hagen, Ralf Matthias
This study assesses the nasal occurrence of β-lactamase-producing Enterobacteriaceae both in patients in a hospital department of infectious diseases at admission and in healthy Madagascan students and health care workers. Nasal swabs from 681 students, 824 health care workers, and 169 patients were obtained in Antananarivo, Madagascar, and transferred to Germany. Screening for β-lactamase (ESBL, ampC) producing Enterobacteriaceae was performed by cultural and molecular approaches, comprising Brilliance ESBL agar, E-testing, ABCD-testing, and commercial hyplex ESBL and SuperBug ID PCR. Regarding ESBL-positive strains and strains with resistance against at least three out of the four tested bactericidal antibiotic drugs, 0.3% (five out of 1541) of the students and health care workers group showed nasal colonization, whereas colonization was observed in 7.1% (12 out of 169) of the hospitalized patients at admission. No appreciably reduced detection rates after sample storage and intercontinental transport were observed. A considerable proportion of nasal colonization with cephalosporin-resistant Enterobacteriaceae was demonstrated in Madagascan hospital patients at admission, posing a risk of developing future endogenous infections. The nasal colonization of healthy individuals was negligible. Good storage and transport stability of Enterobacteriaceae will allow for future studies even in areas difficult to access. PMID:25908994
A paired comparison of tuberculin skin test results in health care workers using 5 TU and 10 TU tuberculin
Stuart, R.; Bennett, N.; Forbes, A.; Grayson, M
BACKGROUND—Historically, 10 TU has been employed in Australia and the United Kingdom to perform the tuberculin skin test (TST). However, this makes it difficult to compare the rates of TST positivity with other countries such as the USA who use 5 TU. To assess the impact of the dose of tuberculin on the TST a comparison was made of TST responses in health care workers given a TST with both 5 and 10 TU. METHODS—Two TSTs were performed simultaneously in each health care worker using 5 and 10 TU. Each dose was randomly assigned in a blinded manner to the right or left forearm and read at 48-72 hours by a single nurse who was blinded to the assignment of the 5 and 10 TU doses. RESULTS—A total of 128 health care workers were enrolled, 119 (93%) of whom had a past history of BCG vaccination. The overall mean difference in paired reaction sizes for the two doses was 1.5 mm with 95% limits of agreement of -3.6 to 6.5 mm. CONCLUSION—A slightly larger TST reading was seen with 10 TU than with 5 TU. The mean difference of 1.5 mm between the two doses should be considered when comparing rates of TST positivity between countries who use different doses of tuberculin to perform the tuberculin skin test. PMID:10899248
The Role of Social Workers in Spiritual Care to Facilitate Coping With Chronic Illness and Self-Determination in Advance Care Planning.
Francoeur, Richard B; Burke, Nancy; Wilson, Alicia M
Spiritual values and beliefs of patients and families influence resilience during chronic illness and shape patient choices during advance care planning. The spiritual needs of Baby Boomers will be more diverse than previous generations, in connection with the questioning, experimental mind-set of this group and the fact that it includes a higher proportion of immigrant populations outside the Judeo-Christian tradition. Social workers are trained explicitly to intervene with diverse populations and are well positioned to offer spiritual support in ways that do not necessarily conform to traditional religions. To the extent of their individual expertise and competence, social workers should assess and provide spiritual care to clients, including those who either are underserved or prefer not to seek assistance from clergy or chaplains because they feel alienated from religious institutions and representatives. They should also be aware of ethical dilemmas in consulting with spiritual care professionals in developing spiritual interventions. Social work education should address clients' humanistic and existential concerns, beliefs and behaviors of the major religions, and forms of nontraditional religious and spiritual experiences; it should also provide experiential opportunities for engaging with grief and earlier advance care planning. There should be attention to different theodical perspectives of the major religions regarding the problem of good and evil, which may preoccupy even clients who no longer participate in organized religion, because these unresolved existential issues may weaken client coping with chronic conditions and may diminish clarity and self-awareness for engaging authentically and effectively in advance care planning. PMID:27187806
A critique of using age to ration health care.
Hunt, R W
Daniel Callahan has argued that economic and social benefits would result from a policy of withholding medical treatments which prolong life in persons over a certain age. He claims 'the real goal of medicine' is to conquer death and prolong life with the use of technology, regardless of the age and quality of life of the patient, and this has been responsible for the escalation of health care expenditure. Callahan's proposal is based on economic rationalism but there is little evidence to suggest that substantial economic savings could be achieved. Moreover, his argument raises serious moral objections. A policy of withholding treatments from members of a social group involves elements of compulsion and discrimination, both of which would intrude on the doctor-patient relationship, undermine the autonomy of elderly patients, and invoke the slippery slope towards involuntary forms of euthanasia. Life-death decisions should be based on more than the one criterion of age, and take account of more relevant factors such as the patient's usual state of well-being, her/his expressed wishes, informed consent and the type of illness. Any move to the implementation and enforcement of the policy Callahan recommends would be rejected by health professionals and the public. PMID:8459434
Gaps in the hepatitis C continuum of care among sex workers in Vancouver, British Columbia: Implications for voluntary hepatitis C virus testing, treatment and care
Socías, M Eugenia; Shannon, Kate; Montaner, Julio S; Guillemi, Silvia; Dobrer, Sabina; Nguyen, Paul; Goldenberg, Shira; Deering, Kathleen
BACKGROUND: Hepatitis C virus (HCV) eradication leads to reduced morbidity, mortality and transmission. Despite the disproportionate burden of HCV among sex workers, data regarding the HCV care continuum in this population remain negligible. METHODS: Using baseline data from an ongoing cohort of women sex workers in Vancouver (An Evaluation of Sex Workers' Health Access, January 2010 to August 2013), the authors assessed HCV prevalence and engagement in the HCV care continuum within the past year. Multivariable logistic regression analyses were used to evaluate associations with recent (ie, in the past year) HCV testing. RESULTS: Among 705 sex workers, 302 (42.8%) were HCV seropositive. Of these, 22.5% were previously unaware of their HCV status, 41.7% had accessed HCV-related care, 13.9% were offered treatment and only 1.0% received treatment. Among 552 HCV-seronegative sex workers, only one-half (52.9%) reported a recent HCV test. In multivariable analysis, women who self-identified as a sexual/gender minority (adjusted OR [aOR] 1.89 [95% CI 1.11 to 3.24]), resided in the inner city drug use epicentre (aOR 3.19 [95%CI 1.78 to 5.73]) and used injection (aOR 2.00 [95% CI 1.19 to 3.34]) or noninjection drugs (aOR 1.95 [95% CI 1.00 to 3.78]) had increased odds of undergoing a recent HCV test, while immigrant participants (aOR 0.24 [95% CI 0.12 to 0.48]) had decreased odds. CONCLUSIONS: Despite a high burden of HCV among sex workers, large gaps in the HCV care continuum remain. Particularly concerning are the low access to HCV testing, with one-fifth of women living with HCV being previously unaware of their status, and the exceptionally low prevalence of HCV treatment. There is a critical need for further research to better understand and address barriers to engage in the HCV continuum for sex workers. PMID:26492129
The Evaluation of Existing Federal Interagency Day Care Requirements: Day Care for the School-Age Child.
ERIC Educational Resources Information Center
Bergstrom, Joan M.; Dreher, Donna L.
As part of an evaluation of the existing Federal Interagency Day Care Requirements (FIDCR), this paper reviews the current regulations and presents recommendations for modifications in the requirements as they relate to group or family day care services for school age children from 5 to 14 years of age. The paper is divided into five major…
Health, fitness, physical activity, and morbidity of middle aged male factory workers. I.
Tuxworth, W; Nevill, A M; White, C; Jenkins, C
A description of the fitness, physical activity of lifestyle, and some aspects of health status and attitudes in a population of male factory workers aged 35-60 is presented as the first part of a report on a study of morbidity in this population. A total of 1394 subjects were included, undergoing medical examination, fitness testing by bicycle ergometry, assessment of body fat, and interview questionnaire. The inter-relation of fitness, body composition, habitual exertion, health risk factors, and attitudes to exercise are discussed. Fitness levels are compared with those reported in other studies and discussed in terms of capacity for walking and running and in relation to criteria for health benefit. In these two latter respects fitness appears to be inadequate among the great majority of those tested, although it is comparable with that reported by several other recent studies. Fitness is associated with physical activity of leisure but not that of work. Only relatively strenuous physical activity in leisure time appears to be related to fitness, and is only participated in by some 28% of the sample. Cycling has the strongest association with fitness of all the physical activity variables. Blood pressure and percentage body fat are also associated, inversely, with fitness, the latter not unexpectedly because of the weight related measure of fitness. PMID:3790455
Assessment of the Center for Epidemiological Studies Depression Scale factor structure among middle-aged workers in Japan.
Sugawara, Norio; Yasui-Furukori, Norio; Sasaki, Giro; Umeda, Takashi; Takahashi, Ippei; Danjo, Kazuma; Matsuzaka, Masashi; Kaneko, Sunao; Nakaji, Shigeyuki
Our aim was to assess the internal consistency and structural/construct validity of the Center for Epidemiological Studies Depression Scale among middle-aged employees in Japan. We conducted a cross-sectional study of 7284 workers, aged 49.0 ± 6.3 (mean ± SD) years old. Structural/construct validity was assessed by confirmatory factor analysis. The 4-factor structure reported in the general population was replicated, and a second-order model with an overarching depression factor fitted well. These findings indicate that the Center for Epidemiological Studies Depression Scale is a valid and reliable measure of depressive symptoms for middle-aged workers in Japan. PMID:21265946
What Qualities Are Valued in Residential Direct Care Workers from the Perspective of People with an Intellectual Disability and Managers of Accommodation Services?
ERIC Educational Resources Information Center
Dodevska, G. A.; Vassos, M. V.
Background: To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a "good" direct care…
Increased EMRSA-15 health-care worker colonization demonstrated in retrospective review of EMRSA hospital outbreaks
Background Health care worker (HCW) colonization with methicillin resistant Staphylococcus aureus (MRSA) is a documented cause of hospital outbreaks and contributes to ongoing transmission. At Royal Perth Hospital (RPH) it had been anecdotally noted that the increasing prevalence of EMRSA-15 appeared to be associated with increased HCW colonization compared with Aus2/3-EMRSA. Hence we compared HCW colonization rates during outbreaks of EMRSA-15 and Aus2/3-EMRSA at a single institution. Methods We performed a retrospective review of EMRSA-15 and Aus2/3-EMRSA outbreaks from 2000–2009 at RPH, a quaternary hospital in Western Australia. Outbreak files were reviewed and relevant data extracted. Results Ten EMRSA-15 outbreaks were compared with seven Aus2/3 outbreaks. The number of patients colonized was similar between EMRSA-15 and Aus2/3-EMRSA outbreaks (median 7 [range 3–20] and 11 [5–26], respectively; P = 0.07) but the number of HCWs colonized was significantly higher in EMRSA-15 outbreaks compared to Aus2/3-EMRSA outbreaks (median 4 [range 0–15] and 2 [1-3], respectively; P = 0.013). The percentage of HCWs colonized was also higher in EMRSA-15 outbreaks versus Aus2/3-EMRSA outbreaks (median 3.4% [range 0–5.5%] and 0.81% [0.56–2.2%], respectively; P = 0.013). Conclusions This study demonstrates a higher level of HCW colonization during EMRSA-15 outbreaks compared with Aus2/3-EMRSA outbreaks. This finding suggests that MRSA vary in their ability to colonize HCWs and contribute to outbreaks. MRSA type should be determined during outbreaks and future research should investigate the mechanisms by which EMRSA-15 contributes to increased HCW colonization. PMID:24588849
Ethical analyses of institutional measures to increase health care worker influenza vaccination rates.
Zimmerman, Richard K
Health care worker (HCW) influenza vaccination rates are modest. This paper provides a detailed ethical analysis of the major options to increase HCW vaccination rates, comparing how major ethical theories would address the options. The main categories of interventions to raise rates include education, incentives, easy access, competition with rewards, assessment and feedback, declination, mandates with alternative infection control measures, and mandates with administrative action as consequences. The aforementioned interventions, except mandates, arouse little ethical controversy. However, these efforts are time and work intensive and rarely achieve vaccination rates higher than about 70%. The primary concerns voiced about mandates are loss of autonomy, injustice, lack of due process, and subsuming the individual for institutional ends. Proponents of mandates argue that they are ethical based on beneficence, non-maleficence, and duty. A number of professional associations support mandates. Arguments by analogy can be made by mandates for HCW vaccination against other diseases. The ethical systems used in the analyses include evolutionary ethics, utilitarianism, principalism (autonomy, beneficence, non-maleficence, and justice), Kantism, and altruism. Across these systems, the most commonly preferred options are easy access, assessment and feedback, declinations, and mandates with infection control measures as consequences for non-compliance. Given the ethical imperatives of non-maleficence and beneficence, the limited success of lower intensive interventions, and the need for putting patient safety ahead of HCW convenience, mandates with additional infection control measures as consequences for non-compliance are preferred. For those who opt out of vaccination due to conscience concerns, such mandates provide a means to remain employed but not put patient safety at risk. PMID:24188752
Neglecting the Importance of the Decision Making and Care Regimes of Personal Support Workers: A Critique of Standardization of Care Planning Through the RAI/MDS
Kontos, Pia C.; Miller, Karen-Lee; Mitchell, Gail J.
Purpose: The Resident Assessment Instrument–Minimum Data Set (RAI/MDS) is an interdisciplinary standardized process that informs care plan development in nursing homes. This standardized process has failed to consistently result in individualized care planning, which may suggest problems with content and planning integrity. We examined the decision making and care practices of personal support workers (PSWs) in relation to the RAI/MDS standardized process. Design and Methods: This qualitative study utilized focus groups and semi-structured interviews with PSWs (n = 26) and supervisors (n = 9) in two nursing homes in central Canada. Results: PSWs evidenced unique occupational contributions to assessment via proximal familiarity and biographical information as well as to individualizing care by empathetically linking their own bodily experiences and forging bonds of fictive kinship with residents. These contributions were neither captured by RAI/MDS categories nor relayed to the interdisciplinary team. Causal factors for PSW exclusion included computerized records, low status, and poor interprofessional collaboration. Intraprofessional collaboration by PSWs aimed to compensate for exclusion and to individualize care. Implications: Exclusive institutional reliance on the RAI/MDS undermines quality care because it fails to capture residents' preferences and excludes input by PSWs. Recommendations include incorporating PSW knowledge in care planning and documentation and examining PSWs' nascent occupational identity and their role as interprofessional brokers in long-term care. PMID:20026525
Plasticity of the worker bumble bee brain in relation to age and rearing environment
Jones, Beryl M.; Leonard, Anne S.; Papaj, Daniel R.; Gronenberg, Wulfila
The environment experienced during development can dramatically affect the brain, with possible implications for sensory processing, learning and memory. Although the effects of single sensory modalities on brain development have been repeatedly explored, the additive or interactive effects of multiple modalities have been less thoroughly investigated. We asked how experience with multisensory stimuli affected brain development in the bumble bee, Bombus impatiens. First, to establish the timeline of brain development during early adulthood, we estimated regional brain volumes across a range of ages. We discovered significant age-related volume changes in nearly every region of the brain. Next, to determine whether these changes were dependent upon certain environmental stimuli, we manipulated the visual and olfactory stimuli available to newly emerged bumble bee workers in a factorial manner. Newly emerged bumble bees were maintained in the presence or absence of supplemental visual and/or olfactory stimuli for seven days, after which the volumes of several brain regions were estimated. We found that the volumes of the mushroom body lobes and calyces were larger in the absence of visual stimuli. Additionally, visual deprivation was associated with the expression of larger antennal lobes, the primary olfactory processing regions of the brain. In contrast, exposure to plant-derived olfactory stimuli did not have a significant effect on brain region volumes. This study is the first to explore the separate and interactive effects of visual and olfactory stimuli on bee brain development. Assessing the timing and sensitivity of brain development is a first step toward understanding how different rearing environments differentially affect regional brain volumes in this species. Our findings suggest that environmental factors experienced during the first week of adulthood can modify bumble brain development in many subtle ways. PMID:24281415
Community Health Workers to Improve Antenatal Care and PMTCT Uptake in Dar es Salaam, Tanzania: A Quantitative Performance Evaluation
Sando, David; Magesa, Lucy; Machumi, Lameck; Mungure, Esther; Mwanyika Sando, Mary; Geldsetzer, Pascal; Foster, Dawn; Kajoka, Deborah; Naburi, Helga; Ekström, Anna M.; Spiegelman, Donna; Li, Nan; Chalamilla, Guerino; Fawzi, Wafaie; Bärnighausen, Till
Background: Home visits by community health workers (CHW) could be effective in identifying pregnant women in the community before they have presented to the health system. CHW could thus improve the uptake of antenatal care (ANC), HIV testing, and prevention of mother-to-child transmission (PMTCT) services. Methods: Over a 16-month period, we carried out a quantitative evaluation of the performance of CHW in reaching women early in pregnancy and before they have attended ANC in Dar es Salaam, Tanzania. Results: As part of the intervention, 213 CHW conducted more than 45,000 home visits to about 43,000 pregnant women. More than 75% of the pregnant women identified through home visits had not yet attended ANC at the time of the first contact with a CHW and about 40% of those who had not yet attended ANC were in the first trimester of pregnancy. Over time, the number of pregnant women the CHW identified each month increased, as did the proportion of women who had not yet attended ANC. The median gestational age of pregnant women contacted for the first time by a CHW decreased steadily and significantly over time (from 21/22 to 16 weeks, P-value for test of trend <0.0001). Conclusions: A large-scale CHW intervention was effective in identifying pregnant women in their homes early in pregnancy and before they had attended ANC. The intervention thus fulfills some of the conditions that are necessary for CHW to improve timely ANC uptake and early HIV testing and PMTCT enrollment in pregnancy. PMID:25436818
Training and Development for Transitional Employment in Mature-Aged Manual Workers
ERIC Educational Resources Information Center
Pillay, Hitendra; Kelly, Kathy; Tones, Megan
Objectives: The purpose of the current article was to explore perceptions of transitional employment and training and development amongst blue collar workers employed in technical, trade, operations or physical and labour-intensive occupations within the local government system. Methods: The responses of manual workers to two national surveys…
Complementary Self-Care Strategies for Healthy Aging.
ERIC Educational Resources Information Center
Barrett, Sondra
Focuses on alternative self-care practices in terms of collaboration with the primary care physician and individual exploration of self-care practices such as acupuncture, meditation, and nutrition counseling. (JOW)
Effectiveness of Personal Protective Equipment for Healthcare Workers Caring for Patients with Filovirus Disease: A Rapid Review
Quach, Pauline; Hamel, Candyce; Thavorn, Kednapa; Garritty, Chantelle; Skidmore, Becky; Vallenas, Constanza; Norris, Susan L.; Egger, Matthias; Eremin, Sergey; Ferri, Mauricio; Shindo, Nahoko; Moher, David
Background A rapid review, guided by a protocol, was conducted to inform development of the World Health Organization's guideline on personal protective equipment in the context of the ongoing (2013–present) Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases. Methods Electronic databases and grey literature sources were searched. Eligibility criteria initially included comparative studies on Ebola and Marburg virus diseases reported in English or French, but criteria were expanded to studies on other viral hemorrhagic fevers and non-comparative designs due to the paucity of studies. After title and abstract screening (two people to exclude), full-text reports of potentially relevant articles were assessed in duplicate. Fifty-seven percent of extraction information was verified. The Grading of Recommendations Assessment, Development and Evaluation framework was used to inform the quality of evidence assessments. Results Thirty non-comparative studies (8 related to Ebola virus disease) were located, and 27 provided data on viral transmission. Reporting of personal protective equipment components and infection prevention and control protocols was generally poor. Conclusions Insufficient evidence exists to draw conclusions regarding the comparative effectiveness of various types of personal protective equipment. Additional research is urgently needed to determine optimal PPE for health care workers caring for patients with filovirus. PMID:26451847
Improved identification and enrolment into care of HIV-exposed and -infected infants and children following a community health worker intervention in Lilongwe, Malawi
Ahmed, Saeed; Kim, Maria H; Dave, Amanda C; Sabelli, Rachael; Kanjelo, Kondwani; Preidis, Geoffrey A; Giordano, Thomas P; Chiao, Elizabeth; Hosseinipour, Mina; Kazembe, Peter N; Chimbwandira, Frank; Abrams, Elaine J
Background Early identification and entry into care is critical to reducing morbidity and mortality in children with HIV. The objective of this report is to describe the impact of the Tingathe programme, which utilizes community health workers (CHWs) to improve identification and enrolment into care of HIV-exposed and -infected infants and children. Methods Three programme phases are described. During the first phase, Mentorship Only (MO) (March 2007–February 2008) on-site clinical mentorship on paediatric HIV care was provided. In the second phase, Tingathe-Basic (March 2008–February 2009), CHWs provided HIV testing and counselling to improve case finding of HIV-exposed and -infected children. In the final phase, Tingathe-PMTCT (prevention of mother-to-child transmission) (March 2009–February 2011), CHWs were also assigned to HIV-positive pregnant women to improve mother-infant retention in care. We reviewed routinely collected programme data from HIV testing registers, patient mastercards and clinic attendance registers from March 2005 to March 2011. Results During MO, 42 children (38 HIV-infected and 4 HIV-exposed) were active in care. During Tingathe-Basic, 238 HIV-infected children (HIC) were newly enrolled, a six-fold increase in rate of enrolment from 3.2 to 19.8 per month. The number of HIV-exposed infants (HEI) increased from 4 to 118. During Tingathe-PMTCT, 526 HIC were newly enrolled over 24 months, at a rate of 21.9 patients per month. There was also a seven-fold increase in the average number of exposed infants enrolled per month (9.5–70 patients per month), resulting in 1667 enrolled with a younger median age at enrolment (5.2 vs. 2.5 months; p<0.001). During the Tingathe-Basic and Tingathe-PMTCT periods, CHWs conducted 44,388 rapid HIV tests, 7658 (17.3%) in children aged 18 months to 15 years; 351 (4.6%) tested HIV-positive. Over this time, 1781 HEI were enrolled, with 102 (5.7%) found HIV-infected by positive PCR. Additional HIC entered
What Do Young People Need When They Leave Care? Views of Care-Leavers and Aftercare Workers in North Dublin
ERIC Educational Resources Information Center
Daly, Fiona
EPIC is an independent voluntary organisation in the Republic of Ireland that advocates for the rights of children in care and young people who have care experience. One aspect of EPIC's work is the Aftercare Advocacy and Support Service, which provides confidential advice and support to young people who are preparing to leave care, those in…
Competence of health workers in emergency obstetric care: an assessment using clinical vignettes in Brong Ahafo region, Ghana
Lohela, Terhi Johanna; Nesbitt, Robin Clark; Manu, Alexander; Vesel, Linda; Okyere, Eunice; Kirkwood, Betty; Gabrysch, Sabine
Objectives To assess health worker competence in emergency obstetric care using clinical vignettes, to link competence to availability of infrastructure in facilities, and to average annual delivery workload in facilities. Design Cross-sectional Health Facility Assessment linked to population-based surveillance data. Setting 7 districts in Brong Ahafo region, Ghana. Participants Most experienced delivery care providers in all 64 delivery facilities in the 7 districts. Primary outcome measures Health worker competence in clinical vignette actions by cadre of delivery care provider and by type of facility. Competence was also compared with availability of relevant drugs and equipment, and to average annual workload per skilled birth attendant. Results Vignette scores were moderate overall, and differed significantly by respondent cadre ranging from a median of 70% correct among doctors, via 55% among midwives, to 25% among other cadres such as health assistants and health extension workers (p<0.001). Competence varied significantly by facility type: hospital respondents, who were mainly doctors and midwives, achieved highest scores (70% correct) and clinic respondents scored lowest (45% correct). There was a lack of inexpensive key drugs and equipment to carry out vignette actions, and more often, lack of competence to use available items in clinical situations. The average annual workload was very unevenly distributed among facilities, ranging from 0 to 184 deliveries per skilled birth attendant, with higher workload associated with higher vignette scores. Conclusions Lack of competence might limit clinical practice even more than lack of relevant drugs and equipment. Cadres other than midwives and doctors might not be able to diagnose and manage delivery complications. Checking clinical competence through vignettes in addition to checklist items could contribute to a more comprehensive approach to evaluate quality of care. Trial registration number NCT00623337
Lessons learned: medical and health care management for emergency workers at the TEPCO Fukushima Daiichi APP accident.
Koerner, John; Yasui, Shojiro
During the emergency work at the Fukushima Daiichi Atomic Power Plant (APP), the Tokyo Electric Power Company (TEPCO) and the Japanese government experienced various problems in medical and health care management issues, including special medical examinations, on-site triage and initial treatment, patient transportation, lodging and food, and long-term health care for emergency workers. To resolve these problems, the Ministry of Health, Labor and Welfare (MHLW) issued a series of compulsory directives and provided administrative guidance to TEPCO. Based on the experiences and lessons learned, the MHLW recognized that the proper management and implementation of medical and health care management in response to a similar accident would require sufficient measures and systematic preparation, including the following: 1. In case of large-scale nuclear accidents, the government needs to assist in dispatching medical staff to the affected plants. 2. Nuclear facility operators, medical facilities and fire departments should make an agreement to clarify the division of the roles played prior to the accident and should conduct emergency drills periodically with the full attendance of related personnel to identify and resolve the problems. 3. Operators need to develop a support base at a safe distance from the plant and to prepare to develop makeshift lodgings in case of emergency. 4. Operators need to come to an agreement to share food stocks among closely located nuclear plants and prepare cooking equipment that can be used in case of blackout to provide warm foods and drinks to as many workers as possible. 5. It is necessary to conduct long-term follow-up for emergency workers, including health care system, medical examinations and mental health consultations. PMID:24467339
Mobile phone tools for field-based health care workers in low-income countries.
Derenzi, Brian; Borriello, Gaetano; Jackson, Jonathan; Kumar, Vikram S; Parikh, Tapan S; Virk, Pushwaz; Lesh, Neal
In low-income regions, mobile phone-based tools can improve the scope and efficiency of field health workers. They can also address challenges in monitoring and supervising a large number of geographically distributed health workers. Several tools have been built and deployed in the field, but little comparison has been done to help understand their effectiveness. This is largely because no framework exists in which to analyze the different ways in which the tools help strengthen existing health systems. In this article we highlight 6 key functions that health systems currently perform where mobile tools can provide the most benefit. Using these 6 health system functions, we compare existing applications for community health workers, an important class of field health workers who use these technologies, and discuss common challenges and lessons learned about deploying mobile tools. PMID:21598267
Preventing Absenteeism and Promoting Resilience Among Health Care Workers In Biological Emergencies
Lesperance, Ann M.; Miller, James S.
The ability to ensure adequate numbers of medical staff represents a crucial part of the medical response to any disaster. However, healthcare worker absenteeism during disasters, especially in the event of an attack of biological terrorism or an epidemic such as pandemic influenza, is a serious concern. Though a significant rate of absenteeism is often included as a baseline assumption in emergency planning, published reports on strategies to minimize absenteeism are comparatively few. This report documents interviews with managers and emergency response planners at hospitals and public health agencies and reviews existing survey data on healthcare worker absenteeism and studies of disasters to glean lessons about the needs of healthcare workers during those disasters. Based on this research, expected rates of absenteeism and individual determinants of absenteeism are presented along with recommendations of steps that hospitals, emergency medical services departments, public health organizations, and government agencies can take to meet the needs of healthcare workers and minimize absenteeism during a biological event.
Health care justice for temporary migrant workers on 457 visas in Australia: a case study of internationally qualified nurses.
O'Brien, Paula; Phillips, Melissa
Workers and their families in Australia under the Temporary Work (Skilled) Visa (subclass 457) scheme have no access to publicly funded health care. Rather, they are required by the Commonwealth government to purchase costly private health insurance. Our empirical study revealed the serious negative effects of the government's policy on the ability of internationally qualified nurses on 457 visas to meet their basic health care needs and to settle effectively into Australian society This article argues that the current policy is unjust and evaluates three options for reform which would accord more fully with the government's obligations to minimise harm to people's health and to ensure that all people in society have their health care needs met in a fair manner. PMID:25980190
Challenges Faced by Social Workers as Members of Interprofessional Collaborative Health Care Teams.
Ambrose-Miller, Wayne; Ashcroft, Rachelle
Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work. Participants identified six themes that can act as barriers and facilitators to collaboration: culture, self-identity, role clarification, decision making, communication, and power dynamics. These findings carry important implications for interprofessional collaboration with social workers in health practice. PMID:27263200
Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over
... April 18, 2012 Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over ... and Roberto Valverde, M.P.H., Division of Health Care Statistics Abstract Objective —This report presents national estimates ...
Developing the Child Care Workforce: Understanding "Fight" or "Flight" Amongst Workers
ERIC Educational Resources Information Center
Bretherton, Tanya
The early childhood education and care sector in Australia is undergoing a shift in philosophy. Changes in policy are driving the industry towards a combined early childhood education and care focus, away from one only on child care. This move has implications for the skilling of the child care workforce. This report examines workforce development…
What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand.
Frey, Rosemary; Boyd, Michal; Foster, Sue; Robinson, Jackie; Gott, Merryn
Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal. PMID:25808936
Effect of Peer Health Workers on AIDS Care in Rakai, Uganda: A Cluster-Randomized Trial
Chang, Larry W.; Kagaayi, Joseph; Nakigozi, Gertrude; Ssempijja, Victor; Packer, Arnold H.; Serwadda, David; Quinn, Thomas C.; Gray, Ronald H.; Bollinger, Robert C.; Reynolds, Steven J.
Background Human resource limitations are a challenge to the delivery of antiretroviral therapy (ART) in low-resource settings. We conducted a cluster randomized trial to assess the effect of community-based peer health workers (PHW) on AIDS care of adults in Rakai, Uganda. Methodology/Principal Findings 15 AIDS clinics were randomized 2∶1 to receive the PHW intervention (n = 10) or control (n = 5). PHW tasks included clinic and home-based provision of counseling, clinical, adherence to ART, and social support. Primary outcomes were adherence and cumulative risk of virologic failure (>400 copies/mL). Secondary outcomes were virologic failure at each 24 week time point up to 192 weeks of ART. Analysis was by intention to treat. From May 2006 to July 2008, 1336 patients were followed. 444 (33%) of these patients were already on ART at the start of the study. No significant differences were found in lack of adherence (<95% pill count adherence risk ratio [RR] 0.55, 95% confidence interval [CI] 0.23–1.35; <100% adherence RR 1.10, 95% CI 0.94–1.30), cumulative risk of virologic failure (RR 0.81, 95% CI 0.61–1.08) or in shorter-term virologic outcomes (24 week virologic failure RR 0.93, 95% CI 0.65–1.32; 48 week, RR 0.83, 95% CI 0.47–1.48; 72 week, RR 0.81, 95% CI 0.44–1.49). However, virologic failure rates ≥96 weeks into ART were significantly decreased in the intervention arm compared to the control arm (96 week failure RR 0.50, 95% CI 0.31–0.81; 120 week, RR 0.59, 95% CI 0.22–1.60; 144 week, RR 0.39, 95% CI 0.16–0.95; 168 week, RR 0.30, 95% CI 0.097–0.92; 192 week, RR 0.067, 95% CI 0.0065–0.71). Conclusions/Significance A PHW intervention was associated with decreased virologic failure rates occurring 96 weeks and longer into ART, but did not affect cumulative risk of virologic failure, adherence measures, or shorter-term virologic outcomes. PHWs may be an effective intervention to sustain long-term ART in low-resource settings
Will an Unsupervised Self-Testing Strategy for HIV Work in Health Care Workers of South Africa? A Cross Sectional Pilot Feasibility Study
Pant Pai, Nitika; Behlim, Tarannum; Abrahams, Lameze; Vadnais, Caroline; Shivkumar, Sushmita; Pillay, Sabrina; Binder, Anke; Deli-Houssein, Roni; Engel, Nora; Joseph, Lawrence; Dheda, Keertan
Background In South Africa, stigma, discrimination, social visibility and fear of loss of confidentiality impede health facility-based HIV testing. With 50% of adults having ever tested for HIV in their lifetime, private, alternative testing options are urgently needed. Non-invasive, oral self-tests offer a potential for a confidential, unsupervised HIV self-testing option, but global data are limited. Methods A pilot cross-sectional study was conducted from January to June 2012 in health care workers based at the University of Cape Town, South Africa. An innovative, unsupervised, self-testing strategy was evaluated for feasibility; defined as completion of self-testing process (i.e., self test conduct, interpretation and linkage). An oral point-of-care HIV test, an Internet and paper-based self-test HIV applications, and mobile phones were synergized to create an unsupervised strategy. Self-tests were additionally confirmed with rapid tests on site and laboratory tests. Of 270 health care workers (18 years and above, of unknown HIV status approached), 251 consented for participation. Findings Overall, about 91% participants rated a positive experience with the strategy. Of 251 participants, 126 evaluated the Internet and 125 the paper-based application successfully; completion rate of 99.2%. All sero-positives were linked to treatment (completion rate:100% (95% CI, 66.0–100). About half of sero-negatives were offered counselling on mobile phones; completion rate: 44.6% (95% CI, 38.0–51.0). A majority of participants (78.1%) were females, aged 18–24 years (61.4%). Nine participants were found sero-positive after confirmatory tests (prevalence 3.6% 95% CI, 1.8–6.9). Six of nine positive self-tests were accurately interpreted; sensitivity: 66.7% (95% CI, 30.9–91.0); specificity:100% (95% CI, 98.1–100). Interpretation Our unsupervised self-testing strategy was feasible to operationalize in health care workers in South Africa. Linkages were successfully
Mindfulness-based interventions with social workers and the potential for enhanced patient-centered care: A systematic review of the literature.
Trowbridge, Kelly; Mische Lawson, Lisa
The use of mindfulness-based interventions (MBIs) is well documented in the mental health, medical, and education literature. There is minimal research on the use of mindfulness with social workers. As demonstrated in other professional and helping fields, mindfulness may enhance clinical skills, reduce burnout, and increase job satisfaction among social workers. In the health care field mindfulness appears integral to patient and family relationships and personal resilience. The evolving and expanding role of hospital social workers may lead to increased work stress and greater demands from both the medical system and patients and families. Research with medical providers, such as physicians and nurses, suggests mindfulness may help in reducing stress, enhancing relationships, and fostering the self-reflection required to provide patient-centered care. We systematically reviewed the existing literature to begin understanding both mindfulness qualities and practices and the effectiveness of MBIs among social workers as well as the relationship of mindfulness to patient-centered care. PMID:26745592
Prevalence of coronary heart disease or stroke among workers aged <55 years--United States, 2008-2012.
Luckhaupt, Sara E; Calvert, Geoffrey M
Cardiovascular disease accounts for one in three deaths in the United States each year, and coronary heart disease and stroke account for most of those deaths. To try to prevent 1 million heart attacks and strokes by 2017, the U.S. Department of Health and Human Services launched the Million Hearts initiative, promoting proven and effective interventions in communities and clinical settings. In workplace settings, cardiovascular disease can be addressed through a Total Worker Health program, which integrates occupational safety and health protection with health promotion. To identify workers likely to benefit from such a program, CDC analyzed data from the National Health Interview Survey (NHIS) for the period 2008-2012 to estimate the prevalence of a history of coronary heart disease or stroke (CHD/stroke) among adults aged <55 years by selected characteristics, employment status, occupation category, and industry of employment. The results of that analysis showed that 1.9% of employed adults aged <55 years reported a history of CHD/stroke, compared with 2.5% of unemployed adults looking for work, and 6.3% of adults not in the labor force (e.g., unemployed adults who stopped looking for work, homemakers, students, retired persons, and disabled persons). Workers employed in service and blue collar occupations were more likely than those in white collar occupations to report a history of CHD/stroke. Two industry groups also had significantly higher adjusted prevalence ratios (aPRs) for CHD/stroke: Administrative and Support and Waste Management and Remediation Services* and Accommodation and Food Service.† Workers in these occupation and industry groups might especially benefit from a Total Worker Health approach to reducing the risk for CHD/stroke. PMID:25078653
Carriage of Multidrug Resistant Bacteria on Frequently Contacted Surfaces and Hands of Health Care Workers
Visalachy, Sowndarya; Kopula, Sridharan Sathyamoorthy; Sekar, Uma
Introduction Maximal contact between the patients and Health Care Workers (HCWs) happens in the Intensive Care Units (ICU). Control of nosocomial infections requires compliance with hand hygiene and contamination free surfaces. Aim To determine the colonization of potential pathogens in the hands of HCWs and frequent contacted environmental surfaces. Materials and Methods A cross sectional study was conducted between September 2012 and May 2013 at Sri Ramachandra Medical College and Hospital. A total of 327 samples were collected using Glove juice technique from hands and swabs from frequently contacted surfaces. A sum of 157 samples were collected by glove juice technique from the hands of HCWs which included Consultants (20), Internees (3), Residents (10), Staff nurse (102) and support staff (22). A total of 170 samples were collected through swabbing which included frequently touched surfaces of apron and dress (140 which included 10 consultants, 3 internees, 9 Residents, 101 Staff nurse and 17 support staff), 9 door handle, 4 key board, 12 tap handles and 5 monitors. The samples were inoculated into Blood agar, Chocolate agar and Mac-Conkey agar plates and incubated at 370C aerobically. The plates showing growth were further processed to identify the organisms by Gram staining and biochemical reactions. Antibiotic susceptibility testing was done for the isolates by Kirby-baur disc diffusion method as per CLSI guidelines. Results Out of the 157 hand sampling done by glove juice method 67(42.7%) of them showed growth and 90(57.3%) showed no growth. The potential pathogens grown were 13 (8.3%), consisting of Methicillin Sensitive Staphylococcus aureus (MSSA) 6(3.8%), Methicillin Resistant Staphylococcus aureus (MRSA) 2(1.3%), Pseudomonas spp 4(2.6%) and Acenitobacter spp 1 (0.6%). The MRSA was seen in Consultant 1(5%; n=20) and Staff nurse 1(0.9%; n= 102). Among the 140 sampling from the dress of HCWs growth was observed in 69(49.3%) and growth was absent in 71
Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa
Moshabela, Mosa; Sips, Ilona; Barten, Francoise
Background Community care workers (CCWs) in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs), and other members of the social support network. Design We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC) encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants' references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients' care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social support network
The Role of Community Health Workers in the Re-Engineering of Primary Health Care in Rural Eastern Cape
le Roux, Karl; le Roux, Ingrid; Mbewu, Nokwanele; Davis, Emily
Background Primary Health Care in South Africa is being re-engineered to create a model of integrated care across different levels of the health care system. From hospitals to clinics, in the community and in the home, health care will focus more on prevention, health-promotion and advocacy for healthy lifestyles and wellbeing, in addition to clinical services. We provide a best practise model of integrating community health workers (CHWs) trained as generalists into a multi-level health system in the Oliver Tambo district of the rural Eastern Cape. Methods Based at Zithulele Hospital, a health care network between the hospital, 13 clinics, and 50 CHWs has been created. The functions of each tier of care are different and complementary. This article describes the recruitment, training, supervision, monitoring, and outcomes when CHWs who deliver maternal, child health, nutrition and general care through home visits. Results CHWs, especially in rural settings, can find and refer new TB/HIV cases, ill children and at-risk pregnant women; rehabilitate malnourished children at home; support TB and HIV treatment adherence; treat diarrhoea, worm infestation and skin problems; and, distribute Vitamin A. CHWs provide follow-up after clinic and hospital care, support families to apply health information, problem-solve the health and social challenges of daily living, and assist in accessing social grants. Case examples of how this model functions are provided. Conclusion This generalist CHW home intervention is a potential model for the re-engineering of the primary health care system in South Africa. PMID:26279948
Sexual incidents in an extended care unit for aged men.
Szasz, G
A survey was conducted among the nursing staff of a 400-bed extended-care unit for aged men by questionnaire to find out what patient behaviors were identified as sexual by the staff and how they reacted to these behaviors. Three types of behavior were identified as sexual and as "causing problems": sex talk (e.g., using foul language); sexual acts (e.g., touching or grabbing, exposing genitalia); and implied sexual behavior (e.g., openly reading pornographic magazines). As many as 25 per cent of the residents were thought to create such incidents. Acceptable sexual behavior identified by the staff were limited to hugging and kissing on the cheek, although their answers implied that residents could need more intimate touching and affection. The survey raised questions about the nature and causes of different types of sexual behavior in the institutionalized elderly and about the roles nursing staff, physicians, and administrators can play in recognizing individual needs while safeguarding both the residents and the staff from the consequences of unacceptable incidents. PMID:6863791
The Effect of a Freely Available Flipped Classroom Course on Health Care Worker Patient Safety Culture: A Prospective Controlled Study
Ling, Lowell; Gomersall, Charles David; Samy, Winnie; Joynt, Gavin Matthew; Leung, Czarina CH; Wong, Wai-Tat
Background Patient safety culture is an integral aspect of good standard of care. A good patient safety culture is believed to be a prerequisite for safe medical care. However, there is little evidence on whether general education can enhance patient safety culture. Objective Our aim was to assess the impact of a standardized patient safety course on health care worker patient safety culture. Methods Health care workers from Intensive Care Units (ICU) at two hospitals (A and B) in Hong Kong were recruited to compare the changes in safety culture before and after a patient safety course. The BASIC Patient Safety course was administered only to staff from Hospital A ICU. Safety culture was assessed in both units at two time points, one before and one after the course, by using the Hospital Survey on Patient Safety Culture questionnaire. Responses were coded according to the Survey User's Guide, and positive response percentages for each patient safety domain were compared to the 2012 Agency for Healthcare Research and Quality ICU sample of 36,120 respondents. Results We distributed 127 questionnaires across the two hospitals with an overall response rate of 74.8% (95 respondents). After the safety course, ICU A significantly improved on teamwork within hospital units (P=.008) and hospital management support for patient safety (P<.001), but decreased in the frequency of reporting mistakes compared to the initial survey (P=.006). Overall, ICU A staff showed significantly greater enhancement in positive responses in five domains than staff from ICU B. Pooled data indicated that patient safety culture was poorer in the two ICUs than the average ICU in the Agency for Healthcare Research and Quality database, both overall and in every individual domain except hospital management support for patient safety and hospital handoffs and transitions. Conclusions Our study demonstrates that a structured, reproducible short course on patient safety may be associated with an
Clinical review: Tokyo - protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance.
Okumura, Sumie; Okumura, Tetsu; Ishimatsu, Shinichi; Miura, Kunihisa; Maekawa, Hiroshi; Naito, Toshio
Determine the effectiveness of decontamination, and perform thorough dry or wet decontamination, depending on the circumstances. Always remain cognizant of the fact that, even after decontamination has been completed, contamination may not have been completely eliminated. Perform periodic monitoring to determine whether secondary exposure has occurred in health care workers; if it appears that secondary exposure has occurred, then the PPE level must be increased and attempts must be made to identify and eliminate the source of the contamination. Finally, if the victims were exposed through ingestion, then consider the possibility that secondary exposure will occur during gastric lavage. PMID:16137390
A Model for Art Therapy-Based Supervision for End-of-Life Care Workers in Hong Kong.
Potash, Jordan S; Chan, Faye; Ho, Andy H Y; Wang, Xiao Lu; Cheng, Carol
End-of-life care workers and volunteers are particularly prone to burnout given the intense emotional and existential nature of their work. Supervision is one important way to provide adequate support that focuses on both professional and personal competencies. The inclusion of art therapy principles and practices within supervision further creates a dynamic platform for sustained self-reflection. A 6-week art therapy-based supervision group provided opportunities for developing emotional awareness, recognizing professional strengths, securing collegial relationships, and reflecting on death-related memories. The structure, rationale, and feedback are discussed. PMID:24870589
Validation of Horne and Ostberg morningness-eveningness questionnaire in a middle-aged population of French workers.
Taillard, Jacques; Philip, Pierre; Chastang, Jean-François; Bioulac, Bernard
As suggested by the authors, the Horne and Ostberg morning/evening questionnaire (MEQ) has never been adapted to evaluate a nonstudent population. The purpose of this study was to validate this MEQ in a sample of middle-aged workers by modifying only the cutoffs. It was administered in 566 non-shift-workers aged 51.2 to 3.2 years who presented no sleep disorders. According to the Home and Ostberg classification, the sample consisted of 62.1% morning type, 36.6% neither type, and 2.2% evening type. Multiple correspondence analysis, which determines the principal components, was performed on all MEQ items. Then an ascending hierarchical classification was applied to determine 3 clusters from these principal components. On the basis of these 3 clusters, new cutoffs were determined: evening types were considered as scoring under 53 and morning types above 64, thus giving 28.1% morning type, 51.7% neither type, and 20.2% evening type. As an external validation, eveningness was associated with later bedtime and waking-up time (more pronounced at the weekend), greater need for sleep, larger daily sleep debt, greater morning sleepiness, and ease of returning to sleep in the early morning. A positive correlation between age and morningness was again found. This study confirms that "owls" are not rare in a middle-aged sample. We conclude that this adapted MEQ could be useful when investigating age-related changes in sleep. PMID:14964706
Radiation and mortality of workers at Oak Ridge National Laboratory: positive associations for doses received at older ages.
Richardson, D B; Wing, S
We examined associations between low-level exposure to ionizing radiation and mortality among 14,095 workers hired at the Oak Ridge National Laboratory between 1943 and 1972. Workers at the facility were individually monitored for external exposure to ionizing radiation and have been followed through 1990 to ascertain cause of death information. Positive associations were observed between low-level exposure to external ionizing radiation and mortality. These associations were larger for doses received after 45 years of age, larger under longer lag assumptions, and primarily due to cancer causes of death. All cancer mortality was estimated to increase 4.98% [standard error (SE) = 1.5] per 10-mSv cumulative dose received after age 45 under a 10-year lag, and 7.31% (SE = 2.2) per 10-mSv cumulative dose received after age 45 under a 20-year lag. Associations between radiation dose and lung cancer were of similar magnitude to associations between radiation dose and all cancers except lung cancer. Nonmalignant respiratory disease exhibited a positive association with cumulative radiation dose received after age 45, whereas ischemic heart disease exhibited no association with radiation dose. These findings suggest increases in cancer mortality associated with low-level external exposure to ionizing radiation and potentially greater sensitivity to the carcinogenic effects of ionizing radiation with older ages at exposure. Images Figure 1 PMID:10417363
I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.
While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership. PMID:25362750
'When you visit a man you should prepare yourself': male community care worker approaches to working with men living with HIV in Cape Town, South Africa.
Gittings, Lesley
Caring is typically constructed as a feminised practice, resulting in women shouldering the burden of care-related work. Health-seeking behaviours are also constructed as feminine and men have poorer health outcomes globally. Employing men as carers may not only improve the health of the men they assist but also be transformative with regards to gendered constructions of caring. Using semi-structured interviews and observational home visits, this study explored the techniques that community care workers employ when working with male clients. The empirical analysis draws on the perspectives of eight care workers and three of their male clients from the Cape Town area. Interviews reveal how care workers and clients perform and negotiate masculinities as they navigate hegemonic masculine norms that require men to act tough, suppress emotions and deny weakness and sickness. Both parties bump up against ideals of what it means to be a man as they strive to provide care and receive support. Community care workers avoid rupturing client performances of hegemonic masculinities which inhibit confession and support. To do this, they use techniques of indirectly broaching sensitive subjects, acting in a friendly way and being clear about the intention of their work. PMID:26967538
The Key Role of Social Workers in Promoting the Well-Being of Children in State Care--A Neglected Dimension of Reforming Policies.
ERIC Educational Resources Information Center
Gilligan, Robbie
Examines the increasing demands on social workers to provide services to children in state care and the need for policy and service delivery changes in this area. Suggests changes in government and agency initiatives to improve staffing levels, renewed training, and adequate support for social work services to children in state care. (JPB)
Most Sick, Aging Americans Live Far from In-Home Care
... medlineplus.gov/news/fullstory_160328.html Most Sick, Aging Americans Live Far From In-Home Care Study ... to swell. "The Baby Boomer generation, they're aging fast and they are living longer with multiple ...
Mainstreaming Works! Volume I. Child Care Worker In-Service Education Module Special Needs Child Care Training.
ERIC Educational Resources Information Center
Impact, Inc., Ft. Myers, FL.
This in-service education module is intended to facilitate mainstreaming of young children with special needs in child care centers by providing information and training in mainstreaming concepts and activities to child care center owners, operators, and personnel. Guidelines for instructors in preparing for planned sessions are followed by a…
The Impact of a Participatory Care Model on Work Satisfaction of Care Workers and the Functionality, Connectedness, and Mental Health of Community-Dwelling Older People.
Bernoth, Maree; Burmeister, Oliver K; Morrison, Mark; Islam, Md Zahidul; Onslow, Fiona; Cleary, Michelle
This study describes and evaluates an innovative program designed to reduce functional decline among seniors, using a participatory care approach and integrated health teams. The evaluation provides older people and community support workers (CSWs) with the opportunity to share their experiences of being involved with an innovative program to reduce functional decline (mobility, skin integrity, nutrition, mental health, continence) of older, community dwelling adults implemented by a Nursing Service in a major capital city in Australia. As part of the program, CSWs were trained to provide care that aimed to reduce functional decline, and improve the quality of life for the care recipients. Data were collected through in-depth interviews with older people receiving care and a focus group (FG) was conducted with CSWs. Seven themes emerged during data analysis: 1) functionality/independence; 2) prevention; 3) confidence; 4) connection; 5) the approach; 6) care plans; and 7) the role of the CSWs. The relationship built between care giver and receiver and the mutual respect facilitated through adopting a participatory care approach was crucial. This relationship-focused care contributed to improved functionality and consequently quality of life for the older person, and for the CSW professional it contributed to their development, improved satisfaction with their role, and increased pride in the difference they make in the lives of their clients. Opportunities for improvement of the program included ensuring that participants understood the rationale for all aspects of the program, including regular reminders, as well as the use of regular reviews of individual outcomes. PMID:27070378
Dermatological disease in the older age group: a cross-sectional study in aged care facilities
Deo, Maneka S; Vandal, Alain C; Jarrett, Paul
Objectives To estimate the prevalence of dermatological disease in aged care facilities, and the relationship between cognitive or physical disability and significant disease. Setting 2 large aged care facilities in Auckland, New Zealand, each providing low and high level care. Participants All 161 residents of the facilities were invited to participate. The only exclusion criterion was inability to obtain consent from the individual or designated guardian. 88 participants were recruited—66 females (75%), 22 males (25%) with average age 87.1 years (SD 5.5 years). Primary and secondary outcome measures Primary—presence of significant skin disease (defined as that which in the opinion of the investigators needed treatment or was identified as a patient concern) diagnosed clinically on full dermatological examination by a dermatologist or dermatology trainee. Secondary—functional and cognitive status (Rehabilitation Complexity Scale and Abbreviated Mental Test Score). Results 81.8% were found to have at least one significant condition. The most common disorders were onychomycosis 42 (47.7%), basal cell carcinoma 13 (14.8%), asteototic eczema 11 (12.5%) and squamous cell carcinoma in situ 9 (10.2%). Other findings were invasive squamous cell carcinoma 7 (8%), bullous pemphigoid 2 (2.3%), melanoma 2 (2.3%), lichen sclerosus 2 (2.3%) and carcinoma of the breast 1 (1.1%). Inflammatory disease was more common in those with little physical disability compared with those with serious physical disability (OR 3.69; 95% CI 1.1 to 12.6, p=0.04). No significant association was found between skin disease and cognitive impairment. Conclusions A high rate of dermatological disease was found. Findings ranged from frequent but not life-threatening conditions (eg, onychomycosis), to those associated with a significant morbidity (eg, eczema, lichen sclerosus and bullous pemphigoid), to potentially life-threatening (eg, squamous cell carcinoma, melanoma and breast cancer
Moving Towards the Age-friendly Hospital: A Paradigm Shift for the Hospital-based Care of the Elderly
Huang, Allen R.; Larente, Nadine; Morais, Jose A.
Introduction Care of the older adult in the acute care hospital is becoming more challenging. Patients 65 years and older account for 35% of hospital discharges and 45% of hospital days. Up to one-third of the hospitalized frail elderly loses independent functioning in one or more activities of daily living as a result of the 'hostile environment' that is present in the acute hospitals. A critical deficit of health care workers with expertise and experience in the care of the elderly also jeopardizes successful care delivery in the acute hospital setting. Methods We propose a paradigm shift in the culture and practice of event-driven acute hospital-based care of the elderly which we call the Age-friendly Hospital concept. Guiding principles include: a favourable physical environment; zero tolerance for ageism throughout the organization; an integrated process to develop comprehensive services using the geriatric approach; assistance with appropriateness decision-making and fostering links between the hospital and the community. Our current proposed strategy is to focus on delirium management as a hospital-wide condition that both requires and highlights the Geriatric Medicine specialist as an expert of content, for program development and of evaluation. Conclusion The Age-friendly Hospital concept we propose may lead the way to enable hospitals in the fast-moving health care system to deliver high-quality care without jeopardizing risk-benefit, function, and quality of life balances for the frail elderly. Recruitment and retention of skilled health care professionals would benefit from this positive 'branding' of an institution. Convincing hospital management and managing change are significant challenges, especially with competing priorities in a fiscal environment with limited funding. The implementation of a hospital-wide delirium management program is an example of an intervention that embodies many of the principles in the Age-friendly Hospital concept
Determinants of Quality of Life in Primary Care Patients with Diabetes: Implications for Social Workers
ERIC Educational Resources Information Center
Ayalon, Liat; Gross, Revital; Tabenkin, Hava; Porath, Avi; Heymann, Anthony; Porter, Boaz
Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical…
Huge Increase in Day-Care Workers: A Result of Multiple Societal Changes.
ERIC Educational Resources Information Center
Bureau of Labor Statistics (DOL), Washington, DC.
Using Bureau of Labor Statistics estimates of employment in day-care establishments, this study analyzes changes in day care over the past 20 years. Growth in day-care employment has been much stronger than that of other industries. Since 1972, employment has increased by nearly 250 per cent. Causes of growth includes changing trends in enrollment…
Does community emergency care initiative improve the knowledge and skill of healthcare workers and laypersons in basic emergency care in India?
Bhoi, Sanjeev; Thakur, Nirmal; Verma, Pankaj; Sawhney, Chhavi; Vankar, Sameer; Agrawal, Deepak; Sinha, Tejprakash
Background: Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue. Aim: To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course. Materials and Methods: Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated. Results: A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12th standard) and were nonmedicos. Conclusion: BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care. PMID:26957820
Comparison of the 1996 and 2001 census data for Aboriginal and non-Aboriginal workers in health care occupations.
Lecompte, Emily; Baril, Mireille
To meet the unique health needs of Aboriginal peoples (First Nations, Inuit and Métis), it is important to increase and encourage Aboriginal representation in health care. One Federal initiative, the Aboriginal Health Human Resource Initiative (AHHRI) at Health Canada, focuses on: (1) increasing the number of Aboriginal people working in health careers; (2) adapting health care educational curricula to support the development of cultural competencies; and (3) improving the retention of health care workers in Aboriginal communities. A health care system that focuses on understanding the unique challenges, concerns, and needs of Aboriginal people can better respond to this specific population, which suffers disproportionately from ill health in comparison to their non-Aboriginal counterparts. This report examines the supply of Aboriginal health care providers in Canada, based on geographic region, area of residence, Aboriginal identity, and occupation. Findings are drawn from the 1996 and 2001 censuses from Statistics Canada. Quantitative results provide a greater understanding of labour force characteristics of First Nation, Inuit, Métis, and non-Aboriginal health providers. PMID:18447068
Succeeding Through Service Innovation: Consumer Directed Care in the Aged Care Sector
NASA Astrophysics Data System (ADS)
Wilkins, Linda; Laragy, Carmel; Zadeh, Hossein S.
The growing challenge and diversity of ageing populations is a key global issue for struggling health systems. Consumer Directed Care (CDC), an innovative service delivery system, opens up possibilities for re-defining consumer expectations, prompting change in how health service providers operate. As a service delivery model, CDC offers improved responsiveness to individual requirements; and increased transparency in the use of allocated funding. Where implemented, CDC has established new relationships and interactions between key stakeholders, co-creating value for older citizens. This chapter reviews some drivers for the development of service innovation, surveys various in-country approaches, highlights current trends in CDC delivery and describes an EU policy impact assessment instrument to aid funding bodies. The chapter concludes by speculating on organizational outcomes from CDC and the likelihood that the introduction of this innovative service delivery model will require closer collaborative relationships between service providers and information technology specialists.
Effect of Long Working Hours on Self-reported Hypertension among Middle-aged and Older Wage Workers
Objectives Many studies have reported an association between overwork and hypertension. However, research on the health effects of long working hours has yielded inconclusive results. The objective of this study was to identify an association between overtime work and hypertension in wage workers 45 years and over of age using prospective data. Methods Wage workers in Korea aged 45 years and over were selected for inclusion in this study from among 10,254 subjects from the Korean Longitudinal Study of Ageing. Workers with baseline hypertension and those with other major diseases were excluded. In the end, a total of 1,079 subjects were included. A Cox proportional hazards model was used to calculate hazard ratios and adjust for baseline characteristics such as sex, age, education, income, occupation, form of employment, body mass index, alcohol habit, smoking habit, regular exercise, and number of working days per week. Additional models were used to calculate hazard ratios after gender stratification. Results Among the 1,079 subjects, 85 workers were diagnosed with hypertension during 3974.2 person-months. The average number of working hours per week for all subjects was 47.68. The proportion of overtime workers was 61.0% (cutoff, 40 h per week). Compared with those working 40 h and less per week, the hazard ratio of subjects in the final model, which adjusted for all selected variables, working 41-50 h per week was 2.20 (95% confidence interval [CI], 1.19–4.06), that of subjects working 51-60 h per week was 2.40 (95% CI, 1.07–5.39), and that of subjects working 61 h and over per week was 2.87 (95% CI, 1.33–6.20). In gender stratification models, the hazard ratio of the females tended to be higher than that of the males. Conclusion As the number of working hours per week increased, the hazard ratio for diagnosis of hypertension significantly increased. This result suggests a positive association between overtime work and the risk of hypertension. PMID
Workplace interventions to reduce HIV and TB stigma among health care workers - Where do we go from here?
Siegel, Jacob; Yassi, Annalee; Rau, Asta; Buxton, Jane A; Wouters, Edwin; Engelbrecht, Michelle C; Uebel, Kerry E; Nophale, Letshego E
Fear of stigma and discrimination among health care workers (HCWs) in South African hospitals is thought to be a major factor in the high rates of HIV and tuberculosis infection experienced in the health care workforce. The aim of the current study is to inform the development of a stigma reduction intervention in the context of a large multicomponent trial. We analysed relevant results of four feasibility studies conducted in the lead up to the trial. Our findings suggest that a stigma reduction campaign must address community and structural level drivers of stigma, in addition to individual level concerns, through a participatory and iterative approach. Importantly, stigma reduction must not only be embedded in the institutional management of HCWs but also be attentive to the localised needs of HCWs themselves. PMID:25769042
Home visits by community health workers to improve identification of serious illness and care seeking in newborns and young infants from low- and middle-income countries.
Tripathi, A; Kabra, S K; Sachdev, H P S; Lodha, R
The objectives of this review were to evaluate the effect of home visits by trained community health workers (CHWs) to successfully identify newborns and young infants (up to 59 days of age) with serious illness and improve care seeking from a health facility. The authors searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. Abstracts of all articles were read by two authors independently and relevant articles selected. Data were extracted in a pretested questionnaire by two authors independently. Statistical analysis was performed using Review Manager software. A meta-analysis of included randomized controlled trials (RCTs) was carried out. Pooled estimates (risk ratios (RRs) with 95% confidence intervals (CIs)) of the evaluated outcome measures were calculated by the generic inverse variance method. Seven articles were identified for inclusion in the review. None of them compared the diagnosis of serious illness in young infants by health workers to a 'gold standard' diagnosis. Three studies were available for evaluating the ability of CHWs to identify seriously ill young infants/signs of serious illness. These studies suggest that sensitivity to identify serious illness ranged from 33.3 to 90.5% and specificity from 75.61 to 98.4%. For the outcome of improved care seeking from a health facility, after pooling the data from six RCTs with 4760 subjects in the intervention and 4398 subjects in the control arm, there was a significant improvement in care seeking in the home visit arm (RR=1.35; 95% CI=1.15 to 1.58). Moderate quality evidence indicated that home visits by trained CHWs were associated with improved care-seeking for sick young infants from health facilities by appropriate health care providers in resource-limited settings. However, there is a lack of data regarding successful identification of serious illness. Evidence from validation studies supports the implementation of home visits by trained CHWs for improving outcomes in
Home visits by community health workers to improve identification of serious illness and care seeking in newborns and young infants from low- and middle-income countries
Tripathi, A; Kabra, S K; Sachdev, H P S; Lodha, R
The objectives of this review were to evaluate the effect of home visits by trained community health workers (CHWs) to successfully identify newborns and young infants (up to 59 days of age) with serious illness and improve care seeking from a health facility. The authors searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. Abstracts of all articles were read by two authors independently and relevant articles selected. Data were extracted in a pretested questionnaire by two authors independently. Statistical analysis was performed using Review Manager software. A meta-analysis of included randomized controlled trials (RCTs) was carried out. Pooled estimates (risk ratios (RRs) with 95% confidence intervals (CIs)) of the evaluated outcome measures were calculated by the generic inverse variance method. Seven articles were identified for inclusion in the review. None of them compared the diagnosis of serious illness in young infants by health workers to a 'gold standard' diagnosis. Three studies were available for evaluating the ability of CHWs to identify seriously ill young infants/signs of serious illness. These studies suggest that sensitivity to identify serious illness ranged from 33.3 to 90.5% and specificity from 75.61 to 98.4%. For the outcome of improved care seeking from a health facility, after pooling the data from six RCTs with 4760 subjects in the intervention and 4398 subjects in the control arm, there was a significant improvement in care seeking in the home visit arm (RR=1.35; 95% CI=1.15 to 1.58). Moderate quality evidence indicated that home visits by trained CHWs were associated with improved care-seeking for sick young infants from health facilities by appropriate health care providers in resource-limited settings. However, there is a lack of data regarding successful identification of serious illness. Evidence from validation studies supports the implementation of home visits by trained CHWs for improving outcomes
Activating the Worker in Elderly Care: A Technique and Tactics of Invitation
ERIC Educational Resources Information Center
Fejes, A.; Nicoll, K.
Relatively little attention has been paid to questions of how language acts in and through the interactions of language in situations where people are encouraged to learn to be active in contexts of work. This paper argues that detailed analysis is needed to understand how activation through language acts in the shaping and governing of workers.…
How Do Hired Workers Fare under Consumer-Directed Personal Care?
ERIC Educational Resources Information Center
Dale, Stacy; Brown, Randall; Phillips, Barbara; Carlson, Barbara Lepidus
Purpose: This study describes the experiences of workers hired under consumer direction. Design and Methods: Medicaid beneficiaries who volunteered for the Cash and Counseling demonstration were randomly assigned to the treatment group, which could participate in the consumer-directed program, or the control group, which was referred to agency…
Pre‐pandemic planning survey of healthcare workers at a tertiary care children's hospital: ethical and workforce issues
Cowden, Jessica; Crane, Lori; Lezotte, Dennis; Glover, Jacqueline; Nyquist, Ann‐Christine
Please cite this paper as: Cowden et al. (2010). Pre‐pandemic planning survey of healthcare workers at a tertiary care children's hospital: ethical and workforce issues. Influenza and Other Respiratory Viruses 4(4), 213–222. Background Prior to the development of written policies and procedures for pandemic influenza, worker perceptions of ethical and workforce issues must be identified. Objective To determine the relationship between healthcare worker (HCW) reporting willingness to work during a pandemic and perception of job importance, belief that one will be asked to work, and sense of professionalism and to assess HCW's opinions regarding specific policy issues as well as barriers and motivators to work during a pandemic. Methods A survey was conducted in HCWs at The Children's Hospital in Denver, Colorado, from February to June 2007. Characteristics of workers reporting willingness to work during a pandemic were compared with those who were unwilling or unsure. Importance of barriers and motivators was compared by gender and willingness to work. Results Sixty percent of respondents reported willingness to work (overall response rate of 31%). Belief one will be asked to work (OR 4·6, P < 0·0001) and having a high level of professionalism (OR 8·6, P < 0·0001) were associated with reporting willingness to work. Hospital infrastructure support staffs were less likely to report willingness to work during a pandemic than clinical healthcare professionals (OR 0·39, P < 0·001). Concern for personal safety, concern for safety of family, family's concern for safety, and childcare issues were all important barriers to coming to work. Conclusions Educational programs should focus on professional responsibility and the importance of staying home when ill. Targeted programs toward hospital infrastructure support and patient and family support staff stressing the essential nature of these jobs may improve willingness to work. PMID
Developing a Quality School-Age Child Care Program: An Information and Training Manual for Directors of School-Age Child Care Programs.
ERIC Educational Resources Information Center
Childcare Resources, Birmingham, AL.
This manual for directors of school-age child care (SACC) programs contains six sections. Section I provides a rationale for SACC. Section II describes characteristics of school-age children. The extensive Section III discusses characteristics of high quality SACC. After an initial discussion of the importance of out-of-school time, the section…
Prevalence of HBV and HBV vaccination coverage in health care workers of tertiary hospitals of Peshawar, Pakistan
Background Hepatitis B Virus (HBV) may progress to serious consequences and increase dramatically beyond endemic dimensions that transmits to or from health care workers (HCWs) during routine investigation in their work places. Basic aim of this study was to canvass the safety of HCWs and determine the prevalence of HBV and its possible association with occupational and non-occupational risk factors. Hepatitis B vaccination coverage level and main barriers to vaccination were also taken in account. Results A total of 824 health care workers were randomly selected from three major hospitals of Peshawar, Khyber Pakhtunkhwa. Blood samples were analyzed in Department of Zoology, Kohat University of Science and Technology Kohat, and relevant information was obtained by means of preset questionnaire. HCWs in the studied hospitals showed 2.18% prevalence of positive HBV. Nurses and technicians were more prone to occupational exposure and to HBV infection. There was significant difference between vaccinated and non-vaccinated HCWs as well as between the doctors and all other categories. Barriers to complete vaccination, in spite of good knowledge of subjects in this regard were work pressure (39.8%), negligence (38.8%) un-affordability (20.9%), and unavailability (0.5%). Conclusions Special preventive measures (universal precaution and vaccination), which are fundamental way to protect HCW against HBV infection should be adopted. PMID:21645287
Barriers to care for sexual assault survivors of childbearing age: An integrative review
Munro, Michelle L.
Research indicates that only a small fraction of sexual assault survivors seek comprehensive care afterward, including physical and mental health care, forensic evidence collection, victim services, and legal support. This integrative review was conducted to identify barriers that may be keeping sexual assault survivors of childbearing age from receiving such comprehensive care. PMID:25664329
Standards for Day Care Centers for Infants and Children Under 3 Years of Age.
ERIC Educational Resources Information Center
American Academy of Pediatrics, Evanston, IL.
The Committee on Infant and Preschool Child of the American Academy of Pediatrics has developed basic standards for quality day care for children under 3 years of age. The availability of day care provides a mother with the choice of group day care as one of the means of providing for her children. Options should include full-time or part-time day…
Clinical mentorship to improve pediatric quality of care at the health centers in rural Rwanda: a qualitative study of perceptions and acceptability of health care workers
Background Despite evidence supporting Integrated Management of Childhood Illness (IMCI) as a strategy to improve pediatric care in countries with high child mortality, its implementation faces challenges related to lack of or poor post-didactic training supervision and gaps in necessary supporting systems. These constraints lead to health care workers' inability to consistently translate IMCI knowledge and skills into practice. A program providing mentoring and enhanced supervision at health centers (MESH), focusing on clinical and systems improvement was implemented in rural Rwanda as a strategy to address these issues, with the ultimate goal of improving the quality of pediatric care at rural health centers. We explored perceptions of MESH from the perspective of IMCI clinical mentors, mentees, and district clinical leadership. Methods We conducted focus group discussions with 40 health care workers from 21 MESH-supported health centers. Two FGDs in each district were carried out, including one for nurses and one for director of health centers. District medical directors and clinical mentors had individual in-depth interviews. We performed a hermeneutic analysis using Atlas.ti v5.2. Results Study participants highlighted program components in five key areas that contributed to acceptability and impact, including: 1) Interactive, collaborative capacity-building, 2) active listening and relationships, 3) supporting not policing, 4) systems improvement, and 5) real-time feedback. Staff turn-over, stock-outs, and other facility/systems gaps were identified as barriers to MESH and IMCI implementation. Conclusion Health care workers reported high acceptance and positive perceptions of the MESH model as an effective strategy to build their capacity, bridge the gap between knowledge and practice in pediatric care, and address facility and systems issues. This approach also improved relationships between the district supervisory team and health center-based care
Attachment Style, Home-Leaving Age and Behavioral Problems among Residential Care Children
ERIC Educational Resources Information Center
Shechory, Mally; Sommerfeld, Eliane
In a prospective study, the attachment style, home-leaving age, length of time in residential care, and behavioral problems among Israeli residential care children (N=68), were studied. Data analyses showed that children removed from their homes at a later age suffered from higher levels of anxiety, depression and social problems compared to…
School-Age Child Care: An Action Manual for the 90s and Beyond. Second Edition.
ERIC Educational Resources Information Center
Seligson, Michelle; Allenson, Michael
Evidence suggests that self-care among school-age children has significant costs to the children, in the form of increased fearfulness and loneliness, heightened vulnerability to peer pressure, and greater likelihood of substance abuse. In response to the need for quality school-age care, this book serves as a guide for anyone wanting to implement…
No Time to Waste: An Action Agenda for School-Age Child Care.
ERIC Educational Resources Information Center
Seligson, Michelle; Fink, Dale Borman
This book for persons interested in setting up high quality school-age child care (SACC) programs: (1) provides background information and a rationale; (2) describes a collaborative model of program development; (3) discusses program funding and resources; (4) considers approaches to recognizing high quality school-age child care; and (5) offers…
Older Women Doing Home Care: Exploitation or Ideal Job?
Butler, Sandra S.
The increased need for both personal assistance workers and meaningful employment opportunities for older workers results in growing numbers of older home care aides. This study examined lifetime financial security and perceived advantages of older age in this field through interviews with 31 older home care aides. Study participants experienced high levels of financial insecurity and perceived older workers as particularly well suited to the home care job. The consequences of this low-wage, low-status work are explored along with implications for social workers to advocate for improved conditions for these workers providing essential care to frail elders. PMID:23600600
A University Program to Improve Nursing Care to the Aged
ERIC Educational Resources Information Center
Marten, Marie Lucille
Proposes a series of university nursing education programs developed to increase knowledge and skills relevant to nursing care of elderly and chronically ill persons who reside in nursing homes. Briefly describes five programs intended for persons engaged in long-term care or in preparation for such roles. (EM)
Ethics in human resource management: potential for burnout among healthcare workers in ART and community care centres.
Mala, Ramanathan; Santhosh, Kumar M; Anshul, Avijit; Aarthy, R
This paper examines ethical dilemmas in providing care for people with HIV/AIDS. Healthcare providers in this sector are overworked, particularly in the high prevalence states. They are faced with the dual burden of the physical and the emotional risks of providing this care. The emotional risks result from their inability to control their work environment, while having to deal with the social and cultural dimensions of patients' experiences. The physical risk is addressed to some extent by post exposure prophylaxis. But the emotional risk is largely left to the individual and there is little by way of institutional responsibility for minimising this. The guidelines for training workers in care and support programmes do not include any detailed institutional mechanisms for reducing workplace stress. This aspect of the programme needs to be examined for its ethical justification. The omission of institutional mechanisms to reduce the emotional risks experienced by healthcare providers in the HIV/AIDS sector could be a function of lack of coordination across different stakeholders in programme development. This can be addressed in further formulations of the programme. Whatever the reasons may be for overlooking these needs, the ethics of this choice need to be carefully reviewed. PMID:20806520
Expert perspectives on Western European prison health services: do ageing prisoners receive equivalent care?
Bretschneider, Wiebke; Elger, Bernice Simone
Health care in prison and particularly the health care of older prisoners are increasingly important topics due to the growth of the ageing prisoner population. The aim of this paper is to gain insight into the approaches used in the provision of equivalent health care to ageing prisoners and to confront the intuitive definition of equivalent care and the practical and ethical challenges that have been experienced by individuals working in this field. Forty interviews took place with experts working in the prison setting from three Western European countries to discover their views on prison health care. Experts indicated that the provision of equivalent care in prison is difficult mostly due to four factors: variability of care in different prisons, gatekeeper systems, lack of personnel, and delays in providing access. This lack of equivalence can be fixed by allocating adequate budgets and developing standards for health care in prison. PMID:24965437
Results of the northern Manhattan diabetes community outreach project: a randomized trial studying a community health worker intervention to improve diabetes care in Hispanic adults.
Palmas, Walter; Findley, Sally E; Mejia, Miriam; Batista, Milagros; Teresi, Jeanne; Kong, Jian; Silver, Stephanie; Fleck, Elaine M; Luchsinger, Jose A; Carrasquillo, Olveen
OBJECTIVE The Northern Manhattan Diabetes Community Outreach Project evaluated whether a community health worker (CHW) intervention improved clinically relevant markers of diabetes care in adult Hispanics. RESEARCH DESIGN AND METHODS Participants were adult Hispanics, ages 35-70 years, with recent hemoglobin A1c (A1C) ≥8% (≥64 mmol/mol), from a university-affiliated network of primary care practices in northern Manhattan (New York City, NY). They were randomized to a 12-month CHW intervention (n = 181), or enhanced usual care (educational materials mailed at 4-month intervals, preceded by phone calls, n = 179). The primary outcome was A1C at 12 months; the secondary outcomes were systolic blood pressure (SBP), diastolic blood pressure, and LDL-cholesterol levels. RESULTS There was a nonsignificant trend toward improvement in A1C levels in the intervention group (from unadjusted mean A1C of 8.77 to 8.40%), as compared with usual care (from 8.58 to 8.53%) (P = 0.131). There was also a nonsignificant trend toward an increase in SBP and LDL cholesterol in the intervention arm. Intervention fidelity, measured as the number of contacts in the intervention arm (visits, phone contacts, group support, and nutritional education), showed a borderline association with greater A1C reduction (P = 0.054). When assessed separately, phone contacts were associated with greater A1C reduction (P = 0.04). CONCLUSIONS The trend toward A1C reduction with the CHW intervention failed to achieve statistical significance. Greater intervention fidelity may achieve better glycemic control, and more accessible treatment models, such as phone-based interventions, may be more efficacious in socioeconomically disadvantaged populations. PMID:24496805
Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study
Liu, Hongjie; Dumenci, Levent; Morisky, Donald E; Xu, Yongfang; Li, Xiaojing; Jiang, Baofa
Objectives This study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China. Design A cross-sectional study with respondent-driven sampling (RDS). Setting A multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014. Participants 1245 middle-aged female sex workers who were over 35 years old (about 400 per study site). Main outcome measures Unprotected commercial sex, and syphilis and HIV infection were biologically tested and measured. Results The RDS-adjusted prevalence of active syphilis was 17.3% in Hefei, 9.9% in Qingdao, and 5.4% in Nanning. The RDS-adjusted prevalence of prevalent syphilis was between 6.8% and 33.6% in the three cities. The proportion of unprotected sex in the past 48 h verified by the prostate-specific antigen test (PSA) was between 27.8% and 42.4%. Multiple log-binomial regression analyses indicate that middle-aged FSWs who had 5 or more clients in the past week prior to interviews and engaged in unprotected sex were more likely to be active syphilitic cases. Middle-aged FSWs who had rural residency were less likely to be active syphilitic cases. Conclusions In contrast with previous studies that reported low prevalence of syphilis and high prevalence of protected sex among FSWs in China, both the prevalence of syphilis and unprotected sex were high among middle-aged FSWs. Evidence-based intervention programmes should be developed and evaluated among this vulnerable population in China and other countries with similar settings. PMID:27165644
Shift Work and the Relationship with Metabolic Syndrome in Chinese Aged Workers
Guo, Yanjun; Rong, Yi; Huang, Xiji; Lai, Hanpeng; Luo, Xin; Zhang, Zhihong; Liu, Yuewei; He, Meian; Wu, Tangchun; Chen, Weihong
Background Shift work is indicated to be associated with adverse metabolic disorders. However, potential effects of shift work on metabolic syndrome (MetS) and its components have not been well established. Methods In total, 26,382 workers from Dongfeng-Tongji Cohort were included in this study. Information on shift work history was gathered through questionnaires and metabolic traits were measured. Logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval (CI) for long-term shift work related with MetS and each component, respectively. Further stratification analysis was performed to detect the differences on MetS between female and male shift workers. Results Long-term shift work was associated with MetS without adjusting for any confounders. Compared with the group of non-shift work, the multivariate-adjusted ORs (95%CI) of MetS associated with 1–10, 11−20, and ≥20y of shift work were 1.05 (0.95−1.16), 1.14 (1.03−1.26), 1.16 (1.01−1.31), respectively. In female workers, we found a dose-response relationship that every 10 years increase in shift work was associated with a 10% (95% CI: 1%−20%) elevated OR of MetS, while no significant dose-response trend was found among male workers. Furthermore, shift work duration was significantly associated with ORs of high blood pressure (1.07, 1.01−1.13), long waist circumference (1.10, 1.01−1.20) and high glucose levels (1.09, 1.04−1.15). No significant association was observed between shift work and low HDL cholesterol) and raised triglyceride levels. Conclusions Long-term shift work was associated with metabolic syndrome and the association might differ by gender in retired workers. Applicable intervention strategies are needed for prevention of metabolic disorders for shift workers. PMID:25761114
Awareness and practices regarding bio-medical waste management among health care workers in a tertiary care hospital in Delhi.
Bhagawati, G; Nandwani, S; Singhal, S
Health care institutions are generating large amount of Bio-Medical Waste (BMW), which needs to be properly segregated and treated. With this concern, a questionnaire based cross-sectional study was done to determine the current status of awareness and practices regarding BMW Management (BMWM) and areas of deficit amongst the HCWs in a tertiary care teaching hospital in New Delhi, India. The correct responses were graded as satisfactory (more than 80%), intermediate (50-80%) and unsatisfactory (less than 50%). Some major areas of deficit found were about knowledge regarding number of BMW categories (17%), mercury waste disposal (37.56%) and definition of BMW (47%). PMID:26470969
How Many Social Workers Are Needed in Primary Care? A Patient-Based Needs Assessment Example
ERIC Educational Resources Information Center
McGuire, James; Bikson, Karra; Blue-Howells, Jessica
This study measured levels of self-reported social need in a sample of 684 veterans seen in four primary care clinics of a large Veterans Affairs health care system, using the Social Needs Checklist, and calculated levels of social work staffing to meet these needs. Data were obtained on the presence and severity of 15 areas of social needs,…
22 CFR 40.53 - Uncertified foreign health-care workers.
Code of Federal Regulations, 2011 CFR
... a non-clinical health care occupation as described in 8 CFR 212.15(b)(1); or (2) Who is the... entry into the United States in order to perform health care services as described in 8 CFR 212.15. ....S.C. 1182(r), respectively, and the regulations found at 8 CFR 212.15. (b) Paragraph (a) of...