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Alhammadi, Yasir, Abdelrahman M. Farouk, and Rahimi A. Rahman. "Enhancing Construction Safety Education: Insights from Student Perspectives." Buildings 14, no. 3 (March 1, 2024): 660. http://dx.doi.org/10.3390/buildings14030660.
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Construction safety education is crucial as it ensures worker well-being, improves construction quality, and contributes to sustainable infrastructure development and safeguarding lives. This study aims to examine students’ perceptions of construction safety education. A structured questionnaire survey aligned with the National Examination Board in Occupational Safety and Health (NEBOSH) safety topics was used to collect data from students on their understanding of construction safety topics (CSTs). Data were gathered from 161 students and analyzed using Cronbach’s alpha, mean calculations, standard deviation measurements, normalization value, Kruskal–Wallis tests, and correlation analysis. The findings reveal a strong awareness and interest in fire safety, with variations across engineering faculties, academic years, and specific topics, suggesting the need for tailored educational strategies to improve construction safety knowledge and align education with industry needs. This study represents the first investigation into students’ comprehension of CSTs in Saudi Arabia. The study insights can guide decisionmakers in refining existing curriculums, ensuring students develop a strong understanding of safety protocols in construction projects. By aligning education with industry requirements, policymakers can enhance the preparedness of graduates, promoting safer practices in engineering. This contributes to the overall economic and safety progress of nations.
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Raja, Jawad, Zeenish Azhar, and Alberto Salmoiraghi. "Adult ADHD clinics in north Wales - case load prevalance & compliance with nice guidelines (quality evaluation project)." BJPsych Open 7, S1 (June 2021): S342—S343. http://dx.doi.org/10.1192/bjo.2021.899.
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AimsMeasure compliance with National Institute for Health and Care Excellence (NICE) recommendations in four Adult CMHT'sGuide further service development.We audited the case notes of 20 patients each currently under care of 9 General Adult Consultants across 6 CMHT's in East side of North Wales against NICE standards using an adapted version of the ADHD audit support tool.My role in the Project & How does this represent my practice?I was the audit and overall lead for this projectI formulated the audit tool and registered my project with Audit Registration Team.I lead data collection and compilation of results.MethodOverall, this is the first audit of Adult ADHD Services in East side of North Wales.It established good compliance with NICE guidance for assessment and treatment.NICE has expressed the need for full mental health and social assessment including full history and physical examination prior to the drug treatment.Good compliance was observed in using & documenting Diagnostic Criteria (DSM-IV and/or ICD-10).There were deficiencies in conducting or arranging recommended physical examination & side effect monitoring.Drug treatment was the first line of treatment in the majority of cases.Antipsychotics were used in some patients referred for ADHD assessment, despite the fact that NICE has ruled out the use of antipsychotic drugs in treatment of core symptoms of ADHD.ResultPrevalence of Adult ADHD clinician case load in Wrexham and Fintshire Counties.Diagnosis of Adult ADHD according to ICD 10 & DSM IV Guidelines.Pre treatment screening of physical health for ADHD patients.Side effects monitoring of patients on stimulant medications.ConclusionThe finding highlights the need for more effort in educating clinicians about safety and effectiveness of antipsychotics in ADHD.Comprehensive treatment programmes that address psychological, behavioural, educational and occupational needs should be established.Development of local ADHD Clinics, support groups and in partnership with the voluntary sector should be encouraged.It is important that mental health professionals receive appropriate training in assessment, management & monitoring of ADHD patients with co morbid substance use disorder and other mental illnesses.BETSI Health Board to participate in national Prescribing Observatory for Mental Health (POMH-UK) Quality Improvement Programme (QIP) focusing on prescribing for ADHD in children, adolescents & adults.
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GARBER, M. "National Transportation Safety Board case studies." Clinics in Occupational and Environmental Medicine 2, no. 1 (February 2002): 139–53. http://dx.doi.org/10.1016/s1526-0046(02)00008-0.
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Gebbie, Kristine, Bernard D. Goldstein, David I. Gregorio, Walter Tsou, Patricia Buffler, Donna Petersen, Charles Mahan, and Gillian B. Silver. "The National Board of Public Health Examiners: Credentialing Public Health Graduates." Public Health Reports 122, no. 4 (July 2007): 435–40. http://dx.doi.org/10.1177/003335490712200403.
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The National Board of Public Health Examiners (NBPHE, the Board) is the result of many years of intense discussion about the importance of credentialing within the public health community. The Board is scheduled to begin credentialing graduates of programs and schools of public health accredited by the Council on Education for Public Health (CEPH) in 2008. Among the many activities currently underway to improve public health practice, the Board views credentialing as one pathway to heighten recognition of public health professionals and increase the overall effectiveness of public health practice. The process underway includes developing, preparing, administering, and evaluating a voluntary certification examination that tests whether graduates of CEPH-accredited schools and programs have mastered the core knowledge and skills relevant to contemporary public health practice. This credentialing initiative is occurring at a time of heightened interest in public health education, and an anticipated rapid turnover in the public health workforce. It is fully anticipated that active discussion about the credentialing process will continue as the Board considers the many aspects of this professional transition. The Board wishes to encourage these discussions and welcomes input on any aspects relating to implementation of the credentialing process.
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Shan, Desai, and Katherine Lippel. "Occupational Health and Safety Challenges From Employment-Related Geographical Mobility Among Canadian Seafarers on the Great Lakes and St. Lawrence Seaway." NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 29, no. 3 (August 22, 2019): 371–96. http://dx.doi.org/10.1177/1048291119870762.
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Seafaring involves multiple patterns of mobility. Ships are mobile workplaces that connect and disconnect from land. Many move within and between national boundaries. Maritime labor forces are recruited from multiple locations engaging in varying commutes to and from homeports—international commutes for international labor forces and internal commutes for national labor forces. Mobilities expose seafarers to a range of occupational health and safety hazards, which can be exacerbated by mobility-related constraints on regulatory protections. Based on legal analysis and twenty-five semi-structured interviews with Canadian seafarers, managers, and key informants, this exploratory study examines how employment-related geographical mobility may create occupational health and safety challenges for Canadian seafarers working on the Great Lakes and the St. Lawrence Seaway. Findings show that few legal instruments are available to protect seafarers from commuting-related occupational hazards and that occupational health and safety challenges are numerous. Seafarers’ occupational health and safety rights on board are restricted and they are systemically discouraged from raising safety concerns.
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Nadler, David. "Workforce Diversity and Occupational Hearing Health." Safety 9, no. 2 (April 13, 2023): 23. http://dx.doi.org/10.3390/safety9020023.
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Hearing loss is one of the more common occupation health hazards across the globe yet is preventable. Extensive research has been done across a number of industries measuring the magnitude and frequency of hearing impairment. This study uses the National Health and Nutrition Examination Survey data to analyze hearing impairment in the United States. Regression and structural equation models were developed utilizing this publicly available data. A statistically significant correlation exists between general hearing condition and ethnicity, χ2 (30, N = 8897) = 264.817, p < 0.001. A statistically significant correlation exists in this database between general hearing condition and gender, χ2 (6, N = 8897) = 40.729, p < 0.001. An ordinal logistic regression was significant between the general health and ethnicity, χ2 (30, N = 5968) = 212.123, p < 0.001. A structural equation model presents the first of its type for this area of research. Focusing on addressing diversity issues may be the foundation for hearing health improvement. Tools such as smartphone apps may be useful for tracking hearing loss within the workforce.
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Mannion, Russell, Tim Freeman, Ross Millar, and Huw Davies. "Effective board governance of safe care: a (theoretically underpinned) cross-sectioned examination of the breadth and depth of relationships through national quantitative surveys and in-depth qualitative case studies." Health Services and Delivery Research 4, no. 4 (January 2016): 1–166. http://dx.doi.org/10.3310/hsdr04040.
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BackgroundRecent high-profile reports into serious failings in the quality of hospital care in the NHS raise concerns over the ability of trust boards to discharge their duties effectively.ObjectivesOur study aimed to generate theoretically grounded empirical evidence on the associations between board governance, patient safety processes and patient-centred outcomes. The specific aims were as follows: (1) to identify the types of governance activities undertaken by hospital trust boards in the English NHS with regard to ensuring safe care in their organisation; (2) in foundation trusts, to explore the role of boards and boards of governors with regards to the oversight of patient safety in their organisation; (3) to assess the association between particular hospital trust board oversight activities and patient safety processes and clinical outcomes; (4) to identify the facilitators and barriers to developing effective hospital trust board governance of safe care; and (5) to assess the impact of external commissioning arrangements and incentives on hospital trust board oversight of patient safety.MethodsThe study comprised three distinct but interlocking strands: (1) a narrative systematic review in order to describe, interpret and synthesise key findings and debates concerning board oversight of patient safety; (2) in-depth mixed-methods case studies in four organisations to assess the impact of hospital board governance and external incentives on patient safety processes and outcomes; and (3) two national surveys exploring board management in NHS acute and specialist hospital trusts in England, and relating board characteristics to whole-organisation outcomes.ResultsA very high proportion of trust boards reported the kinds of desirable characteristics and board-related processes that research says may be associated with higher performance. Our analysis of the symbolic aspects of board activities highlights the role and differences in local processes of organising the governance of patient safety. Most boards do allocate a considerable amount of time to discussing patient safety and quality-related issues and were using a wide range of hard performance metrics and soft intelligence to monitor its organisation with regard to patient safety. Although the board of governors is generally perceived to be well-meaning, they were also considered to be being largely ineffective in helping to promote and deliver safer care for their organisations. We did not find any statistically significant relationship between board attributes (self-reported) and processes and any patient safety outcome measures. However, we did find a significant relationship between two dimensions of the Board Self-Assessment Questionnaire and two specific-and-related national staff survey organisational ‘process’ measures: (1) staff feeling safe to raise concerns about errors, near-misses and incidents and (2) staff feeling confident that their organisation would address their concerns, if raised. We also found that contracting and external financial incentives appeared to play only a relatively minor role in incentivising quality and safety improvement.ConclusionsOur research is the first large-scale mixed-methods study of hospital board activity and behaviour related to the oversight of patient safety in the English NHS and the key findings should be used to influence the design of future governance arrangements as well as the training and support of board. Our finding that board governance/competencies appear to be linked to staff feeling safe to raise concerns about patient safety issues, and also their confidence that their organisation would address their concern, is worthy of further and more sustained exploration, particularly in the context of the current focus on improving whistleblowing policies in the NHS.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Dekhtyar, Michael, Linette P. Ross, Jean D’Angelo, Jeanne Guernsey, Karen E. Hauer, Luan Lawson, Martin V. Pusic, and Richard E. Hawkins. "Validity of the Health Systems Science Examination: Relationship Between Examinee Performance and Time of Training." American Journal of Medical Quality 35, no. 1 (June 10, 2019): 63–69. http://dx.doi.org/10.1177/1062860619853349.
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The health systems science (HSS) framework articulates systems-relevant topics that medical trainees must learn to be prepared for physician practice. As new HSS-related curricula are developed, measures demonstrating appropriate levels of reliability and validity are needed. The authors describe a collaborative effort between a consortium of medical schools and the National Board of Medical Examiners to create a multiple-choice HSS examination in the areas of evidence-based medicine/population health, patient safety, quality improvement, and teamwork. Fifteen schools administered the 100-question examination through 2 academic years a total of 1887 times to 1837 first-time takers. Total test score mean was 67% (SD 11%). Total test reliability as measured by coefficient α was .83. This examination differentiated between medical students who completed the examination before, during, and after relevant training/instruction. This new HSS examination can support and inform the efforts of institutions as they integrate HSS-related content into their curricula.
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Maroor, Parimala S., B. S. Pushpalatha, Sangeetha Kodkani, Lourdu Shruthi, Damaraju Ashwini, Anjali Sharma, Himanshu Negandhi, Suresh S. Shapeti, and Sanjay P. Zodpey. "Strengthening of District/Taluk Level Hospitals Through Implementation of Post-graduate Medical Courses in Karnataka, India." Indian Journal of Community Medicine 49, no. 1 (2024): 11–17. http://dx.doi.org/10.4103/ijcm.ijcm_125_23.
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The World Health Organization (WHO) recommends the requirement of human resource for health (HRH) stands at 44.5 skilled health workers per 10,000 population. WHO recognizes India as one of the countries which has HRH crisis. Karnataka, a southern state in India, has the highest number of medical colleges yet faces the shortage of specialists in the public hospitals. We conducted desk review to understand the HRH crisis, particularly the medical specialists in India. Simultaneously, we conducted secondary research to explore the initiatives taken by the Government of Karnataka (GoK) to mitigate the shortage of medical specialists in the rural areas. GoK scaled up the National Board of Examination in Medical Sciences (NBEMS) postgraduate and super-speciality courses such as Diplomate of National Board (DNB), Diploma, and Doctorate of National Board (DrNB) in district hospitals (minimum 250–500 bedded) and taluk hospitals (minimum 100 bedded) by utilizing the existing resources. Karnataka is the first state in India to expand the NBEMS (DNB and Diploma) courses in taluk hospitals and to begin DrNB courses in district hospitals. The paper documents the process of implementation of the NBEMS courses at district and taluk hospitals of Karnataka, which has supported in strengthening these hospitals in the state.
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El Hadri, Mohamed, Omar Idrissi Kaitouni, Mounir Marrakchi, Tarik Ghailan, and Rachid Amiri. "P-378 THE CRITICAL ROLE OF THE FRIENDLY ASSOCIATION OF OCCUPATIONAL PHYSICIANS AND ERGONOMICS IN THE AGRO-INDUSTRIAL SECTOR." Occupational Medicine 74, Supplement_1 (July 1, 2024): 0. http://dx.doi.org/10.1093/occmed/kqae023.1046.
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Abstract Introduction The Association is dedicated to promoting professional integrity and providing high-quality training to occupational health physicians. Its primary mission is to safeguard workers’ health in compliance with labor regulations. Methods The Association employs diverse methods, including preparing physicians for national qualifications in occupational medicine, participating in labor authority meetings, and representing occupational health physicians at professional events. It frequently organizes roundtable discussions and actively engages in national and regional initiatives to promote occupational medicine. Additionally, it plays an active role in COVID-19 prevention by participating in vaccination, employee monitoring, and using radio and TV to raise awareness. It collaborates closely with the national medical board to address challenges related to practicing occupational medicine in Northern Morocco. Results The study’s results underscore the Association’ success in achieving its objectives. It has effectively strengthened bonds among occupational health professionals and represented all associations in Northern Morocco. Active participation in national and international meetings, along with a commitment to occupational medicine and ergonomics training, keeps it at the forefront of occupational health and safety developments. Specific activities, such as preparing physicians for national qualifications, have also been notably successful. Discussion Its commendable efforts to strengthen relationships among occupational health professionals, provide quality training, and actively participate in national and international initiatives make it a key player in safeguarding worker health and promoting best practices in occupational medicine. Conclusion The Association plays a vital role in advancing worker health and occupational medicine in Northern Morocco.
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Borrelli, Ivan, Paolo Emilio Santoro, Maria Rosaria Gualano, Antongiulio Perrotta, Alessandra Daniele, Carlotta Amantea, and Umberto Moscato. "Alcohol Consumption in the Workplace: A Comparison between European Union Countries’ Policies." International Journal of Environmental Research and Public Health 19, no. 24 (December 17, 2022): 16964. http://dx.doi.org/10.3390/ijerph192416964.
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Background: Alcohol use is an ever-growing phenomenon in the population, consumption data indicate that 5–20% of the European working population have serious problems related to alcohol. The use of alcohol constitutes a risk to the health and safety of workers as well as to the safety of the general population. The present work aims to address the problem of alcohol intake in occupational settings by comparatively analyzing alcohol consumption behavior within the 27 countries of the European Union. Methods: The purpose of this research is to analyze the differences between the 27 countries of the European Union in the application of measures to assess and manage the risk of alcohol intake in occupational settings. Results: An examination of the legislation and guidelines of the different countries reveals profound differences in the management of the problem of alcohol in the workplace. The discrepancy is very wide that it ranges from the complete absence of legislative restrictions on a national level in some countries to highly restrictive measures with severe sanctions in others. Conclusions: It would be appropriate—also for the purpose of ease of movement of workers within the European Community—to find shared management models useful for protecting the health and safety of workers and the general population.
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Kurz, Richard S., Christopher Yager, James D. Yager, Allison Foster, Daniel H. Breidenbach, and Zachary Irwin. "Advancing the Certified in Public Health Examination: A Job Task Analysis." Public Health Reports 132, no. 4 (June 22, 2017): 518–23. http://dx.doi.org/10.1177/0033354917710015.
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Objectives: In 2014, the National Board of Public Health Examiners performed a job task analysis (JTA) to revise the Certified in Public Health (CPH) examination. The objectives of this study were to describe the development, administration, and results of the JTA survey; to present an analysis of the survey results; and to review the implications of this first-ever public health JTA. Methods: An advisory committee of public health professionals developed a list of 200 public health job tasks categorized into 10 work domains. The list of tasks was incorporated into a web-based survey, and a snowball sample of public health professionals provided 4850 usable responses. Respondents rated job tasks as essential (4), very important (3), important (2), not very important (1), and never performed (0). Results: The mean task importance ratings ranged from 2.61 to 3.01 (important to very important). The highest mean ratings were for tasks in the ethics domain (mean rating, 3.01). Respondents ranked 10 of the 200 tasks as the most important, with mean task rankings ranging from 2.98 to 3.39. We found subtle differences between male and female respondents and between master of public health and doctor of public health respondents in their rankings. Conclusion: The JTA established a set of job tasks in 10 public health work domains, and the results provided a foundation for refining the CPH examination. Additional steps are needed to further modify the content outline of the examination. An empirical assessment of public health job tasks, using methods such as principal components analysis, may provide additional insight.
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Lee, Jae Yong, Yi-Ryoung Lee, Hyoung-Ryoul Kim, Jun-Pyo Myong, and Mo-Yeol Kang. "Trends in Obesity Prevalence by Occupation Based on Korean National Health and Nutrition Examination Survey From 1998 to 2015." Safety and Health at Work 11, no. 1 (March 2020): 97–102. http://dx.doi.org/10.1016/j.shaw.2019.08.003.
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Batson, Angela, Sharon Newnam, and Sjaan Koppel. "Examining Coroners’ Recommendations for Health and Safety Management of Ageing Heavy Vehicle Drivers: A STAMP Analysis." International Journal of Environmental Research and Public Health 19, no. 23 (December 1, 2022): 16112. http://dx.doi.org/10.3390/ijerph192316112.
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Recommendations were analysed from coronial cases involving ageing heavy vehicle drivers (≥55 years) and mapped onto a Systems Theoretic Accident Model and Processes (STAMP) control structure to identify the controllers and control actions influential in the heavy vehicle industry with regard to health and safety. A National Coronial Information System (NCIS) database search revealed 38 coroners’ recommendations arising from 14 unique cases of ageing driver involvement. There were no ageing themes identified in the analysis of coroners’ findings and recommendations. An examination of the STAMP control structure identified that the highest concentration of recommendations was in the level of regulation, the second most senior level of control, although safety constraints were advised for all five levels of the system. In regard to identifying themes of control flaws in the recommendations, the study found that “unidentified hazards” were the most common type of safety failure in the analysis of cases of ageing drivers, concentrated at the regulatory level, which indicates that additional risk identification methods by upper levels of control are needed. Therefore, a recommendation arising from the current study is that additional controls in safety intervention are necessitated in the upper and middle levels of the road freight transportation system; in particular, formalising health and safety education for organisational managers, with a focus on identifying ageing issues, would fill a gap in the system for managing ageing heavy vehicle drivers. In conclusion, this study has found that improving the health and safety of ageing heavy vehicle drivers necessitates additional safety constraints with a focus on formalised safety education for organisational managers, in addition to a means to detect emerging and unforeseen hazards in the road freight transportation industry.
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Vingilis, Evelyn, and Piotr Wilk. "Medical Conditions, Medication Use, and Their Relationship With Subsequent Motor Vehicle Injuries: Examination of the Canadian National Population Health Survey." Traffic Injury Prevention 13, no. 3 (May 2012): 327–36. http://dx.doi.org/10.1080/15389588.2012.654411.
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Kochetkov, O. A., A. P. Panfilov, V. Yu Usoltsev, Vladimir N. Klochkov, S. M. Shinkarev, A. V. Simakov, and A. G. Tsovyanov. "RADIATION HYGIENE AND SAFETY OF NUCLEAR INDUSTRY." Hygiene and sanitation 96, no. 9 (March 27, 2019): 868–74. http://dx.doi.org/10.18821/0016-9900-2017-96-9-868-874.
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This article covers basic issues of the radiation protection in nuclear industry. It contains an overview of history of the national nuclear industry including the creation of industry-specific facilities (research centers, medical units etc.). Main stages of the creating the regulatory system for radiation protection, starting from the beginning of the industrial radiation protection, stages of introducing exposure limits and implementation of the radiation protection system in international documents are described. In 1996, for the first time, radiation protection requirements in Russia were documented in the form of the Federal Law 3-FZ of 09.01.1996 “Radiation Protection of the Public". A new stage of updating the global methodological foundation of radiation protection began in 2007. IRCP recommendations of 2007 moved from the legacy practice and intervention approach focused on the process to the approach based on characteristics of exposure situation. The evolvement of new technologies (specifically, in the field of reactor engineering and used nuclear fuel) in recent years requires a special focus on the safety of the personnel and the public. This stipulates the necessity of the appropriate radiation protection support of activities for the safe implementation of modern technologies. Handling of spent nuclear fuel and generated radioactive wastes, safe decommissioning of radiation hazardous facilities, radiation protection during operation of radiation facilities in nonstandard conditions are all the issues requiring specific examination. Regulatory and procedural documents on radiation protection of the personnel and the public during development and implementation of new technologies have been developed and approved as a result of long-term work of scientists and other professionals.
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Seo, Songwon, Wan Young Lim, Dal Nim Lee, Jung Un Kim, Eun Shil Cha, Ye Jin Bang, Won Jin Lee, Sunhoo Park, and Young Woo Jin. "Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study." BMJ Open 8, no. 3 (March 2018): e017359. http://dx.doi.org/10.1136/bmjopen-2017-017359.
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IntroductionThe cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure.Methods and analysisApproximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose–response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status.Ethics and disseminationThis study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings of the study will be disseminated through scientific peer-reviewed journals and be provided to the public, including radiation workers, via the study website (http://www.rhs.kr/) and onsite radiation safety education.
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Manfredo, Irena. "Accidental discovery of asbestos-related occupational pleural disease in unemployed carpenter: a healthcare safety net that needs mending / Poklicna bolezen plevre zaradi izpostavljenosti azbestu pri mizarju." Archives of Industrial Hygiene and Toxicology 66, no. 3 (September 1, 2015): 213–15. http://dx.doi.org/10.1515/aiht-2015-66-2682.
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Abstract Unemployed persons are often on the margins of the healthcare system and under the radar of safety and health organisations, as no systematic records are kept of occupational diseases caused by exposure at previous work place. Law in Slovenia requires that asbestos-related occupational diseases are verified by establishing the causal relationship between exposure at work and its effect on the worker. This report describes a case of verifying occupational pleural disease in an unemployed carpenter who was referred for consultation with occupational health specialist as part of the regular procedure for the unemployed registered at the Employment Service of Slovenia. At the consultation it turned out that the carpenter had been exposed to asbestos when he worked as a teenage apprentice. The diagnosis of the bilateral pleural disease and asbestosis was confirmed by X-ray and high-resolution computed tomography. Because he had no record of exposure in that period, we analysed his past working environment for minerals and found chrysotile in all asbestos board samples. The case was presented to an interdisciplinary committee, which verified his disease as occupational. This case points to the need of adopting guidelines for occupational health specialists providing counsel to the national employment service so that the number of unrecorded occupational diseases is minimised and their treatment is covered by the state.
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Jenn Zhueng Tam, Zuraida Mohamed, Sharifa Ezat Wan Puteh, and Noor Hassim Ismail. "COMPARISONS BETWEEN BACKS QUESTIONNAIRE AND OTHER EXISTING QUESTIONNAIRES AGAINST STANDARDS SET BY A SOCIAL SECURITY ORGANIZATION BASED IN A DEVELOPING COUNTRY." Malaysian Journal of Public Health Medicine 19, no. 2 (April 1, 2019): 96–102. http://dx.doi.org/10.37268/mjphm/vol.19/no.2/art.175.
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In a country that struggles on safety standards and relying heavily on manual labour, Malaysia over the decade had to be very objective in defining work- relatedness among musculoskeletal disorder cases especially chronic low back pain. The BACKS questionnaire was a proposed Back Apparatus; a Collaboration between National University of Malaysia Medical Centre (UKMMC) with Malaysian Social Security Organization (SOCSO) to assist in determining occupational chronic back pain. In the questionnaire, chronic back pain was defined as minimal cumulative back pain for more than 2 weeks in the past year, Pain Visual Analog Score above 2 cm and Oswestry Disability Index of above 20%. Based on the SOCSO registry from 2008 to 2010, 428 (56.3%) workers of 760 workers with back pain agreed and met the requirements of our study. According to the standards of the Medical Board, the BACKS Tool reported a sensitivity of 62.7%, specificity of 94.5%, positive- predictive value (PPV) of 92.9% and negative- predictive value (NPV) of 69.0% with moderate agreement as Kappa value was 0.56. The BACKS Tool served as a complementary assessment along with visits to the workplace that has its advantages when one would to conduct a self- administered assessment of their workplace by safety and health officers, organizations with limited funding.
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Azil, Nurul Ain Shuhada, and Izatul Laili Jabar. "A PRELIMINARY SURVEY ON SAFETY PRACTICES AT CONSTRUCTION SITE: TOWARDS SAFE ENVIRONMENT FOR PUBLIC." Journal of Tourism, Hospitality and Environment Management 6, no. 26 (December 1, 2021): 300–310. http://dx.doi.org/10.35631/jthem.626027.
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The construction industry is globally known as one of the most hazardous workplaces. Companies in the construction sector are undeniably often focused on completing projects on time, which results in tight work schedules and increases the risks of regular construction site activities, especially for the public who lives in the area. Inadequate rules and regulations in public safety and construction sites not practicing the safety practices to protect the public from harm are potential to cause public accidents to happen. Additionally, little improvement in safety practices at the construction sites and lack of awareness in implementing proper safety practices at a construction site could cause the increasing the rate of public accidents too. This study merely aims to explore the safety practices to be implemented at a construction site in a way to prevent public accidents from occurring. In order to achieve the aim, this study has two (2) objectives; 1: to determine the experience in handling accident cases involving the public at a construction site, and, objective 2: to explore the safety practices to be implemented at the construction site. For this preliminary survey, the qualitative research design was selected and the total number of five (5) professional individuals specialized in safety and health in construction sites were chosen as interviewees based on their experiences in handling public safety issues in construction sites. The results show the most recommended safety practices that need to be implemented which is barricade all entrances and exits of the construction site to prevent access from the public. This study provides good insights to the Department of Occupational Safety and Health (DOSH), National Institute of Occupational Safety and Health (NIOSH), and Construction Industry Development Board (CIDB) in identifying the need for safety practices to prevent public accidents at the construction site in congested urban areas.
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Stephens, Mark B., Ting Dong, and Steven J. Durning. "Physical Fitness and Academic Performance: A Pilot Investigation in USU Medical Students." Military Medicine 180, suppl_4 (April 1, 2015): 77–78. http://dx.doi.org/10.7205/milmed-d-14-00559.
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ABSTRACT This study examined the correlations between physical fitness parameters and standard measures of academic performance in a cohort of students at the Uniformed Services University. Significant positive correlations were noted between the average aerobic fitness score and preclerkship grade point average (GPA; r = 0.37, p < 0.05) and cumulative GPA (r = 0.38, p < 0.05). Positive correlations were also noted between the average overall fitness score and preclerkship GPA (r = 0.34, p < 0.05), medical school cumulative GPA (r = 0.34, p < 0.05), and the score on Step 1 of the national board examination (r = −0.33, p < 0.05). Physical fitness may serve as one indicator to predict which students will succeed in medical school and to identify those who are at risk for poor performance and might benefit from a wellness intervention.
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Khan, Mohammed Arshad, Vivek Vivek, Maysoon Khojah, Mohammed Kamalun Nabi, Mohinder Paul, and Syed Mohd Minhaj. "Learners’ Perspective towards E-Exams during COVID-19 Outbreak: Evidence from Higher Educational Institutions of India and Saudi Arabia." International Journal of Environmental Research and Public Health 18, no. 12 (June 17, 2021): 6534. http://dx.doi.org/10.3390/ijerph18126534.
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Online examinations, commonly referred to as e-exams (electronic examinations), underwent a considerable progression, getting adapted ubiquitously among higher education institutions worldwide. Their preferment was rapid due to the emergence of the COVID-19 pandemic. The process of conducting exams online is being opted as the appropriate way of assessment, ensuring the students’ safety and well-being. According to Warts et al., this form of examination has been pretty effective in the past when blended with the conventional assessment. However, at present, implemented as the singular way of assessment, e-exams have shown a more significant promise in being beneficial to the learners. As a matter of fact, a comprehensive analysis on understanding the learners’ perception towards the e-exams was not done earlier, particularly in the developing nations. Thus, it was pertinent to examine the pre-requisites of e-exams to promote it as a useful tool for the smooth conduct of exams in the aforesaid nations. Against such a backdrop, this study was conducted during January to March 2021 on 207 students enrolled in four universities, three situated in the National Capital Territory (NCT) of Delhi, India: Delhi University (DU), Jamia Millia Islamia (JMI), and Jawaharlal Nehru University (JNU), and one situated in Saudi Arabia, namely Saudi Electronic University (SEU). A quantitative approach was employed for the study, with the responses recorded via web questionnaires. Confirmatory -factor analysis (CFA) was applied in the study to examine whether the process of conducting online examinations is being chosen as the appropriate form of assessment, ensuring the safety and well-being of students through AMOS (version 24) software. For determining the reliability of the two latent constructs, namely “Perceptions of students towards E-exams (PSE)” and “Pre-requisites of E-exams (POE),” Cronbach’s alpha was used through SPSS (version 25) software in the study, and the results reveal that the strong internal consistency exists between all the measured variables. In addition, the mean and standard deviation were used by the researchers to find out the pre-requisites of the online examination system. The participants expressed their insights on the relative benefits of online examination. Their perception was based on pedagogy, validity and reliability, affective factors, practicality, and security. From their insights, it was concluded that online examination is more advantageous than conventional paper-based exams. The outcome also applies to the authenticity of grading and the overall efficiency concerning the time, effort, and expenditure on conducting the examination. Contrarily, the participating students also recognized numerous hurdles in implementing e-exams concerning security, validity, and impartiality. The conclusion further revealed that online examination is especially relevant for formative assessment of learning instead of summative assessment, provided authenticity, security, and flexibility are used as fundamental tenants in the proper implementation of e-exams. The outcome of the present study will facilitate higher education institutions and policymakers in taking the electronic examination system to the next level.
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Hall, Noemi B., David J. Blackley, Cara N. Halldin, and A. Scott Laney. "Pneumoconiosis progression patterns in US coal miner participants of a job transfer programme designed to prevent progression of disease." Occupational and Environmental Medicine 77, no. 6 (March 13, 2020): 402–6. http://dx.doi.org/10.1136/oemed-2019-106307.
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ObjectivesPneumoconiosis prevalence and severity among US coal miners has been increasing for the past 20 years. An examination of the current approaches to primary and secondary prevention efforts is warranted. One method of secondary prevention is the Mine Safety and Health Administration-administered part 90 option programme where US coal miners with radiographic evidence of pneumoconiosis can exercise their right to be placed in a less dusty area of the mine. This study focuses on characterising the progression of disease among US coal miners who participated in the National Institute for Occupational Safety and Health-administered Coal Workers’ Health Surveillance Programme (CWHSP) and exercised their part 90 job transfer option.MethodsChest radiograph classifications of working underground coal miners who exercised their part 90 job transfer option during 1 January 1986 to 21 November 2016 and participated in the CWHSP during 1 January 1981 to 19 March 2019 were analysed.Results513 miners exercised their part 90 option and participated in the CWHSP at least once during this time period. Of the 149 miners with ≥2 radiographs available, 48 (32%) showed progression after exercising part 90 and had more severe disease prior to exercising, compared with miners who did not progress (severity score of 2.8 vs 1.7, p=0.0002).ConclusionThe part 90 job transfer option programme is not routinely used as intended to prevent progression of pneumoconiosis among US coal miners. The one-third of miners who participated in part 90 and continued to progress, exercised their part 90 option at a later stage of disease compared with non-progressors.
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Lee, Jung-Sug. "A study to evaluate the safety of iodine intake levels in women of childbearing age: 2013–2015 Korea National Health and Nutrition Examination Survey." Journal of Nutrition and Health 54, no. 6 (2021): 644. http://dx.doi.org/10.4163/jnh.2021.54.6.644.
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Jamtsho, Sonam, Tashi Dendup Wangdi, Phuntsho Wangdi, and Phurba Wangdi. "Incidence and factors associated with surgical site infections at the Surgical Ward, National Referral Hospital, Bhutan." Bhutan Health Journal 5, no. 1 (May 15, 2019): 15–20. http://dx.doi.org/10.47811/bhj.74.
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Introduction: The burden related to surgical site infection (SSI) and antibiotic sensitivity of the organisms causing SSI is acause of concern. This is the first study to assess SSI at Bhutan’s largest surgical centre. Methods: This was an observational descriptive study conducted involving patients undergoing incisional surgeries at the Department of Surgery, JDWNRH from July – December 2017 using convenient sampling. Data was collected using a pro forma. The health care workers conducted the first two wound examinations and the information on the third examination was done though phone call. Southampton Wound Score (SWS) was used to assess the postoperative wound. The Research Ethics Board of Health, Bhutan, gave ethical approval. Results: The incidence of surgical site infection was 30.7% and the most common organism was Escherichia coli. SSI occurred in Southampton Wound Grade I and IV. Contaminated (46.2%) and dirty (33.3%) wounds had higher incidence of SSI. Patients age >60 years (p= 0.049) and those with contaminated wound (p= 0.005) were significant risk factors for SSI. Hypertension, diabetes, smoking, alcohol intake and obesity, elective or emergency case, and the seniority of surgeon were not risk factors for SSI. Conclusions: The incidence of SSI is high and antibiotic sensitivity patterns a cause of concern. Strict infection control and patient safety measures need to be implemented.
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Khaja, Saeed U., Kevin C. Mathias, Emilie D. Bode, Donald F. Stewart, Kepra Jack, Steven M. Moffatt, and Denise L. Smith. "Hypertension in the United States Fire Service." International Journal of Environmental Research and Public Health 18, no. 10 (May 19, 2021): 5432. http://dx.doi.org/10.3390/ijerph18105432.
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Hypertension is a major risk factor for atherosclerotic cardiovascular disease and cardiac remodeling and is associated with an increased risk of sudden cardiac events, the leading cause of duty-related death in the fire service. We assessed systemic blood pressures and prevalence of hypertension among US firefighters by decade of life. Medical records of career firefighters (5063 males and 274 females) from four geographically diverse occupational health clinics were assessed. Hypertension was defined as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, or taking antihypertensive medication. Results from the firefighter sample were compared to the US general population (2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys). Among the total sample, 69% of firefighters met the criteria for hypertension and 17% were taking antihypertensive medications. Percentages of hypertensive male and female firefighters were 45% and 11% among 20–29 years old, respectively, and increased to 78% and 79% among 50–59 years old, respectively. Compared to the general population, male firefighters had a higher prevalence of hypertension (p < 0.05) across all age groups (11–16% higher). In order to improve firefighter health and protect against sudden incapacitation in this public safety occupational group, increased efforts are necessary to screen for and manage high blood pressure.
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Brown, Alison, Vicky Mason, and Anne Lyon. "Strengthening clinical governance in community health." Australian Journal of Primary Health 14, no. 2 (2008): 11. http://dx.doi.org/10.1071/py08017.
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This paper outlines the work of the Clinical Governance in Community Health Project that aims to strengthen clinical governance systems in the Victorian community health sector. While clinical governance in community health is not new, the work of the project has aimed to develop a more consistent approach to safety and quality. This represents a strategic response to policy imperatives at a state and national level, which has resulted in a transition to a client population that has greater acuity and complexity in their health and social needs. The project has focused on the areas of clinical risk management, credentialling, defining scope of practice, clinical indicators and board reporting. The project has been evaluated through an annual sector survey which has demonstrated that the majority of respondents have used resources created by the project. Ninety-four per cent of respondents indicated that they had reviewed their clinical governance reporting processes in the previous 12 months. The project has strong governance from a steering group comprised of stakeholders from the community health sector, the acute sector, state government, accreditation agencies and insurance authorities, with the project work being completed by working groups consisting of community health chief executive officers, managers and clinicians. This has resulted in high levels of engagement and ownership by the sector.
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LaRochelle, Jeffrey S., Ting Dong, and Steven J. Durning. "Preclerkship Assessment of Clinical Skills and Clinical Reasoning: The Longitudinal Impact on Student Performance." Military Medicine 180, suppl_4 (April 1, 2015): 43–46. http://dx.doi.org/10.7205/milmed-d-14-00566.
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ABSTRACT Purpose: Many medical schools across the United States are undergoing curriculum reform designed, in part, to integrate basic sciences and clinical skills. Evidence has suggested that preclerkship courses in clinical skills and clinical reasoning are predictive of student performance on the clerkship. We hypothesized that a combination of outcome measures from preclerkship clinical skills and clinical reasoning courses (Objective Structured Clinical Examination scores, preceptor evaluations, National Board of Medical Examiners subject examination scores, and small group participation grades) would be correlated to performance in internship (program director [PD] evaluation form at end of first postgraduate year). Methods: Outcome measures from preclerkship clinical skills and clinical reasoning courses and PD evaluation forms from 514 medical students graduating between 2009 and 2011 were analyzed in a multiple linear regression model. Results: Preclerkship clinical skills and clinical reasoning outcome measures were significant contributors to the linear regression model and were able to explain 13.9% of the variance in expertise and 7.6% of the variance in professionalism as measured by the PD evaluation form. Conclusion: Clinical skills and clinical reasoning courses during the preclerkship period explained a significant amount of performance at the graduate medical education level. Our data suggest that these courses provide valuable information regarding student abilities in internship. Early recognition of struggling students may provide an opportunity to break a cycle of poor performance that can persist into residency training.
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Inacio, Maria C., Catherine Lang, Gillian E. Caughey, Sarah C. E. Bray, Stephanie L. Harrison, Craig Whitehead, Renuka Visvanathan, et al. "The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care." International Journal for Quality in Health Care 32, no. 8 (July 21, 2020): 502–10. http://dx.doi.org/10.1093/intqhc/mzaa078.
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Abstract Objectives To introduce the Registry of Senior Australians (ROSA) Outcome Monitoring System, which can monitor the quality and safety of care provided to individuals accessing residential aged care. Development and examination of 12 quality and safety indicators of care and their 2016 prevalence estimates are presented. Design Retrospective. Setting 2690 national and 254 South Australian (SA) aged care facilities. Participants 208 355 unique residents nationally and 18 956 in SA. Main Outcome Measures Risk-adjusted prevalence of high sedative load, antipsychotic use, chronic opioid use, antibiotic use, premature mortality, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium and/or dementia hospitalisations, emergency department presentations, and pressure injuries. Results Five indicators were estimated nationally; antibiotic use (67.5%, 95% confidence interval (CI): 67.3–67.7%) had the highest prevalence, followed by high sedative load (48.1%, 95% CI: 47.9–48.3%), chronic opioid use (26.8%, 95% CI: 26.6–26.9%), antipsychotic use (23.5%, 95% CI: 23.4–23.7%) and premature mortality (0.6%, 95% CI: 0.6–0.7%). Seven indicators were estimated in SA; emergency department presentations (19.1%, 95% CI: 18.3–20.0%) had the highest prevalence, followed by falls (10.1%, 95% CI: 9.7–10.4%), fractures (4.8%, 95% CI: 4.6–5.1%), pressure injuries (2.9%, 95% CI: 2.7–3.1%), delirium and/or dementia related hospitalisations (2.3%, 95% CI: 2.1–2.6%), weight loss/malnutrition (0.7%, 95% CI: 0.6–0.8%) and medication-related events (0.6%, 95% CI: 0.5–0.7%). Conclusions Twelve quality and safety indicators were developed to monitor aged care provided to older Australians based on the synthesis of existing literature and expert advisory input. These indicators rely on existing data within the aged care and healthcare sectors, therefore creating a pragmatic tool to examine quality and unwarranted care variation.
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Haller and Smith. "Examination of Strenuous Activity Preceding Cardiac Death during Firefighting Duties." Safety 5, no. 3 (August 9, 2019): 50. http://dx.doi.org/10.3390/safety5030050.
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Sudden cardiac death accounts for approximately 45% of duty-related fatalities among United States firefighters. Strenuous physical exertion is recognized as a trigger of sudden cardiac events. This study describes the duration of strenuous physical exertion on-scene preceding a fatal cardiac event by situation encountered during firefighting duties. Data provided by the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program for duty-related firefighter fatalities over a 9-year period were analyzed. Among the 235 fatalities investigated, 45% had a cause of death that was cardiac in origin. Time (mean ± SD) spent on-scene in strenuous work was 30 ± 26 min, 14 ± 15 min, and 47 ± 52 min for fire, non-fire emergency, and training situations, respectively. Across all emergency operations and training, 31% of fatalities occurred among firefighters who performed ≤10 min of strenuous work, whereas 13% of fatalities occurred among those who performed >60 min. Study findings indicate that there is considerable variability in the duration of strenuous work preceding fatal cardiac events during firefighting duties. Notably, a high percentage of fatal cardiac events occurred after a relatively brief period of strenuous work, suggesting that the performance of any strenuous work, even that of short duration, may be sufficient to provoke a cardiac event in a firefighter with underlying cardiac disease.
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Boyle, John, Glen Nowak, Rachel Kinder, Ronaldo Iachan, and James Dayton. "Better Understanding Adult COVID-19 Vaccination Hesitancy and Refusal: The Influence of Broader Beliefs about Vaccines." International Journal of Environmental Research and Public Health 19, no. 11 (June 2, 2022): 6838. http://dx.doi.org/10.3390/ijerph19116838.
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Published surveys in the United States provide much evidence that COVID-19 vaccination is influenced by disease and vaccine-related risk perceptions. However, there has been little examination of whether individual’s general beliefs about vaccines are also related to COVID-19 vaccination, especially among unvaccinated adults. This study used an August 2021 national survey of 1000 U.S. adults to examine whether general beliefs about vaccines were associated with COVID-19 vaccination status. In addition, it used multivariate analyses to assess the relative contribution of individual vaccine beliefs to current vaccine status independently of COVID-19-specific attitudes and experiences, and demographics. The findings indicated that, collectively, general vaccine beliefs mattered more than demographics, COVID-19-specific risk perceptions, confidence in government, or trust in public health agencies in COVID-19 vaccination status. Overall, the findings affirm the importance of vaccine education and communication efforts that help people understand why vaccines are needed, how vaccine safety is established and monitored, and how vaccines provide protection from infectious diseases. To achieve success among vaccine-hesitant individuals, communication strategies should target vaccine beliefs that most influence vaccination outcomes.
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de Voogt, Alex, and Keyashia Nero. "Technical Failures in Helicopters: Non-Powerplant-Related Accidents." Safety 9, no. 1 (February 22, 2023): 10. http://dx.doi.org/10.3390/safety9010010.
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Technical failures in helicopters are a main concern for helicopter safety. The prominence of mechanical failures differs for specific helicopter operations. This analysis used 151 General Aviation accident reports from the National Transportation Safety Board online database from an 11-year time period. The information in each report was collated, including the list of findings for each accident. Possible relations between causes and specific flight operations were analyzed by looking at significant differences between expected and actual values within the dataset of categorical data. It is found that the proportion of fatal accidents in this category of accidents is low (16.6%) compared with the percentage of fatal helicopter accidents in general, as well as those of specific helicopter operations. Instructional flights appear significantly more likely to be associated with maintenance-related causes. Causes related to fatigue of aircraft parts are more often associated with ferry and positional flights, as well as helicopters with turbo-shaft engines. Future research is recommended for these specific associations to further mitigate the number of accidents with non-powerplant failures.
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de Voogt, Alex, and Kayla Louteiro. "Nose-Over and Nose-Down Accidents in General Aviation: Tailwheels and Aging Airplanes." Safety 10, no. 2 (April 13, 2024): 39. http://dx.doi.org/10.3390/safety10020039.
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Safety in General Aviation has been a continuous concern. About 12% of all airplane accidents in General Aviation involve nose-overs and nose-down events. A total of 134 accidents reported by the National Transportation Safety Board that include nose-overs and nose-downs were analyzed for their main causes. It was found that 35% of the defining events involved a loss of control on the ground while 58% of the total dataset involved tailwheel-type aircraft. A relatively high proportion of aircraft built before 1950 were found, which are also aircraft that have tailwheel-type landing gear, and thereby a higher propensity for ground loops and nose-overs. It is shown that the high accident rate in General Aviation, especially for accidents that did not result in a fatality, was, to an important extent, explained by tailwheel and older aircraft in the US General Aviation airplane fleet struggling with controlling the aircraft on the ground. Attention to this group of aircraft in future studies may help to more effectively address the relatively high accident rates in General Aviation.
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Nasir, Naima, Sassy Molyneux, Fred Were, Adeniyi Aderoba, and Sebastian S. Fuller. "Medical device regulation and oversight in African countries: a scoping review of literature and development of a conceptual framework." BMJ Global Health 8, no. 8 (August 2023): e012308. http://dx.doi.org/10.1136/bmjgh-2023-012308.
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Regulatory and other governance arrangements influence the introduction of medical devices into health systems and are essential for ensuring their effective and safe use. Challenges with medical device safety, quality and use are documented globally, with evidence suggesting these are linked to poor governance. Yet, medical device regulation and oversight remain inadequately defined and described, particularly in low-income and middle-income settings. Through this review, we sought to examine the literature available on regulatory and oversight processes for medical devices in African countries.Following a systematic approach, we searched academic databases including PubMed, Embase (Ovid) and MEDLINE (Ovid), supplemented by search for grey literature and relevant organisational websites, for documents describing medical device regulation and oversight in African countries. We summarised the data to present key actors, areas for regulation and oversight and challenges.A total of 39 documents reporting regulation and oversight of medical devices were included for analysis. Regulatory and oversight guidelines and processes were reported as inadequate, including limited pre-market testing, reliance on international certifications and limited processes for post-market monitoring and reporting of adverse events. Challenges for regulation and oversight reported included inadequate funding, personnel and technical expertise to perform regulatory functions. The literature highlighted gaps in guidelines for donated medical devices and in information on governance processes at the national level.The current literature provides a general overview of medical device regulatory guidelines and limited evidence on the implementation of regulatory/oversight processes at national and especially subnational levels. We recommend further research to elucidate existing governance arrangements for medical devices within African countries and propose a conceptual framework to inform future studies. The framework provides entry points for careful examination of governance and oversight in policy and practice, the exploration of governance realities across the health system and the influence of wider system dynamics.
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Belgodère, Laëtitia, Dominique Pougheon Bertrand, Marie Christine Jaulent, Vololona Rabeharisoa, Walter Janssens, Victoria Rollason, Janine Barbot, et al. "Patient and public involvement in the benefit–risk assessment and decision concerning health products: position of the Scientific Advisory Board of the French National Agency for Medicines and Health Products Safety (ANSM)." BMJ Global Health 8, no. 5 (May 2023): e011966. http://dx.doi.org/10.1136/bmjgh-2023-011966.
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Saleh, Mansoor, Karishma Sharma, Aisleen Shamshudin, Innocent Obayo, Stacey Gondi, and Noureen Karimi. "Regulatory approval of clinical trials: is it time to reinvent the wheel?" BMJ Global Health 9, no. 1 (January 2024): e013727. http://dx.doi.org/10.1136/bmjgh-2023-013727.
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Less than 1% of all clinical trials are conducted in Africa. In 2019, only six of 26 oncology clinical trials conducted in Africa were conducted in countries with subjects of African ancestry. There are multiple barriers that hinder the conduct of cancer clinical trials in Africa. Time to trial activation (TTA) is the administrative and regulatory process required before a study can be activated—an important metric and often a major barrier for site selection. In Kenya, TTA involves review by Institutional Review Board (IRB), Pharmacy and Poisons Board, National Commission for Science, Technology and Innovation and Ministry of Health, all in a sequential fashion. We performed a prospective review of TTA for all clinical trials initiated and began enrolment at the Aga Khan University-Clinical Research Unit between June 2020 and November 2022. TTA was defined as total time from submission of study documents (to regulatory bodies) to site activation by the sponsor. A total of 12 studies were submitted for regulatory review. Eleven (nine industry sponsored and two investigator initiated) were approved for activation. Three were COVID-19-related studies and eight were non-COVID-19-related studies. Mean TTA for COVID-related studies was 80 days (range 40–120). Mean TTA for non-COVID-related studies was 259 days (range 190–399). This TTA difference was statistically significant (p=0.02). TTA remains a significant barrier to the efficient regulatory approval of and subsequent conduct of clinical trials in Africa. COVID-19 pandemic revealed that parallel processing and expedited review of clinical trials allows efficient TTA without compromising human subject safety or data integrity. These lessons need to be applied to all clinical trials in order for African sites to become competitive and contribute data from African patients to global knowledge.
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Sabo, Samantha, Dulce J. Jiménez, Alexandra Samarron Longorio, Omar Gomez, Melissa Liebert, Miriam Adriana Cuautle, Sara Shuman, Jill Guernsey de Zapien, and Shefali Milczarek-Desai. "Aquí Entre Nos (Just Between Us): Engagement of Hotel Housekeepers During Sociopolitical and Environmental Change." Progress in Community Health Partnerships: Research, Education, and Action 18, no. 2 (June 2024): 213–23. http://dx.doi.org/10.1353/cpr.2024.a930717.
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Abstract: Background: Aquí Entre Nos (Between Us) is a community-based participatory research project to engage rural, ethno-racially diverse hotel housekeepers in a right to work state during a time of national anti-immigrant policy, wildfires and emergence of a global pandemic. Objectives: We aimed to (1) build trust and social support with the hotel housekeeping community, (2) learn about the occupational health, safety, and workers’ rights challenges, strategies, and solutions held by workers, and (3) develop a workforce-driven research and action agenda to improve labor and health conditions. Methods: Participatory mixed methods rooted in popular education are described to form an advisory board and engage the workforce. Lessons Learned: Trusted relationships built through community organizing around immigration, housing, and minimum wage were critical to engage and drive a worker centered research agenda. Conclusions: Despite challenges, housekeeper advisors defined a research agenda that addressed immediate-and long-term needs of the workforce.
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Min, Young-Sun, Min-Gi Kim, and Yeon-Soon Ahn. "Rheumatoid Arthritis in Silica-Exposed Workers." International Journal of Environmental Research and Public Health 18, no. 23 (December 3, 2021): 12776. http://dx.doi.org/10.3390/ijerph182312776.
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Few studies have examined rheumatoid arthritis (RA) risk and severity in Korean workers exposed to silica. We compared the hospitalization risk of RA between silica-exposed workers and the general Korean population. The study cohort consisted of male workers exposed to silica who had undergone at least one silica-associated special medical examination between 1 January 2000 and 31 December 2004 (N = 149,948). The data were from the Korea Occupation Safety and Health Agency. RA morbidity based on hospital admission records was estimated from 2000 to 2005 using the Korea National Health Insurance Service claims data. The standardized admission ratio (SAR) was calculated by dividing the observed number of admissions in silica-exposed workers by the expected number of admissions in the general reference population. For the sum of “Seropositive rheumatoid arthritis” (M05) and “Other rheumatoid arthritis” (M06), the SAR was higher in the silica-exposed group (1.34, 95% CI 1.08–1.64). For M05, workers with <10 years of silica exposure had a significantly higher SAR (2.54, 95% CI 1.10–5.01) than the general population. More silica-exposed workers without a diagnosis of pneumoconiosis were hospitalized for RA than the general population. Our analysis reaffirms the link between silica exposure and RA and suggests that the severity of RA is increased by silica. Further studies of silica-exposed workers with longer follow-up are needed.
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Teferi Dellie, Seife, Ambaye Fisehaw Tesfaw, Marema Jebessa Kumsa, and Birhanu Turi Tolawak. "Local Diagnostic Reference Levels for Common Adult Computed Tomography Procedures in Addis Ababa." Dose-Response 21, no. 2 (April 2023): 155932582311714. http://dx.doi.org/10.1177/15593258231171492.
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Background Computed Tomography has become the major source of population exposure in diagnostic x-rays. This concerned issue will be resolved by stetting Local Diagnostic Reference Levels. Objectives The main objective of this study is to assess dose indicators for the establishment of Local Diagnostic Reference Levels. Materials and methods A prospective cross-sectional study design was conducted on 8 public and private hospitals performing CT examinations. A total of 725 adult patients who underwent abdominopelvic, chest, and head CT examinations were evaluated from October 2021 to March 2022. Patients’ demography, exposure parameters, and dose descriptors were collected. The minimum, maximum, mean, median, and third quartile values were analyzed using SPSS software version 26. Finally, the third quartile values of collected data were compared with national and international values. Results The third quartile values obtained from median of volumetric computed tomography dose index (mGy) and dose length product (mGy.cm) which are considered as local DRLs for head, chest, and abdominopelvic CT examination, respectively, were 53 mGy, 14 mGy and 13 mGy; 1307 mGy.cm, 575 mGy.cm, and 932 mGy.cm. Conclusion The results of this study showed that practices of CT imaging in both public and private hospitals in Addis Ababa were comparable to other national and international values.
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Lu, Jinky Leilanie. "Assessment of Pesticide-Related Pollution and Occupational Health of Vegetable Farmers in Benguet Province, Philippines." Journal of Health and Pollution 7, no. 16 (December 1, 2017): 49–57. http://dx.doi.org/10.5696/2156-9614-7.16.49.
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Background. Agriculture accounts for 20% of the national income in the Philippines. In order to boost agricultural activity and prevent crop damage, farmers rely on pesticides for vector control and management. Objectives. The present study assessed the pesticide exposure and occupational health of agricultural farmers in the Philippines. The study site is one of the largest vegetable-producing provinces in the Philippines. Methods. This study employed both a survey questionnaire and physical health assessment, including a mental state examination. Pesticide exposure was estimated based on the duration of pesticide use, as well as the amount per spray application. The data results were segregated by gender, as women are also heavily engaged in agriculture in this part of the Philippines. Results. The results showed that pesticide exposure usually occurred during agricultural activities such as spray applications in the field (63.7%), mixing (38.4%), loading (34.1%) and field re-entry (9.7%). The most frequently used pesticides were Tamaron, Selecron, and Dithane. The mean duration of pesticide exposure was 14.23 years for males and 15.4 years for females. The longest used pesticide among males was Sumicidine (16.2 years), and Tamaron for females (18 years). In terms of amount used, the average was 147 ml per spray application for males and 65.5 ml for females. Exposure to pesticides was expressed in number of years and amount used per spray application, and the average exposure of males was 2,024.43 ml/years and 993.55 ml/years for females. Among farmers, 49% complained of being sick due to their work. Of those who became ill, a large percentage (69.8%) did not receive any medical attention. The most prevalent health symptoms were muscle pains (63.3%), muscle weakness (55%), and easy fatigability (52.4%). For the mini-mental state examination, abnormalities were found in 5.4% of males and 13.3% of females. The use of insecticides was associated with weakness, easy fatigability and weight loss. Discussion. The present study demonstrated frequent and significant duration of pesticide use among farmers in Benguet province, Philippines. Conclusions. Pesticide exposure was considerable among the farmers in the present study. The occupational health conditions reported by the study subjects can be linked to their pesticide use. Although this study assessed risk factors associated with general health symptoms, further investigation is needed to determine specific pesticide exposure-health correlations. Participant Consent. Obtained Ethics Approval. The study was approved by the Research Ethics Board of the University of the Philippines, Manila, which is recognized and accredited by the Forum for Ethical Review Committees in Asia and the Western Pacific (FERCAP). Competing Interests: The authors declare no competing financial interests.
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Kwon, Soon-Chan, Inah Kim, and Yu-Mi Kim. "Emotional Demand and Mental Health in Korean Employees." International Journal of Environmental Research and Public Health 18, no. 14 (July 8, 2021): 7312. http://dx.doi.org/10.3390/ijerph18147312.
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Background: Emotional demand (ED) at work is related to mental health in the general workforce, not just emotional workers. We investigated the relationships between ED and mental health outcomes, including distress, depressive symptoms (DS), experience of depression (DE), and suicidal ideation (SI) on the entire general workforce using nationally representative data. Methods: 5787 full-time employees were analyzed using cross-sectional design with the fourth Korean National Health and Nutrition Examination Survey (K-NHANES IV). Work-related psychosocial factors and mental health status were measured through face-to-face interviews. Multi-stage and stratified survey designs were considered in the analysis, and the mental health effects of ED were analyzed using multivariable logistic analysis. The Cochran–Armitage trend test was conducted to investigate increases in the relationship between the severity of ED and mental health outcomes. Results: The subjects comprised 3089 men and 2698 women. ED was reported by 36.7% of men and 39.3% of women. The estimated prevalence of distress was 27.5% in men and 34.6% in women. Adjusted odds ratios (ORs) of ED for distress were 2.62 (95% confidence interval (CI) = 2.10–3.28) for men and 2.57 (95% CI = 1.92–3.45) for women. DS was significantly related to ED (men: OR = 1.72, 95% CI = 1.18–2.50; women: OR = 1.91, 95% CI = 1.33–2.74). ED was also significant psychosocial risk factor for DE (men: OR = 1.88, 95% CI = 1.07–3.29; women: OR = 1.77, 95% CI = 1.15–2.75) and SI (men: OR = 1.64, 95% CI = 1.11–2.41; women: OR = 2.31, 95% CI = 1.63–3.28). Conclusions: ED was a risk factor for distress, DS, DE, and SI in the general workforce. Legal and social safety networks should be constructed for workers whose emotions may be hidden at work, as well as workers in emotion-related fields.
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Zaheer, Dania, Arooj Munawar, and Sarwat Ali. "Relation of sleep and musculoskeletal disorders among workers: a systematic review." Journal of the Pakistan Medical Association 73, no. 7 (June 15, 2023): 1468–74. http://dx.doi.org/10.47391/jpma.6716.
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Objective: To systematically review literature on the relationship of sleep with musculoskeletal disorders. Method: The systematic review was conducted after approval from the ethics review board of the University of Lahore, Lahore, Pakistan, and comprised search of relevant literature published from 2012 to 2020 on Web of Science, Latin America and the Caribbean Literature on Health Sciences and PakMedinet electronic databases. The key words used during the search included workers, musculoskeletal pain, insomnia, musculoskeletal diseases, pain and sleep disorders. outcome measures were the Nordic Musculoskeletal Questionnaire, Numerical Rating Scale, Musculoskeletal Complaint Severity Index, Epworth Sleepiness Scale, Bergen Insomnia Scale, Karolinska Sleepiness Questionnaire and the National Institute for Occupational Safety and Health score. PROSPERO CRD42021281084 Results: Of the 1,538 studies found, 13(0.8%) were reviewed. The relationship between pain and sleep was not found among studies but, sleep disturbances were found to be linked to MSK pain in various parts of the body among workers. Conclusion: Healthy lifestyle contributing to improvement in sleep quality and prevention of musculoskeletal pain should be considered in order to enhance the quality of life among workers. Systematic review registration: PROSPERO CRD42021281084 Key Words: Allied health personnel, Insomnia, Musculoskeletal pain, Musculoskeletal diseases, Pain, Sleep disorders.
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Ullmann, W., and W. Röhnsch. "Measurement and Calibration Experience with Short-Lived Radon Daughters." Radiation Protection Dosimetry 24, no. 1-4 (August 1, 1988): 285–88. http://dx.doi.org/10.1093/oxfordjournals.rpd.a080288.
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Abstract In view of the health effects of short-lived radon daughters, various methods and instruments for determining their concentrations in air have been developed in the National Board for Atomic Safety and Radiation Protection (SAAS) of the GDR for reasons of radiation protection. A survey is given of the respective measurement requirements and of the quantities measured. Devices for short-term as well as time-integrated measurements of the potential alpha energy concentration, using different kinds of detectors, are described in detail, including the determination of the equilibrium factor and of the free fraction of short-lived daughters. Information is given regarding international comparison of measuring devices, of calibration methods applied at the SAAS and of elaboration of a primary standard for the unit of the potential alpha energy concentration. The use of the methods and instruments in the radiation protection practice of the SAAS is outlined.
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Petersen, Kyle, Ting Dong, Paul A. Hemmer, and William F. Kelly. "Online Virtual Patient Cases vs. Weekly Classroom Lectures in an Internal Medicine Clerkship: Effects on Military Learner Outcomes." Military Medicine 188, no. 5-6 (May 25, 2022): 914–20. http://dx.doi.org/10.1093/milmed/usac136.
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ABSTRACT Introduction Virtual patient cases (VPCs), a type of simulated, interactive electronic learning, are a potentially important tool for military health care providers in austere or pandemic settings to maintain skills but need more validation. Our military internal medicine clerkship is spread across military treatment facilities around the country and has 15 weekly live student lectures, but students randomly miss the first, second, or third 5 weeks due to their psychiatry clerkship. We hypothesized that VPCs would be an adequate replacement for lost lectures. Materials and Methods We compared live lectures to a web-based VPC and analyzed the academic outcomes of 734 students from 2015 to 2022. Results Using our end-of-clerkship Script Concordance Test (SCT) as the primary outcome, there was no significant difference in performance between the 2 learning methods (VPC, 63.9% correct; lectures 63.2%, P = .27). After controlling for gender, baseline knowledge, and the total number of VPCs completed, there was still not a statistically significant difference between teaching methods (F(1,728) = 0.52, P = .47). There was also no significant differences in all other clerkship outcomes including National Board of Medical Examiner and Objective Structured Clinical Examination scores. Conclusion VPCs appear noninferior at teaching clinical reasoning as measured by SCT. VPCs might be substituted for traditional, live lectures in clerkships when time or other resources are limited, in austere environments such as military deployments, or during conditions limiting interpersonal contact such as pandemics but are not a complete substitution for in-person learning.
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Green, Althea, Ting Dong, Deanna N. Schreiber-Gregory, Laura Tilley, and Steven J. Durning. "Prior Enlisted Medical Students at the Uniformed Services University: Outcomes During Four Years of Medical School." Military Medicine 188, Supplement_2 (May 1, 2023): 1–6. http://dx.doi.org/10.1093/milmed/usad072.
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ABSTRACT Introduction The Uniformed Services University (USU) implemented the Enlisted to Medical Degree Preparatory Program (EMDP2) with the goal of enhancing the diversity of the military physician corps. Programs like EMDP2 can assist students in making the social and intellectual transition from undergraduate studies to medical school and beyond. These types of programs are also opportunities to reduce health disparities and prepare students to work in multicultural settings. The purpose of this study was to evaluate whether there was any significant difference in performance between USU medical students who had attended the EMDP2 and those who had not. Materials and Methods We compared the results of National Board of Medical Examiners (NBME) Clinical Science Subjects, United States Medical Licensing Examination (USMLE) Step 1, and USMLE Step 2 Clinical Knowledge exams of EMDP2 learners from the School of Medicine classes of 2020 to 2023 to those of four similarly sized cohorts of their peers who varied by age and prior military service. Results We found that the performance of EMDP2 graduates was comparable to their peers who followed more traditional and other alternative paths to medical school. For example, regression models showed that EMDP2 status was not a statistically significant predictor of average clerkship NBME exam score, nor of USMLE Step 1 failure. Conclusion EMDP2 graduates performed on a par with their medical school peers, and EMDP2 status does not appear to influence NBME or USMLE performance. EMDP2 provides a focused curriculum and addresses the mandate to make medical education opportunities available to a more diverse population.
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Lee, Doo Woong, Kwanghyun Kim, Jongmin Baek, Sarah Soyeon Oh, Sung-In Jang, and Eun-Cheol Park. "Association of habitual alcohol use on risk-taking behaviors while using a car: The Korean National Health and Nutrition Examination Survey 2009–2013." Accident Analysis & Prevention 144 (September 2020): 105651. http://dx.doi.org/10.1016/j.aap.2020.105651.
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Xiao, Jin, Cyril Meyerowitz, Patricia Ragusa, Kimberly Funkhouser, Tamara R. Lischka, Luis Alberto Mendez Chagoya, Nisreen Al Jallad, et al. "Assessment of an Innovative Mobile Dentistry eHygiene Model Amid the COVID-19 Pandemic in the National Dental Practice–Based Research Network: Protocol for Design, Implementation, and Usability Testing." JMIR Research Protocols 10, no. 10 (October 26, 2021): e32345. http://dx.doi.org/10.2196/32345.
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Background Amid COVID-19, and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care, are cost effective, and ensure the safety of patients and dental health care personnel (DHCP). Traditional dental examinations, which number more than 300 million per year in the United States, rely on person-to-person tactile examinations, pose challenges to infection control, and consume large quantities of advanced-level personal protective equipment (PPE). Therefore, our long-term goal is to develop an innovative mobile dentistry (mDent) model that takes these issues into account. This model supplements the traditional dental practice with virtual visits, supported by mobile devices such as mobile telephones, tablets, and wireless infrastructure. The mDent model leverages the advantages of digital mobile health (mHealth) tools such as intraoral cameras to deliver virtual oral examinations, treatment planning, and interactive oral health management, on a broad population basis. Conversion of the traditional dental examinations to mDent virtual examinations builds upon (1) the reliability of teledentistry, which uses intraoral photos and live videos to make diagnostic decisions, and (2) rapid advancement in mHealth tool utilization. Objective In this pilot project, we designed a 2-stage implementation study to assess 2 critical components of the mDent model: virtual hygiene examination (eHygiene) and patient self-taken intraoral photos (SELFIE). Our specific aims are to (1) assess the acceptance and barriers of mDent eHygiene among patients and DHCP, (2) assess the economic impact of mDent eHygiene, and (3) assess the patient’s capability to generate intraoral photos using mHealth tools (exploratory aim, SELFIE). Methods This study will access the rich resources of the National Dental Practice-Based Research Network to recruit 12 dentists, 12 hygienists, and 144 patients from 12 practices. For aims 1 and 2, we will use role-specific questionnaires to collect quantitative data on eHygiene acceptance and economic impact. The questionnaire components include participant characteristics, the System Usability Scale, a dentist-patient communication scale, practice operation cost, and patient opportunity cost. We will further conduct a series of iterative qualitative research activities using individual interviews to further elicit feedback and suggestion for changes to the mDent eHygiene model. For aim 3, we will use mixed methods (quantitative and qualitative) to assess the patient’s capability of taking intraoral photos, by analyzing obtained photos and recorded videos. Results The study is supported by the US National Institute of Dental and Craniofacial Research. This study received “single” institutional review board approval in August 2021. Data collection and analysis are expected to conclude by December 2021 and March 2022, respectively. Conclusions The study results will inform the logistics of conducting virtual dental examinations and empowering patients with mHealth tools, providing better safety and preserving PPE amid the COVID-19 and possible future pandemics. International Registered Report Identifier (IRRID) PRR1-10.2196/32345
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Boafo, Yvonne, Sayed Mostafa, and Emmanuel Obeng-Gyasi. "Association of Per- and Polyfluoroalkyl Substances with Allostatic Load Stratified by Herpes Simplex Virus 1 and 2 Exposure." Toxics 11, no. 9 (September 1, 2023): 745. http://dx.doi.org/10.3390/toxics11090745.
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Herpes Simplex Virus (HSV) 1 and 2 are persistent infections that affect a significant percentage of United States (US) adults, with 48% having HSV-1 and 12% having HSV-2. Using data stratified by HSV-1 and HSV-2 exposures, this study investigated the association of per- and polyfluoroalkyl substances (PFAS), a group of toxic synthetic organofluorine chemical compounds found in environmental, occupational, and home settings, with allostatic load (AL), an index of chronic physiological stress. Descriptive statistics, multivariable logistic regression, and Bayesian Kernel Machine Regression (BKMR) modeling were used to assess the effects of multi-PFAS exposures on AL using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2014. Results indicated participants not exposed to PFAS exhibited 77% to 97% lower odds of higher AL (p < 0.001). For example, PFOS per unit increase brought forth a 2% odds increase in higher AL (OR: 1.02; 95% CI: 1.00, 1.05; p < 0.05). Participants exposed to PFAS had reduced odds of higher AL (77%–79%), regardless of their HSV-1 and HSV-2 status. PFAS exposure was more prevalent in those with HSV-1 (60%) than in those with HSV-2 (20%) infection, while AL levels were comparable in both groups (17%). BKMR revealed a nonlinear PFAS-AL association and confirmed interactions among PFAS. In summary, PFAS exposure increased the likelihood of higher AL among those with persistent HSV infections. Our study enhances the current understanding of the complex dynamics involving PFAS, persistent infections, and AL, which hold significant implications for public health and clinical intervention strategies.
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Kalagher, Hilary, and Alex de Voogt. "Loss of Visual Reference in U.S. Aviation: An Analysis of 129 Accidents." Safety 8, no. 1 (February 16, 2022): 13. http://dx.doi.org/10.3390/safety8010013.
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A “loss of visual reference” is a term used by the National Transportation and Safety Board investigators to describe a situation in which the pilot has lost reference to the horizon or ground. Previous research has largely focused on the conditions that are often associated with a loss of visual reference (e.g., spatial disorientation) instead of the term itself. The purpose of the present study is to examine the accident and pilot characteristics that are associated with a loss of visual reference and the extent to which both are associated with fatalities. A total of 129 accident reports from 2008 through 2020 were extracted from the NTSB online database in which the term loss of visual reference appeared in the event category. Fatal accidents, which made up more than half of the dataset, were more likely to have occurred during the en-route phase of flight compared to all of the other phases of flight combined. The reports in which “decision making” or “decision making/judgment” was present were more likely to be for fatal accidents compared to reports in which the terms were not listed. It is the pilot’s decision and lack of attention that are most commonly associated with accidents in which a loss of visual reference occurred. Decisions that are likely to cause a loss of visual reference include initiating or continuing in adverse weather or light conditions. The dangers of loss of visual reference need to be part of ongoing training of pilots as opposed to their initial training only.
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Ono, Koji, Takafumi Kumasawa, Keiichi Shimatani, Masatoshi Kanou, Ichiro Yamaguchi, and Naoki Kunugita. "Radiation Dose Distribution of a Surgeon and Medical Staff during Orthopedic Balloon Kyphoplasty in Japan." Journal of Radiation Protection and Research 47, no. 2 (June 30, 2022): 86–92. http://dx.doi.org/10.14407/jrpr.2021.00304.
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Background: The present study investigated the radiation dose distribution of balloon kyphoplasty (BKP) among surgeons and medical staff, and this is the first research to observe such exposure in Japan.Materials and Methods: The study subjects were an orthopedic surgeon (n = 1) and surgical staff (n = 9) who intervened in BKP surgery performed at the National Hospital Organization Disaster Medical Center (Tokyo, Japan) between March 2019 and October 2019. Only disposable protective gloves (0.022 mmPb equivalent thickness or less) and trunk protectors were used, and no protective glasses or thyroid drapes were used.Results and Discussion: The surgery time per vertebral body was 36.2 minutes, and the fluoroscopic time was 6.8 minutes. The average exposure dose per vertebral body was 1.46 mSv for the finger (70 μm dose equivalent), 0.24 mSv for the lens of the eye (3 mm dose equivalent), 0.11 mSv for the neck (10 mm dose equivalent), and 0.03 mSv for the chest (10 mm dose equivalent) under the protective suit.The estimated cumulative radiation exposure dose of 23 cases of BKP was calculated to be 50.37 mSv for the fingers, 8.27 mSv for the lens, 3.91 mSv for the neck, and 1.15 mSv for the chest.Conclusion: It is important to know the exposure dose of orthopedic surgeons, implement measures for exposure reduction, and verify the safety of daily use of radiation during surgery and examination.