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Egham, United Kingdom

Noonan J.,Occupational Health
AAOHN journal : official journal of the American Association of Occupational Health Nurses | Year: 2010

This article provides an overview of current literature about workplace-related musculoskeletal disorders from a biopsychosocial perspective. The authors conclude that disability management and early intervention efforts can only be meaningful within the context of targeted interventions, including mechanisms for psychosocial screening. In addition, they suggest that return to work should be considered an integral, rather than superficial, contribution to the rehabilitative process. Copyright 2010, SLACK Incorporated.

Govender K.,Durban University of Technology | Grainger L.,Occupational Health | Naidoo R.,Durban University of Technology
African Journal of Emergency Medicine | Year: 2013

Introduction: There is a growing and dire shortage of advanced life support (ALS) paramedics in South Africa (SA). To further understand this phenomenon, a novel and comprehensive mixed method study was conducted. The study was undertaken in two Phases. In Phase One, the aim was to identify factors that influenced the migration and intended migration of ALS paramedics from SA. The aim of Phase Two was to provide, through consensus agreement, an expanded description of those factors, within the context of organisational policies and profession-guided beliefs. The findings of Phase One, published already, and Phase Two, presented in this study, were integrated to obtain an in-depth understanding of SA ALS paramedic migration. This understanding resulted in the development of steering principles, for a framework of strategies on how to retain or encourage the return of SA ALS paramedics. This article presents these steering principles, as well as the findings from Phase Two of the study. Methods: ALS paramedics who qualified between 2001 and 2006 made up the study population. In Phase Two, purposive sampling was used to choose a subsample of the study population. In-depth interviews were conducted with this subsample; data were recorded, transcribed verbatim, and analysed thematically using qualitative research techniques. Results and discussion: Findings suggest that the success of retention and return strategies depends on the degree of collaborative stewardship that must exist between the SA National and Provincial Department of Health, the Emergency Medical Service/s (EMS) statutory governing body, training institutions, and private and public EMS providers. In addition, the constructs of return and retention strategies have to extend as far as revising both acceptance criteria and candidate recruitment policies. Furthermore, while particular attention must be placed on improving working conditions, security, and remuneration of ALS paramedics, return and retention strategies have to be continuously monitored, and updated. © 2012 African Federation for Emergency Medicine. Production and hosting by Elsevier B.V. All rights reserved.

Kalman C.J.,Occupational Health
Radioactivity in the Environment | Year: 2013

The consistent application of standards and control, together with consistent provision of advice and information remain the keystone of effective worker safety from the hazards of ionizing radiation.With radiation's huge media profile, it was not surprising that radiation workers were the test cases in terms of development of ethics of worker involvement in occupational health research. The identification that the researcher owes the worker a duty of care and the worker is a customer of such research is achieving growing acknowledgment, not only confined to the radiation worker situation. © 2013 Elsevier Ltd.

Crespo M.,Hospital Del Mar | Collado S.,Hospital Del Mar | Mir M.,Hospital Del Mar | Cao H.,Hospital Del Mar | And 9 more authors.
Clinical Journal of the American Society of Nephrology | Year: 2011

Background and objectives: Data are needed to assess safety and efficacy of the 2009 pandemic influenza A H1N1 vaccine in renal patients. Design, setting, participants, & measurements: We prospectively evaluated seroconversion, predictors of response, and vaccine safety in renal patients. Hemagglutination inhibition tests to detect serum antibodies against a new influenza A-H1N1 virus were performed in 79 transplant patients, 48 hemodialysis patients, and 15 healthy workers before and 1 month after vaccination. Healthy controls and 88 of 127 renal patients were vaccinated. Seroconversion was defined as at least 2 dilutions increase in titer. Results: We excluded 19 individuals seroprotected (≥1/40) against the novel H1N1 in the initial sample. Efficacy rate in the 96 vaccinated individuals was 43.7% (42 of 96 seroconverted versus four of 27 nonvaccinated patients, P = 0.007). For vaccinated subgroups, efficacy was 41.8% in transplant patients (P = 0.039 versus nonvaccinated), 33.3% in hemodialysis patients (P = 0.450), and 81.8% in controls. Healthy controls showed better response to vaccine than transplant (P = 0.021) and dialysis (P = 0.012) patients. For the transplant subgroup, longer time after transplantation (P = 0.028) was associated with seroconversion, but no influence was found for age, gender, renal function, or immunosuppression. In the hemodialysis subgroup, younger age was associated with response (55.7 ± 20.8 versus 71.6 ± 10.1 years, P = 0.042), but other specific variables, including Kt/V or time on dialysis, were not. No serious adverse events were reported, and kidney function was stable. Conclusion The novel influenza A 2009 H1N1 vaccine was safe in renal patients, although administration of a single dose of adjuvanted vaccine induced a poor response in these patients. © 2011 by the American Society of Nephrology.

Higgins A.,Occupational Health | O'Halloran P.,Queens University of Belfast | Porter S.,Queens University of Belfast
Journal of Occupational Rehabilitation | Year: 2014

Purpose The success of measures to reduce long-term sickness absence (LTSA) in public sector organisations is contingent on organisational context. This realist evaluation investigates how interventions interact with context to influence successful management of LTSA. Methods Multi-method case study in three Health and Social Care Trusts in Northern Ireland comprising realist literature review, semi-structured interviews (61 participants), Process-Mapping and feedback meetings (59 participants), observation of training, analysis of documents. Results Important activities included early intervention; workplace-based occupational rehabilitation; robust sickness absence policies with clear trigger points for action. Used appropriately, in a context of good interpersonal and interdepartmental communication and shared goals, these are able to increase the motivation of staff to return to work. Line managers are encouraged to take a proactive approach when senior managers provide support and accountability. Hindering factors: delayed intervention; inconsistent implementation of policy and procedure; lack of resources; organisational complexity; stakeholders misunderstanding each other’s goals and motives. Conclusions Different mechanisms have the potential to encourage common motivations for earlier return from LTSA, such as employees feeling that they have the support of their line manager to return to work and having the confidence to do so. Line managers’ proactively engage when they have confidence in the support of seniors and in their own ability to address LTSA. Fostering these motivations calls for a thoughtful, diagnostic process, taking into account the contextual factors (and whether they can be modified) and considering how a given intervention can be used to trigger the appropriate mechanisms. © 2014 Springer Science+Business Media New York

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