Evaluating the relative status of health and safety programs for minority academic and research institutions

A variety of occupational hazards are indigenous to academic and research institutions, ranging from traditional life safety concerns, such as fire safety and fall protection, to specialized occupational hygiene issues such as exposure to carcinogenic chemicals, radiation sources, and infectious microorganisms. Institutional health and safety programs are constantly challenged to establish and maintain adequate protective measures for this wide array of hazards. A unique subset of academic and research institutions are classified as historically Black universities which provide educational opportunities primarily to minority populations. State funded minority schools receive less resources than their non-minority counterparts, resulting in a reduced ability to provide certain programs and services. Comprehensive health and safety services for these institutions may be one of the services compromised, resulting in uncontrolled exposures to various workplace hazards. Such a result would also be contrary to the national health status objectives to improve preventive health care measures for minority populations.^ To determine if differences exist, a cross-sectional survey was performed to evaluate the relative status of health and safety programs present within minority and non-minority state-funded academic and research institutions. Data were obtained from direct mail questionnaires, supplemented by data from publicly available sources. Parameters for comparison included reported numbers of full and part-time health and safety staff, reported OSHA 200 log (or equivalent) values, and reported workers compensation experience modifiers. The relative impact of institutional minority status, institution size, and OSHA regulatory environment, was also assessed. Additional health and safety program descriptors were solicited in an attempt to develop a preliminary profile of the hazards present in this unique work setting.^ Survey forms were distributed to 24 minority and 51 non-minority institutions. A total of 72% of the questionnaires were returned, with 58% of the minority and 78% of the non-minority institutions participating. The mean number of reported full-time health and safety staff for the responding minority institutions was determined to be 1.14, compared to 3.12 for the responding non-minority institutions. Data distribution variances were stabilized using log-normal transformations, and although subsequent analysis indicated statistically significant differences, the differences were found to be predicted by institution size only, and not by minority status or OSHA regulatory environment. Similar results were noted for estimated full-time equivalent health and safety staffing levels. Significant differences were not noted between reported OSHA 200 log (or equivalent) data, and a lack of information provided on workers compensation experience modifiers prevented comparisons on insurance premium expenditures. Other health and safety program descriptive information obtained served to validate the study's presupposition that the inclusion criteria would encompass those organizations with occupational risks from all four major hazard categories. Worker medical surveillance programs appeared to exist at most institutions, but the specific tests completed were not readily identifiable.^ The results of this study serve as a preliminary description of the health and safety programs for a unique set of workplaces have not been previously investigated. Numerous opportunities for further research are noted, including efforts to quantify the relative amount of each hazard present, the further definition of the programs reported to be in place, determination of other means to measure health outcomes on campuses, and comparisons among other culturally diverse workplaces. ^

A practice-based culminating experience with Texas Children's Hospital: A hospital's journey to baby-friendly status

Breastfeeding and the use of human milk are widely accepted as the most complete form of nutrition for infants. Breastfeeding is shown to be associated with many positive health outcomes for both infants and mothers. Healthy People 2000 goals to increase breastfeeding rates in the early postpartum period to 75% fell short, with only 64% of mothers meeting this objective. Lack of support from healthcare providers, and unsupportive hospital policies and practices are noted as barriers to the initiation and duration of breastfeeding. The purpose of this study was to evaluate implementation of the BFHI Ten Steps to Successful Breastfeeding at Texas Children's Hospital. ^ The Baby-Friendly Hospital Initiative (BFHI) was developed in 1991 by the World Health Organization and the United Nations Children's Fund (UNICEF) to ensure that healthcare facilities offering maternity services adhere to the Ten Steps of Successful Breastfeeding and the International Code of Marketing of Breast-Milk Substitutes, and create legislation to protect the rights of breastfeeding women. The instrument used in this study was the BFHI 100 Assessment Tool created by Dr. Laura Haiek, Director of Public Health in Monteregie, Quebec, and her staff at Health and Social Services Agency of Quebec. The BFHI 100 tool utilizes 100 different indicators of compliance with BFHI through questionnaires administered to staff and administrators, pregnant and postpartum mothers, and an observer. ^ The study concluded that although there is much room for improvement in educating breastfeeding mothers, overall, the mothers interviewed were satisfied with their level of care in regards to breastfeeding support. Areas of improvement include staff training, as some nursing staff admitted to relying on the lactation consultants to provide most of the breastfeeding education for mothers. Only a small percentage of mothers interviewed reported that their baby “roomed-in” on average of 22 hours per day during their hospital stay. Staff encouragement of the rooming-in practice will help to increase the proportion of mothers who allow their babies to room-in. The current breastfeeding policy will also need to be revised and strengthened to be compliant with the Ten Steps. Ideally, Baby-Friendly practices will become the norm after staff are trained and policy revisions are made. Staff training and acceptance of breastfeeding as optimal nutrition for infants are the most critical factors that will ultimately drive change for the organization. ^

Conhecimentos sobre a RNCCI: um estudo exploratório sobre a perceção dos alunos do curso de enfermagem

A Rede Nacional de Cuidados Continuados (RNCCI) foi criada em 2006 pelo decreto-lei nº 101/2006, no âmbito do Ministério da Saúde e da Segurança Social. A RNCCI tem como missão prestar os cuidados adequados, de saúde e apoio social, a todas as pessoas que, independentemente da idade, se encontrem em situação de dependência, e articula-se com os serviços de saúde e sociais já existentes. Para cumprir a sua missão, a RNCCI, necessita de uma equipa multidisciplinar, na qual integram vários profissionais, tais como: médicos, enfermeiros, assistentes sociais, psicólogos, entre muitos outros, de entre estes os enfermeiros são os profissionais que maior percentagem detêm na constituição da mesma. Daí que seja pertinente a realização de estudos de investigação, com enfermeiros e estudantes de enfermagem, nesta nova valência de cuidados. O presente estudo incide sobre os conhecimentos dos estudantes de enfermagem sobre a RNCCI, que frequentam o terceiro e quarto ano na Escola Superior de Saúde do Instituto Politécnico de Bragança. Sendo a questão de investigação deste estudo: “Quais os conhecimentos dos alunos de enfermagem do terceiro e quarto ano da licenciatura em enfermagem sobre a RNCCI?”. Foi realizado um estudo de natureza quantitativa, descritivo, correlacional, num plano transversal. Optou-se por um processo de amostragem não probabilística de conveniência, que refletisse a distribuição da população por ano de escolaridade. Assim, considerou-se uma amostra de 120 alunos (75 % da população), selecionados acidentalmente, visando a disponibilidade, rapidez e o menor custo na recolha de dados. Concluiu-se que os alunos de enfermagem de uma forma geral apresentam conhecimentos sobre a RNCCI. Destacando-se uma percentagem de 90% de respostas corretas referentes sobre a RNCCI. No entanto 75% dos alunos responderam erradamente às afirmações relacionados com o processo de referenciação e tipologia das respostas da RNCCI. Comparando estes resultados com estudos realizados com enfermeiros que exercem funções na RNCCI, verifica-se que os alunos não apresentam conhecimentos suficientes para desencadear funções ou processos relacionados com a RNCCI, apesar de terem conhecimentos gerais da mesma, pois apresentam consideráveis falhas desde logo no processo de referenciação, assim como profissionais que já trabalham na área. Tais factos constatados salientam a importância de formação teórica e/ou prática, no plano curricular da licenciatura de enfermagem, preparando os futuros enfermeiros para exercerem as suas funções na RNCCI, e não só. Pois os enfermeiros que trabalham nos cuidados de saúde primários e secundários, também eles necessitam de ter conhecimentos sobre a RNCCI, verificando-se muito frequentemente é durante o internamento que se inicia o processo de referenciação. Sugerindo que o conhecimento dos alunos sobre a RNCCI, são adquiridos na sua maioria durante a realização do ensino clínico, onde acompanham este tipo de atividades. Embora a formação base da licenciatura, permita uma vasta aquisição de competências teórico-práticas, e a integração de formação sobre a RNCCI, seja considerada pelos alunos de enfermagem, como importante ou muito importante, a mesma pode considerar-se atualmente praticamente inexistente.

Age words : a glossary on health and aging.

Mode of access: Internet.

National Health and Nutrition Examination Survey III : data collection forms.

"March 1990."

The neuroscience of mental health : a report on neuroscience research : status and potential for mental health and mental illness from panels of scientists representative of contributing disciplines.

Mode of access: Internet.

County jail and detention facility report.

Title from cover.

Public health statistics, Wisconsin.

Supplements accompany some issues.

Wisconsin public health statistics

Supplements accompany some issues.

Research programs of the National Institute of Child Health and Human Development /

Mode of access: Internet.

Health.

Bimonthly, Jan./Feb. 1949-May/June 1953.

Genetics and teratology : research programs of the National Institute of Child Health and Human Development.

"Prepared by the Genetics and Teratology Section of the Clinical Nutrition and Early Development Branch for presentation to the National Advisory Child Health and Human Development Council, May 1980"--P. 2 of cover.

Pregnancy and perinatology ; research programs of the National Institute of Child Health and Human Development /

Cover title.

Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK

Objective: To evaluate the cost of atrial fibrillation (AF) to health and social services in the UK in 1995 and, based on epidemiological trends, to project this estimate to 2000. Design, setting, and main outcome measures: Contemporary estimates of health care activity related to AF were applied to the whole population of the UK on an age and sex specific basis for the year 1995. The activities considered ( and costs calculated) were hospital admissions, outpatient consultations, general practice consultations, and drug treatment ( including the cost of monitoring anticoagulant treatment). By adjusting for the progressive aging of the British population and related increases in hospital admissions, the cost of AF was also projected to the year 2000. Results: There were 534 000 people with AF in the UK during 1995. The direct'' cost of health care for these patients was pound 244 million (similar toE350 million) or 0.62% of total National Health Service ( NHS) expenditure. Hospitalisations and drug prescriptions accounted for 50% and 20% of this expenditure, respectively. Long term nursing home care after hospital admission cost an additional pound46.4 million (similar toE66 million). The direct cost of AF rose to pound459 million (similar toE655 million) in 2000, equivalent to 0.97% of total NHS expenditure based on 1995 figures. Nursing home costs rose to pound111 million (similar toE160 million). Conclusions: AF is an extremely costly public health problem.

E-health and the Universitas 21 organization: 2. Telemedicine and underserved populations

Telemedicine activities in underserved communities were reviewed as part of the Universitas 21 (U21) e-health project. A SWOT analysis (strengths, weaknesses, opportunities, threats) was conducted on 12 articles identified in a literature review, supplemented by expertise from U21 members. The analysis showed that threats include the reluctance of populations to use telemedicine services, and a general absence of infrastructure and resources to sustain them. Opportunities centre around potential research, including cost-effectiveness analyses and quantitative assessments of existing telemedicine services. The great strength of telemedicine is that it can improve access to health services among those most in need. However, its greatest weakness is the lack of evidence supporting its clinical and cost advantages relative to traditional services. This represents an important opportunity for research on telemedicine initiatives among underserved populations.