Acute hypersensitivity pneumonitis in a paint quality controller : a case report

Introduction: Isocyanates are sensitizing chemicals used in various industries such as polyurethane foam production or paint-related purposes. Acting as haptens recognized by T-lymphocytes, they can cause allergic asthma and rarely hypersensitivity pneumonitis (HP). We aim to present a case report of acute HP due to hexamethylene diisocyanate (HDI) in a paint quality controller, a profession not generally considered at a high risk for work-related Isocyanates exposure. Case report: A 30-yr-old otherwise healthy female, light smoker working as a paint quality controller developed shortness of breath, malaise, sweating and chills at workplace six hours after handling a HDI-based hardener. Upon admission to emergency department, symptoms had progressed to severe respiratory failure. HR computer tomography (HRCT) showed bilateral ground-glass attenuation without pleural effusion. Rapid clinical and radiological improvement occurred under facial oxygen supply and systemic steroid therapy. Occupational medicine investigations revealed regular handling of HDI using latex gloves without respiratory protection. Assessment at workplace showed insufficient air renewal (1.5 times per hour), inadequate local aspiration and HDI exposure at levels of 1-4.25 ppb/m3 (Swiss Occupation Exposure Limit 5 ppb/m3). Biological monitoring after identical work procedure executed by a co-worker showed HDI exposure (5.1 micrograms hexamethylene diamine/g creatinine). Resumption of work was disadvised because of the life-threatening event. Discussion: The diagnosis of occupational HP is highly supported by classical findings on imagery and typical symptoms occurring within approved latency interval, associated with rapid clinical improvement. Although neither broncho-alveolar lavage nor specific IgG diagnosis (en route) were performed during the acute episode, various blood tests managed to rule out evidence of an infection or autoimmune disease. Other causes of HP seem unlikely as the patient did not have any recurrence of symptoms since absence from work. Workplace evaluation provided significant information on HDI exposure and allowed substantial recommendations to diminish Isocyanate exposure for the 20 still healthy laboratory co-workers. Although the entryways (air or skin) and precise mechanism of toxicity remain unclear, the present case clearly shows that Isocyanates may trigger acute HP in susceptible workers in a profession not generally considered at a high risk.

Els delictes contra la seguretat viària: aspectes substantius, processals i criminològics

Les infraccions penals en matèria de seguretat viària constitueixen un dels grups delictius que més interès teòric i pràctic han despertat en la doctrina i la jurisprudència. Per aquest motiu, al llarg de la recerca s'ha dut a terme l'anàlisi dels diferents il·lícits penals des d'una perspectiva interdisciplinar i transversal on no tan sols han tingut cabuda les reflexions teòriques i pràctiques sobre els arts. 379 i ss. CP, sinó també la valoració dels problemes processals i criminològics que són propis d'aquests fets justiciables que es vinculen amb la seguretat viària

Active Travel - Healthy Lives

Across Ireland, there is considerable scope to replace many short car journeys with walking and cycling which would bring about a range of benefits to health as well as saving money for individuals and society.'Active travel, healthy lives' presents a summary of international evidence on the health and economic benefits of active travel and makes recommendations on how active travel can become a viable, safe and attractive alternative to car use.

IPH response to the National Transport Authority on the Greater Dublin Area Draft Transport Strategy 2011-2030

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland.IPH has a keen interest in the interactions between transport and health. IPH has produced two papers in the recent past on this topic, the most recent being Active travel – healthy lives published in January 2011 which built on the 2005 publication Health impacts of transport. The IPH welcomes the draft transport strategy in terms of addressing each of the key messages outlined in the Active travel – healthy lives paper.IPH is interested in this area not only in terms of increasing ‘active travel’ for healthier lives, but also in terms of the environmental and social impacts of inequitable access to forms of private and public transport.

IPH response to consultation: Introduction of 20mph speed restrictions on smaller residential streets

Conall McDevitt (SDLP MLA) launched a consultation regarding the introduction of 20mph speed restrictions in residential streets as part of his bid to introduce legislation through a Private Members Bill in the Northern Ireland Assembly.  The purpose of the Bill is to increase road safety, particularly for pedestrians and other road users, with additional health and environmental benefits. IPH submitted a response to the Private Members’ Bill regarding the introduction of 20mph speed restriction on smaller residential roads.  IPH recognises the potential public health benefits of this proposal in terms of reduced injuries and fatalities in built up areas; more opportunities for walking and cycling (helping to tackle obesity and reduce the risk of diabetes, heart disease and stroke); greater social cohesion among communities and improved mental health; and reduced emissions that contribute to climate change, air and noise pollution.

IPH response to DRD Belfast Rapid Transit Consultation

The Department for Regional Development (NI) recently consulted on policy proposals for a Belfast rapid transit.   The IPH response highlighted the need for the proposal to maximise potential for health and a coordinated approach to the development of active travel in Northern Ireland providing alternatives to private transport, increasing physical activity and reducing obesity.

IPH response to Department for Regional Development public transport reform consultation

This is the IPH response to the Department for Regional Development's public transport reform consultation.

IPH response to the HIQA consultation on the National Demographic Dataset and Guidance for use in health and social care settings in Ireland

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland. IPH have previously responded to consultations to the Department of Health’s Discussion Paper on the Proposed Health Information Bill (June 2008), the Health Information and Quality Authority on their Corporate Plan (Oct 2007), and the Road Safety Authority of Ireland Road Safety Strategy (Jul 2012). IPH supports the development of a national standard demographic dataset for use within the health and social care services. Provided necessary safeguards are put in place (such as ethics and data protection) and the purpose of collecting the information is fully explained to subjects, mandatory provision of a minimum demographic dataset is usually the best way to achieve the necessary coverage and data quality. Demographic information is needed in several forms to support the public health function: Detailed aggregated information for comparison to population counts in order to assess equity of access to healthcare as well as examining population patterns and trends in morbidity and mortality Accurate demographic information for the surveillance of infectious disease outbreaks, monitoring vaccination programmes, setting priorities for public health interventions Linked to other data outside of health and social care such as population data, survey data, and longitudinal studies for research and analysis purposes.   Identify and address public health issues to tackle health inequalities, and to monitor the success of such efforts to tackle them.

Minority Report by Mature Enjoyment of Alcohol in Society Limited

MEAS (Mature Enjoyment of Alcohol in Society Limited) is an alcohol social responsibility organisation committed to tackling the problems of alcohol abuse and misuse. A registered charity, MEAS works in partnership with Government, with other appropriate bodies, including An Garda Siochana, the Road Safety Authority and local authorities and with the alcohol industry to promote the responsible marketing, retailing and use of alcohol in Irish society. Click here to download PDF 176kb

Creació d'un entorn web de treball per a una biblioteca : Fent ús de Struts, Tiles i Hibernate

El següent projecte final de carrera vol assolir assolir la creació d'un entorn web de treball per a una Biblioteca. L'aplicació al món real es base en un mòdul administratiu, que podrà ser utilitzat pels treballadors de la pròpia Biblioteca i un mòdul que servirà de consulta als socis.

Plaisir et souffrance au travail : une lecture psychodynamique au sein d'un office régional de placement suisse

En Suisse, comme dans la plupart des pays industrialisés, le stress au travail et l'épuisement qui en découle sont devenus, au cours des dernières décennies, une réalité qui ne cesse de s'accentuer. Différentes disciplines scientifiques ont tenté de rendre compte, depuis le milieu du siècle dernier, des difficultés rencontrées par les individus dans le cadre de leur travail, avec une prédominance marquée pour des analyses de type causaliste. Dans le cadre de cette étude doctorale, nous nous sommes penché sur le cas d'un office régional de placement, mais avec une perspective sensiblement différente. La grille de lecture psychodynamique utilisée permet en effet de donner accès au sens des situations de travail et d'ouvrir sur une compréhension originale des mécanismes à l'origine des problèmes de santé mentale au travail. Cette approche permet ainsi de comprendre les rapports complexes que les individus entretiennent avec leur travail tel que structuré et organisé, et d'analyser leur expérience en termes de plaisir, de souffrance, de défenses face à la souffrance et de répercussions sur la santé. Dans ce but, nous avons utilisé une méthodologie basée sur des entrevues collectives, afin de stimuler l'expression libre des travailleurs. L'enquête s'est déroulée en deux temps : une première série d'entretiens de groupe a permis la récolte des données empiriques, puis une seconde série, appelée entretiens de restitution, a donné la possibilité aux participants de réagir sur l'interprétation de leur parole faite par le chercheur, et de valider l'analyse. Nos résultats mettent alors en évidence que le travail, tel qu'organisé au sein de cette institution de service public, apparaît considérablement pathogène, mais heureusement compensé par le pouvoir structurant de la relation d'aide aux assurés. Ils montrent également que l'expérience subjective de travail des participants a pour principales sources de souffrance la perception désagréable d'un manque de reconnaissance, d'autonomie et de pouvoir sur leurs actes. - In Switzerland and in other industrialized countries, work-related stress and resulting burn-out has become an ever increasing problem in recent decades. Many researchers Jrom many different fields have made efforts to understand the difficulties employees encounter at work since the middle of the last century. Most of this research is based on a cause and effect analysis approach. For this doctoral research project, we have analyzed cases handled by an unemployment office in Switzerland. We have taken a novel approach by using a number of psychodynamic criteria which permitted us to interpret situations at work and to open up a new way of understanding the mechanisms at work which lead to mental health problems. This approach allows us to understand account the complex relationship people have towards structured and organized work as well as to take into account and to analyze their experience in terms of pleasure, suffering, defense mechanisms against suffering and the consequences on their mental health. In order to achieve this goal we performed collective interviews in order to encourage workers to express themselves freely. The interviews were divided into two series. The first series of group interviews allowed us to collect empirical statistics and the second series gave the workers an opportunity to react to the researchers ' analysis of their answers and to validate the researchers ' interpretation of their answers. Our results show that work has considerable negative effects on mental health. Fortunately, these negative effects are counterbalanced by the psychological support system offered by the unemployment office. Our project also shows that the subjective negative experiences of workers are caused by their perceptions of being under-appreciated, lack of autonomy and having no power over their acts.

Three points for speed

This poster focuses on the effects of speed. The poster message is 'Three points for speed' and then lists three of the effects: 1. Extreme tiredness 2. Disturbed sleep 3. Paranoia. It also provides contact details for the National Drugs Helpline. Tel: 0800 776600.

Recursos de información en una biblioteca virtual : la Biblioteca Virtual de la Universitat Oberta de Catalunya

La Biblioteca Virtual de la UOC té com a principal objectiu ésser al servei d'una comunitat acadèmica formada per estudiants, personal docent i personal de gestió i administració que desenvolupen la seva activitat totalment en línia, usant per a aquesta finalitat una intranet o Campus Virtual. Sobre la base d'aquest objectiu, es dissenyen i ofereixen tota una sèrie de serveis, recursos i eines que permetin cobrir les necessitats informatives que se'ls plantegin als membres d'aquesta comunitat virtual en el desenvolupament de les seves activitats - ja siguin aquestes laborals, docents o acadèmiques - i oferint diferents vies d'accés per tal d'aconseguir una major personalització.

Exigences visuelles pour la conduite: y voir plus clair [Requirements on vision for driving: to see more clearly].

Primary care physicians have to assess visual functions essential for driving when determining medical fitness to drive. However, it can be difficult to apply the legal requirements that are described in annex 1 of the ordinance regulating the admission to road traffic of 1976 (OAC) due to lack of unambiguousness. This article discusses those visual functions that have to be assessed namely visual acuity, the visual field and the detection of diplopia and it presents the appropriate methods for the primary care setting. Another objective is to discuss the relevance of road safety requirements on vision and to present the new Swiss requirements proposed for the future in comparison to some international recommendations.

Psychological challenges for the oncology clinician who has to break bad news

Work-related stress of the oncology clinician is not only due to heavy clinical and administrative duties, but also arises when breaking bad news. However, there is important interindividual variation in stress levels during patient encounters, mainly due to the significance the situation represents for the oncologist. A reflection on his own development, his professional identity, and ways of dealing with the patient's suffering can reduce his levels of stress and distress and prevent burnout and other psychiatric disturbances. This chapter summarizes the psychological challenges the oncology clinician is facing when he announces the diagnosis of cancer, deals with the deception of relapse, discusses the transition to palliative care, copes with progression of the disease and uncertainty, and cares for the dying who is facing the unknown. Ways of refiecting on and dealing with these situations from a psychological and communicational perspective are described and illustrated by case vignettes.