The justice-workplace health relationship:The mediating role of emotions

Purpose - The purpose of this paper is to examine the mediational effects of positive and negative emotions in the relationship between organisational justice and health. Design/methodology/approach - This cross-sectional research obtained data from 206 workers employed within the financial/banking, manufacturing, and retail industries in Barbados. Findings - Structural equation modelling analyses revealed that positive and negative emotions completely mediated the effects of relational justice (but not procedural justice) on overall health. Research limitations/implications - Research was cross-sectional, and relied on self-report measures. The findings suggest that employers must properly evaluate their health and safety policies and practices in the organisation to ensure that aspects of the psychosocial work environment are being properly implemented, managed, and monitored, to ensure that individuals' health and well-being are not at risk. Originality/value - The paper represents a first attempt to investigate the roles of positive and negative emotions in the justice-health relationship in a different cultural context such as the Caribbean. Justice has been rarely researched as a psychosocial work stressor. The study described in the paper focused on multiple health outcomes. Copyright © 2012 Emerald Group Publishing Limited. All rights reserved.

‘The Defining Features of the European Union’s Approach to Regulating New Health Technologies’

The brief for this chapter is to determine the defining features of the relationships between European Union law and new health technologies, by reference to risk, ethics, rights, and markets.

Climate Adaptation: The future of extra-care housing for the elderly in the United Kingdom.

This paper describes the result of a project to develop climate adaptation design strategies funded by the UK’s Technology Strategy Board. The aim of the project was to look at the effects of climate change in the distant future (2080) on a vulnerable group such as older people with special needs and see how architectural design strategies and technologies may be used today to help mitigate problems ahead caused by climate change.
Older people are the most vulnerable sector of society and are particularly at risk in extreme weather, either excess cold in winter or continual high temperatures in summer. In the UK it is predicted that average temperatures may rise by as much as 8 degrees in Summer by 2080 and there will be a 20% greater chance of extreme weather events. This will place extreme stress on the building stock which is designed for today’s mild maritime climate.
The project took a current proposal for an extra-care home for the elderly designed to 2010 regulations and developed a road map to 2080 using climate models developed by the UK Meteorological Office. This allowed the current design to be assessed using future climatic data, proposals for improvement of the scheme to be made within existing constraints and also a new scheme to be developed from first principals using this data, and projections of new technologies that will be available. By comparing these schemes, the approach allowed a reassessment of the initial scheme, and allowed a new design to be developed that offered a more flexible solution incorporating future retrofit which allows new renewable technologies for heating, cooling and water storage to be added at a later date.

Elderly patients with hypercholesterolaemia:a double-blind study of the efficacy, safety and tolerability of fluvastatin

Coronary heart disease is a major cause of morbidity and mortality in the elderly, a rapidly growing section of the population. Elderly patients have been excluded from most preventative risk factor trials.

Capitalism, the state and health care in the age of austerity:A Marxist analysis

The capacity to provide satisfactory nursing care is being increasingly compromised by current trajectories of healthcare funding and governance. The purpose of this paper is to examine how well Marxist theories of the state and its relationship with capital can explain these trajectories in this period of ever-increasing austerity. Following a brief history of the current crisis, it examines empirically the effects of the crisis, and of the current trajectory of capitalism in general, upon the funding and organization of the UK and US healthcare systems. The deleterious effect of growing income inequalities to the health of the population are also addressed. Marx’s writings on the state and its relation to the capitalist class were fragmentary, and historically and geographically specific. From them, we can extract three theoretical variants: the instrumentalist theory of the state, where the state has no autonomy from capital; the abdication theory, whereby capital abstains from direct political power and relies on the state to serve its interests; and the class-balance theory of the state, whereby the struggle between two opposed classes allows the state to assert itself. Discussion of modern Marxist interpretations include Poulantzas’s structuralist abdication theory and Miliband’s instrumentalist theory. It is concluded that, despite the pluralism of electoral democracies, the bourgeoisie do have an overweening influence upon the state. The bourgeoisie’s ownership of the means of production provides the foundation for its influence because the state is obliged to rely on it to manage the supply of goods and services and the creation of wealth. That power is further reinforced by the infiltration of the bourgeoisie into the organs of state. The level of influence has accelerated rapidly over recent decades. One of the consequences of this has been that healthcare systems have become rich pickings for the evermore confident bourgeoisie.

A Qualitative Evaluation of the Provision of Bereavement Care Accessed by Service Users Living in a Health and Social Care Trust Area in Northern Ireland

Within the health and social care sector in the United Kingdom, the
management of death and bereavement has become increasingly
challenging. This service evaluation sought to explore the bereavement
care offered to individuals living in one Health and Social Care
Trust catchment area of Northern Ireland. Qualitative interviews
were conducted with key government and voluntary agency staff.
The findings indicated that much of the bereavement provision is
based on the interest and initiative of individual staff members, with
few processes to assess the level of bereavement care needed and those
best skilled to provide it. Recommendations are made for a bereavement
care strategy that outlines a bereavement needs assessment process,
identifying the scope of interventions and protocols for practice.

Examination of the physical and psychosocial determinants of health behaviour in 4-5-year-old children with congenital cardiac disease

To assess the general health and activity levels of 4- and 5-year-old children after intervention for congenital cardiac disease.

A comparative analysis of the health and wellbeing of cancer survivors to the general population

Background
The population of people surviving cancer is continually increasing and currently cancer survivors represent approximately 3.7% of the American population and 3% of the UK population. There is limited and inconclusive empirical evidence regarding the long-term health and well-being of cancer survivors.

Methods
Two hundred eighty-nine cancer survivors and 262 matched-age and sex patients from the same group of General (primary care) Practices completed postal questionnaires measuring health and well-being, health service utilisation and satisfaction and health care needs.

Main Results
Cancer survivors reported poorer health and well-being and health service utilisation than the general population. Despite this poorer health, the majority of cancer survivors reported satisfaction with services and almost two-thirds of the survivors did not report any needs.

Conclusions
The majority of cancer survivors do not appear to require additional support services. There is, however, a subgroup of survivors who warrant specialist support, particularly survivors who are older, experience late effects and have had adjuvant treatments. Future research should focus on developing methods that could be used in routine clinical practice to identify ‘at risk’ or vulnerable patients and to provide appropriate and timely support.

The effects of the Omagh bomb on adolescent mental health: a school-based study

Background: The main objective of this study was to assess psychiatric morbidity among adolescentsfollowing the Omagh car bombing in Northern Ireland in 1998.

Methods: Data was collected within schools from adolescents aged between 14 and 18 years via a selfcompletionbooklet comprised of established predictors of PTSD; type of exposure, initialemotional response, long-term adverse physical problems, predictors derived from Ehlers andClark’s (2000) cognitive model, a PTSD symptoms measure (PDS) and the General HealthQuestionnaire (GHQ).

Results:Those with more direct physical exposure were significantly more likely to meet caseness onthe GHQ and the PDS. The combined pre and peri trauma risk factors highlighted in previousmeta-analyses accounted for 20% of the variance in PDS scores but the amount of varianceaccounted for increased to 56% when the variables highlighted in Ehlers and Clark’scognitive model for PTSD were added.

Conclusions: High rates of chronic PTSD were observed in adolescents exposed to the bombing. Whilstincreased exposure was associated with increased psychiatric morbidity, the best predictors ofPTSD were specific aspects of the trauma (‘seeing someone you think is dying’), what youare thinking during the event (‘think you are going to die’) and the cognitive mechanismsemployed after the trauma. As these variables are in principle amenable to treatment theresults have implications for teams planning treatment interventions after future traumas.

An international review of the patterns and determinants of health service utilisation by adult cancer survivors

Background: There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services.

Methods: Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review.

Results: Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provisions- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors.

Conclusions: Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure that post-treatment needs and recommendations for care are met.