PubMed Health⌕ Search

Biomedical subjects

Annalee Yassi

Publications and source records attributed to Annalee Yassi.

At least 19 recordsLinked to original sources
PubMed2007

Lead and mercury exposures: interpretation and action.

Lead and mercury are naturally occurring elements in the earth's crust and are common environmental contaminants. Because people concerned about possible exposures to these elements often seek advice from their physicians, clinicians need to be aware of the signs and symptoms of lead and mercury poisoning, how to investigate a possible exposure and when intervention is necessary. We describe 3 cases of patients who presented to an occupational medicine specialist with concerns of heavy metal toxicity. We use these cases to illustrate some of the issues surrounding the investigation of possible lead and mercury exposures. We review the common sources of exposure, the signs and symptoms of lead and mercury poisoning and the appropriate use of chelation therapy. There is a need for a clear and consistent guide to help clinicians interpret laboratory investigations. We offer such a guide, with information about population norms, lead and mercury levels that suggest exposure beyond that seen in the general population and levels that warrant referral for advice about clinical management.

Adult↗
PubMed2006

Evaluation of a comprehensive integrated workplace-based program to reduce occupational musculoskeletal injury and its associated morbidity in a large hospital.

OBJECTIVE: The objective of this study was to investigate the effectiveness of an integrated workplace-based program to reduce musculoskeletal injuries (MSIs) and the impact of those injuries in healthcare workers. METHODS: A pre-/postintervention with concurrent control study design was applied-3 years of data before the program with 1 year of data during the program. RESULTS: Time-loss (TL) MSIs increased at the intervention site during the intervention year. However, the program returned injured employees back to work in a shorter time and, compared with average historical data, reduced compensation costs and healthcare costs associated with TL MSIs during the first year. CONCLUSION: The findings that MSI-associated TL and compensation costs were significantly lower during the program illustrates the effectiveness of this program and demonstrates that increased reporting of MSIs need not be associated with increased claims costs.

Accidents, Occupational↗
PubMed2006

Use of a violence risk assessment tool in an acute care hospital: effectiveness in identifying violent patients.

This study examined the use and effectiveness of the Alert assessment form. The form is part of the Alert system, used by one large acute care hospital to identify patients with a propensity for violence. All reported incidents of patient violence from August 1, 2003, through December 31, 2004, were included in patient charts. One hundred seventeen violent patient charts were reviewed and compared with 161 non-violent patient charts, randomly chosen from the same time period. Overall use of the Alert assessment form for violent and non-violent patients was 75.7% and 35.4%, respectively. The assessment form was found to have moderate sensitivity (71%) and high specificity (94%). It is reasonably effective in identifying potentially violent or aggressive patients when it is used according to protocol. Efforts to improve the tool are warranted, as is evaluation of its benefit in settings with low prevalence of violence. Also, greater effort must be taken to prevent violence once an aggressive patient has been identified.

Acute Disease↗
PubMed2005

Evaluation of the effectiveness of portable ceiling lifts in a new long-term care facility.

Researchers and health and safety practitioners have advocated replacing manual patient handling techniques with ceiling lifts in long-term care. The majority of these studies have only evaluated the impact of fixed ceiling lifts on extended care residents where the ratio of ceiling lifts to resident beds is one to one. This pre-post intervention study assesses the effectiveness of portable ceiling lifts in a new multi-level care facility on risk of patient handling injuries where the ratio of ceiling lifts to resident beds is one to six. Results indicated that staff perceived they were at significantly (p<0.05) less risk of injury when using ceiling lifts compared to manual methods. Seventy-five percent of staff preferred to use the ceiling lifts over any other method for lifting and transferring residents. Compensation costs due to patient handling decreased in the intervention facility, with a 241% increase in the comparison facility. This study demonstrates that incorporating ceiling lifts into the design of a new multi-level care facility reduced patient handling injuries and decreased perceived risk of injury among care staff.

Adult↗
PubMed2005

The three-year economic benefits of a ceiling lift intervention aimed to reduce healthcare worker injuries.

Ceiling lifts are frequently advocated to mitigate risk of injury to healthcare workers when lifting, transferring, or repositioning patients. A longitudinal case-study was conducted in an extended care facility to evaluate the efficacy of overhead lifts in reducing the risk of injury beyond that previously reported for the first year post-intervention (Am. Assoc. Occup. 50 (3) (2002) 120-127, 128-134). Analysis of injury trends spanning 3 years pre-intervention and 3 years post-intervention, found a significant and sustained decrease in days lost, workers' compensation claims, and direct costs associated with patient handling injuries. The payback period was estimated assuming that pre-intervention injury costs would either continue to increase (0.82 years) or plateau (2.50 years) in the year immediately preceding intervention. The rapid economic gains and sustained reduction in the frequency and cost of patient handling injuries beyond the first year strongly advocate for ceiling lift programs as an intervention strategy.

Accident Prevention↗
PubMed2005

Training the next generation of researchers in work disability prevention: the Canadian Work Disability Prevention CIHR Strategic Training Program.

INTRODUCTION: There is a need to create, disseminate, and implement new knowledge in the work disability prevention (WDP) field. Training programs attracting high-quality applicants and taking into account the complexity of this emerging field are urgently needed. METHODS: An advanced training program, funded by the Canadian Institutes of Health Research (CIHR), was developed by 24 mentors affiliated with nine different universities. The main objective of this program is to develop transdisciplinary knowledge, skills, and attitudes regarding WDP. This program has been developed for PhD students or post-doctoral fellows already registered full-time in a Canadian or recognized foreign university whose main interest is WDP, regardless of the health problem. RESULTS: Since its implementation, the program received two successive cohorts of 10 students. They were registered in 13 universities in five countries and trained in nine different disciplines. CONCLUSIONS AND SIGNIFICANCES: Appropriate WDP research may save major societal costs attributable to prolonged work disability. The proposed training program will contribute to developing tomorrow's research workforce.

Attitude of Health Personnel↗
PubMed2005

Protecting health care workers from SARS and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines.

BACKGROUND: Traditional infection control policies have focused on engineering controls, specific protocols, and personal protective equipment (PPE). In light of the variable success in protecting health care workers (HCWs) from Severe Acute Respiratory Syndrome (SARS) in 2003, organizational and individual factors related to self-protective behavior in health care settings may also play an important role. METHODS: A critical review of the literature was conducted, directed at understanding what organizational and individual factors are important in protecting HCWs from infectious diseases at work. RESULTS: Organizational factors, such as a positive safety climate, have been associated with increased HCW adherence to universal precautions. There is some evidence that appropriate training of HCWs could be effective in changing HCW behavior if appropriate follow-up is applied. Very little research into these factors has been conducted with regard to preventing exposures to respiratory tract pathogens, but there was evidence from the SARS outbreaks that training programs and the availability of adequate PPE were associated with a decrease risk of infection. CONCLUSION: Variations in organizational and individual factors can explain much of the variations in self-protective behavior in health care settings. It is likely that these factors were also important determinants during the SARS outbreaks, but they have not been extensively studied.

Canada↗
PubMed2005

Protecting health care workers from SARS and other respiratory pathogens: a review of the infection control literature.

BACKGROUND: Severe Acute Respiratory Syndrome (SARS) was responsible for outbreaks in Canada, China, Hong Kong, Vietnam, and Singapore. SARS focused attention on the adequacy of and compliance with infection control practices in preventing airborne and droplet-spread transmission of infectious agents. METHODS: This paper presents a review of the current scientific knowledge with respect to the efficacy of personal protective equipment in preventing the transmission of respiratory infections. The effectiveness of infection control policies and procedures used in clinical practice is examined. RESULTS: Literature searches were conducted in several databases for articles published in the last 15 years that related to infection control practices, occupational health and safety issues, environmental factors, and other issues of importance in protecting workers against respiratory infections in health care settings. CONCLUSION: Failure to implement appropriate barrier precautions is responsible for most nosocomial transmissions. However, the possibility of a gradation of infectious particles generated by aerosolizing procedures suggests that traditional droplet transmission prevention measures may be inadequate in some settings. Further research is needed in this area.

Humans↗
PubMed2005

Implementing information technology to improve workplace health: a web-based information needs assessment of managers in Fraser Health, British Columbia.

A web-based questionnaire-survey was administered primarily to determine what information is useful to managers in Fraser Health, of British Columbia to support decision-making for workplace health and safety. The results indicated that managers prefer electronic quarterly reports, with targets, goals, and historical trends rated as "very important." Over 85.7% "agree" that if information was readily available in the "most beneficial" format, they would be able to improve workplace health. Recommendations include that managers be presented with clear and concise workplace health reports that facilitate analysis for decision-making.

Administrative Personnel↗
PubMed2005

Research gaps in protecting healthcare workers from SARS and other respiratory pathogens: an interdisciplinary, multi-stakeholder, evidence-based approach.

OBJECTIVE: To identify priorities for further research in protecting healthcare workers (HCWs) from severe acute respiratory syndrome (SARS) and other respiratory pathogens by summarizing the basic science of infectious bioaerosols and the efficacy of facial protective equipment; the organizational, environmental, and individual factors that influence the success of infection control and occupational health programs; and factors identified by HCWs as important. METHOD: An extensive literature review was conducted and 15 focus groups held, mostly with frontline HCWs in Toronto. Critical gaps in knowledge were identified and prioritized. RESULTS: Highest priority was given to organizational factors that create a climate of safety. Other priority areas included understanding aerosolization risks and practical measures to control bioaerosols at the source. CONCLUSIONS: Further research is warranted to improve safety climate in health care and, specifically, to provide greater protection against respiratory pathogens.

Canada↗
PubMed2005

Patient safety--worker safety: building a culture of safety to improve healthcare worker and patient well-being.

Patient safety within the Canadian healthcare system is currently a high national priority, which merits a comprehensive understanding of the underlying causes of adverse events. Not least among these is worker health and safety, which is linked to patient outcomes. Healthcare workers have a high risk of workplace injuries and more mental health problems than most other occupational groups. Many healthcare professionals feel fatigued, stressed, in pain, or at risk of illness or injury-factors they feel impede their ability to provide consistent quality care. With this background, the Occupational Health and Safety Agency for Healthcare (OHSAH) in British Columbia, jointly governed by healthcare unions and healthcare employers, launched several major initiatives to improve the healthcare workplace. These included the promotion of safe patient handling, adaptive clothing, scheduled toileting, stroke management training, measures to improve management of aggressive behaviour and, of course, infection control-all intended to improve the safety of workers, but also to improve patient safety and quality of care. Other projects also explicitly promoting physical and mental health at work, as well as patient safety are also underway. Results of the projects are at various stages of completion, but ample evidence has already been obtained to indicate that looking after the well-being of healthcare workers results in safer and better quality patient care. While more research is needed, our work to date suggests that a comprehensive systems approach to promoting a climate of safety, which includes taking into account workplace organizational factors and physical and psychological hazards for workers, is the best way to improve the healthcare workplace and thereby patient safety.

British Columbia↗
PubMed2005

Occupational health and infection control practices related to severe acute respiratory syndrome: health care worker perceptions.

The spread of severe acute respiratory syndrome (SARS) in 2003 was largely driven by hospital-associated transmission where health care workers experienced the largest burden of disease. In attempting to improve occupational health and infection control procedures to prevent occupationally acquired infections in health care workers, it is important to examine the perceptions of those workers who are expected to adhere to specific policies. The authors conducted 15 focus groups of health care workers representing seven different job classifications in two Canadian provinces where SARS outbreaks occurred in 2003 using a theoretical framework which divided factors associated with self-protective behaviour at work into organizational, environmental, and individual factors. Content analysis of these discussions revealed that workers placed more importance on organizational factors than environmental and individual factors. The results are similar to those of a recently completed literature review of this subject, and should be considered when developing new occupational health initiatives to protect health care workers from existing or emerging respiratory tract infections.

Adult↗
PubMed2004

Sociocultural, environmental, and health challenges facing women and children living near the borders between Afghanistan, Iran, and Pakistan (AIP region).

BACKGROUND: For hundred of years, people in the region encompassed by the Afghanistan-Iran-Pakistan borders (AIP region) have been challenged by conflict and political and civil instability, mass displacement, human rights abuses, drought, and famine. It not surprising that health and quality of life of vulnerable groups in this region are among the worst in the world. In general, women and children, in particular girls, in the AIP region have had especially limited access to healthcare. Women and children have dramatically high rates of communicable and non-communicable disease, morbidity, and mortality and a general low life expectancy that is rapidly declining. In spite of national and international efforts to improve health status of vulnerable populations in this region, the key underlying sociocultural determinants of health and disparities (ie, gender, language, ethnicity, residential status, and socioeconomic status) have not been systematically studied, nor have their relationships to environmental challenges been examined. OBJECTIVES: We set out to summarize existing information regarding the sociocultural, environmental, and traditional determinants of health disparities among different population groups in the AIP region; identify gaps in research regarding the communities' needs in the region; and highlight factors that must be considered in the design and implementation of future health intervention studies in the region. METHODS: We reviewed current health literature, official documents, and other information (eg, reports of UN agencies) related to the social, cultural, and environmental factors that may influence the health outcomes of subpopulations living in the AIP region. We also interviewed individuals who had recently worked in this region. RESULTS: Overall, the health problems faced by this underdeveloped region can be categorized into those resulting from lack of essential supplies and services and those stemming from the existing cultural practices in the area. The low health status of the people, particularly women and children, in the AIP region is associated with not only poor hygiene and lack of water but also limited knowledge and lack of access to healthcare services. In addition, cultural, political, and socioenvironmental factors play a role, including gender inequality and differences between languages spoken locally in the region and those most often used in written health education materials. CONCLUSION: Future intervention programs designed for this region must use culturally sensitive strategies not only to provide health information and health services but also to address the underlying nonmedical determinants of health related to gender inequalities.

Adult↗
PubMed2004

Lessons from the margins of globalization: appreciating the Cuban health paradox.

It is widely recognized that Cuba, despite poor economic performance, has achieved and sustained health indices comparable to those in developed countries--the Cuban Paradox. There has been, however, remarkably little scholarship evaluating how this has been accomplished, especially during a period of extreme economic hardship. Cuba's exclusion from the mainstream of "globalization," moreover, allows us to gain insights into the population health impact of policies that have accompanied globalization. Cuba's experience challenges the conventional assumption that generating wealth is the fundamental precondition for improving health. As peoples around the world search for cost-effective ways to improve well-being, they might want to learn how alternative public policy approaches, such as those used in Cuba, may be effective. We therefore reviewed the literature on the health-wealth relationship in this globalizing era; then systematically examined public policy in Cuba, not only for health services (financing, vertical and horizontal integration, prevention and primary-care focus, inter-sectoral linkages, etc.) but for non-medical determinants of health as well. These included education, housing, nutrition, employment, etc. plus the community mobilization and social cohesion that the Cuban system has generated. It appears that the active implementation of public policy affecting a wide variety of health determinants explains the Cuban paradox, and that the international community can learn from Cuba's experience. The prospect for healthy public policy can thus exist within, rather than only on the margins of globalization. The importance of monitoring how Cuba sustains such policies as it faces growing challenges in this globalizing era is increasingly worth observing.

Cuba↗
PubMed2004

What the Cuban context provides health researchers: the feasibility of a longitudinal multi-method study of the impact of housing improvements on health in Havana, Cuba.

BACKGROUND: From extensive participatory research in inner city communities in Central Havana, Cuba, we found housing to be the largest perceived source of health risk. The objective of this study, therefore, was to ascertain the feasibility of conducting a multi-method longitudinal evaluation of the impact of housing improvements on health. METHODS: Meetings with community and governmental stakeholders were held; housing policy documents were reviewed; key informants were interviewed; decisions were made by a collaborative interdisciplinary team regarding measurement instruments for health as well as housing quality; training was conducted for use of new measurement tools; and a 3 month multi-method trial with repeated measures was conducted on individuals in good housing and poor housing in the inner city of Central Havana. Questionnaires were administered at monthly intervals for 3 months to 25 adults living in good housing and 25 in poor housing. RESULTS: Cuba's housing policies made it easy to identify a suitable cohort and control group for possible longitudinal study. Consent to participate was enthusiastically obtained, and no difficulties were encountered in collecting or analysing the data. Housing quality measurements were conducted using validated instruments with minimal difficulties. There was strong community involvement and support for a comprehensive longitudinal study. CONCLUSION: Cuba, although a poor country, has the necessary infrastructural support and capacity to make it an excellent site for health and housing intervention studies.

Adult↗
PubMed2004

Choosing a model of care for patients in alternate level care: caregiver perspectives with respect to staff injury.

The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing. The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury. Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained (n = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units. The risk for caregiver injuries was lowest on dedicated ALC units. These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.

Absenteeism↗
PubMed2004

Implementation of a scheduled toileting program in a long term care facility: evaluating the impact on injury risk to caregiving staff.

This study evaluated the impact of a scheduled toileting program on the risk of injury to caregivers and on resident agitation or aggressive behaviors. Injury data, ergonomic assessments, staff questionnaires, and resident agitation checklists were used to evaluate the program in a 75 bed unit, with a similar unit acting as a comparison. The program resulted in an increased percentage of residents toileted regularly in the intervention unit, while aggressive incidents declined in both groups. Staff in the intervention unit reported a significantly lower perceived risk of injury to the head and neck than the comparison group. Although the program resulted in increased workload to manage multitasking, monitor an additional aspect of scheduled care, and perform more toileting transfers, overall risk of physical injury was reduced. The toileting program, a shift toward resident focused care, and enhanced agitation awareness combined to reduce resident handling injuries and resident agitation expressed as verbal behaviors or emotional upset, but not as physical behaviors. Clear communication, mentoring, and monitoring were important for successfully changing care practices.

Accidents, Occupational↗