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[Drug dependence and self-injury within the scope of health occupations].

Members of the health profession live within a special field of tensions between permanent contact with disease and dying; the own biography sometimes influences choice of profession, and moreover may contribute irritating factors for the further life in profession; functioning within the professional and the familial situation at the same time; pressure of public opinion. Some examples of profession-specific conflictouse constellations are presented here. They just want to be examples by no means systematic or comprehensive. However they want to help members of the health professions to come out of their isolation, want to give them more courage for self reflection and for adequate psychohygienic means.

Health Personnel↗

Smoke-free nurses: leading by example.

Occupational health nurses' scope of practice includes health promotion and restoration of health from environmental hazards (American Association of Occupational Health Nurses, n.d.). Because the nursing profession is the largest constituent of health care providers, it is essential that occupational health nurses tackle the smoking epidemic among the nursing profession. By encouraging smoking cessation among nurses, occupational health nurses reduce the environmental hazard of second-hand smoke and improve the health of nurses who smoke. When occupational health nurses take an active role in encouraging smoking cessation among nurses, they become leaders in reducing smoking within their communities. Members of the nursing profession are also role models. Occupational health nurses must help nurses become healthy role models and credible educators in the battle against smoking.

Cardiovascular Diseases↗

[Working and living conditions of Danish medical assistant].

In spring 1988 almost 6,000 members of the Danish Association of Young Doctors answered a questionnaire containing 132 questions about their working and living conditions. The Danish study shows that many young doctors are worried by uncertain conditions of employment, lack of opportunities for further training, and demanding emergency duty. Traditional sex role patterns in the families afflict the women doctors who have difficulty in holding their own in the keen competition. Stress in different forms is regarded as a problem by about 25 per cent. Almost half of the respondents had wholly or partially regretted their choice of a career and one fifth had considered changing their profession. The physicians own occupational injuries are substantially (24 per cent) underreported. Swedish and Finnish studies indicate that the problems in the medical profession are similar in the Nordic countries.

Alcohol Drinking↗

Factors influencing the education of occupational therapists in Ontario.

This paper examines some of the factors which were involved in the December 1974, decision, of the Ontario's Minister of Colleges and Universities to Mohawk College of Applied Arts and Technology to establish an experimental program in occupational therapy. This program is being launched without the endorsement of the provincial and national association of occupational therapy which wish to maintain a baccalaureate level of education for occupational therapists in a university settings. Some questions which are explored in the examination of this case are: What is a College of Applied Arts and Technology? How is it different from a University? What is a profession? What is a paraprofession? Is occupational therapy a profession or a paraprofession? Why did Mohawk College propose an occupational therapy program? What factors contributed to the occupational therapists' inability to stop the proposal? What was the process of approval of the proposal? How important are status and prestige as factors in these issues? The following discussion will attempt to deal with these questions as they relate to the educational arrangements for occupational therapists in Ontario.

Education↗

[Clinical aspects of occupational pathology caused by noise and vibration].

The paper is concerned with the results of many year-old clinical studies on workers of vibration-risk and "noisy" professions. The authors consider occupational and biomedical risk factors contributing to the development of vibratory disorders and noisy cochlear neuritis, the main clinical syndromes of this occupational pathology, modern methods of their preclinical and early clinical diagnosis. The basic principles of differentiated follow-up and combined prevention as well as problems of therapy, medical labor examination and rehabilitation of patients with vibratory disease and occupational cochlear neuritis are described.

Humans↗

The competent scholar.

Scholars in occupational therapy are responsible for ensuring that the profession's body of knowledge is so formulated that it provides the foundation for carrying out the work of the profession effectively, compassionately, and ethically. This article delineates the knowledge, skills, and typical personal attributes of competent scholars. Some suggestions are offered about how the occupational therapy profession might increase its number of competent scholars.

Health Knowledge, Attitudes, Practice↗

Cardiovascular perfusion: evolution to allied health profession and status 1986.

The occupation of cardiovascular perfusion has evolved from a technical to a professional status during the past 25 years. The national thoracic surgical organizations, The American Association for Thoracic Surgery and the Society of Thoracic Surgeons, have supported this process of development through participation on various boards and committees of the perfusionist organizations. The rapid growth of cardiac surgical services in the past decade produced concern about the availability of perfusionist manpower. This concern was exacerbated by creation of formal processes for the certification of perfusionists and the accreditation of perfusion educational programs. Today, these issues are largely resolved and cardiovascular perfusion is recognized as an allied health profession.

Accreditation↗

The role of occupational therapy in home care.

Occupational therapy is a health discipline and rehabilitation profession based on the premise that "occupations," such as ordinary everyday activities (work, play, self-care), have a restorative or normalizing effect. The goal of occupational therapy is to assist patients in achieving a maximum level of independent living by developing the capacities that remain after disease, accident, or deformity.

Activities of Daily Living↗

Occupational contact dermatitis to textile dyes in airline personnel.

BACKGROUND: Reports of textile dye allergic contact dermatitis are becoming frequent in the literature. Occupational exposure to textile dyes has been reported, but less frequently. OBJECTIVE: To report 2 cases of allergic contact dermatitis to Disperse Blue dyes 106 and 124 occurring in airline personnel. METHODS: The patients were patch tested to the European or North American standard series, a textile dye series, and 1 patient was tested with pieces of textile from an airplane seat. RESULTS: Patch testing elicited in both patients a 2+ reaction to Disperse Blue dyes 106 and 124, and a 1+ reaction to paraphenylenediamine in one patient. CONCLUSION: We describe 2 cases of occupational textile dye allergy occurring in airline personnel. Both cases showed the utility of Disperse Blue dyes 106 and 124 to serve as the screening allergens for textile dermatitis. Mandatory uniforms might be an occupational hazard in certain professions.

Aircraft↗

Professionals and professions: a philosophical examination of an ideal.

Being regarded as a professional and having one's occupational group regarded as a profession are often deemed desirable. It is not immediately apparent why this is so. 'Professional' often contrasts simply with 'amateur', and as a label conveys not honor but the recognition that the one so labelled is paid for doing what others do for free. But there is a distinct, honorific sense in which the professional contrasts not with the amateur but with the person who simply has a job rather than a life-long calling. It is in this honorific sense that physicians, attorneys and members of the clergy serve as paradigm professionals. Aspiring professionals in disciplines other than the paradigm ones regard themselves as more nearly like these paradigms than is usually recognized, and this is their claim to recognition as professionals. The paper explores several possible points of similarity by developing an account of the ideal for professionals which has been held in Western society at least since the time of the Hippocratic Oath, which best captures its spirit. As the Oath makes clear, professionals have fiduciary relations with their patients or clients, and provide services of a personal nature. The paper explores the principal demands of this ideal, the principal steps which physicians have taken in pursuit of it, and some of the implications of this ideal for various groups of social scientists associated with medicine. Finally, it recognizes a professional spirit or attitude which transcends occupation.

Clinical Competence↗

The occupational therapist as an expert witness.

The legal profession has begun to discover the contribution of the occupational therapist as an expert witness. The role of the therapist is to assist the plaintiff's or defendant's attorney in presenting evidence to the jury regarding injuries sustained by the injured party and implications of these injuries for functional capacity. In preparing themselves educationally and clinically to meet these demands, occupational therapists must define their role more precisely. Through effective reporting, record keeping, and an understanding of the uses and benefits of legal intervention, occupational therapists can have a positive impact in the litigation process.

Disability Evaluation↗

Historical continuities and constraints in the professionalization of nursing.

The support of medicine and the state may be crucial to nursing's current professional aspirations for legitimation and implementation of nursing reforms and for new roles for nurses in health care. As such, medicine and the state are in the invidious position of influencing nursing's occupational future. This situation is not new. An historical analysis of the establishment of nursing at Prince Alfred Hospital, Sydney, Australia, at the end of the nineteenth century reveals that the State Government of NSW and the medical profession supported nursing's occupational development, yet set the framework within which this could occur. For instance, the state provided patronage to nursing through recommendations of the 1873 Royal Commission and because it financially backed Prince Alfred Hospital, while the medical profession defined nursing knowledge and practice through its control of the nursing curriculum. Membership of the hospital board provided both medicine and the state with powerful positions over hospital policies that affected nursing. While nursing became established as a distinct occupation for women with the aid of State and medical support, its subordinate position in health care was, and continues to be, constrained by these traditional supporters. This relationship between nursing, medicine and the state has implications for nursing's current professionalization strategies and aspirations.

Curriculum↗

Skin problems related to the occupation of commercial fishing in North Carolina.

OBJECTIVE: Commercial fishing is one of the most dangerous professions with many of the occupational health problems related to the skin. This study elucidates the types of occupational skin disorders that occur in commercial fishermen in North Carolina. STUDY DESIGN/SETTINGS: Booths were set up offering free skin cancer screenings at various seafood festivals, a "blessing of the fleet" event and commercial fishing shows, which were located throughout eastern North Carolina from 2002-2004. When commercial fishermen were screened, they were asked about significant skin problems that they had experienced and were related to their occupation. They were specifically asked about their history of (1) cancerous and precancerous skin lesions, (2) eczemas, (3) superficial fungal infections, (4) bacterial infections of the skin, (5) traumatic injuries related to the skin, (6) bites and stings, (7) shocks from fish, and (8) skin problems related to environmental extremes. RESULTS: Eighty-one North Carolina watermen were screened: seven of the fishermen (9%) had at least one basal cell carcinoma, five (6%) had at least one squamous cell carcinoma, and no melanomas were detected. Many occupationally related skin disorders were noted on the historical survey, and some of the more dangerous of these included traumatic injuries related to fishing equipment, cutaneous cancers, fish bites, infections, stingray injuries, and man-of-war stings. LIMITATIONS: The sample population was comprised of volunteers, which limits generalizability, and some diagnoses were established retrospectively. CONCLUSIONS: There are a wide variety of skin disorders among commercial fishermen in North Carolina and healthcare professionals should be aware of these when working with watermen.

Adult↗

Knee moment at work: validation of a questionnaire based on knee moment in working life.

Classifications of occupations, such as those of the International Labor Organization, have previously been constructed with respect to the physical strain and joint moment to be expected in conjunction in a profession. To detect which occupational activities specifically induce high knee moments, we designed a questionnaire to analyze walking, knee bending, climbing of stairs and ladders, and jumping during three consecutive 15-year exposure periods in the professional lives of 920 consecutive residents [329 men with a mean age of 72 (range 47-96) and 561 women with a mean age of 77 (range 47-96)] drawn from the population records of the City of Malmö. The answers, classified into three categories with respect to knee joint moment, were compared with a classification of the occupations of all probands according to the same principles by three independent specialists in industrial hygiene. The two classifications showed a high degree of agreement, with Cramer's V ranging from 0.49 to 0.6, suggesting a co-variance with a common variable, i.e. the true work-related knee moment.

Age Distribution↗

Work hardening: occupational therapy in industrial rehabilitation.

Work hardening, presented in this paper as a "new" service for the industrially injured, is actually well grounded in the traditional models and practices of occupational therapy. From the profession's early roots in industrial therapy to the development of a variety of programs for the industrially injured through the 1950s and 1960s, the historical and philosophical bases of occupational therapy support the use of work as an evaluative and therapeutic medium. What is actually new is the adoption of terminology, technology, and a program format that fits in with the needs of consumers in the 1980s. Recent developments that created the need for the specialized services that occupational therapists are uniquely qualified to provide include growth of private sector vocational rehabilitation, changes in workers' compensation laws, and increasing costs of vocational rehabilitation. This paper describes work hardening in its present form. A case example is given that demonstrates how work hardening can be a cost-effective and time-saving bridge which spans the gap between curative medicine and the return to work.

Accidents, Occupational↗

Structuring education: development of the first educational standards in occupational therapy, 1917-1930.

The movement to standardize educational preparation in occupational therapy grew as the profession developed following World War I. This paper explores the debates that surrounded the evolution of occupational therapy's first sanctioned educational system. A variety of professionals involved in the formation of occupational therapy engaged in these debates. They focused their attention primarily on whether education should be regulated and, if so, how that education might be structured. Each coveted different views about how the fledgling profession might develop. These early debates signify one of the first attempts to identify a vision for the evolution of occupational therapy.

Curriculum↗

Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results.

OBJECTIVES: Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants' attitudes towards health) and medical aims (e.g. optimising diagnostic procedures, complementing individual therapy). METHODS: Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient's history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. RESULTS: In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. CONCLUSIONS: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.

Adult↗