Educators assail Reagan's health professions budget.
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The relationships between occupation, smoking, and the three most common histologic types of lung cancer (squamous cell carcinoma, small-cell carcinoma, and adenocarcinoma) were explored in a case-control study with the use of data collected during the Third National Cancer Survey. The largest histologic group was squamous cell carcinoma (152 cases), followed by adenocarcinoma (50 cases), and small-cell carcinoma (45 cases). The control series was comprised of cancers at all anatomic sites except those believed to be associated with either smoking or occupational exposures. Cigarette smoking was significantly associated with all three histologic types of lung cancer. Overall, the relationship with small-cell carcinoma was strongest (odds ratio = 5.1), whereas those with squamous and adenocarcinoma were approximately equivalent (odds ratio = 3.1). Dose-response relationships were evident for all three histologic types; however, the linear relationship was found to be statistically significant (P less than 0.05) only for squamous and small-cell carcinomas. Squamous cell carcinoma was the type most frequently associated with occupational categories. It was significantly associated (P less than 0.05) with "blue collar" professions (odds ratio = 2.1). No occupational categories were significantly associated with adenocarcinoma. In addition, no occupational categories were associated with all histologic types of lung cancer combined. This last observation suggested that the sensitivity of epidemiologic studies might not only be increased by use of improved occupational histories but more specifically by consideration of histology in examination of associations between occupation and respiratory cancer.
Subject of the study are the two up-to-date professions with well expressed neuropsychic stress and hypodynamia: 19 managers from industry and 41 controllers from the railway transport. Both professional groups were subject to a definite dose of physical loading and estimation of the ECG changes by the aid of Minnesota's code (WHO 1968) and its modification by the Swedish Cardiological Association. Relatively high percents of positive working samples for healthy middle-aged men were found, which could be related with considerable occupational risk in both professions.
This paper is the result of an investigation carried out in February 1997, which set out to learn about the development and application of occupational health standards, and in turn approaches to occupational environmental monitoring, in Russia, and to see how these were similar to, or different from, what takes place in other countries. The enquiry involved face-to-face meetings with senior Russian occupational health scientists and officials. It was confirmed that Russian occupational exposure standards are very stringent and provide a very high level of protection of workers. However, they are difficult to enforce, and it is suggested that the development of a strong and distinctive occupational hygiene discipline and profession in Russia would provide a "bridge" to enable more effective implementation and interpretation of those standards.
This article reviews the process that the Council on Government Affairs of the Connecticut Occupational Therapy Association undertook from 1979 to 1982 to obtain payment mandated by legislation for occupational therapy. The process included learning the Connecticut legislative system, marketing occupational therapy as a profession in the health arena, and coordinating, planning, and communicating all phases of activity to reach a final objective of mandated payment.
Lumbar disc surgery is frequently performed but only few long-term outcome studies have been published. To assess the socioeconomic long-term outcome after lumbar disc surgery this study was performed using the Functional Economic Rating scale developed by Prolo et al. in 1986. The study group, mailed a questionnaire, consisted of 663 patients (18 to 60 years) operated on in 1983 or 1984. 23 patients (3.5%) died in the follow-up period. 406 (66% male and 34% female) patients answered the questionnaires (61%), therefore being eligible for further investigation. Mean age at the time of operation was 43 +/- 9.5 years. Preoperatively 29% of patients did sedentary work, 46% were employed in less strenuous and 25% in strenuous occupations. A motor deficit was present in 59% of patients preoperatively. In 51% the L4/5 level and in 38% the L5/S1 level was operated; 5% were operated in more than one level. In 45% an intraspinal sequester was found intraoperatively. Intra- and postoperative complications occurred in 14 patients (complication rate 3.4%). Six weeks after surgery all patients were examined in our outpatient department. 93% were more or less relieved of their complaints. 10 years after lumbar disc surgery a good outcome defined as Prolo scale 8-10 was achieved in 38%, a moderate outcome (Prolo scale 6-7) in 40% and a poor outcome (Prolo scale < 5) in 22%, respectively. Patients with strenuous occupations had a significantly (p < 0.001) less favorable outcome than patients with less strenuous or sedentary occupations. 32% were able to work in the previous profession with no restrictions. 42% were able to work part time at the previous occupation or with limited status and 9% had to change their profession. 17% were not able to gain any occupation postoperatively and retired. Vocational consequences depended on the preoperative type of occupation. 54% of patients with strenuous occupations had to change the profession or to retire compared to 15% of patients with sedentary occupations. During the 10-year follow-up period, 125 patients (31%) underwent at least another lumbar disc operation 4.8 +/- 3.8 years after their first surgery. Recurrence at the same level and the same side occurred in 14%. Reoperated patients had a significantly (p < 0.001) less favorable outcome than patients not operated on again. The results of this study indicate the recommendation of a prolonged postoperative course of treatment, especially in patients with strenuous occupations.
OBJECTIVE: To determine if the perception of clinical laboratory science (CLS), as a profession, influences career progression. DESIGN: A questionnaire was designed to collect information on job history including salary and positions held, reasons for leaving the field, satisfaction with the field and the perception of the field as a profession or a technical occupation. SETTING: Research facilities at the Graduate School of Public Health, San Diego State University, San Diego, CA. PARTICIPANTS: Graduates from the CLS program of the University of Minnesota Division of Medical Technology, 1923-1996, were sent questionnaires; 1338 (70.2%) responded. MAIN OUTCOME MEASURES: The comparison of career progression for those who perceive CLS to be a profession to those who perceive it to be a technical field. RESULTS: Seventy-seven percent of the respondents perceived the field to be a profession. They were 1.7 times more likely to have progressed in their careers than those who perceived CLS to be a technical field. This was reflected in the percentage achieving higher positions both currently and over the respondents' entire job history. CONCLUSIONS: Those who perceive CLS to be a profession are more likely to progress in their career and remain in the field of CLS.
The derailment of occupational therapy, exemplified by the profession's symbiosis with the medical model, its alignment with the rehabilitation movement, and its devaluation of the arts and crafts is the central theme of this article. The occupational behavior paradigm, which represents a recommitment to the values and beliefs of the profession's founders, has emerged to arrest the derailment process and thereby reinstate the substantive goals of occupational therapy.
Occupational therapists need an acceptable terminology to describe a client's clinical performance. The language or terminology must be in harmony with common language in the health care system but also reflect occupational therapists' professional responsibility. The aim of this paper is to help clarify similarities and differences between concepts in occupational therapy and the International Classification of Functioning, Disability and Health (ICF). Two studies were completed in which items in the International Classification of Impairments, Disabilities and Handicaps (ICIDH-2) were compared with concepts from the Swedish version of the assessment of Motor and Process Skills (AMPS) and the Assessment of Communication and Interaction Skills (ACIS-S). An expert panel of occupational therapists served as raters and 33 clients with learning disabilities and mental health problems were assessed. The result showed that 12 (60%) of the skills items from the ACIS-S were found to be equivalent to items in then ICIDH-2. In total, 41% (n = 23) of the items in the AMPS or ACIS-S have a correlation higher then 0.60 with the ICIDH-2. The classification can serve as a useful tool for occupational therapists and supports communication between professions, but is not sufficient as a professional language for occupational therapists. Further research is indicated to examine how the ICF can be applied in occupational therapy and its implications on clinical practice.