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Working and "drugging" in the city: economics and substance use in a sample of working addicts.

Employment status is often treated as a "risk factor" in epidemiologic studies of drug use. The process that underlies the supposed relationship has remained, however, essentially unexamined. This article uses life history data to look at the relationship between work and drug use in a sample of addicts from Baltimore City, Maryland. The narratives constructed by these individuals demonstrate that the processes involved in creating and maintaining drug- and nondrug-related identities are neither linear nor straightforward. Rather, managing complex, emergent identities is a product of the economic situation, the organization of the drug scene, and the larger milieu in which these addicts operate.

Adult↗

Making team working work--a real life experience.

Southern Derbyshire Speech and Language Therapy Department has a team of six specialist speech and language therapists who support children with Specific Language Impairment in their mainstream schools via joint commissioning with education. As the team expanded in October 1995 this coincided with health trust and education changes and produced great instability and insecurity within the team. This paper outlines the implementation of a formal team working package using a facilitator provided by the trust's quality team and shows how it is possible to problem solve and develop within a framework of group rules, such as honesty and openness. Following its success its principles have allowed us to co-operate more effectively with both school staff and the community team and to support colleagues through a re-organisation of their service.

Education, Special↗

"We have worked while we played and played while we worked": discipline and disobedience at the Kingston General Hospital Training School for Nurses, 1923-1939.

Drawing on evidence found in nurses' journals, oral accounts, yearbooks and other cultural productions as well as in hospital records, this paper considers the experiences of apprentices in a hospital nursing training school in the interwar period. By combining elements of scientific management with an older paternalist ethos, hospital administrators sought to imprint student nurse "material" with standards of work and behaviour valued by the hospital institution and the community that supported it. Students, whose expectations for nursing school often conflicted with those of management, developed a culture of mutuality that provided them with valuable resources to subvert and/or ameliorate the effects of disciplinary technologies and to re-appropriate the spaces and discourses of nursing training.

Canada↗

To work or not to work: that is not the question.

1. Although employers in the public mental health arena may be expected to hire consumers of mental health services, it has been much more difficult for people with mental disabilities to find work in the private sector, or to return to such jobs after an acute episode of mental illness. 2. Many consumer-and survivor-run services around the country offer those with mental illness not only volunteer and employment opportunities, job training, and placement services, but also good role models and hope for the future. 3. How to address gaps in résumés is still controversial. However, since it is illegal for employers to ask questions designed to elicit information about illness, many experts advise consumers to get the job first; they can disclose their illness and ask for reasonable accommodations later.

Persons with Disabilities↗

Diagnosis and management of dyspepsia--clinical guideline, 1999. Dyspepsia Working Group, South African Medical Association, South African Gastroenterology Society Working Group.

OBJECTIVE: To outline an approach for the effective, practical and safe diagnosis and management of uninvestigated dyspepsia at a primary level of care appropriate to South Africa. The target group for guideline use included general practitioners and other primary health care providers in the public and private sectors. The guideline includes referral points to higher levels of care. OPTIONS: Two main treatment options for the management of patients with uninvestigated dyspepsia were considered to be relevant to South Africa: Empiric medical therapy (often based on the dominant symptom or symptom complex) with further investigation reserved for 'empiric treatment failures'. Immediate diagnostic evaluation (endoscopy/radiology) of all cases and targeting of therapy based on results. EVIDENCE: Literature review of relevant studies. However, there are insufficient South African data to make fully evidence-based recommendations. VALUES: The working group considered that immediate investigation (by endoscopy/radiology) was not a practical option in the South African setting, owing to a lack of resources. The group stressed the importance of adequate initial evaluation to identify the 'high-risk' patient. RECOMMENDATIONS: Early identification of 'high-risk' patients needing immediate referral to a higher level of care and for further investigation. The remaining 'low-risk' patients should be offered acceptable symptomatic management of dyspepsia. As there is no single ideal first choice drug, selection is often empiric after considering the following: level of contact and care, dominant dyspepsia symptom, availability and cost of medicines, individual preferences. Drug treatment should continue for a finite period (2-4 weeks) and response should be monitored. If treatment fails after a trial of a second drug, then further investigation should be considered as for the 'at-risk' patient. All patients should be given advice on lifestyle changes. A diagnosis of non-ulcer dyspepsia should only be considered when further investigation has not shown specific pathology. When indicated, endoscopy is the preferred method of investigation, but if not available then a barium meal is recommended. The role of Helicobacter pylori in dyspepsia is poorly understood. Empiric H. pylori eradication therapy is not recommended. VALIDATION: Endorsement by the South African Gastroenterology Society, SAMA and other groups that sent representatives to a multidisciplinary consensus meeting to consider the draft guideline and its later modifications. FINANCIAL SPONSOR: Development supported by an unrestricted educational grant by Janssen-Cilag to SAMA.

Antacids↗

[Work-hygienic studies connected with the manipulation of silver-tin-mercury alloys at the dentists working place].

By means of a spectro-photometric measuring method, tests are made regarding the development of Hg vapors at the dental working place when processing amalgam. Depending on the step in amalgam processing and the location, more or less high Hg vapors concentrations, were measured. They are highest with high-speed, dry preparation of amalgam fillings, they decrease considerably with lower speed and more intensive colling (spray!).

Air Pollutants↗

The epidemiology of work and work-related disease in Rhode Island, 1876-2001.

Most Rhode Island workers now work in service industries, though many workers continue to be exposed to the risks of goods production in the workplace. Most reported occupational death is related to transportation and homicide, although in Rhode Island in 1999, exposure to harmful substances or environments was a significant cause of Rhode Island's few occupationally related deaths. How much occupational and environmental exposure contributes to Rhode Island's heart disease and cancer mortality rates in unknown. Musculoskeletal injuries are the predominant form of reported non-fatal occupational injuries, but there are questions about the completeness and accuracy of data on occupational injury and death.

History, 19th Century↗

Non-work factors associated with musculoskeletal upper extremity disorders in women: Beyond the work environment.

It is women who are predominantly affected by musculoskeletal disorders of the upper extremities (MSD/UE), especially those disorders attributed to repetitive strain or cumulative trauma. This study focuses on a female sample of supermarket employees and the effects of stress acquired from their non-work environments on the reporting of musculoskeletal symptoms. Stress and life events were shown to be positively associated with the presence of UE disorders and measures of intensity, duration, and frequency of pain. A multifactorial model for explaining the development of MSD/UE in female workers is proferred, while the significance of understanding the inter-relational nature of women's lives is underscored. Additionally, the study lends credence to the physiological underpinning of stress.

Journal Article↗

[The working conditions and morbidity with temporary loss of work capacity for those engaged in the manufacture of household chemical preparations].

Workers engaged in production of household chemical goods (paints, synthetic detergents, aerosols) are exposed to harmful factors (noise levels higher than the maximal allowable ones, concentration of chemical agents in the air surpassing the MACs). Such work conditions are estimated as unfavourable according to the hygienic classification. The total morbidity and some nosologic forms (respiratory, digestive, locomotor systems and skin) are growing in number especially in workers of aerosol production. Statistic analysis revealed that the length of service was directly related to the level of total morbidity and the incidence of gastrointestinal diseases in the workers engaged in manufacture of household chemical goods.

Absenteeism↗

[Consulting work cited in the hospital laboratory annual progress report of the laboratory information and consulting work and its role in Toyama Medical and Pharmaceutical University Hospital].

Recently, it is difficult for general patients to understand clinical inspection. Therefore we opened the laboratory information and consulting office (called Kensa Yorozu Consulting Room) from April, 2004. It is most characteristic that our office is managed by a clinical laboratory physician. A full time-specialized doctor who is belong to clinical laboratory, is stationed in the office. Duties contents of our office are consultation, publishing laboratory report and information, education and the clinical studies. We don't limit a person of consultation in particular. We accept consultations for 24 hours by coming our office, telephone, Fax or E-mail. The amount of consultations is about 5-10 per one month. The contents are suggesting inspection plan, explanation of pathophysiologic information based on clinical inspect result and so on. The examples compiled it into a database and maintains and their answers information. Because there are clinical laboratory physicians in this office, there are merits that follow. As for the medical technologist, it was not interfered with routine duties. For doctors and co-medical staffs, it is possible for detailed arguments to the diagnosis and treatment considered the condition of a patient and a characteristic of laboratory method. Doctors of outside can talk with us by telephones or emails easily. For patients, they can smoothly talk about their diseases with their physicians knowing more laboratory information. More medical stuffs need our office, because there are many repeaters although the total number is small. Therefore it is important that we let everybody know about our works and that we make good communication environment to talk easily, keeping privacy. We want to compile and share database of laboratory information. Then we can contribute to the area medical care.

Allied Health Personnel↗

Work activity of persons working as members of advisory committees established under the Federal Advisory Committee Act (FACA). Final rule.

We are revising our disability regulations under titles II and XVI of the Social Security Act to establish a new, special rule that affects individuals who are receiving payments or providing services as members or consultants of a committee, board, commission, council or similar group established under the Federal Advisory Committee Act (FACA). Under this special rule, we will not count any earnings an individual is receiving from serving as a member or consultant of a FACA advisory committee when we determine if the individual is engaging in substantial gainful activity under titles II and XVI of the Social Security Act (the Act). In addition, we will not evaluate any of the services the individual is providing as a member or consultant of the FACA advisory committee when determining if the individual has engaged in substantial gainful activity under titles II and XVI of the Act. Based on our experience with FACA advisory committees and the frequency and level of activity required by these committees, we believe that performance of activity on these committees does not demonstrate the ability to perform substantial gainful activity. We believe this to be consistent with Congress's view, as it has recognized in creating the Ticket to Work advisory committee, for example, that current disability beneficiaries should be considered for membership. This also will encourage individuals with disabilities to serve on FACA advisory committees, thereby providing the benefit of their unique perspective on policies and programs to the Federal Government.

Advisory Committees↗

[Help, I can work again. Analysis of the rehabilitation process into work life of a chronically ill patient after survival of myocardial infarct].

The prime objective of the pension insurances' rehabilitation measures is to successfully reintegrate clients into their working environment. The high number of early retired clients indicates that Germany's health system cannot reach this objective satisfactorily. Empirical studies as to the various causes and factors leading to illness and--as a consequence--to early retirement provided only a few results. The client's personal and psycho-social situation in particular, as well as her/his biographical data and the available scope of action are hardly ever considered appropriately. With this in mind, we set out to reconstruct the rehabilitation process from a client's view using the method of structural hermeneutics. Against the background of biographical development, we describe the origin of illness, rehabilitation results and the opinion of social medicine experts preceding reintegration. The hermeneutic analysis shows that--in spite of the intentions of the persons concerned--an unconscious agreement arises between the client and the therapeutic system manifesting itself in the application of rehabilitation measures reproducing premorbid behaviour. On the basis of the reconstructed client-related situation a critical aspect of the general structure of Germany's health system becomes apparent: the fragmentation of the client into responsibilities of experts giving the opinion and those responsible for treatment.

Adaptation, Psychological↗

[Working conditions and morbidity with temporary loss of work capacity among metallurgists from Mill 300 of the Predmet firm--in Debelt].

Occupational hygienic and medico-statistical study is carried out in shop LOOM-300 for rolling of steel. The rate of exposure to chemical and dust factor of the workers is determined by means of index of exposure after the formula [formula: see text] The personal analysis of morbidity with temporary disability shows an increase of the basic indices "frequency" and "gravity" during the three year period. The per cent of the sick is higher in men, in the workers with higher index of exposure and in the younger age groups (up to 40 years old) with short labour of service, which certifies, for insufficient adaptation to the new working conditions. A conclusion is made, that the progressive increase of the indices of morbidity are serious warning for future high rate of morbidity, if labour hygienic and medico-preventive measures are not taken.

Absenteeism↗

Nutrition education strategies for work-site wellness: evaluation of a graduate course targeted to work-site wellness majors.

A course incorporating concepts of wellness with nutrition intervention strategies was developed and targeted to graduate students in the health education and wellness program. Pretest/final test evaluations of course participants indicated significant increases in students' nutrition knowledge and confidence in their ability to perform tasks identified in the course objectives. By offering courses for future wellness professionals that emphasize nutrition education strategies and resource selection, the number and quality of nutrition-related programs offered at work sites might increase.

Chi-Square Distribution↗

[Characteristics of work capacity of patients with silicosis occurring after stopping their work in exposure to dust].

The whole contingent of patients, ill with silicosis manifested after interrupting work with dust, registered up to 1984, at the Clinic of Occupational Diseases, Sofia was examined. Analysis was made of the lasting disability of the patients. A study was performed on the relation between group of invalidity and age groups in the newly discovered cases; group of invalidity and length of service at dry drilling; group and diagnosis of the illness in stages; connection between x-ray morphological displays and functional disturbances and group of invalidity. Recommendations are given concerning the basic pneumoconiosis process and its complications and the interrelations between pneumoconiosis disease, chronic bronchitis and pulmonary emphysema.

Adult↗