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[Assurance and assessment of education quality in occupational hygiene in the United Kingdom, United States and Canada].

There is an urgent need to develop and formally recognise the profession of occupational and environmental hygienist in Poland. A high quality of specialist training in occupational hygiene is a prerequisite for any successful action aimed at accomplishing this goal. Assurance and assessment of education quality in this domain is inseparably associated with the problem of accreditation and certification. The first difficulty lies in a limited number of patterns or points of reference, such as systems of accreditation and certification in the area of occupational hygiene that already function. Insufficient dissemination of knowledge of the systems which already exist and function properly is another difficulty. Based on the Anglo-Saxon literature dealing with this subject, the author tries to bridge this gap.

Education, Medical↗

After rehabilitation: meeting the long-term needs of persons with traumatic brain injury.

Many survivors of traumatic brain injury have significant needs for long-term support. The rehabilitation professions, including occupational therapy, have begun to recognize these needs more fully during the last decade. The literature describes various models of supported living that provide housing, support services, and vocational assistance; however, these programs are not widely available due to limitations in public funding and inadequate insurance coverage for long-term care. Occupational therapists can contribute a broad expertise to the provision of supported living services, and the profession is encouraged to provide leadership and advocacy with respect to the long-term care needs of survivors of traumatic brain injury.

Adult↗

Old themes, new directions--occupational therapy in the 21st century.

The paper begins with a brief look at directions for the future of occupational therapy as expressed in occupational therapy literature over the past six decades. The major contributions in the areas of practice, research and education, professional organization, and theory/knowledge base are highlighted. It then considers current social issues in Canadian society which have a bearing on occupational therapy and implications for its future development: population trends, health status and hospitalization, universal access to health and social services, unemployment, client expectations, multiculturism, medical ethics, family breakdown and child abuse. It looks at the occupational therapy profession in relation to these social issues and concludes with a summary of implications for occupational therapy and predictions for its future into the 21st century based on the analysis of these trends.

Canada↗

Occupational deaths among healthcare workers.

Recent experiences with severe acute respiratory syndrome and the US smallpox vaccination program have demonstrated the vulnerability of healthcare workers to occupationally acquired infectious diseases. However, despite acknowledgment of risk, the occupational death rate for healthcare workers is unknown. In contrast, the death rate for other professions with occupational risk, such as police officer or firefighter, has been well defined. With available information from federal sources and calculating the additional number of deaths from infection by using data on prevalence and natural history, we estimate the annual death rate for healthcare workers from occupational events, including infection, is 17-57 per 1 million workers. However, a much more accurate estimate of risk is needed. Such information could inform future interventions, as was seen with the introduction of safer needle products. This information would also heighten public awareness of this often minimized but essential aspect of patient care.

HIV Infections↗

Personal reflections on occupational health in the twentieth century: spiraling to the future.

The history of occupational health in the United States during the twentieth century demonstrates pendular swings, with periods of rapid progress followed by periods of reversal. Happily, the last three decades have witnessed the most impressive gains, with establishment of a near-universal system for regulating conditions in the workplace, legitimization and growth of the occupational health professions, a marked increase in scientific research, most notably epidemiology, and the transfer of knowledge about occupational health to affected workers and the larger US population. Not surprisingly, rates of injury and illness have fallen. However, analysis of these cyclical historic changes suggests that extrinsic factors--broad social currents, changes in health care financing, and societal perceptions of health and disease--have dominated over enhanced scientific knowledge, technologic changes or professional achievements, usually the determinants of medical or public health advances. Practitioners of occupational health are not, and have never been, in a particularly advantageous position to fashion future events in their own field, and the current situation, however encouraging, is likely no exception.

Forecasting↗

Intraprofessional team building.

This article discusses the importance of team building between occupational therapists and occupational therapy assistants and the relationship of teamwork to the effectiveness of service delivery within the profession of occupational therapy. If team members' needs are not satisfied, dysfunctional intraprofessional teams result. Team building is based on the satisfaction of three areas of individual need: (a) ministration, which leads to mutual respect; (b) mastery or effective performance; and (c) maturation or personal growth and professional socialization. A better understanding and appreciation of the roles of therapist and assistant and their relationships can resolve the team deficits. A developmental team chart that uses a systems theory model as an organizing framework is presented as an action plan for team building. Suggestions are made to academic and fieldwork educators and professional and technical clinicians to strengthen intraprofessional relationships in occupational therapy.

Clinical Competence↗

Changing times: trials and tribulations of the move to Master's entry-level education in Canada.

BACKGROUND: Most health care professions are reviewing issues related to the changing nature of professional education and practice. Social work, physical therapy, speech-language pathology, audiology, and recently occupational therapy, have raised the entry-level training requirements to the graduate level to enhance formal education programs. PURPOSE AND SCOPE: In the past few years, this trend has generated considerable debate and discussion within the occupational therapy profession both in Canada and internationally. In November, 2001 the Canadian Association of Occupational Therapists (CAOT) announced that Canadian universities must convert to entry-level Master's programs by 2008 to receive re-accreditation (CAOT, 2002a). This paper describes the historical evolution of Canadian occupational therapy education, outlines several issues within occupational therapy that are impacting the move, and discusses benefits and challenges to Master's level training. PRACTICE IMPLICATIONS: Recommendations are presented for the development of Master's entry-level occupational therapy training programs in Canada.

Accreditation↗

Prestige of radiologic technologists: perception of two allied health professions.

Physical and Occupational Therapists in large urban hospitals rated the prestige of 13 allied health professions, generally hospital based. Radiologic Technologist was ranked 13th by PTs and 12th by OTs. PTs were more negative with 35% using ratings below "average," while OTs assigned 28%. Only 27% of the PTs used ratings above "average," while 33% of the OTs did so. Prestige scores derived for Radiologic Technologists placed them among nonprofessionals.

Attitude of Health Personnel↗

Occupation by design: dimensions, therapeutic power, and creative process.

Two forces are converging, creating conditions both challenging and potentially fruitful for occupational therapy. The profession's knowledge base describing occupation is growing exponentially. At the same time, functional outcomes of intervention are being increasingly valued within the health care environment. Other professions imitate and claim our areas of expertise in the most flattering and dangerous ways. To benefit from the convergence of these forces, occupational therapy must expeditiously translate understanding of occupation into powerful occupation-based practice. Three bridges must be built: a generative discourse, demonstration sites, and effective education. The occupational design approach offers important conceptual tools with which to rapidly build these bridges to powerful practice. Described here are subjective and contextual dimensions of occupational experience, elements of the occupational design process, and how these factors produce therapeutic power through the appeal, intactness, and accuracy of interventions.

Curriculum↗

Regulatory initiatives: instruments for leadership.

As this paper has emphasized, regulation of the health professions does not exist in a vacuum. First, regulation of professions and occupations always depends on political circumstances for its inception and operation. Second, regulatory policy issues revolve on questions of value accorded competing issues. In a democracy, values are the province of the public, not of the experts. Nurses can aid the public in sorting out relevant values by taking a leadership role in regulatory initiatives. Third, certain characteristics--expertise, cohesiveness, political salience and leadership--are significant in advancing the policy agenda. The nursing profession must rethink its position on the policy agenda. Fourth, the regulatory pattern of the future outlines an essential role for government--government acting as our agent in accomplishing tasks of social control and social justice. As James Reagan has stated, "Laws inevitably reflect the times in which they were written, expressing social objectives, scientific knowledge and technical capabilities of the era." We can extend that observation to rule making, modes of procedure and legislative patterns. None of these factors is static. Fifth, proposing regulatory initiatives is the cutting edge of practice. In the present social-political-technological environment, only one certainty exists for nursing professionals: The health care field will continue for some time in its present state of flux. Now as never before, nurses have the opportunity to demonstrate leadership, to influence public opinion about health care, and to play an important role in new regulations governing health care and the nursing profession.

Health Occupations↗

The occupational toxicologist: professionalism, morality and ethical standards in the context of legal and non-litigation issues.

By its very nature, practice and intended applications, the profession of occupational toxicology has individual and collective responsibilities related to the design, conduct, interpretation and extrapolation of laboratory and controlled human clinical studies in order to determine the potential for industrial xenobiotics to produce adverse effects. The implications for health-related adverse effects in the workplace, and in the domestic and general environment carries many and various responsibilities for the toxicologist which are related to multiple and wide-ranging ethical issues. This review presents and discusses some of the major areas where the occupational toxicologist may experience potential ethical problems related to the conduct of routine professional activities. Emphasis is placed on the design, conduct, interpretation and reporting of laboratory studies; animal welfare; regulatory activities; human clinical volunteer studies; roles and responsibilities in defining workplace safety and protective measures; malpractices in various disciplines and work practices; misconduct in publication; and codes of ethical behavior.

Animal Experimentation↗

Brandon/Hill selected list of books and journals in allied health.

This list of 410 books and 78 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and described in the AMA's Health Professions Education Directory, 1997-1998, plus physical therapist and medical secretary. Some programs do not have their own specific literatures. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (160 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1998 subscriptions) would require an expenditure of about $29,180. The cost of only the asterisked items total $11,390.

Allied Health Occupations↗

Audit in the therapy professions: some constraints on progress.

AIMS: To ascertain views about constraints on the progress of audit experienced by members of four of the therapy professions: physiotherapy, occupational therapy, speech and language therapy, and clinical psychology. METHODS: Interviews in six health service sites with a history of audit in these professions. 62 interviews were held with members of the four professions and 60 with other personnel with relevant involvement. Five main themes emerged as the constraints on progress: resources; expertise; relations between groups; organisational structures; and overall planning of audit activities. RESULTS: Concerns about resources focused on lack of time, insufficient finance, and lack of access to appropriate systems of information technology. Insufficient expertise was identified as a major constraint on progress. Guidance on designing instruments for collection of data was the main concern, but help with writing proposals, specifying and keeping to objectives, analysing data, and writing reports was also required. Although sources of guidance were sometimes available, more commonly this was not the case. Several aspects of relations between groups were reported as constraining the progress of audit. These included support and commitment, choice of audit topics, conflicts between staff, willingness to participate and change practice, and concerns about confidentiality. Organisational structures which constrained audit included weak links between heads of professional services and managers of provider units, the inhibiting effect of change, the weakening of professional coherence when therapists were split across directorates, and the ethos of regarding audit findings as business secrets. Lack of an overall plan for audit meant that while some resources were available, others equally necessary for successful completion of projects were not. CONCLUSION: Members of four of the therapy professions identified a wide range of constraints on the progress of audit. If their commitment to audit is to be maintained these constraints require resolution. It is suggested that such expert advice, but also that these are directed towards the particular needs of the four professions. Moreover, a forum is required within which all those with a stake in therapy audit can acknowledge and resolve the different agendas which they may have in the enterprise.

Allied Health Occupations↗

Selected list of books and journals in allied health.

This list of 410 books and 76 journals is intended as a selection guide to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and described in the AMA's Allied Health and Rehabilitation Professions Education Directory, plus physical therapy, dental allied health, medical secretarial, nutrition, and speech pathology/audiology programs. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (163 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (1996 subscriptions) would require an expenditure of about $26,740. The cost of only the asterisked items totals $11,160.

Journal Article↗

The effectiveness of master's degree programs for occupational therapists.

Are graduates of master's degree programs in occupational therapy satisfied with the content of their programs and the results of their studies? Are these programs commensurate with the needs of the occupational therapy profession in the development of skilled practitioners, educators, administrators, and researchers. These two questions provided the framework for an investigation to determine the needs, trends, strengths, and weaknesses of graduate study in occupational therapy in the United States today. The responses of 100 occupational therapists from 12 universities, 61.4 per cent of those who received questionnaires, were tabulated and analyzed. The results presented a composite picture of master's degree programs in occupational therapy and other graduate programs such as education, vocational rehabilitation, and special education. The conclusions suggest that requirements of the master's programs encourage independent inquiry, provide for the individual's academic needs, and prepare researchers. However, the programs are only partially fulfilling the requirements of the profession for skilled practitioners and educators.

Attitude↗