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This paper compares the short-term outcome of a group of seven patients released from an inpatient facility during an employee strike and a group of eight released at the optimal time according to the treating physicians. There was no difference in the outcome of the two groups, only two fifth of the entire cohort could be considered as doing well. The reasons for the findings are explored.
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The authors sampled the feelings and attitudes of patients and staff toward an 8-day strike by 2,500 health care employees of a metropolitan hospital. The strike had a major impact, and most respondents felt angry at one of the parties of the strike. Sympathies toward the strikers and the hospital management were equally divided.
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We describe the experience of the occupational health centre at the Sarnia Division of Dow Chemical Canada prior to, during and after a work stoppage of seven months duration. A descriptive analysis was performed of the occupational health case load during the work stoppage compared to the same period one year earlier. Total visits as well as those for dermatologic, upper respiratory, musculoskeletal and those associated with a non-occupationally related situation (e.g., sunburn) exceeded normal frequencies during the first ten weeks of the work stoppage. In particular, there was a peak number of visits during the first two weeks when a 'lock-in' prevented employees from visiting their own physicians except for emergency situations. In the Discussion section, recommendations are outlined to lessen the chance of adverse health effects in workers responsible for operating a chemical plant during a work stoppage.
The socio-demographic and clinical characteristics of patients admitted to a large psychiatric hospital during a six month period of industrial action by nurses are described and compared with those from a similar period in the previous year. During the industrial action, the nursing staff agreed only to accept "emergency cases" for admission. The way that medical and social work practices were affected by the restricted conditions are discussed. The admission threshold was raised across all diagnostic categories, although the level of violence and social isolation was markedly less than expected. Chronic patients with a duration of illness of ten years or more were least likely to be admitted during the action. It is probable that some patients were admitted under a compulsory order to facilitate access to in-patient treatment.
This is a report on the effects of a psychiatrists' strike in Israel on emergency psychiatric referrals and admissions from two catchment areas. One had comprehensive psychiatric services, the other did not. Three periods were compared - before, during and after the strike. During the strike period, overall referrals to the emergency room decreased by 3.9%. A significant 15.8% decrease in referrals was registered in the comprehensive psychiatric service area, and an 11.4% increase in referrals in the other catchment area. Although no increase was seen in total emergency admissions during the strike, involuntary admissions increased by 21.6%, within the catchment area which did not have a comprehensive service, whereas within the area with the comprehensive service there was a significant decrease of 33% in involuntary admissions. The impact of these services on emergency referrals and admissions, especially during the strike, is discussed.
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PURPOSE: To study the influence of the 1988 French nurses' strikes on mortality in a geriatric hospital. MATERIALS AND METHODS: Two nurses' strikes affected the Charles Foix Hospital near Paris from June 29 to July 31 and from September 17 to October 22, 1988. Mortality was studied in nine geriatric wards of this hospital, including two rehabilitation units comprising 187 beds, and seven long-term care units comprising 1,132 beds. Monthly mortality rates were calculated from the hospital's administrative registers and expressed as deaths per 1,000 patient-days. These rates were calculated in each of the aforementioned nine units for the 36 months preceding the first strike (control period) and for the 12 months following it (study period). RESULTS: Over the control period, monthly mortality was significantly higher in rehabilitation units than in long-term care units (2.46 +/- 1.21 versus 0.83 +/- 0.47, p less than 0.001), but mortality rates among rehabilitation units, as well as among long-term care units, were comparable. Also, during the control period, large seasonal fluctuations in monthly mortality rates were observed in both rehabilitation units and long-term care units (peak in winter and nadir in summer). These rates tended to decrease from year to year in rehabilitation units but not in long-term care units. A statistical model based on time-series analysis of the control period data was used to calculate the expected monthly mortality rates for the study period in rehabilitation units and in long-term care units, respectively. Three of the 12 actual monthly mortality rates exceeded the upper limit of the 95% confidence interval of the 12 expected monthly mortality rates, in the units where the more severe care disruption occurred. A detailed analysis of discharge summaries of these units failed to identify a possible link between some of these deaths and a possible absence of care. CONCLUSIONS: The nurses' strikes did not induce a clear-cut increase in mortality in this population of elderly patients. However, we cannot exclude the possibility that these strikes had some negative effects on health. Our results fail to provide answers to the difficult ethical problems created by such stoppages.