Saúde dos trabalhadores de enfermagem: revisando as estratégias de promoção à saúde / The health of nursing professionals: reviewing health promotion strategies / Salud de los trabajadores de enfermería: revisando las estrategias de promoción a la salud

Objective: The study's purpose has been to further understand the health promotion strategies towards nursing professionals. Methods: It is an integrative literature review with a qualitative approach, which is composed of 23 articles that answer the following guiding question: What are the health promotion strategies developed for nursing professionals? Results: The findings were gathered into four strategy groups, as follows: Promoting the Work Planning, which are based on regulating the workload and salary relationship; Promoting Knowledge, which are focused on the professional update through the use of technologies; Promoting Physical Activity, aiming to guarantee the access to physical exercise, both intra and extra the work environment; and, Promoting Integrative and Complementary Practices, indicating music therapy, relaxation techniques and yoga, which together with the other ones might contribute to reduce work stress, musculoskeletal and cardiovascular problems. Conclusion: The work planning can be considered the main strategy of health promotion for nursing professionals, since it is associated with the development of the others

Objetivo: Conhecer as estratégias de promoção à saúde para os trabalhadores de enfermagem. Método: Revisão integrativa composta por 23 artigos que respondem a questão norteadora: Quais as estratégias de promoção à saúde, desenvolvidas para os trabalhadores de enfermagem? Aplicou-se uma abordagem qualitativa. Resultados: As estratégias para Promoção da Organização do Trabalho pautam-se na regulação da relação carga de trabalho e salário. As do Conhecimento, na atualização profissional com uso de tecnologias. Já as da Atividade Física, na garantia do acesso ao exercício físico, intra e extra, ambiente de trabalho. As de Promoção de Práticas Integrativas e Complementares indica a musicoterapia, as técnicas de relaxamento e yoga, que em conjunto com as demais, contribuem para reduzir o estresse laboral e problemas musculoesqueléticos e cardiovasculares. Conclusão: A organização do trabalho pode ser considerada a principal estratégia de promoção à saúde para trabalhadores de enfermagem, pois a ela associa-se o desenvolvimento das demais

Objetivo: Conecer las estrategias de promoción a la salud para los trabajadores de enfermería. Método: Revisión integrativa compuesta por 23 artículos que responden a la cuestión orientadora: ¿Cuáles son las estrategias de promoción a la salud, desarrolladas para los trabajadores de enfermería? Se aplicó un enfoque cualitativo. Resultados: Las estrategias para Promoción de la Organización del Trabajo se basan en la regulación de la relación carga de trabajo y salario. Las del Conocimiento, en la actualización profesional con uso de tecnologías. Las de la Actividad Física, en la garantía del acceso al ejercicio físico, intra y extra, ambiente de trabajo. Las de Promoción de Prácticas Integrativas y Complementarias indica la musicoterapia, las técnicas de relajación y yoga, que en conjunto con las demás, contribuyen para reducir el estrés laboral y problemas musculoesqueléticos y cardiovasculares. Conclusión: La organización del trabajo puede ser considerada la principal estrategia de promoción a la salud para trabajadores de enfermería, pues a ella se asocia el desarrollo de las demás

¿Es necesario conocer qué trabajadores son portadores de SARM en contacto con enfermos oncológicos? / Is it necessary to know which workers are carriers of MRSA in contact with cancer patients?

Nuestro objetivo fue determinar la prevalencia de Staphylococcus aureus resistente a meticilina (SARM) en los trabajadores que tuvieron contacto directo con enfermos oncológicos infectados por SARM e ingresados en la unidad de cuidados intensivos del Instituto Valenciano de Oncología. La prevalencia de colonización por SARM se estudió en 62 trabajadores. Las muestras obtenidas de las fosas nasales y faringe (n= 124) fueron incubadas durante 24 horas en medio de transporte Amies Viscosa (Eurotubo®) y después sembradas en agar chocolate, agar MRSA II y caldo Brain Heart Infusion. Las colonias que se identificaron mediante la tinción de Gram como cocos gram-positivos con disposición en racimos, catalasa positiva y coagulasa positiva, se procesaron para estudio de sensibilidad mediante el método de Kirby-Bauer y prueba de cribado de la meticilina (10 µg de Oxoid®) en Mueller-Hinton (Becton-Dickinson®, BD), suplementado con NaCl (2%). A los aislamientos de SARM confirmados, se les volvió a realizar estudio de sensibilidad mediante microdilución (MicroScan® de Siemens), para determinar las CMI (mg/L). La prevalencia de SARM fue del 1,61% (1 trabajador) y 12,90% (8 trabajadores) para Staphylococcus aureus sensible a meticilina (SASM), procedentes de fosas nasales. Las medidas adoptadas fueron: aplicación de mupirocina nasal al trabajador colonizado, control de las medidas de aislamiento en los pacientes colonizados y/o infectados y adoctrinamiento al personal relacionado(AU)

Our objective was to determine the prevalence of methicillin-resistant Staphylococcus aureus in workers who had direct contact with oncologic patients infected with MRSA and admitted to the intensive care unit of the Valencian Institute of Oncology. A study of prevalence of MRSA colonization of 62 workers was performed. Samples were taken from nose and pharynx in each of the workers. After 24 hours of incubation in Amies transport medium Viscose (Eurotubo®), 124 samples were seeded (N = 124) in chocolate agar agar, MRSA II and BHI broth (Brain Heart Infusion). Those colonies that were identified by Gram stain gram-positive cocci in clusters available, catalase positive and coagulase positive were processed for study of sensitivity by Kirby-Bauer method and screening test for methicillin (10ìg of Oxoid®) on Mueller-Hinton (Becton-Dickinson®, BD), supplemented with NaCl (2%). Those confirmed MRSA isolates, he returned to perform sensitivity study by microdilution (MicroScan®, Siemens) to determine the MIC (mg/L). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 1.61% (1) and 12.90% (8) for methicillin-sensitive Staphylococcus aureus (MSSA), from nostrils. The measures implemented were: nasal application of mupirocin to the worker colonized control isolation measures in infected patients and indoctrination of the personnel involved(AU)

The occupational health nurse as the trusted clinician in the 21st century.

Occupational health nurses as trusted clinicians use their direct care skills in both on-site and off-site roles to protect human resources and contain health care costs. On-site clinics leverage the knowledge, skills, and abilities of occupational health nurses. To maximize the health of the work force, occupational health nurses use strategies aimed at improving health, engaging employees, enhancing accountability of employees, linking provider strategies, using technology creatively, and promoting healthy work environments. Occupational health nurses maintain a proactive and effective impact on occupational health and safety as part of a broader framework of holistic primary care.

[Structure of human resources and activities of occupational medicine service in Poland in 2009 and dynamics and trends in recent years]. / Struktura kadr i dzialalnosc sluzby medycyny pracy w Polsce w 2009 r. oraz dynamika i kierunki zmian w ostatnich latach.

BACKGROUND: The main objective of the study was to provide the most important results concerning the state of human resources and activities of occupational medicine services in Poland in 2009 and their dynamics and trends in the recent years. MATERIALS AND METHODS: Information about the state of human resources and activities of occupational medicine services has been obtained from statistical forms (more than 10,000) filled by occupational physicians carrying out the preventive g care of workers, and health care centers (or their separate parts), which are the primary occupational medicine units and regional occupational medicine centers (forms: MZ-35A, MZ-35B and MZ-35). RESULTS: In 2009, essential changes were noted in the structure of the primary occupational medicine units. 'Ihere was a significant decrease in the number of public health care centers. This phenomenon has resulted from the transformation of public health care centers into non-public structures. CONCLUSIONS: The range of occupational medicine services has reached the level sufficient enough to achieve the objectives of the occupational health care mandatory assignment. However, the structure of the tasks actually performed by regional occupational medicine centers greatly varies, from focusing on the statutory tasks to their marginalization.

[Analysis of health concept in low-educated workers of 4 European Union countries for improving efforts to preserve health at workplace].

Study carried out in 4 EC countries revealed significant differences in attitude towards health between two examined groups of workers with various education levels, and between countries. Low-educated workers, when compared to more educated workers, are different in acceptable information sources on health state and in general view of study.

Cost-effectiveness of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: design of a randomised controlled trial.

BACKGROUND: Within the working population there is a vulnerable group: workers without an employment contract and workers with a flexible labour market arrangement, e.g. temporary agency workers. In most cases, when sick-listed, these workers have no workplace/employer to return to. Also, for these workers access to occupational health care is limited or even absent in many countries. For this vulnerable working population there is a need for tailor-made occupational health care, including the presence of an actual return-to-work perspective. Therefore, a participatory return-to-work program has been developed based on a successful return-to-work intervention for workers, sick-listed due to low back pain.The objective of this paper is to describe the design of a randomised controlled trial to study the (cost-)effectiveness of this newly developed participatory return-to-work program adapted for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders, compared to usual care. METHODS/DESIGN: The design of this study is a randomised controlled trial with one year of follow-up. The study population consists of temporary agency workers and unemployed workers sick-listed between 2 and 8 weeks due to musculoskeletal disorders. The new return-to-work program is a stepwise program aimed at making a consensus-based return-to-work implementation plan with the possibility of a (therapeutic) workplace to return-to-work. Outcomes are measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure is duration of the sickness benefit period after the first day of reporting sick. Secondary outcome measures are: time until first return-to-work, total number of days of sickness benefit during follow-up; functional status; intensity of musculoskeletal pain; pain coping; and attitude, social influence and self-efficacy determinants. Cost-benefit is evaluated from an insurer's perspective. A process evaluation is part of this study. DISCUSSION: For sick-listed workers without an employment contract there can be gained a lot by improving occupational health care, including return-to-work guidance, and by minimising the 'labour market handicap' by creating a return-to-work perspective. In addition, reduction of sickness absence and work disability, i.e. a reduction of disability claims, may result in substantial benefits for the Dutch Social Security System. TRIAL REGISTRATION NUMBER: NTR1047.

Occupational health services now and in the future: the need for a paradigm shift.

OBJECTIVE: Occupational health services (OHS) evolved in response to the needs of hazardous industries and on the premise that work was harmful. In the developed world, most of these industries have disappeared, and classical occupational diseases are uncommon. EVIDENCE: The evidence now is that most work is safe and safe work is good for health. Access to OHS is inconsistent, and there is no continuity of care for workers who move to another employer or leave work because of ill health. CONSENSUS PROCESS: OHS therefore care for survivor populations and generally those in large enterprises who need OHS the least. From a societal viewpoint, OHS are not fit for purpose. They have not adapted to the evolving small business and more informal work sector. The health impact of long-term worklessness is large and the workless need access to the competencies of OHS. CONCLUSION: In the future, OHS should develop to meet the needs of the working-age population and to maximize the functional capacity.

Occupational health care for the 21st century: from health at work to workers' health.

A survey of relevant national and international legislation and recommendations on occupational health (OH) organization revealed two fundamental approaches to OH: 1) the historically older labor approach, essentially seeing OH care as an obligation of the employer derived from the labor contract, and 2) an emerging health approach, including all workers and all aspects of health, A draft decree on OH in Flanders seeks to integrate the two approaches. It extends the scope of OH to all workers (not only employees), introduces holistic health surveillance, rejects the incapacity concept, provides for strong integration of health and workplace surveillance, and stresses ethics. Workers' satisfaction is seen as the first criterion in quality control. Systematic data collection and analysis, and when necessary, scientific research are recommended. Additional resources for OH services should be provided by stakeholders other than employers.

Occupational health services in PR China.

In China, the origin of occupational health started in the mid 1950s soon after the founding of the People's Republic of China. However, more complete concept and practice of occupational health was defined after the early 1980s, when China started her full-scale drive for economic reform and policy of openness. The integrity intends to cover occupational health, occupational medicine, industrial toxicology, industrial hygiene, occupational ergonomics, and occupational psychology as theoretical and practical components of occupational health. As a result, occupational health in China has undergone many changes and has improved over the past decades. These changes and improvements came about, most likely due to a new scheme, where a holistic approach of the recognition, regulation, and provision of occupational health services in a wider coverage is gradually formed and brought into effect. This presentation provides the current status of occupational health and safety problems, the latest legislative to occupational health and safety, and a general scenario of the organizational structure and function of occupational health services in China. It attempts to share with participants both our experience and lessons learned towards creating a more open and effective channel of ideas and information sharing.

EMS offshore. A new horizon for paramedics.

The difficulty in getting medical aid to offshore drilling platforms can be a source of life-threatening delays. Recently, some companies have charted new waters by actually stationing EMS crews on their rigs.

Occupational medicine in the eighties: decade of change.

This chapter focuses on current medical practices in the petroleum industry as they reflect the social, managerial, technological and regulatory changes of the present decade. Modern health policies and medical organizations are reviewed, with emphasis on health evaluation programs, health information distribution and clinical services. The author concludes with commentary about apparent future trends.

Experience in controlling lead poisoning in the People's Republic of China.

This paper summarizes the work done to control lead poisoning in the People's Republic of China. The work can be divided into the following four phases: (i) health surveillance of lead workers, (ii) health standard setting, (iii) research for early detection indicators, and (iv) improvement of the work conditions and health surveillance of "undeserved" groups. In 1949 prevention started with the initiation of the health surveillance of lead workers. Since then health surveillance has been used to supplement environmental monitoring in the early detection of lead poisoning, and the prevalence of lead poisoning has decreased. This activity has also helped to identify the needs for improvement in technological control. The next step has been the promulgation of health standards. The current standard for lead gives the maximum allowable concentration in air as 0.03 mg/m3 for lead fume and 0.05 mg/m3 for lead dust. Research on indicators for the early detection of lead has improved the quality of prevention. It has recently led to the addition of zinc protoporphyrin to the list of indicators in use. Finally the work conditions and surveillance of workers that had earlier been considered "underserved," particularly workers in agriculture and small industries in rural areas, are being improved.