Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Emergency medical personnel have a number of occupational risk factors that are listed in the reviewed literature (Davis and Heaney 2000, Volinn 1997 and Andersson 1999) as risk factors for low back pain. Physical lifting and carrying of patients and equipment increases stress on the lower back, while occupational stress and a high level of patient responsibility are mental risk factors (Davis and Heaney, 2000). Emergency medical personnel that spend long hours in response vehicles, ambulances or helicopters are exposed to vibrational stressors and may therefore have an increased risk of low back pain due to this whole body vibration (Palmer et al, 2000). In addition it has been noted that the number of motor vehicle accidents will also increase the risk of low back pain due to mechanical injury (Cassidy et al, 2003). Low back pain could therefore interfere with their ability to carry out their duties, affect their attitude towards patients and colleagues, impact on the level of patient care required of them, and result in increased absenteeism. Persistence of chronic low back with the inability to perform their duties may result in the need to find alternative employment or result in premature dismissal. The objectives of this study were: to determine if emergency medical personnel have a higher risk factor for the development of low back pain due to their occupation than the general population; as well as determine if an increase in the number of years working in the field (i.e. years of exposure) leads to an increased incidence and / or prevalence of low back pain. / M

The aim of this doctoral research was to explore CAM use in pregnancy from the perspectives of pregnant women and health professionals. The research was conducted in four phases: a systematic review of the published literature from 2008-2012; cross sectional surveys of two cohorts of women during the first and last trimester; and a cross sectional survey of health professionals (midwives, obstetricians, anaesthetists) at Aberdeen Maternity Hospital. The systematic review reported a significant proportion of women used CAM during pregnancy with prevalence rates ranging from 5.8% to 74.2%. The study of health professionals identified that more than 30% of respondents have prescribed, referred or advised the use of CAM to pregnant women. The main associated factor for CAM use was, 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09–22.05; P < 0.001). Two thirds of women (63%) reported using CAM, excluding vitamins and minerals, during early pregnancy. The independent predictors of CAM use identified were: use by family and friends (OR 4.1, 95% CI 2.3–7.3, p < 0.001); ethnicity (non-white British) (OR 3.4, 95% CI 1.8–6.8, p < 0.001); and use prior to pregnancy (OR 2.4, 95% CI 1.2–4.8, p = 0.014). Two thirds of women (61.4%) reported using CAM, excluding vitamins and minerals, during the third trimester. The independent associated factors for CAM medicine use identified were: CAM use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39–7.95, P<0.001); a university education (OR 2.41, 95% CI 1.46–4.0, P<0.001), and CAM use by family or friends (OR 2.36, 95% CI 1.61–3.47,P<0.001). The lack of an evidence based approach together with the reliance on the advice of family and friends is of concern given the lack of robust data of efficacy and safety. To date, four peer reviewed papers from this doctoral research have been published.

M.Comm. / Sub-Saharan Africa is facing a health crisis. The prevalence of disease has intensified in recent decades. The debilitating effects of communicable and non-communicable diseases continue to abound. The disease burden, accompanied by increasing populations has further strained health care facilities. Notwithstanding the challenge of disease, the supply of health professionals remains low and it is worsened by their emigration to developed countries. The objective of this paper is to investigate the causes and effects of skilled health professionals’ migration from the South African public health sector to developed countries and to devise viable solutions. Main push factors influencing the medical brain drain include poor working conditions, inadequate remuneration, lack of funds for specialities and research, as well as the lack of equipment and supplies. These push factors are coupled by intensive recruitment campaigns, better prospects for career development and attractive salaries offered by developed countries. The most important cause of brain drain is the attractive remuneration offered by developed countries. This dissertation discusses ways of mitigating the health professionals’ migration including training, retention, return and circulation of skills or also known as brain circulation. It argues that the best strategy of dealing with brain drain is based on brain circulation because it yields mutual benefits for both sending and receiving countries. Measures that can facilitate brain circulation include intensifying international cooperation between sending and receiving countries, mobilising diaspora networks to contribute to the development of their home v countries and promoting the immigration of skilled professionals from countries that possess excess supply of medical professionals.

Objectives: Risk associated with needlestick injuries (NSI) in health care workers (HCWs) in Taiwan has not been characterized. We conducted this investigation to study 1) the prevalence and yearly incidence of NSI in HCWs in Taiwan, and the risk factors associated with NSIs; 2) reporting behavior when a NSI was sustained; and 3) seroprevalence of blood-borne pathogens among inpatients. Combination of the above information allowed for risk estimation for contracting hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in HCWs. Methodology: A cross-sectional questionnaire survey for life-time experience and frequency of NSI was conducted in a random sample from four strata of accredited hospitals according to the number of employees, from July 1996 to June 1997 in Taiwan. All full time employees, including physicians, nurses, technicians, and supporting personnel were recruited. Seroprevalence was examined for HBV, HCV and HIV among inpatients six years in age or older in one teaching hospital during July 1997 to June 1998. Results: A total of 10,469 health care workers were recruited from 16 out of 132 accredited hospitals and 82.6% (8,645) completed the survey, including nurses (61.0%), physicians (16.1%), medical technicians (14.9%), supporting personnel (7.9%). The prevalence of NSI were 93.1%, 86.6%, 78.3%, 61.0% in nurses, physicians, technicians, and supporting personnel respectively. The reported incidence of needlestick and other sharps injuries was 1.30 and 1.21 times per person in the past 12 months. Of the most recent episodes of NSIs, ordinary syringe needles accounted for 80.3% (95% CI, 79.4% - 81.2%) of hollow-bore needles associated incidents, and 74.1% (95% CI, 72.8% - 75.4%) of them were contaminated. The most frequently reported circumstance was the "Breakdown of Universal Precautions", recapping-related behaviors (81.6%, 95% CI 80.3% - 82.9%) of HCWs. More than a quarter (27.8%, 2,399) of HCWs were unprotected (either not vaccinated or having an unknown serological status) against HBV. Seroconversion in stuck HCWs was reported 1.8% for HBV (135), 0.2% (18) for HCV, 0.2% (15) for both HBV and HCV, 0.1% (5) for syphilis and less than 0.1% (2) for HIV. ^M A total of 81.8% of NSIs were unreported. Similarly, high incidence of NSI and low reporting rate were also found in student nurses. Seroprevalence of HBV, HCV, and HIV among inpatients were found higher than the reported rate in source patients of this survey. Seroprevalence of HBsAg was 16.7% in hospitalized patients, 1.7% positive for HBeAg, 12.7% for Anti-HCV, and 0.8% for Anti-HIV. Different seroprevalence rates of HBsAb (+), HBsAg (+), Anti-HCV (+), Anti-HIV (+) in different seasons were also found significant (p<0.001). The risk of seroconversion to HBV was thus estimated to be 0.003 ~ 0.008 time per person-year, HCV 0.003 ~ 0.007 per person-year, and HIV 0.4 ~ 1.2 /100, 000 person-year. Considering the number of HCWs in Taiwan, a total of 330 ~ 917 HCWs will seroconvert to HBV (+) in a year, 330 ~ 880 HCWs seroconvert to HCV (+), and less than one to two HCWs seroconvert to HIV (+). Conclusions: Needlestick and sharps injuries were highly prevalent among Taiwanese HCW and across job categories. Risk of seroconversion is real and significant. Preventive measures are warranted for reduction of contracting blood-borne pathogens in HCWs in Taiwan.

Thesis (M.A.)--York University, 1997. Graduate Programme in Philosophy. / Typescript. Includes bibliographical references (leaves 101-109). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ27378.

Thesis (Ph.D.) -- University of Texas at Arlington, 2008.

Thesis (Ph. D.)--Loyola University of Chicago, 1976. / Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 159-163).

published_or_final_version / Public Health / Master / Master of Public Health

No description available.

We used the results from two large scale cardiovascular investigations as a platform for examining ways in which psychological response style measures could improve the prediction of cardiovascular health outcomes. Of particular focus was the long-standing conceptual controversy over whether response styles are better treated as confounds to the self-report of stress-related personality characteristics or as separate personality traits. Study 1 consisted of a 3-year prospective study of ambulatory blood pressure levels in a healthy adult sample of males and females (N=T25). Study 2 comprised a pharmacological treatment study among ischemic heart disease patients (N=95). Questionnaire batteries completed in each study included self-report measures of depression, anger expression, daily stress, and hostility, along with self-deception and impression management response style scales. In each study, we investigated direct relationships between the response style measures and cardiovascular outcomes, moderator relationships between response style x psychological risk factor interactions and cardiovascular endpoints, and finally between the psychological risk factors and cardiovascular measures after statistically extracting response style variance from the p sychological risk factor scores. Results most strongly supported the main effects model. Higher self-deception scores predicted elevated 3-year diastolic and systolic blood pressure means in study 1, and poorer treatment outcomes in study 2. In both investigations these relationships proved stable after controlling for baseline cardiovascular standing. Importantly, efforts to statistically control for response style effects within the psychological risk factors did not improve predictive power with these measures. The above findings favor efforts to treat response styles as potentially independent psychological contributors to cardiovascular health outcomes, and support ongoing attempts to identify biobehavioral mechanisms through which personality dispositions may impact the appearance or progression of disease.