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

Call number: LD2668 .T4 1925 D598 / Master of Science

"This investigation is a study of the health status of students, upon arrival and during their subsequent four years at Florida State University, for the purpose of determining the nature and extent of illness and injuries experienced by them from academic year to year as compared with their medical status upon arrival"--Introduction. / Typescript. / "January, 1956." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Science." / Includes bibliographical references (leaves 50-51).

This dissertation traces the evolution of ideas and experiences of mental illness (seishinbyō) in Japan around the turn of the twentieth century, showing how it changed from a diagnostic category of biomedical disease into a dynamic but stigmatized pathology of the self in which the mental and emotional core of a person – who he or she was, essentially – was thought to have malfunctioned. In the course of this transformation, seishinbyō had multiple manifestations, its meanings shifting across time and in different social contexts. It originated in Japanese psychiatric discourse of the 1870s as an allegedly universal category of disease, but was soon modified to account for such existing phenomena as fox-spirit possession. In the family, one of the main sites for the management and treatment of madness in modern Japan, mental illness was associated less with medical etiology and more with violent and socially unacceptable behavior, as seen in cases of home confinement. As the concept of mental illness spread in popular culture and legal discourse, it evolved into a broader cultural idiom about the pathology of the self during a time of rapid social and cultural change. From the gendering of hysteria as the feminine counterpart to male neurasthenia in the media to the menstrual psychosis defense invoked to absolve female defendants of criminal responsibility, gender played an especially prominent role in this evolution. By the 1930s, the idea that the self was the source of its own distress had taken root, shifting attention away from external and social factors, whether fox possession or the stresses of modernity, to inner causes of suffering. The driving forces behind this conceptual change were the social structures and relations of family, gender, and the urban-rural divide. In the context of these three overlapping social sites, changing ideas and practices concerning the mentally ill produced broader transformations in the understanding of the relationship between self and society, including conceptions of mind and body, gendered norms of thought and behavior, and the boundary between the inner self and social forces during a time of modernizing change.

No description available.

Abstract not available

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.

OBJECTIVES The overall aim of the project were to conduct a survey of the physical and mental health status of prisoners in New South Wales (NSW). A more specific aim, which is addressed in this PhD, was to analyse in detail a number of key health areas which have particular relevance to prisoner populations namely: tuberculosis, viral hepatitis, herpes simplex type 2 virus, childhood sexual abuse (CSA), and drug and alcohol use. METHODS A cross-sectional, random sample of prisoners, stratified by sex, age and Aboriginality was chosen from 27 correctional centres (24 male and 3 female) in NSW in 1996. Screening was conducted by nurses from within the correctional health system. A detailed face-to-face interview was used to collect self-reported information on a range of physical and mental health characteristics, and behavioural issues. The physical health component covered chronic illness, recent symptoms, health services utilisation, medications, and self assessed health status. Mental health issues which were covered included: suicide attempts, self-harm, prior mental illness and psychiatric medication. Standardised screening instruments were used to test for depression, hopelessness and suicidal intent. Behavioural factors sought were drug and alcohol use, gambling, and sexual abuse. Blood samples were taken to screen for a range of infectious diseases and health indicators. These included HIV, syphilis, herpes simplex type-2 virus, rubella, chlamydia, and hepatitis (B, C, and G). A Mantoux skin test was performed to screen for tuberculosis infection. Hearing was assessed using otoacoustic emissions. RESULTS A total of 789 inmates (657 males and 132 females), including 235 Aboriginal people were screened, representing approximately 11% of males and 40% of females in full-time incarceration. For the key areas examined in the chapters we found: Overall health status ???? Overall health status was poor compared with the NSW general population in regard to self-reported chronic illness, recent health complaints, and well-being. Hospitalisation was less frequent in male prisoners than general community males but higher in female prisoners for mental health problems compared with community females. Tuberculosis ???? No previously undetected cases of tuberculosis were found; however, Mantoux positivity was higher in Aboriginal and overseas born prisoners. Viral hepatitis ???? Markers for hepatitis B, hepatitis C, and hepatitis G were significantly more common in the NSW prisoner population than in the general community. Significant disparities were found between prisoners???? self-report of past exposure to hepatitis (B and C) and their serostatus. Thirty five percent of inmates who were hepatitis C antibody positive believed that they were negative, and for hepatitis B, 72% of positives reported they were negative. Multivariate analysis identified Aboriginality, long-term injecting, and injecting while in prison as risk factors for HBV. Risk factors for exposure to HCV were female sex, non-Aboriginality, history of childhood institutionalisation, and injecting-related behaviours. For HGV, female sex, and previous imprisonment were significant risk factors but injecting was not; being aged 25-39 years was associated with a decreased risk for HGV as compared to younger and older inmates. Herpes simplex virus type 2 ???? The prevalence of HSV-2 antibodies in this prisoner population was similar to that observed in NSW STD clinic attendees, and was higher in females than males. Exposure was related to: increasing age and Aboriginality for men, and higher reported number of lifetime sexual partners and the presence of hepatitis C antibodies for women. Few prisoners (1%) reported a previous diagnosis of genital herpes. Childhood sexual abuse ???? The prevalence of self-reported childhood sexual abuse was higher in females than males, and similar to that observed in clinical populations. There was an association between CSA and mental health outcomes, including a history of psychiatric treatment and suicide attempts. Male survivors of CSA were more likely to report self-harm, depression, and involvement in violent relationships. Both men and women with a history of CSA were more likely to report having a sexually transmissible disease (STD). Females exposed to CSA were more likely to report subsequent abusive adult relationships involving physical assault, sexual assault, and verbal abuse. Drug use ???? Overall, 64% of prisoners had used illicit drugs at some time in the past with cannabis (males 56%, females 63%) and heroin (males 29%, females 49%) being the most common. Forty four percent of prisoners had a history of injecting drug use, with injecting prevalence significantly higher in females than males (64% vs. 40%). Half of male and female injectors had done so while in prison. Harmful or hazardous use of alcohol was associated with imprisonment for violent crimes, whereas opiate and methadone use were associated with non-violent crimes. Sixty two percent of property offenders had an injecting history. Alcohol intoxication at the time of offending was associated with imprisonment for homicides and assaults. Males were more likely than females to seek treatment in prison for drug problems. IMPLICATIONS Prisoners in NSW have a number of special health needs which are evidenced in the high levels of infectious diseases (hepatitis B, hepatitis C, hepatitis G, and herpes simplex virus type 2) and exposure to factors (childhood sexual abuse and alcohol and drug use) with a clear relationship to adverse health outcomes. Prisons represent an opportunity for public health interventions to address some of the health problems identified in this study. Potentially valuable programmes include education to prevent the spread of blood borne communicable diseases and STDs, immunisation for vaccine preventable diseases such as hepatitis B, and treatment to alleviate the effects of drug use and childhood sexual abuse. In the case of prison drug use the prison environment itself presents a threat to health in that sterile injecting equipment is not available to prisoners despite evidence that injecting in prison is widespread. The challenge for prison health planners is twofold: to make maximum use of the window of opportunity to improve the health status of this group, and to provide a continuum of care between the community and prison.

Graduation date: 1994

Patient noncompliance to treatment regimen is a common problem for health service providers. Five personality variable subscales of the Millon Behavioral Health Inventory were related to trainer-judged adherence to treatment plans of 50 injured athletes. Multiple regression analysis showed only Somatic Anxiety was a significant predictor of adherence (r = -.427); injured athletes with high scores are less likely to adhere to treatment recommendations. Results suggest the promise of the MBHI as a diagnostic instrument for evaluating injured athletes and enhancing their treatment, and provide evidence for construct validity of the Somatic Anxiety subscale using a previously unstudied population.