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Yes / Objectives To test whether an occupation based lifestyle intervention can sustain and improve the mental wellbeing of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants 288 independently living adults aged 65 years or over, with normal cognition were recruited from two UK sites between December 2011 and November 2015. Interventions Lifestyle Matters is a NICE recommended multi-component preventive intervention designed to improve the mental wellbeing of community living older people at risk of decline. It involves weekly group sessions over four months and one to one sessions. Main outcome measures The primary outcome was mental wellbeing at 6 months (mental health dimension of the SF-36).Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness(de Jong Gierveld Loneliness Scale),assessed at 6 and 24 months. Results Data on 262 (intervention =136; usual care =126) participants were analysed using intention to treat analysis. Mean SF-36 mental health scores at six months differed by 2·3 points (95 CI -1·3 to 5·9; P=0·209) after adjustments. Conclusions Analysis shows little evidence of clinical or cost effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote wellbeing in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline. / Primary Care Research Network (PCRN) funding was accessed to support recruitment activity in GP surgeries in Sheffield and NISCHR provided support in North Wales.

by Chen Wei-Qing. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (p. 143-158). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Os Centros de Toxicologia (denominação adotada neste trabalho para definir os Centros Brasileiros que atendem casos de exposição a substâncias tóxicas) fazem parte de uma rede de informações tóxico-farmacológicas denominada SINITOX, que coleta as informações do atendimento, publicando anualmente sua produtividade. Estes dados são utilizados na produção documentos para comunicação e gerenciamento de riscos toxicológicos. Paralelamente, os hospitais que integram o Sistema Único de Saúde (SUS), notificam os casos de internação hospitalar e óbitos ao DATASUS, formando uma grande base de dados de morbidade e mortalidade hospitalar. A proposta deste trabalho foi de analisar estas informações, comparando-as ao Toxic Exposure Surveillance Sysrem (TESS), estabelecendo as similaridades e diferenças entre os sistemas e propondo harmonizações que pudessem contribuir ao aperfeiçoamento do Sistema Brasileiro de Toxicovigilância, com ênfase na comunicação e gerenciamento dos riscos toxicológicos. Visando a melhor análise dos casos, este trabalho propõe a adoção Poison Severity Seore (PSS), elaborado pela Organização Mundial da Saúde pela Associação Européia dos Centros de Controle de Intoxicações, para padronizar os casos atendidos segundo um critério de gravidade. Propõe, ainda, que as intoxicações sejam agrupadas em um único capítulo do Código Internacional de Doenças (CID), e que seja utilizado todos os sistemas. / The Centers of Toxicology (denomination adopted in this work to define the Brazilian Centers that handle cases of exposure to toxic substances) part of a net of toxic-pharmacological information called SINlTOX, which collect information related to of the attendance of chemical exposure, and publish annually their productivity data. These data are used to elaborate a document that helps toxicological communication and management. The hospitals that integrate the Brazilian Health Unified System (SUS), notify the cases of hospitalizations and deaths cases to the DATASUS, forming a database of morbidity and hospital mortality. The purpose of this work was to analyze these information, comparing them to the American Toxic Exposure Surveillance System (TESS), establishing the similarities and differences between systems and considering harmonization that could contribute to the perfectioning of the Brazilian System of Toxic Exposure Surveillance, with emphasis in the communication and management of the toxicological risks. Aiming at the best analysis of the cases, this work considers adoption of Poison Severity Score (PSS) elaborated by the World Health Organization and by the European Association of the Control Poison Centers standardize the cases according to a gravity criterion. It is also suggested that the poisoning cases would be grouped in a chapter of the International Code Diseases, and used in all systems.

Os Centros de Toxicologia (denominação adotada neste trabalho para definir os Centros Brasileiros que atendem casos de exposição a substâncias tóxicas) fazem parte de uma rede de informações tóxico-farmacológicas denominada SINITOX, que coleta as informações do atendimento, publicando anualmente sua produtividade. Estes dados são utilizados na produção documentos para comunicação e gerenciamento de riscos toxicológicos. Paralelamente, os hospitais que integram o Sistema Único de Saúde (SUS), notificam os casos de internação hospitalar e óbitos ao DATASUS, formando uma grande base de dados de morbidade e mortalidade hospitalar. A proposta deste trabalho foi de analisar estas informações, comparando-as ao Toxic Exposure Surveillance Sysrem (TESS), estabelecendo as similaridades e diferenças entre os sistemas e propondo harmonizações que pudessem contribuir ao aperfeiçoamento do Sistema Brasileiro de Toxicovigilância, com ênfase na comunicação e gerenciamento dos riscos toxicológicos. Visando a melhor análise dos casos, este trabalho propõe a adoção Poison Severity Seore (PSS), elaborado pela Organização Mundial da Saúde pela Associação Européia dos Centros de Controle de Intoxicações, para padronizar os casos atendidos segundo um critério de gravidade. Propõe, ainda, que as intoxicações sejam agrupadas em um único capítulo do Código Internacional de Doenças (CID), e que seja utilizado todos os sistemas. / The Centers of Toxicology (denomination adopted in this work to define the Brazilian Centers that handle cases of exposure to toxic substances) part of a net of toxic-pharmacological information called SINlTOX, which collect information related to of the attendance of chemical exposure, and publish annually their productivity data. These data are used to elaborate a document that helps toxicological communication and management. The hospitals that integrate the Brazilian Health Unified System (SUS), notify the cases of hospitalizations and deaths cases to the DATASUS, forming a database of morbidity and hospital mortality. The purpose of this work was to analyze these information, comparing them to the American Toxic Exposure Surveillance System (TESS), establishing the similarities and differences between systems and considering harmonization that could contribute to the perfectioning of the Brazilian System of Toxic Exposure Surveillance, with emphasis in the communication and management of the toxicological risks. Aiming at the best analysis of the cases, this work considers adoption of Poison Severity Score (PSS) elaborated by the World Health Organization and by the European Association of the Control Poison Centers standardize the cases according to a gravity criterion. It is also suggested that the poisoning cases would be grouped in a chapter of the International Code Diseases, and used in all systems.

Agriculture is a hazardous industry worldwide, and certain groups of agricultural workers are at increased risk of experiencing adverse health outcomes. Agricultural workforces are becoming increasingly transitional, as established and experienced workers exit the industry and new workers take their place. Limited occupational health surveillance exists among certain transitional agricultural workforces. In the US, beginning farmers, i.e., agricultural workers with 10 years or less experience operating a farm, may differ from established farmers in terms of their demographics, length of experience within the agricultural industry, and occupational exposures and health outcomes. Separately, South Indian tea harvesting workers are exposed to occupational physical demands that are risk factors for musculoskeletal health outcomes. However, few studies have examined associations between occupational demands and musculoskeletal pain among these workers. Furthermore, no studies have identified additional occupational health issues within the tea harvesting process. To address the lack of available knowledge on beginning farmers and tea harvesting workers, the goals of this mixed method study were to estimate the associations between musculoskeletal symptoms and occupational physical demands and occupational psychosocial stress among beginning farmers in the US and tea harvesting workers in South India. An additional goal was to identify occupational health issues within the tea harvesting process and to determine how tea harvesting workers conceptualize and prioritize these issues. An online survey was conducted among beginning farmers across the U.S. Participants answered questions about their demographics, personal health and farm characteristics, occupational physical demands, occupational psychosocial stress, and musculoskeletal symptoms of the low back, neck/shoulder, and elbow/wrist/hand. An interviewer-based survey was conducted among South Indian tea harvesting workers. Participants answered questions about their demographics, personal health, occupational physical demands, occupational psychosocial stress, and musculoskeletal symptoms of the neck/upper back, lower back, upper extremity region, and lower extremity region. A qualitative study was conducted using focus groups among South Indian tea harvesting workers and semi-structured interviews and structured interviews among South Indian tea harvesting workers and supervisors. Results from the cross sectional online survey concluded that musculoskeletal symptoms were common among beginning farmers. In addition, occupational physical demands were associated with musculoskeletal pain, particularly low back pain was associated with working in awkward and cramped positions, bending or twisting the back, and carrying, lifting, or moving heavy material by hand. Results from the cross sectional interviewer-based survey concluded that musculoskeletal symptoms were also common among South Indian tea harvesting workers. Musculoskeletal pain was associated with exposure to forceful exertions, awkward posture, and repetition. Finally, results from the qualitative study identified additional occupational health issues within tea harvesting, including the presence of animals and pelvic organ prolapse. The study further identified important influential stakeholders within the tea harvesting process. Findings from these three studies may be used to inform future health interventions among these transitional workforces.

The primary goal of this two-phased, sequential mixed-methods study was to discover whether union affiliation is associated with a lower occurrence of burnout in factory workers by comparing union and nonunion workers. The objective was to determine levels of burnout in union and nonunion employees as well their perception of social support in the workplace. The theoretical synthesis consisted of conservation of resources theory and the theory of reasoned action. The Oldenburg Burnout Inventory (OLBI) and the Quality of Worklife Questionnaire were used to identify the characteristics of the workplace (job demands and job resources) and the level of burnout. Quantitative results confirmed the presence of burnout in both sample populations. Regression results for union participants identified both poor management and increased in job demands as significant predictors of burnout. Conversely, regression results for nonunion participants pointed to poor management only as a significant predictor of burnout. Qualitative descriptive and explanatory thematic results provided additional contextual support for the quantitative findings - specifically, that both union and nonunion participants identified management as a primary concern. In addition, union participants also identified manpower and support as primary concerns in the work environment. The findings point to the negative consequences of burnout for the employer and employee and to areas of concern that need to be addressed in the employment setting. Implications for positive social change include the development of programs to minimize the development of burnout and increase an employee's organizational commitment.

Many adults in the United States experience posttraumatic stress disorder (PTSD) within their lifetimes. Researchers have identified compassion fatigue (CF), which debilitates mental health providers as a result of being exposed to their clients' traumatic experiences, as an occupational hazard. The purpose of this study was to examine whether a correlation exists between the presence of CF and the level of resilience. A confidential survey using the Connors-Davidson Resilience Scale, the Professional Quality of Life Scale Version 5, and a demographic questionnaire were given to graduate-level mental health clinicians who self-identified as routinely working with and/or treating trauma victims in the past 6 months. Participants were recruited from the New England Society for the Treatment of Trauma and Dissociation, the Metropolitan Atlanta Therapists Network, Dallas Chapter NASW listserv, and the Georgia Therapist Network. A multivariate analysis on the collected data was conducted to determine whether a relationship exists between the resilience scale and the subscales of CF within these population samples. According to study findings, there is a correlation between resilience and the 3 compassion fatigue subscales---CF, burnout, and compassion satisfaction. This study may lead to positive social change by helping guide clinicians to find ways to enhance resilience, and therefore, decrease risks of CF.

There are three to five million migrant and seasonal farmworkers in the United States that work in one of the most hazardous industries. They are exposed to numerous occupational and non-occupational injuries and illnesses daily, including but not limited to, pesticide and chemical-related health conditions, heat-related health conditions, muscle and joint pain, eye injuries, diabetes, high blood pressure, obesity, and depression. Furthermore, these farmworkers also experience multiple vulnerabilities including cultural and language barriers and low socioeconomic status. A survey was administered in interview setting to characterize farmworkers’ occupational and non-occupational health conditions, their healthcare-seeking behavior, and their use of preventive measures and health education. Muscle and/or joint pain and eye injuries were the most commonly reported occupational health outcomes, and diabetes and high blood pressure were the most commonly reported non-occupational health outcomes. Farmworker participants requested more information covering prevention, management, and care for these health outcomes. There were low reports of receiving health education regarding common occupational and non-occupational health conditions. Future research efforts and next steps should focus on creating networks between healthcare providers, employers, and other organizations that serve farmworkers as well as continue to host programs that directly involve farmworkers to understand their perceptions of their health and access to healthcare.

Thesis (M.P.H.)--University of Michigan, 1946.