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Adverse events associated with lay emergency response programs: the public access defibrillation trial experience.

https://arctichealth.org/en/permalink/ahliterature168751
Source
Resuscitation. 2006 Jul;70(1):59-65
Publication Type
Article
Date
Jul-2006
Author
Mary Ann Peberdy
Lois Van Ottingham
William J Groh
Jerris Hedges
Thomas E Terndrup
Ronald G Pirrallo
N Clay Mann
Ruchir Sehra
Author Affiliation
Virginia Commonwealth University Health System, Box 908204, Richmond, VA 23298, USA. mpeberdy@aol.com
Source
Resuscitation. 2006 Jul;70(1):59-65
Date
Jul-2006
Language
English
Publication Type
Article
Keywords
Canada
Cardiopulmonary Resuscitation - adverse effects - education - psychology
Community Health Services - methods - statistics & numerical data
Defibrillators - adverse effects
Electric Countershock - adverse effects
Emergency Medical Services - methods - statistics & numerical data
Heart Arrest - therapy
Humans
Public Sector - statistics & numerical data
United States
Volunteers - education - psychology
Abstract
The adverse event (AE) profile of lay volunteer CPR and public access defibrillation (PAD) programs is unknown. We undertook to investigate the frequency, severity, and type of AE's occurring in widespread PAD implementation.
A randomized-controlled clinical trial.
One thousand two hundred and sixty public and residential facilities in the US and Canada.
On-site, volunteer, lay personnel trained in CPR only compared to CPR plus automated external defibrillators (AEDs).
Persons experiencing possible cardiac arrest receiving lay volunteer first response with CPR+AED compared with CPR alone.
An AE is defined as an event of significance that caused, or had the potential to cause, harm to a patient or volunteer, or a criminal act. AE data were collected prospectively.
Twenty thousand three hundred and ninety six lay volunteers were trained in either CPR or CPR+AED. One thousand seven hundred and sixteen AEDs were placed in units randomized to the AED arm. There were 26,389 exposure months. Only 36 AE's were reported. There were two patient-related AEs: both patients experienced rib fractures. There were seven volunteer-related AE's: one had a muscle pull, four experienced significant emotional distress and two reported pressure by their employee to participate. There were 27 AED-related AEs: 17 episodes of theft involving 20 devices, three involved AEDs that were placed in locations inaccessible to the volunteer, four AEDs had mechanical problems not affecting patient safety, and three devices were improperly maintained by the facility. There were no inappropriate shocks and no failures to shock when indicated (95% upper bound for probability of inappropriate shock or failure to shock = 0.0012).
AED use following widespread training of lay-persons in CPR and AED is generally safe for the volunteer and the patient. Lay volunteers may report significant, usually transient, emotional stress following response to a potential cardiac arrest. Within the context of this prospective, randomized multi-center study, AEDs have an exceptionally high safety profile when used by trained lay responders.
PubMed ID
16784998 View in PubMed
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Allergic rhinitis alone or with asthma is associated with an increased risk of sickness absences.

https://arctichealth.org/en/permalink/ahliterature142913
Source
Respir Med. 2010 Nov;104(11):1654-8
Publication Type
Article
Date
Nov-2010
Author
Paula Kauppi
Paula Salo
Riina Hakola
Jaana Pentti
Tuula Oksanen
Mika Kivimäki
Jussi Vahtera
Tari Haahtela
Author Affiliation
Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland. paula.kauppi@hus.fi
Source
Respir Med. 2010 Nov;104(11):1654-8
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Asthma - economics - epidemiology
Female
Finland - epidemiology
Humans
Male
Middle Aged
Occupational Health
Prevalence
Prospective Studies
Public Sector - statistics & numerical data
Rhinitis, Allergic, Perennial - economics - epidemiology
Risk factors
Sick Leave - economics - statistics & numerical data
Young Adult
Abstract
The aim of the study is to examine the risk of sickness absence in public sector employees with allergic rhinitis or asthma or both conditions combined. This is a prospective cohort study of 48,296 Finnish public sector employees. Data from self-reported rhinitis and asthma were obtained from survey responses given during either the 2000-2002 or 2004 periods. Follow-up data on sickness absences for the public sector employees surveyed were acquired from records kept by the employers. During the follow-up, mean sick leave days per year for respondents were 17.6 days for rhinitis alone, 23.8 days for asthma alone and 24.2 days for both conditions combined. Respondents with neither condition were absent for a mean of 14.5 days annually. The impact of asthma and rhinitis combined on the risk of sick leave days was marginal compared to asthma alone (RR 1.1; 95% CI 1.0-1.3). In the subgroup analysis (those with current asthma or allergy medication), the risk ratio for medically certified sickness absence (>3 days) was 2.0 (95% CI 1.9-2.2) for those with asthma and rhinitis combined. Rhinitis, asthma and both these conditions combined increased the risk of days off work.
PubMed ID
20542677 View in PubMed
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An analysis of dental patient safety incidents in a patient complaint and healthcare supervisory database in Finland.

https://arctichealth.org/en/permalink/ahliterature275277
Source
Acta Odontol Scand. 2016;74(2):81-9
Publication Type
Article
Date
2016
Author
Nora Hiivala
Helena Mussalo-Rauhamaa
Hanna-Leena Tefke
Heikki Murtomaa
Source
Acta Odontol Scand. 2016;74(2):81-9
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Databases as Topic - statistics & numerical data
Dental Auxiliaries - statistics & numerical data
Dental Care - statistics & numerical data
Dental Hygienists - statistics & numerical data
Dental Technicians - statistics & numerical data
Dentists - statistics & numerical data
Dissent and Disputes
Expert Testimony
Female
Finland
Humans
Male
Malpractice - statistics & numerical data
Middle Aged
Patient Harm - classification - prevention & control - statistics & numerical data
Patient Safety - statistics & numerical data
Private Sector - statistics & numerical data
Public Sector - statistics & numerical data
Risk Management
Sex Factors
Abstract
Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland.
The sample included all available fully resolved dental cases (n = 948) during 2000-2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases.
Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications.
Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.
PubMed ID
25967591 View in PubMed
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Association of contractual and subjective job insecurity with sickness presenteeism among public sector employees.

https://arctichealth.org/en/permalink/ahliterature141949
Source
J Occup Environ Med. 2010 Aug;52(8):830-5
Publication Type
Article
Date
Aug-2010
Author
Tarja Heponiemi
Marko Elovainio
Jaana Pentti
Marianna Virtanen
Hugo Westerlund
Pekka Virtanen
Tuula Oksanen
Mika Kivimäki
Jussi Vahtera
Author Affiliation
Service System Research Unit, National Institute for Health and Welfare, Helsinki, Finland. tarja.heponiemi@thl.fi
Source
J Occup Environ Med. 2010 Aug;52(8):830-5
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adult
Aged
Attitude
Cross-Sectional Studies
Employment
Faculty
Female
Finland
Humans
Male
Middle Aged
Nurses
Occupational Health
Personnel Management - statistics & numerical data
Public Sector - statistics & numerical data
Young Adult
Abstract
We examined the associations of contractual job insecurity (fixed-term vs permanent employment contract) and subjectively assessed job insecurity with sickness presenteeism among those who had no sickness absences during the study year.
Survey data from a sample of 18,454 Public sector employees were gathered in 2004 (the Finnish Public Sector study).
Fixed-term employees were less likely to report working while ill (odds ratio = 0.88, 95% confidence interval = 0.77 to 0.99) than permanent employees. Subjective insecurity was associated with higher levels of working while ill, and this association was stronger among older employees. These results remained after adjustments for demographics, health-related variables, and optimism.
Our results suggest that subjective job insecurity might be even more important than contractual insecurity when a public sector employee makes the decision to go to work despite feeling ill.
PubMed ID
20657303 View in PubMed
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[Consultations with specialists in private practice in a Norwegian district]

https://arctichealth.org/en/permalink/ahliterature75983
Source
Tidsskr Nor Laegeforen. 2005 Nov 17;125(22):3130-2
Publication Type
Article
Date
Nov-17-2005
Author
Lars Erik Kjekshus
Ronny Jørgenvåg
Author Affiliation
Forskningsprogram for ledelse og organisering i helsesektoren (HORN), Institutt for helseledelse og helseøkonomi, Det medisinske fakultet, Universitetet i Oslo, Postboks 1089 Blindern, 0317 Oslo. l.e.kjekshus@medisin.uio.no
Source
Tidsskr Nor Laegeforen. 2005 Nov 17;125(22):3130-2
Date
Nov-17-2005
Language
Norwegian
Publication Type
Article
Keywords
Ambulatory Care - statistics & numerical data - utilization
Comparative Study
English Abstract
Family Practice - statistics & numerical data
Hospitalists
Humans
Norway
Physicians, Family
Private Sector - statistics & numerical data - utilization
Public Sector - statistics & numerical data - utilization
Questionnaires
Referral and Consultation - statistics & numerical data - utilization
Reimbursement Mechanisms
Specialties, Medical - statistics & numerical data
Abstract
BACKGROUND: After the Norwegian hospital reform of 2002, there has been increased acceptance of private-sector health-care providers. Still, the use of specialist services in private practice is less well documented. This article explores the use of private specialist health care in the south-east of Norway. MATERIAL AND METHODS: The article is based on several sources of data, including data from the Norwegian Patient Register and from the National Insurance Administration on reimbursements. Also a survey was sent out to a sample of general practitioner; in-depth interviews were carried out with a sample of hospital physicians and private specialists. RESULTS: The article shows that private specialists with contract with Helse Øst provided 151 consultations per 1000 inhabitants over the period September to November 2003, while the public outpatient clinics provided 186 consultations. The service provision varies geographically and between specialties. In one county the use of private specialists is 174 consultations per 1000 inhabitants; in another it is 80 per 1000 inhabitants. Private-sector specialists within the fields of eye, ear-nose-throat and skin provided two thirds of all outpatient services in their respective fields. INTERPRETATION: The results indicate that the services of specialists in private practice should be more focused on and discussed in relation to integrated healthcare and the relationship between specialised hospital services and primary healthcare.
PubMed ID
16299572 View in PubMed
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Dental student enrollment and graduation: a report by state, census division, and region.

https://arctichealth.org/en/permalink/ahliterature83385
Source
J Dent Educ. 2006 Oct;70(10):1023-37
Publication Type
Article
Date
Oct-2006
Author
Byck Gayle R
Kaste Linda M
Cooksey Judith A
Chou Chiu-Fang
Author Affiliation
Midwest Center for Health Workforce Studies, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA. gbyck1@uic.edu
Source
J Dent Educ. 2006 Oct;70(10):1023-37
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Censuses
Cross-Sectional Studies
Dentists - statistics & numerical data - supply & distribution
Education, Dental - statistics & numerical data
Female
Humans
Male
Population Density
Private Sector - statistics & numerical data
Public Sector - statistics & numerical data
Residence Characteristics - statistics & numerical data
Schools, Dental - legislation & jurisprudence - statistics & numerical data
Sex Factors
Students, Dental - statistics & numerical data
United States
Abstract
The purpose of this study is to provide descriptive data on the presence of dental schools, dental school graduates, instate enrollment, and interstate dental education agreements for U.S. states, districts, and regions. This information may be helpful in deciding to open or maintain a dental school. Data from the American Dental Association (ADA), American Dental Education Association (ADEA), and U.S. Census Bureau were used to conduct cross-sectional comparisons for states, census divisions, and regions for 2000. In 2000, there were fifty-four dental schools in thirty-two states and the District of Columbia. Total graduation across 1990-2000 was 43,289 dentists. Over half (56 percent) of the graduates were from public schools. The distribution of schools and graduates differed by geographic region. Alaska, Utah, Hawaii, and Nebraska were outliers with respect to high and low numbers of dental schools in states, in-state enrollment, and dentists to population. U.S. states, districts, and regions vary widely on the number of dental schools, dentists to population, first-year dental school enrollees, and dental school graduates. Further assessment on additional factors such as dental health provider shortage areas, state oral health status, and attractiveness of locations to dentists is needed to more fully understand the impact of these factors.
PubMed ID
17021281 View in PubMed
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The effectiveness of vocationally oriented multidisciplinary intervention on sickness absence and early retirement among employees at risk: an observational study.

https://arctichealth.org/en/permalink/ahliterature152674
Source
Occup Environ Med. 2009 Apr;66(4):235-42
Publication Type
Article
Date
Apr-2009
Author
H. Suoyrjö
T. Oksanen
K. Hinkka
M. Kivimäki
T. Klaukka
J. Pentti
J. Vahtera
Author Affiliation
The Hospital District of South Ostrobothnia, Hanneksenrinne 7, FI-60220 Seinjoki, Finland. hsuoyr@utu.fi
Source
Occup Environ Med. 2009 Apr;66(4):235-42
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adult
Case-Control Studies
Cohort Studies
Female
Finland - epidemiology
Humans
Male
Middle Aged
Pensions - statistics & numerical data
Public Sector - statistics & numerical data
Rehabilitation, Vocational
Retirement - statistics & numerical data
Risk assessment
Sick Leave - statistics & numerical data - trends
Abstract
To study the effect of a preventive vocationally oriented intervention on rates of sickness absence and disability pension in employees considered to be at risk of future work disability.
An observational register-based study of public sector employees.
2236 intervention programme participants and 8944 matched controls were followed up for 8 years.
Multidisciplinary intervention was carried out at rehabilitation institutions. Data on demographics and sickness absences were obtained from employers' records and information about health at baseline, participation in the intervention and subsequent disability pension from national registers.
Before the intervention participants had 17% more annual sick leave days and a 23% higher rate of absence spells lasting >21 days than controls. In the intervention year and 3 subsequent years, the sickness absence rate among participants reduced to that observed among controls but thereafter increased to the pre-intervention level (p for curvilinear trend
PubMed ID
19211774 View in PubMed
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Employee control over working times and risk of cause-specific disability pension: the Finnish Public Sector Study.

https://arctichealth.org/en/permalink/ahliterature147377
Source
Occup Environ Med. 2010 Jul;67(7):479-85
Publication Type
Article
Date
Jul-2010
Author
Jussi Vahtera
Sari Laine
Marianna Virtanen
Tuula Oksanen
Aki Koskinen
Jaana Pentti
Mika Kivimaki
Author Affiliation
Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18 B, Turku, Finland. jussi.vahtera@ttl.fi
Source
Occup Environ Med. 2010 Jul;67(7):479-85
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cardiovascular Diseases - epidemiology
Disability Evaluation
Female
Finland - epidemiology
Health Surveys
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Musculoskeletal Diseases - economics - epidemiology
Neoplasms - epidemiology
Nervous System Diseases - epidemiology
Occupational Diseases - economics - epidemiology
Occupational Health
Pensions - statistics & numerical data
Public Sector - statistics & numerical data
Retirement - economics - statistics & numerical data
Risk assessment
Sex Distribution
Young Adult
Abstract
To examine the association between worktime control and subsequent disability pension among employees.
Two scores of worktime control (self-assessed and co-worker assessed) were obtained from a survey in 2000-2001 (score range 1-5) among 30 700 public sector employees (78% women) aged 18-64 years. Information on cause-specific disability pension during follow-up was collected from national registers.
During a mean follow-up of 4.4 years, 1178 employees were granted disability pensions (incidence per 1000 person-years: 9.2 in women and 8.7 in men). The most common causes of a disability pension were musculoskeletal disorders (43% of all pensions), mental disorders (25%), tumours (8%) and diseases of the circulatory system (6%) and nervous system (6%). A one unit increase in self-assessed and co-worker assessed worktime control score was associated with a 41-48% decrease in risk of disabling musculoskeletal disorders in men and a 33-35% decrease in women. This association was robust to adjustment for 17 baseline covariates (in men and women combined, adjusted HR 0.76, 95% CI 0.67 to 0.87 and 0.64, 95% CI 0.51 to 0.79 per one unit increase in self-assessed and co-worker assessed worktime control, respectively). Self-assessed, but not co-worker assessed, worktime control was also associated with risk of disability retirement due to mental disorders in women. Disability pensions from other disease categories were not related to worktime control.
In these public sector employees, high worktime control was associated with reduced risk of early retirement caused by musculoskeletal disorders independent of baseline characteristics.
Notes
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PubMed ID
19914911 View in PubMed
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Health and gender differences between middle and senior managers in the Canadian Public Service.

https://arctichealth.org/en/permalink/ahliterature207412
Source
Soc Sci Med. 1997 Nov;45(10):1589-96
Publication Type
Article
Date
Nov-1997
Author
M. Tomiak
J F Gentleman
M. Jetté
Author Affiliation
Statistics Canada, Social and Economic Studies Division, Ottawa, Ontario, Canada.
Source
Soc Sci Med. 1997 Nov;45(10):1589-96
Date
Nov-1997
Language
English
Publication Type
Article
Keywords
Administrative Personnel - classification - statistics & numerical data
Adult
Age Distribution
Body mass index
Canada - epidemiology
Chi-Square Distribution
Cholesterol - blood
Cross-Sectional Studies
Educational Status
Female
Health Behavior
Health status
Health Surveys
Humans
Logistic Models
Male
Middle Aged
Occupational Health - statistics & numerical data
Public Sector - statistics & numerical data
Sex Factors
Social Class
Type A Personality
Women's health
Women, Working - statistics & numerical data
Abstract
Most studies of the relationship between socioeconomic status (SES) and health have concentrated on disparities between the richest and poorest men; few studies have examined such relationships for women due to difficulties in measuring SES for women. For the present study, data collected from Canadian Public Service middle and senior managers provided an opportunity to examine associations between SES and health within the upper end of the SES spectrum for both genders, since women managers can be assumed to have a relatively high SES. Demographic, health and lifestyle characteristics are compared for middle and senior managers for each gender separately to determine whether women experience the health benefits associated with higher SES that have been previously observed for men. The results support the hypothesis that achieving a higher SES through work is a more stressful process for women than for men and that women's upward mobility is restricted compared to that of men. Despite these findings, there is little evidence that women's health has been adversely affected. Compared to male managers, fewer female managers smoke or drink and fewer have high body mass index, high blood pressure or high cholesterol levels. Female managers are also more likely to report being in good health.
PubMed ID
9351149 View in PubMed
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Implementation of community-based public access defibrillation in the PAD trial.

https://arctichealth.org/en/permalink/ahliterature173473
Source
Acad Emerg Med. 2005 Aug;12(8):688-97
Publication Type
Article
Date
Aug-2005
Author
Lynne D Richardson
Mary D Gunnels
William J Groh
Mary Ann Peberdy
Sarah Pennington
Ilene Wilets
Venard Campbell
Lois Van Ottingham
Mary Ann McBurnie
Author Affiliation
Department of Emergency Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1620, New York, NY 10029, USA. lynne.richardson@mssm.edu
Source
Acad Emerg Med. 2005 Aug;12(8):688-97
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Age Distribution
Canada
Community Health Services - methods - statistics & numerical data
Defibrillators - statistics & numerical data
Emergency Medical Services - methods - statistics & numerical data
Female
Focus Groups
Health Plan Implementation - methods - statistics & numerical data
Humans
Male
Middle Aged
Public Sector - statistics & numerical data
Sex Distribution
Socioeconomic Factors
United States
Volunteers - education - statistics & numerical data
Abstract
The Public Access Defibrillation (PAD) Trial was a randomized, controlled trial designed to measure survival to hospital discharge following out-of-hospital cardiac arrest (OOH-CA) in community facilities trained and equipped to provide PAD, compared with community facilities trained to provide cardiopulmonary resuscitation (CPR) without any capacity for defibrillation.
To report the implementation of community-based lay responder emergency response programs in 1,260 participating facilities recruited for the PAD Trial in the United States and Canada.
This was a descriptive study of the characteristics of participating facilities, volunteers, and automated external defibrillator (AED) placements compiled by the PAD Trial, and a qualitative study of factors that facilitated or impeded implementation of emergency lay responder programs using focus groups of PAD Trial site coordinators.
The PAD Trial enrolled 1,260 community facilities (14.8% residential), with 20,400 lay volunteers (mean +/- standard deviation = 13.4 +/- 10.7 per facility) trained to respond to OOH-CA. The 598 locations randomized to receive AEDs required 2.7 +/- 1.8 AEDs per facility. Volunteer attrition was high, 36% after two years. Barriers to recruitment and implementation included identification of appropriate "at-risk" facilities, lack of interest or fear of litigation by a facility key decision maker, lack of motivated potential volunteer responders, training and retraining resource requirements, and lack of an existing communication/response infrastructure.
These data indicate that implementation of community-based lay responder programs is feasible in many types of facilities, although these programs require substantial resources and commitment, and many barriers to implementation of effective PAD programs exist.
PubMed ID
16079421 View in PubMed
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28 records – page 1 of 3.