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[Activities and staffing in intensive care units in Norway--still need of better registration].

https://arctichealth.org/en/permalink/ahliterature195091
Source
Tidsskr Nor Laegeforen. 2001 Feb 28;121(6):694-7
Publication Type
Article
Date
Feb-28-2001
Author
A. Fredriksen
Author Affiliation
Helsepolitisk avdeling Den norske laegeforening Postboks 1152 Sentrum 0107 Oslo. audun.fredriksen@legeforeningen.no
Source
Tidsskr Nor Laegeforen. 2001 Feb 28;121(6):694-7
Date
Feb-28-2001
Language
Norwegian
Publication Type
Article
Keywords
Humans
Intensive Care Units - organization & administration - utilization
Medical Staff, Hospital - education - statistics & numerical data
Norway
Personnel Staffing and Scheduling - statistics & numerical data
Physicians - statistics & numerical data
Questionnaires
Workload - statistics & numerical data
Abstract
Standards in Intensive Care Medicine were approved by the Board of the Norwegian Medical Association in 1997. Their purpose is to clarify issues of responsibility, accountability and management in intensive care units. It also gives recommendations on management, staffing, education and resources.
In order to obtain a reference point for any future assessment of the impact of the Standards document, a survey was carried out, addressing work load, medical staff, and questions of accountability, responsibility and cooperation.
16 hospitals responded (76%). The results seem to indicate that medical staff in relation to work load is smaller than recommended. It also seems that junior doctors only to a small extent are present in the intensive care units during ordinary working hours, and consequently have little opportunity to learn from working with experienced colleagues. However, both conclusions, especially the first one, are not entirely reliable, as close examination of the answers indicate that important concepts concerning the description of work load and staffing are poorly defined, and that the monitoring of work load is insufficient.
It is concluded that staffing and work load in intensive care units are still insufficiently defined and monitored. The training environment for specialists is not optimal.
PubMed ID
11293351 View in PubMed
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Adult social position and sick leave: the mediating effect of physical workload.

https://arctichealth.org/en/permalink/ahliterature275793
Source
Scand J Work Environ Health. 2015 Nov;41(6):542-53
Publication Type
Article
Date
Nov-2015
Author
Karina Corbett
Jon Michaeal Gran
Petter Kristensen
Ingrid Sivesind Mehlum
Source
Scand J Work Environ Health. 2015 Nov;41(6):542-53
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety Disorders - epidemiology
Child
Female
Humans
Male
Middle Aged
Norway
Occupations - statistics & numerical data
Sick Leave - statistics & numerical data
Social Class
Socioeconomic Factors
Workload - statistics & numerical data
Abstract
This study aimed to quantify how much of the adult social gradient in sick leave can be attributed to the mediating role of physical workload while accounting for the role of childhood and adolescent social position and neuroticism.
Our sample consisted of 2099 women and 1229 men from a Norwegian birth cohort study (born 1967-1976) who participated in the Nord-Trøndelag Health Study (2006-2008) (HUNT3). Data on sick leave (defined as >16 calendar days; 2006-2009) and social position during childhood, adolescence, and adulthood were obtained from national registers. Study outcome was time-to-first sick leave spell. Physical workload and neuroticism were self-reported in HUNT3. Mediating effects through physical workload were estimated using a method based on the additive hazards survival model.
A hypothetical change from highest to lowest group in adult social position was, for women, associated with 51.6 [95% confidence interval (95% CI) 24.7-78.5] additional spells per 100,000 person-days at risk, in a model adjusted for childhood and adolescent social position and neuroticism. The corresponding rate increase for men was 41.1 (95% CI 21.4-60.8). Of these additional spells, the proportion mediated through physical workload was 24% (95% CI 10-49) and 30% (95% CI 10-63) for women and men, respectively.
The effect of adult social position on sick leave was partly mediated through physical workload, even while accounting for earlier life course factors. Our findings provide support that interventions aimed at reducing physical workload among those with lower adult social position could reduce sick leave risk.
PubMed ID
26416156 View in PubMed
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Agricultural work activities reported for children and youth on 498 North American farms.

https://arctichealth.org/en/permalink/ahliterature191950
Source
J Agric Saf Health. 2001 Nov;7(4):241-52
Publication Type
Article
Date
Nov-2001
Author
B. Marlenga
W. Pickett
R L Berg
Author Affiliation
National Children's Center for Rural and Agricultural Health and Safety, Marshfield Medical Research and Education Foundation, Wisconsin 54449, USA. marlengb@mmrf.mfldclin.edu
Source
J Agric Saf Health. 2001 Nov;7(4):241-52
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - prevention & control
Adolescent
Agriculture - statistics & numerical data
Child
Child Welfare
Female
Humans
Male
Ontario - epidemiology
Safety
United States - epidemiology
Workload - statistics & numerical data
Abstract
Children are at high risk for agricultural injury, yet there is little documentation about the range of farm work that children perform or the ages at which children experience these work exposures. The purpose of this study was to identify the scope of agricultural jobs performed by farm children and to describe variations in work involvement within demographic subgroups. A descriptive analysis was conducted of baseline data collected by telephone interview during a multi-site randomized controlled trial. The study population consisted of 1,138 children from 498 North American farms. A total of 2,389 jobs were reported for the 1,138 children. The leading categories of work were animal care, crop management, and tractor with implement operation. Regional differences were observed, consistent with variations in commodities. Substantial proportions of children were assigned to farm work even in the youngest age group of 7-9 years. Males were differentially assigned to tractor with implement operations, while females were more often assigned to animal care. This study provides one of the first systematic accounts of farm work performed by North American children. This analysis of work exposures provides information from which known prevention priorities can be reinforced and new opportunities for prevention identified.
PubMed ID
11787753 View in PubMed
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Are manual workers at higher risk of death than non-manual employees when living in Swedish municipalities with higher income inequality?

https://arctichealth.org/en/permalink/ahliterature167962
Source
Eur J Public Health. 2007 Apr;17(2):139-44
Publication Type
Article
Date
Apr-2007
Author
Göran Henriksson
Peter Allebeck
Gunilla Ringbäck Weitoft
Dag Thelle
Author Affiliation
Department of Social Medicine, Göteborg University SE 405 30 Göteborg, Sweden. goran.henriksson@socmed.gu.se
Source
Eur J Public Health. 2007 Apr;17(2):139-44
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Adult
Censuses
Employment - classification - economics - statistics & numerical data
Female
Humans
Income - classification - statistics & numerical data
Male
Middle Aged
Occupational Diseases - mortality
Occupations - classification - economics - statistics & numerical data
Poisson Distribution
Poverty Areas
Residence Characteristics - classification
Risk factors
Social Class
Sweden - epidemiology
Urban Health - statistics & numerical data
Vulnerable Populations - statistics & numerical data
Workload - statistics & numerical data
Abstract
To test the hypothesis that manual workers are at higher risk of death than are non-manual employees when living in municipalities with higher income inequality.
Hierarchical regression was used for the analysis were individuals were nested within municipalities according to the 1990 Swedish census. The outcome was all-cause mortality 1992-1998. The income measure at the individual level was disposable family income weighted against composition of family; the income inequality measure used at the municipality level was the Gini coefficient.
The study population consisted of 1 578 186 people aged 40-64 years in the 1990 Swedish census, who were being reported as unskilled or skilled manual workers, lower-, intermediate-, or high-level non-manual employees.
There was no significant association between income inequality at the municipality level and risk of death, but an expected gradient with unskilled manual workers having the highest risk and high-level non-manual employees having the lowest. However, in the interaction models the relative risk (RR) of death for high-level non-manual employees was decreasing with increasing income inequality (RR = 0.77; 95% CI, 0.63-0.93), whereas the corresponding risk for unskilled manual workers increased with increasing income inequality (RR = 1.24; 95% CI, 1.06-1.46). The RRs for skilled manual, low- and medium- level non-manual employees were not significant. Controlling for income at the individual level did not substantially alter these findings, neither did potential confounders at the municipality level.
The findings suggest that there could be a differential impact from income inequality on risk of death, dependent on individuals' social position.
PubMed ID
16899476 View in PubMed
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Are physicians with better clinical skills on licensing examinations less likely to prescribe antibiotics for viral respiratory infections in ambulatory care settings?

https://arctichealth.org/en/permalink/ahliterature138131
Source
Med Care. 2011 Feb;49(2):156-65
Publication Type
Article
Date
Feb-2011
Author
Genevieve Cadieux
Michal Abrahamowicz
Dale Dauphinee
Robyn Tamblyn
Author Affiliation
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. genevieve.cadieux@mail.mcgill.ca
Source
Med Care. 2011 Feb;49(2):156-65
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Ambulatory Care - organization & administration
Anti-Bacterial Agents - therapeutic use
Child
Clinical Competence - statistics & numerical data
Drug Prescriptions - statistics & numerical data
Educational Measurement
Female
General Practice - education - organization & administration
Health Services Research
Humans
Insurance Claim Reporting - statistics & numerical data
Licensure, Medical - statistics & numerical data
Logistic Models
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Patient Selection
Pediatrics - education - organization & administration
Physician's Practice Patterns - organization & administration
Quebec
Respiratory Tract Infections - drug therapy - virology
Sex Factors
Workload - statistics & numerical data
Abstract
Viral respiratory infections (VRIs) are a common reason for ambulatory visits, and 35% are treated with an antibiotic. Antibiotic use for VRIs is not recommended, and it promotes antibiotic resistance. Effective patient-physician communication is critical to address this problem. Recognizing the importance of physician communication skills, licensure examinations were reformed in the United States and Canada to evaluate these skills.
To assess whether physician clinical and communication skills, as measured by the Canadian clinical skills examination (CSE), predict antibiotic prescribing for VRI in ambulatory care.
A total of 442 Quebec general practitioners and pediatricians who wrote the CSE in 1993-1996 were followed from 1993 to 2007, and their 159,456 VRI visits were identified from physician claims.
The outcome was an antibiotic prescription from a study physician dispensed within 7 days of the VRI visit. Multivariate logistic regression analyses were used to estimate the association between antibiotic prescribing for VRI and CSE score, adjusting for physician, patient, and encounter characteristics.
Better clinical and communication skills were associated with a reduction in the risk of antibiotic prescribing, but only for female physicians. Every 1-standard deviation increase in CSE score was associated with a 19% reduction in the risk of antibiotic prescribing (risk ratio, 0.81; 95% confidence interval, 0.68-0.97). Better clinical skills were associated with an even greater reduction in risk among female physicians with higher workloads (risk ratio, 0.48; 95% confidence interval, 0.29-0.79).
Physician clinical and communication skills are important determinants of antibiotic prescribing for VRI and should be targeted by future interventions.
Notes
Erratum In: Med Care. 2011 May;49(5):527-8
PubMed ID
21206293 View in PubMed
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Are there high-risk groups among physicians that are more vulnerable to on-call work?

https://arctichealth.org/en/permalink/ahliterature265028
Source
Am J Emerg Med. 2015 May;33(5):614-9
Publication Type
Article
Date
May-2015
Author
Tarja Heponiemi
Anna-Mari Aalto
Laura Pekkarinen
Eeva Siuvatti
Marko Elovainio
Source
Am J Emerg Med. 2015 May;33(5):614-9
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Circadian Rhythm
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Job Satisfaction
Male
Middle Aged
Physicians - psychology
Questionnaires
Stress, Psychological - epidemiology - psychology
Work Schedule Tolerance - psychology
Workload - statistics & numerical data
Abstract
Work done in the emergency departments is one stressful aspect of physicians' work. Numerous previous studies have highlighted the stressfulness of on-call work and especially of night on call. In addition, previous studies suggest that there may be individual differences in adjusting to changes in circadian rhythms and on-call work.
The objective of this study was to examine whether physicians' on-call work is associated with perceived work-related stress factors and job resources and whether there are groups that are more vulnerable to on-call work according to sex, age, and specialization status.
This was a cross-sectional questionnaire study among 3230 Finnish physicians (61.5% women). The analyses were conducted using analyses of covariance adjusted for sex, age, specialization status, and employment sector.
Physicians with on-call duties had more time pressure and stress related to team work and patient information systems compared with those who did not have on-call duties. In addition, they had less job control opportunities and experienced organization as less fair and team climate as worse. Older physicians and specialists seemed to be especially vulnerable to on-call work regarding stress factors, whereas younger and specialist trainees seemed vulnerable to on-call work regarding job resources.
Focusing on team issues and resources is important for younger physicians and trainees having on-call duties, whereas for older and specialists, attention should be focused on actual work load and time pressure.
PubMed ID
25680563 View in PubMed
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The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.

https://arctichealth.org/en/permalink/ahliterature274088
Source
BMC Pregnancy Childbirth. 2015;15:237
Publication Type
Article
Date
2015
Author
Stefan Malmqvist
Inger Kjaermann
Knut Andersen
Inger Økland
Jan Petter Larsen
Kolbjørn Brønnick
Source
BMC Pregnancy Childbirth. 2015;15:237
Date
2015
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Disability Evaluation
Educational Status
Female
Humans
Job Satisfaction
Lifting
Norway - epidemiology
Pain Measurement
Pelvic Girdle Pain - epidemiology
Physical Exertion
Posture
Pregnancy
Pregnancy Complications - epidemiology
Retrospective Studies
Sick Leave - statistics & numerical data
Sleep Wake Disorders - epidemiology
Surveys and Questionnaires
Workload - statistics & numerical data
Young Adult
Abstract
The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP.
All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis.
PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave.
A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture, which decreases sick leave. We recommend these issues to be further examined in a prospective longitudinal study since it may have important implications for sick leave frequency during pregnancy.
Notes
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PubMed ID
26437972 View in PubMed
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Associations of hip osteoarthritis with history of recurrent exposure to manual handling of loads over 20 kg and work participation: a population-based study of men and women.

https://arctichealth.org/en/permalink/ahliterature137806
Source
Occup Environ Med. 2011 Oct;68(10):734-8
Publication Type
Article
Date
Oct-2011
Author
Leena Kaila-Kangas
Jari Arokoski
Olli Impivaara
Eira Viikari-Juntura
Päivi Leino-Arjas
Ritva Luukkonen
Markku Heliövaara
Author Affiliation
Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland. leena.kaila-kangas@ttl.fi
Source
Occup Environ Med. 2011 Oct;68(10):734-8
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Finland - epidemiology
Humans
Lifting - adverse effects
Male
Middle Aged
Occupational Diseases - epidemiology
Occupational Exposure - statistics & numerical data
Osteoarthritis, Hip - epidemiology
Risk factors
Weight-Bearing
Workload - statistics & numerical data
Abstract
We reviewed work histories of manual handling of loads >20 kg in relation to hip osteoarthritis by age, exposure and work participation.
A nationally representative sample of 3110 Finnish men and 3446 women aged 30-97 was recruited. Diagnosis of hip osteoarthritis was based on standardised clinical examination by trained physicians. Previous exposure to physically loading work was evaluated through interviews. Logistic regression was used to estimate associations between work factors and hip osteoarthritis.
1.9% of men and 2.1% of women had hip osteoarthritis. Almost half the men and a quarter of the women had recurrently handled heavy loads at work. Subjects who had manually handled loads >20 kg had a 1.8-fold increased risk of hip osteoarthritis compared to non-exposed references, when age, body mass index, traumatic fractures and smoking were accounted for. Results were similar for men (OR 2.0; 95% CI 1.0 to 4.0) and women (1.8; 1.1 to 2.8). In a sub-analysis of subjects with hip replacement, the OR was 1.7 (1.0 to 2.9). Risk increased first after 12 years' exposure: among men it was 2.2 (0.8 to 5.9) for 13-24 years' exposure, and 2.3 (1.2 to 4.3) for >24 years' exposure. Among women it was 3.8 (1.7 to 8.1) for 13-24 years' exposure. Work participation among men aged 20 kg showed a strong association with hip osteoarthritis in all age groups except the youngest.
PubMed ID
21245478 View in PubMed
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174 records – page 1 of 18.