An investigation of workplace AIDS training with implications for occupational health promotion efforts.

Workplace AIDS training is a recent addition to many corporations' occupational health agenda. However, little is known about the objectives, content, and practices of AIDS training programs. A survey of 126 workplace AIDS trainers was conducted to determine the impact of the trainer's organizational affiliation (in-house, consultant, union, etc.) and personal motives on training program objectives, content, and practices. Results indicate that the organizational affiliation of trainers is significantly related to training objectives, topics, and practices, whereas strong personal motives for becoming an AIDS trainer is significantly associated with an emphasis on more controversial content areas and training practices. Findings are discussed in terms of applicability to other values-oriented training topics, applications to practice, and future research needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change management in health services: the South African experience

The purpose with this article is to describe the principles of change management in health services, as experienced in South Africa to date. The driving forces are highlighted, followed by a brief explanation of the three phases in change management. The principles and process of change management, as applied to the South African health system, are described as perceived by the author. The paper was read as an invited presentation at the Commonwealth Nurses Federation's General Meeting and workshop on 13 June 1997 in Vancouver, Canada.     

Maternal health services in South Africa. During the 10th anniversary of the WHO 'Safe Motherhood' initiative

The tenth anniversary of the World Health Organisation's 'Safe Motherhood' initiative is being celebrated this year and the organisation is using the opportunity to assess critically its gains, its strengths and its weaknesses. South Africa has taken some bold steps to address maternal health services, specifically introducing free health care for pregnant women and children under 5. In this paper we explore what further steps are necessary to ensure improved health outcome for pregnant women. South African health care administrations are, in some cases, engaged in broad health systems interventions at provincial level. This approach to improving health services is nonetheless frustrated by programme-specific initiatives, such as the introduction of female condoms or other piecemeal additions. We argue that making the systems function is the essential, primary step in the success of any intervention. The case of maternal health is explored in this paper.     

Health professionals and South Africa: supporting change in the health sector

Now that political change is on the way in South Africa, what should be the position of doctors who are invited to visit the country? Does the "academic boycott" still have relevance? Waterston and Zwi review the case for and against an academic boycott policy, using evidence collected during the recent visit by Physicians for Human Rights (UK) and the Johannes Wier Foundation. The health system in South Africa is still inequitable, and despite progress towards desegregation in hospitals there is little momentum towards universal provision of primary health care, especially in the rapidly growing townships around big cities. The authors consider that pressure on the government should be maintained by outside organisations but that support directed towards appropriate health care should be encouraged, particularly in public health and primary health care.     

Post-splenectomy sepsis--the role of occupational health

Persons who have had their spleens removed (asplenics) have a high risk of infection. The risks from infection are life-long and the illness can be a quick, overwhelming, septicaemia, that can lead to death within 48 hours, without appropriate treatment. Many persons who have had elective splenectomy, especially before 1977, may not have had prophylactic vaccinations, antibiotics or advice. This paper describes the risks of serious infection, the prophylaxis available and the role of the occupational health department in protecting asplenic employees.     

The role of forensic dentistry in South Africa

Forensic dentistry has become an integral part of forensic medicine over the past 100 years. This has been due to the dedication of people like Amoedo, Gustafson, Sognaes, Keiser-Nielsen and Suzuki, to name but a few. They established the essential role which forensic dentistry plays mainly in the identification of human remains. Dental hard tissues are extremely resistant to fire and are usually the only remains after an extended period of burial. If antemortem dental records are available for an individual then dental identification is as certain as those of fingerprints. In South Africa forensic dentistry had its beginning in 1969 during the Windhoek air disaster. Since then there have been several cases of interest throughout the country, one of which was the crash of the Helderberg off the coast of Mauritius. Other aspects of forensic dentistry are the examination of bite marks and the recognition of facial trauma especially in cases of child abuse; the determination of age, sex and race of skeletal remains; dental ethics and jurisprudence as well as malpractice also form part of the duties of the forensic dentist. The five dental schools in South Africa each have a forensic team which is consulted on a regular basis by forensic pathologists and district surgeons. Forensic dentists are active members of the medicolegal team and should be consulted on a regular basis especially in cases where identification is concerned.     

Nurse managed occupational health services: a primary care model in practice

1. Managed care focus on delivering health care which values prevention, early intervention, continuity of care, commitment to quality care, and outcomes, as well as client satisfaction. Occupational health nurses routinely integrate these values into their practice. 2. An on-site model of primary health care delivery, incorporating the fundamentals of occupational health nursing, can bring significant savings to the organization in health related costs. 3. Case management may provide the greatest potential for growth in occupational health nursing. It is a method that can be used together with managed care to maximize quality health care services. 4. Viewing health related costs as an investment as opposed to part of a benefit plan, influences employees to make positive choices. It also impacts the delivery of health care services on a systematic, global level, which affects total health care costs.     

Mental health services and the emerging role of psychology in Greece.

Notes that, of the few mental health services available in Greece, those resources that do exist are centralized in large cities and few psychologists are involved. The majority of persons requesting help receive pharmaceutical treatments; psychotherapy and counseling are rare. The present authors discuss how recently psychology is rapidly emerging as a science/profession in Greece. Licensure now is required of most academic psychologists, who are expected to practice as well as teach and do research. Although all Greek psychologists must be trained abroad, this multicultural education provides opportunity for broader theoretical perspectives; however, this same multicultural orientation may also pose difficulties in establishing standards for practice. Current increasing demand for psychological services may result in needed support for training programs within Greece. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational health nurses and occupational hygiene: a study of South African nurses' attitudes

The objectives of this study were to assess the current occupational hygiene practices of occupational health nurses and to assess their attitudes to the identification and initial quantification of workplace hazards. A questionnaire was mailed to all occupational health nurses registered with the South African Society of Occupational Health Nurses. Responses were obtained from 221 (53.7%). Responders and non-responders did not differ on key characteristics. Only 14 (6%) of the respondents performed occupational hygiene tasks as part of their routine work and only 31 (14%) volunteered hazard identification and quantification as tasks that would significantly improve practice. Nevertheless, when asked directly, 120 (54%) agreed that occupational hygiene fell into the ambit of occupational health nursing. Over 70% were positive about receiving theoretical and practical hygiene training. Constraints to greater hazard identification included limited time and resources and concern about intruding into the domains of other practitioners. Sufficient numbers of occupational health nurses were interested in identifying hazards in the workplace for training courses to be planned and offered now; however, restraints to practice need to be clarified and removed for these new skills to be used effectively.     

The role of the Federal government in financing health and medical services

A detailed examination on a group of oxen naturally infested with Parafilaria bovicola suggested a prepatent period varying from 238 to 250 days. In these animals 54% of all lesions bled only once, 22% a second time and 24% more than twice. Of all active lesions 42% occurred in the shoulder region and decreased from this area both cranially and caudally. The same tendency was noticeable on carcasses after slaughter. During the observation period May 1974 to February 1975 the number of positive animals increased, reaching peak values during September - October 1974, after which a decline was noticed. The filaricidal effects of nine compounds were tested. These were suramin (used in combination with diethylcarbamazine citrate), thiacetarsamide sodium, fenchlorphos, phosmet, mebendazole, fenbendazole, levamisole hydrochloride and trichlorphon.     

The role of psychology in the delivery of health services.

Considers whether psychology is both a health science and a health profession. The question is answered affirmatively. The pattern of psychological research in the health domain is analyzed. Current and evolving demands for psychological service in both preventive and treatment contexts are surveyed. Implications for training at both doctoral and subdoctoral levels are examined. (52 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Struggling for control: the care experiences of 'difficult' patients in mental health services

Although there is increasing recognition of the existence of 'difficult' patients who present particular challenges to mental health nurses, no research has been conducted into their perceptions of services and their experiences of care. This study identifies mental health service users who are defined by nurses as 'difficult' and explores their perceptions of their care experience. The results support earlier studies which suggested that 'difficult' patients challenge nurses' competence and control: despite their different roles both nurses and 'difficult' patients were aware of the struggle to gain or retain a notion of control. Respondents were able to identify the qualities of nurses and nursing interventions which had a positive effect on their care experience. Where nurses were perceived to demonstrate respect, time, skilled care and a willingness to give patients some control and choice in their own care, feelings of anger were reduced. These findings are discussed within the conceptual framework of 'power over' and 'power to' and implications for practice and research are considered.     

A cholera outbreak and control in a rural region of South Africa

Dance injuries associated with cervical radiculopathy have not been described in the literature. This report describes the case of an international-style ballroom dancer who developed a cervical radiculopathy as a result of frequent lateral rotation and hyperextension of the cervical spine during dancing. The patient's symptoms and signs suggestive of a left C7 radiculopathy were confirmed and documented by both magnetic resonance imaging and electrodiagnostic testing. The patient was treated conservatively with activity modification, nonsteroidal anti-inflammatory drugs, and alternative medicine approaches, including herbs and acupuncture. Her neck pain and cervical radicular symptoms declined in severity, but continued even 4 1/2 months after the onset of her symptoms. She did not wish to try steroids either through an oral or epidural route and refused surgical intervention. This case report illustrates an unconventional manner in which a left cervical radiculopathy was clinically produced. The neck motions and positions of frequent hyperextension and lateral rotation demonstrated by this ballroom dancer simulated a pattern and sequence of movements that promoted the development of signs and symptoms of a left cervical radiculopathy.