Occupational health psychology: The convergence of health and clinical psychology with public health and preventive medicine in an organizational context.

Occupational health psychology (OHP) applies psychology in organizational settings for the improvement of work life, the protection and safety of workers, and the promotion of healthy work. This article has three sections, the first of which offers a historical and educational perspective on this emerging field, which actually dates to the turn of the past century in America. The second section reviews three dimensions in OHP: the work environment, the individual, and the work–family interface. Concepts within each dimension are discussed. The third section offers an intervention framework based on the public health notions of primary, secondary, and tertiary prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational stress, safety, and health: conceptual framework and principles for effective prevention interventions

The authors present an overarching conceptual model of occupational stress, safety, and health, incorporating multiple factors from diverse disciplines. They examine specific implications of the model for the development of prevention interventions (e.g., context-specific interventions and primary, secondary, and tertiary prevention). They review prevention interventions and describe and analyze 4 case studies that address exposure to environmental, ergonomic, and psychosocial stressors and a combination of physical-environmental and psychosocial stressors. The authors examine lessons learned from these interventions in light of the conceptual model (e.g., role of top management and integrating research and intervention).     

Reflections of an advocate for research and health promotion: An interview with Jacob K. Javits.

Senator Jacob K. Javits views the role of scientists and scientific organizations working with Congress as twofold: (1) the scientists' expertise is critical to the workings of Congress and (2) scientists must be involved in the process to highlight their ethical and moral concerns. He discusses the social, political, and philosophical factors that have contributed to the activist, antiscience, and antiresearch movement that developed in the US during the early 1980s. Javits identifies the integration of health and behavior as the radical change that has occurfed in the latter part of the 20th century. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational stress and health care use

This study investigated the relationship between health care use and (a) stressful work events; (b) strain; (c) social support; (d) type of job and industry; and (e) the individual characteristics of control, commitment, and length of time in position. A sample of 260 individuals (95 men, 165 women) from two different industries was used. Correlational analyses suggested that health care claims and costs were positively related to stressful work events and strain and negatively related to employees' length of time in position. Industry type also played a role in predicting the health care variables. Multivariate analyses suggested that environmental, stressor, and strain variables accounted for up to 16% of the variance in health care costs and 21.5% of the variance in number of health care claims.     

Occupational health services and OSHA compliance

Two different types of action potentials were observed among the pyramidal cells and interneurons in cat motor cortex: the narrow action potentials and the wide action potentials. These two types of action potentials had similar rising phases (528.8 +/- 77.0 vs 553.1 +/- 71.8 mV/ms for the maximal rising rate), but differed in spike duration (0.44 +/- 0.09 vs 1.40 +/- 0.39 ms) and amplitude (57.31 +/- 8.22 vs 72.52 +/- 8.31 mV), implying that the ionic currents contributing to repolarization of these action potentials are different. Here we address this issue by pharmacological manipulation and using voltage-clamp technique in slices of cat motor cortex. Raising extracellular K+ concentration (from 3 mM to 10 mM), applying a low dose of 4-aminopyridine (2-200 microM) or administering a low concentration of tetraethylammonium (0.2-1.0 mM) each not only broadened the narrow action potentials, but also increased their amplitudes. In contrast, high K+ medium or low dose of tetraethylammonium only broadened the wide action potentials, leaving their amplitudes unaffected, and 4-aminopyridine had only a slight broadening effect on the wide spikes. These results implied that K+ currents were involved in the repolarization of both types of action potentials, and that the K+ currents in the narrow action potentials seemed to activate much earlier than those in the wide spikes. This early activated K+ current may counteract the rapid sodium current, yielding the extremely brief duration and small amplitude of the narrow spikes. The sensitivity of the narrow spikes to 4-aminopyridine may not be mainly attributed to blockade of the classical A current (IA), because depolarizing the membrane potential to inactivate IA did not reproduce the effects of 4-aminopyridine. Blockade of Ca2+ influx slowed the last two-thirds repolarization of the wide action potentials. On the contrary, the narrow action potentials were not affected by Ca(2+)-current blockers, but if they were first broadened by 4-aminopyridine or tetraethylammonium, subsequent application of Ca(2+)-free medium caused further broadening, suggesting that the narrow action potentials were too brief to activate the Ca(2+)-activated potassium currents for their repolarization. Therefore, the effects of low concentrations of tetraethylammonium on the narrow spikes appeared to be mainly due to blockade of an outward current that was different from the tetraethylammonium-sensitive Ca(2+)-activated potassium current (IC). In the neurons with the narrow spikes, voltage-clamp experiments revealed two voltage-gated outward currents that were sensitive to tetraethylammonium and 4-aminopyridine, respectively. Both currents were activated rapidly following the onset of depolarizing steps. Interestingly, the tetraethylammonium-sensitive current was a transient outward current that inactivated rapidly (tau < or = 5 ms), while the 4-aminopyridine-sensitive current was relatively persistent during maintained depolarization. The 4-aminopyridine-sensitive current did not show obvious inactivation even at membrane potential of -40 mV, which completely inactivated the transient tetraethylammonium-sensitive, current. The results indicate that different potassium currents are involved in the repolarization of the narrow and wide action potentials in cat motor cortex. A novel tetraethylammonium-sensitive transient outward current and a 4-aminopyridine-sensitive outward current are responsible for the short duration and small amplitude of the narrow action potentials in the interneurons and some of the layer V pyramidal cells. These two currents are voltage-gated and Ca(2+)-independent. For the wide action potentials that characterize most pyramidal neurons, a Ca(2+)-independent tetraethylammonium-sensitive outward current and a Ca(2+)-activated potassium current are the main contributors to their repolarization.     

Accreditation in managed behavioral health care: an interview with Mary Cesare-Murphy and Claire Sharda. Interview by Gary J. Mihalik

Accreditation of managed behavioral health care organizations is being driven by the demands of multiple stakeholders in the health care industry. Accreditation is expensive-both in terms of the direct and indirect costs of preparation and survey but also in terms of the consequences of failure. Though accreditation is a new expectation for the managed behavioral health care field, it is unlikely that the major organizations in the industry will have the years to achieve accreditation that the nonbehavioral managed care field enjoyed. This article explores, in an interview format, the managed behavioral health care accreditation programs of the Joint Commission on Accreditation of Healthcare Organizations and the National Committee for Quality Assurance.     

Occupational medicine: health protection of liquidation specialists

Taking long-term clinical and epidemiologic observation of rescue team (helicopter pilots) as an example, the authors defined principal concepts concerning prophylaxis, social security and rehabilitation of Chernobyl plant accident liquidators. Methodology and methods of the liquidators' health care are discussed.     

Israel's health policy breakthrough: the politics of reform and the reform of politics

After decades of attempts, Israel has enacted a national health insurance law and begun to substantially change its health care system. I explore the conditions that enabled final passage of the law in light of theories of nonincremental change in pluralist policy systems. I also discuss the implications of this policy breakthrough for links between policy subsystems, leadership, and the establishment of a new policy equilibrium.     

Occupational risk of hepatitis C virus infection to dental health care staff: an update

In this review, we develop four topics on the relationship between blood transfusion and cancer. First, the rationale for not allowing blood donations from patients with infiltrating tumors is presented. Second, the different possibilities for autotransfusions in cancer patients are discussed. Predeposited autotransfusions are rarely possible in these patients, in addition to the high cost. The usefulness of another method, intraoperative autologous transfusion with blood saved from the surgical field, is not well established. Our third topic concerns the effect of transfusion on cancer induction. In some cases, the risk of cancer is higher after allogenic transfusion resulting from a mechanism involving alterations of the immune function. Finally, the relationship between transfusion and cancer recurrence is controversial. In spite of numerous studies attempting to elucidate this relationship, no final conclusion can be drawn at the present time. What is sure, is that patients requiring blood transfusion have a higher risk of recurrence than patients who do not need transfusion.     

Occupational health psychology: Historical roots and future directions.

Occupational health psychology (OHP) is a term first coined by Jonathan Raymond in 1990, yet OHP has historical, international roots dating at least to the early decades of the twentieth century. It involves research and practice to create healthy workplaces. This article has 4 sections. The 1st section discusses psychology's long history of concern for occupational health in industrial organizations, beginning with Hugo Minsterberg's study of industrial accidents and human safety in the late 1800s. The 2nd section focuses on OHP's movement from the convergence of public health and preventive medicine with health and clinical psychology in an industrial/organizational context. The 3rd section addresses the central issues of organizational and individual health through the framework of preventive management. The article concludes with OHP case examples drawn from the Chaparral Steel Company, the U.S. Air Force, and Johnson & Johnson. (PsycINFO Database Record (c) 2010 APA, all rights reserved)