bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-circuit effects on spark ignition engine after-treatment and fuel-to-air ratio control
Authors: Guardiola Carlos , Pla Benjamín , Real Marcelo , Travaillard Cyril , Dambricourt Frederic
Published: September 2018

The short circuit of fresh air is a more and more extended strategy to deal with low-end torque issues, very common in small turbocharged and spark-ignited four-stroke engines. Therefore, from the author’s point of view, it is interesting to check whether the after-treatment system can work properly under these conditions. In the present study, the effect of the fresh air short-circuit on engine emissions has been assessed through its impact on the wideband [Formula: see text] sensor and the three-way catalyst behaviour, which are the key elements of the fuel-to-air ratio control strategy. In particular, the analysis of the sensor dynamic response shows that the [Formula: see text] sensor overestimates the fuel-to-air ratio under short-circuit conditions. The sensor overestimation leads the actual fuel-to-air ratio out of the proper three-way catalyst window; in this sense, results show a non-negligible emissions increase, especially in terms of NOx. Regarding the impact on the three-way catalyst behaviour, the study shows how short-circuit pulses change the exhaust gas composition for a given fuel-to-air ratio at catalyst inlet, which also contributes to a penalty in the three-way catalyst efficiency.
A Multicenter Qualitative Investigation of the Experiences and Perspectives of Substitute Decision Makers Who Underwent Organ Donation Decisions
Authors: Sarti Aimee J. , Sutherland Stephanie , Healey Andrew , Dhanani Sonny , Landriault Angele , Fothergill-Bourbonnais Frances , Hartwick Michael , Beitel Janice , Oczkowski Simon , Cardinal Pierre
Published: September 2018

Background:

Organ donation research has centered on improving donation rates rather than focusing on the experience and impact on substitute decision makers. The purpose of this study was to document donor and nondonor family experiences, as well as lasting impacts of donation.

Methods:

We used a qualitative exploratory design. Semistructured interviews of 27 next-of-kin decision makers were conducted, transcribed verbatim, and entered into qualitative software. We analyzed the process-based reflections using inductive coding and thematic analysis techniques.

Results:

Four broad and interrelated themes emerged from the data: empathetic care, information needs, donation decision, and impact and follow-up. The donation experience left lasting impacts on family members due to lingering, unanswered questions. Suggested solutions to improve the donor experience for families included providers employing multimodal communication, ensuring a proper setting for family meetings, and the presence of a support person.

Discussion:

We now have improved our understanding of the donation process from the perspective of and final impression from the next of kin. To our knowledge, this is the largest cohort interviewed in Canada. We have explored families’ experiences, which included but did not end with donation. We learned that despite being appreciative of nurses, physicians, and organ and tissue donation coordinators, family members were often troubled by unanswered questions.

Conclusion:

This study described donor and nondonor family experiences with donation as well as lasting impacts. Addressing unanswered questions should be done in a place sufficiently remote from the donation event to enhance the family members’ understanding and well-being.
Starting a Business as a Nurse Consultant
Authors: Childre Frances , Papp Elaine M.
Published: September 2018

This is the first of two continuing education (CE) articles for occupational health nurses interested in starting their own business. Both articles build on the January 1997 focused issue with four CE articles dedicated to consulting in occupational health nursing practice. In this issue, Papp explores practical issues and poses questions beginning occupational health nurse consultants must confront prior to starting a business. Rainer's article, scheduled for the April 2000 issue of the AAOHN Journal, focuses on managing financial resources effectively to sustain a profitable business.

Businesses are changing continually in response to a highly competitive marketplace. As a result, occupational health nurses continue to be challenged both clinically and managerially to demonstrate value whether they work within the organization or external to it. This two part series encourages occupational health nurses to examine options for adding value from an entrepreneurial perspective.
Exercise Behavior among Female Occupational Health Nurses
Authors: Piazza Jo , Conrad Karen , Wilbur JoEllen
Published: September 2018

Physical fitness of the American worker is a core element of personal good health and a key factor in corporate cost containment. The Centers for Disease Control and Prevention specifically notes that health professionals should be physically active not only to benefit their own health but also to make more credible their endorsement of an active lifestyle. Guided by Pender's Health Promotion Model, this study gives a profile of the current status of exercise behaviors, physical self efficacy, and perceived health control among a sample of occupational health nurses. Surveys were mailed to a random sample of 300 female members from a midwestern state association of the American Association of Occupational Health Nurses. The mean exercise score was 30.7 MET hours per week, with walking the activity most often selected. Physical self efficacy was a significant positive predictor of exercise practice, while age exerted a significant inverse effect on exercise. The study findings may be used to stimulate discussion among occupational health nurses about how their own physical self efficacy and perceived health control may influence their exercise behaviors, and how in turn these beliefs and exercise practices may influence their decisions about promoting exercise programs at their workplaces.
Roles and Value Added Contributions of the Occupational Health Nurse
Authors: Nelson Yvonne
Published: September 2018

This study replicated a study by Martin (1993) to examine the corporate perceptions of the current and future roles and activities of the occupational health nurse and the nurse's value added contributions in the local operating units of a large Fortune 100 company. A descriptive design was used for this study. The sample consisted of 44 corporate officials.

The study findings are consistent with Martin (1993) and suggested that management is aware of the traditional roles and activities of the nurse, including direct care, education and counseling, and case management. The desired future activities identified were trend analysis, conducting plant rounds, and developing health programs specific to the needs of the corporation. The activities identified as adding value to the corporation included: planning and developing educational programs specific to the needs of the corporation, supervising the provision of nursing care, assisting in rehabilitation of injured workers, and providing follow up on workers' compensation claims. Corporate officials are aware of the traditional roles of the nurse. However, they may not be aware of the newer nursing roles, such as trend analysis, research, and budget development.
The Effect of Injection Speed on the Perception of Intramuscular Injection Pain
Authors: Mitchell Jane R. , Whitney Fay W.
Published: September 2018

Injections are frequently administered by occupational health nurses in worksite health promotion programs. The purpose of this study was to examine the effect of varying injection speed on the perception of pain. Fifty workers were given intramuscular (IM) hepatitis B vaccine at injection speeds of 10 and 30 seconds per cubic centimeter (s/cc). The perception of pain was measured on a visual analogue scale and reported post-injection at three different time intervals. The results showed that no difference in pain was perceived by participants between the two injection speeds. Results also revealed that women consistently had higher mean pain scores than men and significantly more pain at the 0 hour measurement of the 10 s/cc injection. While the results of this study indicate no need to administer an IM injection slower than 10 s/cc, occupational health nurses will need to consider gender differences in pain perception when administering injections.
Effective Ergonomic Teaching for Positive Client Outcomes
Authors: Sitzman Kathleen L.
Published: September 2018

Teaching and intervention are integral aspects of professional nursing practice. Numerous publications encourage the use of specific teaching intervention techniques, but few are validated by studies conducted to assess actual teaching behaviors of nurses who administer successful teaching intervention programs. This is a case study of one occupational health nurse who administers a highly effective ergonomic program for employees in a large urban hospital. Themes identified during observation of nurse and client interactions include mindfulness on the part of the nurse, respect for client autonomy, nurse effort, nurse accessibility, and professional distance. A consistent teaching process identified during observation consists of six steps: inquiry, invitation, assessment, synthesis, validation, and progression. This six step process is embedded within identified themes. Teaching and intervention methods identified in the study are a synthesis of caring behaviors and nursing process. This integrated method is entitled “Effective Teaching Through Unified Process and Caring Interpersonal Behavior.” It may represent a valid teaching and intervention method supporting compliance and positive client outcome when interacting with clients requiring ergonomic teaching and intervention.
Mental Health Issues in Japanese Workers
Authors: Nishisaka Kazuko , Yoshimura Takesumi
Published: September 2018

In this cross sectional study conducted in one city in Japan, psychiatrists were asked to answer self administered questionnaires related to their patients' vital status, constituent family members, employment status, financial support from family, emotional support from family, present state of mental condition, and steps used to help them return to society. The focus of the study was to identify and understand the needs of Japanese workers with mental health problems, and to relate the findings to implications for the workplace. Of the 1,283 male patients reported on in the survey, the greatest proportion (45.1%) suffered from schizophrenia, with the prevalence of this serious illness decreasing with age. One half of the total group worked full or part time, with highest rates of employment among those in their 40s and 50s. The most common jobs were simple physical work or assembly. Workers older than 40 years also were more likely to be responsible for financial support of their families. It is suggested that the occupational health nurse has an important role in providing interventions to help these workers remain productive in the workplace, and thus in society.
Toward a Model for Effectiveness
Authors: Skillen D. Lynn , Anderson Marjorie C. , Seglie JoAnne , Gilbert Julie
Published: September 2018

Effectiveness is difficult to define or measure, but is frequently associated with cost. A two phase study conducted with occupational health nurses in Alberta, Canada resulted in a beginning model for effectiveness. In 1997, Phase One of an exploratory descriptive study focused on physical assessment by occupational health nurses ( N = 137) and perceptions of effectiveness in practice ( n = 104). In 2001, Phase Two used focus groups ( n = 7) to determine occupational health nurses' reactions to the preliminary analysis of questionnaire responses on effectiveness. The focus groups confirmed and expanded categories, and reconfigured the developing model. The model makes explicit the foundations, functions, relationships, and goals for effectiveness in occupational health nursing practice. The foundation includes registered nurse (RN) experience and baseline competence comprising occupational health nursing education, RN and occupational health nurse experience, and multidisciplinary knowledge. Ten specific functions and nine relationships describe the occupational health nursing specialty practice and promote achievement of five goals: balance, communication, continuing competence, leadership, and trust. The goal of balance needs articulation in the nursing literature.
What are the Implications of the ADA in Case Management Practice?
Authors: Kalina Christine M. , Haag Annette B. , Tourigian Robin
Published: September 2018

At the request of our readers, we present this special feature on case management. This feature appears on an occasional basis in the Journal. Based on the suggestion of a reader, we are using a Panel approach to provide a forum for sharing ideas, viewpoints, and perspectives. We have put together a group of individuals with expertise from a variety of case management arenas who have agreed to share their opinions and perspectives in response to specific questions or scenarios. Opinions and perspectives are those of the panel members, and do not necessarily represent the views of the AAOHN, the Editor, or the Publisher. We encourage readers to submit their questions or scenarios for the Panel. This month's Panel members include Christine M. Kalina, Annette B. Haag, and Robin Tourigian.
An Occupational Health Nursing Education Program
Authors: Hodge Bernadette D. , Ackerman Sue , Evans Carol , Erb Tara , Cook Mary Lou Wranesh
Published: September 2018

A collaborative effort between community health faculty in an upper division nursing program and nurses from a nearby agricultural health and research center resulted in an educational program focused on occupational health and safety issues in the agricultural industry. The 3 hour class was presented each semester between 1997 and 1999 to RN students enrolled in a community health organization class. In addition to information about the health and safety hazards in agriculture, the nursing students learned about the center's research projects and clinical services available to the farming community. A follow up survey was mailed to the nursing students to evaluate the effectiveness and relevance of the occupational health program by identifying the proportion of the nurses' caseloads spent on occupational health problems, and whether the information and materials presented in the class were relevant to practice. Results showed that even though the surveyed nurses were employed in nonoccupational practice settings, nearly everyone rated the occupational health information as useful. Findings also revealed that although nurses in nonoccupational practice can spend nearly a quarter of their time caring for clients with work related health problems, they may lack adequate educational preparation to do so.
Occupational Health Nursing Research
Authors: Smith Pegeen S. , Lusk Sally L.
Published: September 2018

Occupational health nursing research contributes to the scientific knowledge base, shapes practice guidelines, lends credibility to the profession, and ultimately benefits worker health and work settings. This descriptive study reviewed occupational health nursing research published from January 1990 through December 1999 in the AAOHN Journal. A single investigator reviewed all articles published during the 10 year period to determine if they qualified for inclusion by applying the inclusion and exclusion criteria. During the 10 year period, a total of 577 articles were published in the AAOHN Journal (the official journal of the American Association for Occupational Health Nurses) with 146 (25.3%) considered to be reports of research. Cumulatively, 261 RNs were authors of the research articles. Of the 146 research articles, 88% addressed the National Occupational Research Agenda (NORA) priorities, 60% addressed the 1989 AAOHN priorities, and 65% addressed the 2000 AAOHN priorities. Occupational health nursing research is performed primarily by graduate and postgraduate level nurses working either alone or with nurse co-investigators. The occupational health nursing research articles addressed NORA priorities often. However, the outcomes focused priorities of AAOHN were addressed less often. Much has been accomplished in the field of occupational health nursing research and more remains to be performed to ensure a strong research base for occupational health nursing practice.
The Lucent-Takes-Heart Cardiovascular Health Management Program
Authors: Guico-Pabia Christine J. , Cioffi Laura , Shoner Lawrence G.
Published: September 2018

This prospective, pre- and postevaluation of a worksite cardiovascular health management program consisted of employee education, measurement of cardiovascular risk factors, and on-site individual counseling for all employees, along with follow up screening for high risk participants. Of 1,099 employees (16.4% of those eligible) who participated in the initial screening, 596 (54.2%) were classified as high risk. A total of 167 (28.0%) high risk participants completed the 6 month follow up screening. Most high risk participants in the 6 month follow up screening reported they had increased their exercise (64.7%), improved their diet (71.3%), and visited a physician (61.7%). A minority of the participants (16.8%) began new cardiovascular medications, and 2.4% were diagnosed with diabetes. In addition, there were statistically significant decreases in the percentages of participants with elevated systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol, and total cholesterol to high density lipoprotein ratio. Almost all (99.7%) of the 909 participants (82.7% of all participants) who completed the satisfaction survey were satisfied or very satisfied with the overall program. Screening in the workplace can identify individuals at high risk for cardiovascular disease. In this study, more than half of the participants were classified as high risk. Most high risk individuals who attended the 6 month follow up screening had improved their cardiovascular health, but attrition remains a challenge for worksite programs.
Workplace Homicides in Chicago
Authors: Hewitt Jeanne Beauchamp , Levin Pamela F. , Misner Susan Terry
Published: September 2018

Using data from police records, this study examined risk factors related to 940 workplace homicides occurring in Chicago between 1965 and 1990. Black men were predominantly both victims (49%) and offenders (75%). The median age for victims was 42 years, but only 25 years for offenders. Women (40%) were more likely than men (6%) to be killed by intimates. Firearms were involved in 83% of all homicides, and robbery was the primary motive (62%). Workplace homicides occurred most frequently in taverns (22%). Alcohol use by tavern workers was involved in 48% of the homicides. Wide disparity in the number of workplace homicides occurred in Chicago's 77 community areas. Strategies to deter robbery and alcohol use, as well as to prevent domestic violence in the workplace, need to be implemented and evaluated. Occupational health nurses play a pivotal role in effective violence prevention.
Physical Activity Determinants in Adults
Authors: Stutts Wanda C.
Published: September 2018

The determinants of physical activity in adults were explored in this study. Explanatory variables included perceived benefits of and perceived barriers to physical activity, and perceived self efficacy for physical activity. Inactive participants were asked to identify barriers to activity, and active participants cited cues prompting them to adopt a physically active lifestyle. Data were collected from 137 adults obtained from work sites, an evening college program, and church groups. Overall, participants were physically active. Self efficacy was the only variable to predict physical activity. Race (i.e., being White) and body mass index (i.e., being overweight) explained perceived barriers to activity. The primary reason for inactivity was lack of time, and the most frequently cited cues to activity were dissatisfaction with one's weight or appearance. Few nursing studies have attempted to increase participants' levels of self efficacy. However, the occupational health nurse is in a unique position to increase workers' perceived self efficacy for activity and, in turn, their activity levels.
Diabetes Update
Authors: Beare Patricia Gauntlett
Published: September 2018

Many clients are started on human insulin since the body does not form antibodies to human insulin. This means that it is easier to regulate the dosage since increasingly higher doses of insulin will not be needed due to antibody production.
Toxicology: An Overview
Authors: Hathaway Barbara Kingsley
Published: September 2018

With the discovery of new “toxins.” the onus is not only on the manufacturer but also on the user This means fully evaluating the health and safety effects of the substances produced and used As health care professionals, we must continue to increase our knowledge and skills In order to maintain a healthy and safe work environment. The role of OHNs in managing health and safety programs is continually expanding Complying with the legislative regulations such as state right-to-know laws and the Hazard Communication Standard, requires the OHN to possess an ongoing knowledge and understandng of toxicology Toxicology allows us a better understanding of how our bodies react with the changing environment that surrounds each one of us A basic understanding of toxicology is a stepping stone to understanding the complexities of occupational health.
Workplace Smoking Policy: An Occupational Health Nurse's Perspective
Authors: Knuth Georgia M. , Parker Jane E.
Published: September 2018

Several topics which relate to workplace smoking are revealed through a literature review and pertinent occupational health nursing skills (e.g. assessment, communication, planning) which may be used for an effective occupational health nurse's (OHN's) response to the worksite smoking issue are presented. The health hazards of voluntary and involuntary cigarette smoking, status of American smoking habits, related economic concerns, involved legal issues, and possible barriers to effective company nonsmoking policies are cited. Some examples of smoking restriction or prohibition policies, several appropriate resources, and viable strategies which can be used by the OHN to facilitate the formulation of worksite smoking policy are discussed. The imperative involvement of the OHN in the establishment of workplace smoking restriction or prohibition policy is emphasized.
Hepatitis B Program for Health Care Personnel: Education, Serologic Surveillance, Immunization
Authors: Kwapien Carol A. , Phillips Dartene A. , Anderson Linda A.
Published: September 2018

A program was developed at a 294-bed community hospital in Western Massachusetts to educate employees to Hepatitis B Virus Infection (HBVI), determine risk levels, and provide potential protection via immunization. Employee responses to education, baseline and post-vaccination serology (Anti-HBs), and immunization were evaluated. Personnel at HBVI risk were identified. Employees with responsibilities associated with blood, blood products and body fluids exposures were assigned to the Priority 1 Group (P1G). Employees received information on the education program, HBVI and vaccine. Fifty-three percent attended the education component. Serology screened susceptible employees. Seventeen employees (10%) were Anti-HBs positive. Post vaccination serology documented immunity A total of 73 people completed the vaccination series with 53 (73%) becoming immune. After receiving booster doses, 11 more persons seroconverted. Conversions, booster efficacy age, sex, job, number of years in health care and at the hospital were evaluated.
Obsessional Thought Disturbance in a Gainfully Employed PTSD Patient
Authors: Miller Thomas W. , Feibelman N. Donald
Published: September 2018

This is a single case study of obsessional thought disturbance in a currently employed Vietnam veteran who experienced traumatic stress during and subsequent to his tour of duty in Vietnam. It was hypothesized that with the diagnostic indicators present a systematic desensitization model with muscle relaxation, covert imagery, cognitive disputation and self-monitoring would offer relief to the patient's obsessive-compulsive features and allow maintenance of employment. Cognitive disputation, especially with spouse participation addressing the irrational belief system, proved to be a very effective component in the treatment program. The patient learned effective coping skills to guard against future obsessional thought disturbance and has been able to maintain gainful employment.
Hepatitis Outbreak! Quick Response is Essential
Authors: Smith Norma Guest
Published: September 2018

An outbreak of hepatitis A can pose a serious health risk, especially when it occurs in a location such as an offshore oil drilling platform. This is one nurses account of just such an outbreak and her efforts to help the crew.
Traditional and Modern Medicine in Worker Health Care
Authors: Yuan Catherine , Yu Jin
Published: September 2018

Nurses from occupational health care settings around the world, interpreting the theme “Communication, Health Care, and the Community,” presented papers at the First International Conference on Occupational Health Nursing in Edinburgh, Scotland in October, 1986. In keeping with AAOHN's commitment to an international perspective, this article is Part II of a five part series of articles that will be printed in the AAOHN JOURNAL. Next month, Part III of the series will feature, “Occupational Health Nursing World Wide.”
Preventing Burnout
Authors: Rabinowitz Stanley , Kushnir Talma , Ribak Joseph
Published: September 2018

Nursing is reported to be a stressful occupation, and chronic stress is often associated with burnout. Many ways of reducing stress have been proposed. Of these, the Balint group method provides a forum in which health professionals can present and attempt to resolve stressful situations with clients, coworkers, or other professionals. Balint groups help health professionals improve coping with psychosocial stressors in a supporting and accepting group atmosphere. This article reports changes in professional self efficacy associated with reduced burnout in a group of 13 nurses working in community based primary care clinics. Results showed significant increases in awareness and ability cognitions after the Balint group and reduced emotional exhaustion and cognitive weariness. The ramifications of these findings are discussed.
Musculoskeletal Symptoms Related to Video Display Terminal Use
Authors: Faucett Julia , Rempel David
Published: September 2018

The occupational use of video display terminals (VDTs) has been associated with the increasing incidence of upper extremity musculoskeletal disorders, often called cumulative trauma disorders. To guide clinical and policy decisions about the prevention and treatment of these VDT related disorders, valid and economic measures of total daily VDT use and VDT related job tasks such as data entry or editing will be important. In this study of newspaper reporters and copy editors (n=83), VDT use was measured with employee self reports and by sampling the work behaviors of a subsample of employees. Behavioral sampling estimated VDT use as a characteristic of the job as opposed to a characteristic of individual employee performance. Overall, the two techniques of measuring occupational VDT use compared favorably, with the exception that self reported hours of VDT use tended to exceed the hours of use estimated by behavioral observation for employees who were younger and those who reported greater job demands. The findings suggest that behavioral sampling is a valid technique for estimating VDT use as a job characteristic.
Back Injury Prevention Interventions in the Workplace
Authors: Karas Barbara E. , Conrad Karen M.
Published: September 2018

The purpose of this integrative review is to describe the state of knowledge about the effect of worksite back injury prevention programs on selected study outcomes. Fifteen experimental and quasi-experimental studies published between 1987 and 1994 were identified through a comprehensive literature search. The research studies were reviewed and analyzed using a data collection abstracting tool. Four types of back injury prevention intervention programs were identified: back belts, back schools, exercise/flexibility training, and educational classes. Positive program outcomes were reported for all four program types; however, the back school and the exercise/flexibility training programs were studied more frequently and demonstrated a greater proportion of positive results than the other two program types. Conclusions should be viewed cautiously due to the small number of studies reviewed and their methodological limitations. Implications for occupational health nursing practice and future research related to worksite back injury prevention are offered.
Environmental Health Competencies
Authors: Bellack Janis P. , Musham Catherine , Hainer Anne , Graber David R. , Holmes Dylan
Published: September 2018

Because of widespread public and governmental concern about the health effects of environmental hazards and exposure in recent years, and the increasing incidence of environmentally induced diseases, it is important that primary care nurse practitioners possess the knowledge and skills to effectively address environmental health as a component of their practice. A mailed questionnaire survey of 187 United States' nurse practitioner (NP) programs was conducted, with a response rate of 64%, to determine: 1) current and ideal emphasis on environmental health, 2)faculty preparation for teaching environmental health, 3) environmental health competencies expected of graduates, 4) didactic and clinical contact hours devoted to environmental health, and 5) barriers and incentives to greater emphasis on environmental health. Findings reveal that more than two thirds of NP program directors believe there should be greater emphasis on environmental health in their programs, but expressed concerns about overcrowded curricula and lack of faculty preparation as barriers to change. Competencies with the highest mean ratings included understanding the relationship between environmental hazards and human health, accessing information resources related to environmental hazards and health, and counseling clients about how they can reduce risks associated with environmental hazards. The two factors identified as most likely to increase the emphasis on environmental health in NP programs were having nurse faculty with expertise and being able to access information resources related to environmental health. Currently, insufficient attention is given to environmental health in NP education programs.
Daughters and Caregiving
Authors: Hawkins Barbara
Published: September 2018

The purpose of this study is to identify the stressors experienced by caregiving daughters of frail, elderly parents and the coping skills used to manage those stressors. The differential effects of paid employment on caregiving daughters are also examined to explore the relationship between work force participation and caregiving stress. Data were collected from a non-random sample of 21 caregivers selected from the caseloads of a home health agency and a state continuity of care association. Two instruments were administered to caregiving daughters: the Caregiver Stress and Coping Instrument, and Lawton and Brody combined ADL and IADL instruments to assess functional level of parents. Findings included: 1) employed caregiving daughters had significantly higher stress scores (M=52.9) than unemployed caregiving daughters (M=46.8, p<.05); and 2) there was no significant relationship between stressor scores and combined ADL and IADL scores. The stressors most often identified were needing help with recreational activities for the care recipient, and worrying about the future. The findings from the study can be used to plan nursing interventions specific to caregiving daughters, develop employee assistance programs promoting family health care or on site adult day care, and reduce costs by increasing employee productivity and retention.
Multi-State Practice: Special Concerns for the Occupational Health Nurse
Authors: Calfee Barbara E.
Published: September 2018

After several months' absence, we are pleased to reinstate the Legal Issues column. We welcome Barbara E. Calfee as the new legal issues columnist, and are pleased that Ms. Calfee has agreed to share her legal expertise with our readers. Her first column focuses on a topic about which many readers have expressed concern. The journal welcomes general questions or practice concerns related to legal issues. Address questions to: Legal Issues Column, AAOHN Journal, 6900 Grove Rd, Thorofare, NJ 08086.
Credentialing
Authors: Olson Debra Kay , Verrall Brian , Lundvall Ann Marie
Published: September 2018

The American Association of Occupational Health Nurses (AAOHN) promotes occupational health nursing by participating in national and state deliberations on credentialing issues. In 1995, AAOHN established the Credentialing Ad Hoc Committee to examine the impact of credentialing on occupational health nursing practice. As one effort by this Committee to clarify credentialing and the issues affecting the occupational health nurse, a series of three articles will appear in AAOHN Journal. This article defines credentialing and describes some of the issues affecting occupational health nursing. The second article will be based on the 1997 American Occupational Health Conference, Catherine Dempsey lecture elaborating on the future of credentialing in occupational health nursing. The final article will present the results of a national project conducted in 1996 asking AAOHN members for input in determining levels of competency in occupational health nursing practice.
Credentialing Study
Authors: Chamberlin Eleanor M. , Rogers Bonnie
Published: September 2018

This article is third in a series of three articles addressing credentialing to appear in AAOHN Journal. The first article, “Credentialing: Concerns and Issues Affecting Occupational Health Nursing,” by Olson, Verrall, and Lundvall, appeared in the May 1997 issue [45(5):231–238]. The second article, “Certification and Occupational Health Nursing: An Historical Perspective,” by Verrall appeared in the June 1997 issue [45(6):283–289].
Treatment of Hand and Wrist Pain
Authors: Stralka Susan W. , Jackson Janice A. , Lewis A. Ritchie
Published: September 2018

To determine the effectiveness of high voltage pulsed current (HVPC) in reducing chronic hand edema, 120 individuals were randomly assigned to one of two treatment groups. Group I clients were given an appropriate sized wrist splint, incorporating an energized, high voltage pulsed unit Group II clients were given an identical splint with a non-energized unit. Each client received daily treatments at the worksite consisting of 30 minute sessions totaling 20 treatments during a 35 day period. Pre-treatment and post-treatment evaluations included measurements of pain, grip strength, and edema volume; repetitive task testing; and Semmes-Weinstein Monofilament sensory testing. In the energized group, post-treatment evaluation showed statistically significant decreases in the amount of stimulation required to stimulate the median nerve and the amount of hand edema and pain. The energized group also had improved repetitive task times. None of these improvements occurred in the non-energized group. Based on these results, HVPC appears to be an effective method for minimizing the severity of repetitive stress injuries of the wrist.
Charles Jeffress Talks about His Priorities for OSHA in the 21st Century
Authors: Lukes Eileen
Published: September 2018

This is the second in an occasional series of interviews with leaders in occupational and environmental health and areas relating to occupational and environmental health.
Client Satisfaction with Nursing Services: Evaluation in an Occupational Health Setting
Authors: Mitchell Ronald , Leanna Jacque C. , Hyde Roberta
Published: September 2018

Client satisfaction surveys have served as a valued appraisal tool of quality nursing care in various health care settings, but there is a paucity of published research using these tools in the occupational health setting. Employing a modified version of the SERVQUAL questionnaire, this study identified employees' current levels of satisfaction and perceived importance of nursing care provided by an occupational health program. Two hundred randomly selected employees were asked to participate by completing the survey, with 86 (43%) responding. Results indicated a positive correlation between client satisfaction and perceived importance of nursing care. Moderately high levels of client satisfaction existed in the sample. The use of client satisfaction surveys based on the strength of client preferences could identify areas of health care that need improvement.
Modifications to Standard Guidelines and Changes in Blood Pressure Readings: Use of an Automatic Blood Pressure Device
Authors: Widener Jeanne , Yang Carolyn , Costello Patricia , Allen Katy
Published: September 2018

The purpose of the study was to determine what effect modifications to American Heart Association (AHA) guidelines produce when taking blood pressures with an automatic device. Eight blood pressure measurements were taken at least 2 minutes apart; two with standard AHA guidelines and six with modifications. Findings of this study suggest that elevation of the arm can have a significant effect on both the systolic and diastolic blood pressure. Two modifications, talking and placing the arm beside the trunk, raised the diastolic pressure. However, some modifications did not have a statistically significant effect. Techniques used to take blood pressures with an automatic device can have a significant effect on the readings.
Preplacement Assessments: Impact on Injury Outcomes
Authors: Nachreiner Nancy , Mcgovern Patricia , Kochevar Laura K. , Lohman William H. , Cato Cathy , Ayers Evelyn
Published: September 2018

Evaluation of the impact of preplacement assessments is important given the resources companies and occupational health nurses allocate to screening and the ambiguity of the literature about the effectiveness of such assessments. This study examined the effects of preplacement assessments on employee injuries. All individuals screened by an occupational health clinic in the upper Midwest and given work restrictions during a 3 year period were identified as cases (n=67). Cases were matched with controls without work restrictions (n=264) on the basis of employer, gender, and job. Age was controlled for statistically. Chi-square analysis, used to test differences in percent distribution of injuries between cases and controls, found no statistically significant differences in musculoskeletal injuries between the groups. Work restrictions recommended as a result of preplacement assessments appear to protect vulnerable workers.
Force and Repetition Measurement of Ham Boning: Relationship to Musculoskeletal Symptoms
Authors: Stoy Daniel W. , Aspen Jack
Published: September 2018

The purpose of this study was to develop a valid methodology for comparing measured torque repetition data along a ham boning line to symptoms reported in an established clinical database, which included history of cumulative stress disorder symptoms. A musculoskeletal stress measurement system was used to measure torque and repetition data associated with boning hams. Twenty-two surveys were conducted across a representative sample of employees performing this task on three different production lines. Two different knife grips were compared in the study to determine if one method produced lower torque. The data were analyzed and work (in-lb) and power (in-lb/sec) calculations were made. Evidence showed an increased rate of reported symptoms by subjects exerting more power as compared to other subjects performing the same task. One method was found to require less power than another. Operators managed a microbreak in the cycle ranging from .88% to 4% of the survey time. Operators not reporting symptoms averaged longer microbreaks than those reporting. The study provided data for structuring a line rotation program for moving people to positions requiring less “power.”
A Worksite Influenza Immunization Program
Authors: Dille JoAnne Hein
Published: September 2018

Using a randomized, retrospective case control survey approach, this study compared emplyees immunized (cases) to a group of non immunized employees (controls) between the months of October and December 1994. In May 1995, a self administered questionnaire was distributed to employees working at the Hanford nuclear reservation located in eastern Washington State. Bivariate analysis included chi-square tests to study the association between influenza vaccine and rates of influenza like illness and related complications, rates of employee absenteeism, rates of physician visits, use of prescribed medication, and rates of hospitalization. To assess the economic benefits associated with vaccination, analysis included estimating the direct and indirect costs associated with immunization and influenza like illnesses, and complications related to influenza like illnesses.

Responses to the survey resulted in 789 employees in the vaccinated group and 931 employees in the nonvaccinated group. As compared to vaccinated employees, nonvaccinated employees reported significantly higher rates of episodes of influenza like illness (78 per 100 compared to 59 per 100, p < 0), influenza related complications (8.0 compared to 5.0, p < .01), lost work days (63 per 100 compared to 35 per 100, p < 0), use of prescription medication (18.6 per 100 compared to 8.7 per 100, p < 0), physician visits (18.6 per 100 compared to 8.7 per 100, p < 0), and inpatient hospital. Cost savings were estimated to be $83.84 per person vaccinated.

The results of this study suggest this worksite influenza vaccination program produced significant health related and economic benefit to employee participants and their employers.
Injured Workers' Perceptions of Case Management Services
Authors: Brines Julie , Salazar Mary K. , Graham Katherine Y. , Pergola Tanya , Connon Catherine
Published: September 2018

This article describes the findings from a study of injured workers conducted as part of a multifaceted evaluation study of a case management program. The sample consisted of workers who filed a workers' compensation claim between January 1 and September 30, 1995. Data collection consisted of written surveys (n=45), personal interviews (n=27), and telephone interviews (n=16). The findings from this study provided many insights into the injured workers' personal and work experiences, and, in particular, their perceptions of their experience with the nurse case management program. Workers satisfied with services described the nurse case manager (NCM) as having the ability to see the “big picture,” to develop appropriate goals, and to anticipate client needs. Dissatisfied workers reported feeling unimportant in terms of service provision. They reported feeling that “the system” did not respond to their needs, and that the NCM was uninterested and disrespectful. This vivid portrayal of workers' experiences and perceptions of case management services provides valuable information about the world view of the injured worker.
Work Related Assaults: The Impact on Victims
Authors: Findorff-Dennis Mary J. , Mcgovern Patricia M. , Bull Margaret , Hung John
Published: September 2018

This pilot project employed a case study design consistent with that of Rice to describe the impact of violence on individuals who incurred a work related assault in 1992. Ten randomly selected subjects were interviewed from a population of 429 individuals reporting a work related assault that resulted in a wage loss claim. Half of the subjects had received permanency ratings, thought to be a measure of injury severity. The study hypothesis, stating the impact of the assault (e.g., pain and suffering, decrease in functioning) years after a work related assault was associated with the severity of the injury (i.e., permanency rating), was not supported by the data. However, individuals' health and quality of life 4 years after the assault were affected significantly and resulted in job changes, chronic pain, changes in functional status, and depression. The new hypothesis resulting from this study is employer support and mental health intervention immediately after an assault may prevent employee job changes and decrease mental health sequelae.
Unpacking What It Means to Be—or Not Be—A Fan
Authors: van Driel Irene I. , Gantz Walter , Lewis Nicky
Published: September 2018

Sports fanship is a multidimensional concept. Fans are fans for a variety of reasons and show their fanship in an assortment of ways. In many studies, sports fanship is based on predetermined categories and closed-ended questions set by researchers. Such categories and questions may include certain types of fans while omitting others. This study assessed the extent to which closed-ended categorizations align with fans’ views of their own fanship. It also captured what it means to be—or not be—a sports fan from the respondent’s perspective. A total of 1,093 adults completed questionnaires using Amazon’s Mechanical Turk. In response to a dichotomous choice question, roughly half self-reported as fans. A majority of self-identified fans described strong emotional and personal ties with sports. Most nonfans found little connection with sports: Sports were boring and inconsistent with how they defined themselves. Open-ended responses from a small proportion of fans and a larger subset of nonfans call into question the validity of a single, dichotomous choice measure of fanship. The results of this study document the importance of explicit conceptualizations and operationalizations of sports fanship.
Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy
Authors: El sharkwy Ibrahim A. , Noureldin Elsayed H. , Mohamed Ekramy A. , Mohamed Ali A.
Published: September 2018

Background

Relieving postoperative pain and prompt resumption of physical activity are of the utmost importance for the patients and surgeons. Infiltration of local anesthetic is frequently used methods of pain control postoperatively. Laparoscopically delivered transversus abdominis plane block is a new modification of ultrasound-guided transversus abdominis plane block.

This study was conducted to compare the efficacy of laparoscopic-guided transversus abdominis plane block with trocar site local anesthetic infiltration for pain control after gynecologic laparoscopy.

Results

No statistically significant difference between the two groups in mean visual analogue scale at 1, 18, and 24 h (P = 0.34, P = 0.41, and P = 0.61, respectively), while the mean visual analogue scale was significantly lower in the laparoscopic-guided transversus abdominis plane block group than in the trocar site local anesthetic infiltration group at 3, 6, and 12 h (P = 0.049, P = 0.011, and P = 0.042, respectively). No statistically significant difference was observed in the cumulative narcotics consumed at 3 h (P = 0.52); however, women with transversus abdominis plane block have consumed significantly less amount of narcotics than women with trocar site infiltration at 6, 12, and 24 h (P = 0.04, P = 0.038, and P = 0.031 respectively). Patient satisfaction was significantly higher in the laparoscopic-guided transversus abdominis plane block group (P = 0.035).

Conclusion

Laparoscopic-guided transversus abdominis plane block is more effective in reduction of both pain scores in the early postoperative period and the cumulative narcotics consumption than trocar site local anesthetic infiltration in gynecologic laparoscopy.

Trial registration

Clinical Trials.gov NCT02973451