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Journal: Occupational medicine (Oxford, England)

149

The infantry accounts for more than a quarter of the British Army but there is a lack of data about the social and educational background of its recruits.

Concepts: Royal Marines, British Army

145

Anecdotal evidence suggests increasing workplace violence against healthcare workers in the Caribbean, but the prevalence is largely undocumented.

46

BackgroundPhysician health programmes (PHPs) are peer-assistance organizations that provide support to physicians struggling with addiction or with physical or mental health challenges. While the services they offer are setting new standards for recovery and care, they are not immune to public debate and criticism since some have concerns about those who are enrolled in, or have completed, such programmes and their subsequent ability to practice medicine safely.AimsTo examine whether medical malpractice claims were associated with monitoring by a PHP using a retrospective examination of administrative data.MethodsData on PHP clients who were insured by the largest malpractice carrier in the state were examined. First, a business-model analysis of malpractice risk examined relative risk ratings between programme clients and a matched physician cohort. Second, Wilcoxon analysis examined differences in annual rates of pre- and post-monitoring claims for PHP clients only.ResultsData on 818 clients was available for analysis. After monitoring, those enrolled in the programme showed a 20% lower malpractice risk than the matched cohort. Furthermore physicians' annual rate of claims were significantly lower after programme monitoring among PHP clients (P < 0.01).ConclusionsThis is the only study examining this issue to date. While there are a variety of reasons why physicians present to PHPs, this study demonstrates that treatment and monitoring is associated with a lowered risk of malpractice claims and suggests that patient care may be improved by PHP monitoring.

Concepts: Health care, Medicine, Patient, Hospital, Relative risk, Physician, Doctor-patient relationship, Medical malpractice

30

Background Work-related post-traumatic stress disorder (PTSD) is an important condition encountered by many occupational health practitioners. Aims To carry out an in-depth review of the research on occupational groups that are at particular risk of developing work-related PTSD. Methods A literature search was conducted in the databases OVID MEDLINE, OVID Embase, Ovid PsycINFO, ISI Web of Science and CSA Health and Safety Science Abstracts. Results Professionals such as police officers, firefighters and ambulance personnel often experience incidents that satisfy the stressor criterion for the PTSD diagnosis. Other professional groups such as health care professionals, train drivers, divers, journalists, sailors and employees in bank, post offices or in stores may also be subjected to work-related traumatic events. Work-related PTSD usually diminishes with time. Conclusions Mental health problems prior to the traumatic event and weak social support increase the risk of PTSD. Prevention of work-related PTSD includes a sound organizational and psychosocial work environment, systematic training of employees, social support from colleagues and managers and a proper follow-up of employees after a critical event.

Concepts: Health care, Psychological trauma, Mental disorder, Occupational health psychology, Posttraumatic stress disorder, Stress, Bibliographic databases, Occupational safety and health

28

We report the detection of high-titre anti-Histoplasma capsulatum IgM in the serum of three young adult males occupationally exposed to bat guano. Multidrug treatment with trimethoprim- sulfamethoxazole was started, followed by ciprofloxacin, clarithromycin, metamizole sodium, rifampicin/isoniazid/pyrazinamide, moxifloxacin and lastly amphotericin B and ceftriaxone. Despite treatment the condition of one patient deteriorated, and he died 23 days after exposure. The other two patients recovered after receiving similar therapy with the addition of voriconazole. They are currently being treated with itraconazole for a 1-year period.

Concepts: Patient, Amphotericin B, Bat, Antifungals, Ergosterol, Histoplasmosis, Guano, World Health Organization essential medicines

19

Understanding of doctors' attitudes towards disclosing their own mental illness has improved but assumptions are still made.

Concepts: Health care, Medicine, Health, Epidemiology, Illness, Mental disorder, Mental illness, Behavioral medicine

14

In the evolving work environment of global competition, the associations between work and home stress and psychological well-being are not well understood.

Concepts: Anxiety, Psychology, Symptoms, Force, Competitive exclusion principle

11

Background Stress and back pain are two key factors leading to sickness absence at work. Recent research indicates that yoga can be effective for reducing perceived stress, alleviating back pain, and improving psychological well-being. Aims To determine the effectiveness of a yoga-based intervention for reducing perceived stress and back pain at work. Methods Participants were recruited from a British local government authority and randomized into a yoga group who received one 50min Dru Yoga session each week for 8 weeks and a 20min DVD for home practice and a control group who received no intervention. Baseline and end-programme measurements of self-reported stress, back pain and psychological well-being were assessed with the Perceived Stress Scale, Roland Morris Disability Questionnaire and the Positive and Negative Affect Scale. Results There were 37 participants in each group. Analysis of variance and multiple linear regression showed that in comparison to the control group, the yoga group reported significant reductions in perceived stress and back pain, and a substantial improvement in psychological well-being. When compared with the control group at the end of the programme, the yoga group scores were significantly lower for perceived stress, back pain, sadness and hostility, and substantially higher for feeling self-assured, attentive and serene. Conclusions The results indicate that a workplace yoga intervention can reduce perceived stress and back pain and improve psychological well-being. Larger randomized controlled trials are needed to determine the broader efficacy of yoga for improving workplace productivity and reducing sickness absence.

Concepts: Better, Psychology, Regression analysis, Variance, Randomized controlled trial, Effectiveness, Efficacy, Emotion

9

The mental health effects of deployment vary widely, and personnel in both combat and combat support roles, including medical personnel, may be adversely affected.

Concepts: United Kingdom, Military

6

Post-traumatic stress disorder (PTSD) in the occupational context, especially following workplace robbery, is still under-investigated.

Concepts: Complex post-traumatic stress disorder, Posttraumatic stress disorder, Stress