Workers' right-to-know legislation: does it work?

Workers' right-to-know (WRTK) laws and regulations were established to empower workers to protect their health by providing them with information about the hazards to which they are exposed while at work. The present study was conducted to examine the implementation of WRTK regulations in Israel. We interviewed 552 workers and 33 safety officers from a random sample employed at 50 industrial plants. The workers' questionnaire included items on awareness and self-management of workplace hazards, and the safety officers answered questions about job experience and hazards communications to workers. In 36% of cases workers and their safety officers disagreed about the existence of hazards in the workplace (p < 0.001). Most (78%) of the workers' knowledge about work hazards was based on informal sources, i.e., not those stipulated by the regulations. There were also discrepancies between worker and safety officer reports regarding the provision of safety training upon employment (p < 0.001), recent instructions about special risks and distribution of relevant printed material. We found that more than 5% of workers were unable to read the language in which the hazards material was written and 22% had levels of education below that required to comprehend the technical terms used. There are serious problems in the implementation of WRTK regulations in Israel. We recommend that employers be made aware of the importance of these laws and of their proactive duty to comply with them and that the material distributed to workers be written in simpler terms and/or explained orally in a language they understand. These findings have important implications for all countries with similar legislation and should form the basis for further and more comprehensive studies world-wide.     

Group work in a Dutch home care organization: does it improve the quality of working life?

Home care in The Netherlands is facing a trend towards increasing workloads, giving it the image of an unattractive sector to work in. To deal with increasing workloads and their effects, many solutions have been developed, including the concept of team or group work. This paper will address the possibilities, conditions and effects involved in the implementation of group work in home care as a means of improving the quality of working life (QWL) in this sector. To this end I have studied QWL in three jobs in two organizations for home care, one of which implemented group work. This comparison concludes that jobs in the team-based organization are more complete and challenging, bringing more job decision latitude, but also higher work pressure.     

Surveillance for hepatocellular carcinoma: does it work?

BACKGROUND: The surveillance of cirrhotic patients for early detection of hepatocellular carcinoma is recommended but its efficacy is now discussed. The aim of our study was to present the results of a screening program in 110 patients. METHODS: it is a retrospective study that included 110 patients with cirrhosis in a screening program of hepatocellular carcinoma, based on the realization of abdominal ultrasound exam and the determination of alpha-fetoprotein amount every 6 months in 95 patients and every 3 months in 15 patients. RESULTS: the mean duration of the surveillance was 36 months. A hepatocellular carcinoma was diagnosed in 13 patients. Curative treatment was done in only 3 cases and consisted in a hepatic resection in 1 patient and an alcoolisation in 2 cases. Ten patients had new treatment : for 8 patients the discussed was very agressive and 2 patients had a server hepotic failure. The cost of this study was 37.500 Tunisian dinars. CONCLUSIONS: systematic screening for hepatocellular carcinoma offer a limited cost effectiveness ratio.     

Who does the work of public health?

Frequently, we take the "public" out of public health and allow the practice to become extremely narrow, limited to experts telling the public what's best for them.     

Pharmaceutical cost control in Canada: does it work?

Governments in Canada have instituted mechanisms intended to control drug prices. These include the establishment of a semi-judicial body by the federal government to control factory-gate prices and of various measures at the provincial level, such as formulary management, use of generics, reference-based pricing, price freezes, and limits on markups. To a large extent, these measures have been effective in price control. Total drug spending in the country continues to rise, however; clearly, mechanisms other than price controls will need to be developed if drug spending is to be better managed.     

The future of work environment reforms: does the concept of work environment apply within the new economy?

"Work environment," as a conceptual framework for reforming working life, may not be readily transferable from the tangible conditions of the industrial context in which it was conceived to the more flexible conditions of modern labor. Since the flexible conditions of work generally presuppose an increased responsibility and some sort of personal commitment on the part of the worker, isolating the environmental conditions from the personal abilities of the worker is becoming more difficult. As a consequence, only to a limited extent can the problems of modern labor be interpreted as work environment issues and subjected to work environment measures. With the propagation of flexible working conditions, work environment institutions and their reform ambitions will be passed by. And work environment reforms, rather than being a practical task of coordinating different protective measures at workplaces, will be reduced to an argument within the ideologically motivated rejection of an increasingly polarized labor market.     

Measles,the media,and MMR: Impact of the 2014–15 measles outbreak

ObjectiveIn late 2014, a measles outbreak beginning in California received significant media attention. To better understand the impact of this outbreak, we conducted a survey to assess and compare among vaccine hesitant and non-hesitant new mothers how this outbreak affected vaccine knowledge, attitudes, vaccination plans, and media use.MethodsA cross-sectional email survey of English-speaking women with a child ⩽1 year old using a convenience sample of women from nine obstetrics and gynecology (OB/GYN) practices in Colorado assessed vaccine hesitancy, knowledge and attitudes about MMR vaccines and the outbreak, MMR vaccination plans before and after the outbreak, and use of and trust for media sources related to the outbreak.ResultsThe response rate was 50% (351/701). Knowledge about the outbreak was high and vaccination attitudes were mostly favorable. Forty-eight percent of respondents thought MMR vaccine was more important after the outbreak. Online news (76%), television news (75%), and social media (68%) were the most frequently used media sources, yet were highly trusted by only 18%, 22%, and 1% of respondents respectively. Government websites (34%) and information from a doctor’s office (34%) were infrequently used, but were highly trusted by 62% and 60% of respondents. Knowledge of the outbreak was lower among vaccine-hesitant respondents. Few mothers changed MMR vaccination plans after the outbreak.ConclusionsNew mothers had high levels of knowledge and favorable attitudes about vaccination after the 2014–15 measles outbreak. Media sources used the most are not the most trusted. Communication about outbreaks of vaccine-preventable diseases should include spread of accurate information to new media sources and strengthening of existing trust in traditional media.     

Covering the uninsured through TennCare: does it make a difference?

Tennessee created TennCare in 1994 to address the needs of "poor and uninsured citizens ... excluded from the health care system." Under TennCare, Tennessee implemented managed care in its Medicaid program and used savings anticipated from the switch to expand insurance coverage to uninsured and uninsurable adults and children. Our analysis of the expansion suggests that it improved access to care, reduced unmet need, and encouraged use of preventive services, particularly for children. These changes coincided with higher levels of satisfaction with care among TennCare beneficiaries.     

The health of adolescent girls: does the law support it?

The law provides protection and creates many policy options that could and do support the health of adolescent girls. Current legal protection pertains to consent for care, confidentiality of information, and insurance coverage; gaps in protection and policy options also exist. The extent to which the protection and options will remain in place and the gaps will be filled is uncertain. Additional issues of current interest and debate include financing treatment for increasingly pressing health concerns, such as eating disorders, obesity, and depression; new challenges concerning statutory rape reporting and enforcement of the laws related to it; and girls' access to emergency contraception.     

Mainstream media and the social determinants of health in Canada: is it time to call it a day?

This article explores the dearth of coverage of the social determinants of health by the Canadian mainstream media. It is argued that this neglect is primarily a reflection of political and economic societal structures that has been associated with increasing corporate control of the mainstream media. Applying a critical political economy lens, it is argued that the barriers to having the Canadian mainstream media report on the social determinants of health are so numerous that it may indeed be 'time to call it a day' in regard to having them assist in the dissemination of social determinants of health findings. Recognizing this reality should spur the development of alternative means of communicating with the public in order to develop a citizens' movement to create health-promoting public policy. Recent dissemination efforts related to the Social Determinants of Health: The Canadian Facts provide an example of how this might be accomplished.