The Role of Information Dissemination in Sustainability of International Partnerships

Abstract

The Fogarty-supported International Training Program of the Southwest Center for Occupational and Environmental Health (SWCOEH) at the University of Texas School of Public Health was initiated in 1995, with its activities focused primarily on Latin America. Asthis program has matured, its participants have been concerned about including elements that increase the likelihood that its trainees and projects will have a sustainable impact on occupational and environmental health in collaborating countries. The Center recently reviewed the experiences of various international organizations and national development agencies with established track records involving donor-supported projects. The authors summarize factors associated with project sustainability and describe how some of them are being incorporated into the SWCOEH program. Particular mention is made of the importance of supporting an infrastructure for broad information dissemination in the language of the intended audience. An example of a project to support a peer-reviewed Spanish-language journal devoted to occupational and environmental health Salud de los Trabajadores, is presented.     

Is short-term training useful in international environmental and occupational health projects? Experience from the Balkans and Latin America.

Short courses/workshops for international training in environmental and occupational health are an important tool for supplementing longer-term training at the graduate-degree level. Considerable collective and shared experiences in short-term training have been accumulated among these 13 projects sponsored by the Fogarty International Center of the National Institutes of Health (NIH), the International Training and Research in Environmental and Occupational Health (ITREOH) program. This article presents general aspects and considerations of short-term training and highlights guidelines drawn from specific experiences with such training activities in Balkan and Latin American countries.     

International Training and Research in Central and Eastern Europe: The University of Iowa model.

In 1995, with support from the Fogarty International Center of the National Institutes of Health, The Center for International Rural and Environmental Health (CIREH) at The University of Iowa began developing the multi-level International Training and Research Program in Occupational and Environmental Health, focusing on countries in Central and Eastern Europe that were formerly under socialist control and have particular occupational and environmental health needs after decades of neglect and mismanagement. The purpose of the program is to prepare health science professionals to return to their home countries with new skills, added confidence, and leadership capabilities in public health to lead their colleagues and institutions in meeting the needs in their respective countries and establish active national and international networks and collaborations. By December 1998, 19 trainees had completed the five-month program and returned home to conduct workshops for others in their countries. Details of the program are presented.     

Environmental health services in primary care centers

Primary Health care centers supported by the Public Health Service through the Community Health Center and Migrant Health Centers programs are now required to provide environmental hazards directly related to clinical findings, but correcting community and occupational environmental problems may be pursued through appropriate agencies. State and local health departments will play key roles in the program in providing professional expertise in environmental health, assisting patients in taking corrective action, and assisting in the coordination with state, local, federal and voluntary agencies. Some primary care centers in areas of great need and limited resources will have their own environmental health professionals, but most will depend on local health departments for this specialty.     

Collaborative Research in Maquiladoras

Abstract

In 1995, with support from the Fogarty International Center of the National Institutes of Health, The Center for International Rural and Environmental Health (CIREH) at The University of Iowa began developing the multi-level International Training and Research Program in Occupational and Environmental Health, focusing on countries in Central and Eastern Europe that were formerly under socialist control and have particular occupational and environmental health needs after decades of neglect and mismanagement. The purpose of the program is to prepare health science professionals to return to their home countries with new skills, added confidence, and leadership capabilities in public health to lead their colleagues and institutions in meeting the needs in their respective countries and establish active national and international networks and collaborations. By December 1998, 19 trainees had completed the five-month program and returned home to conduct workshops for others in their countries. Details of the program are presented.     

Innovation in international training in occupational and environmental health: challenging unspoken assumptions.

The Department of Community and Preventive Medicine of the Mount Sinai School of Medicine, in collaboration with Queens College of the City University of New York, is conducting a research training program in cooperation with partner institutions in Mexico, Brazil, and Chile to assist them to develop an enhanced capacity to identify, document, and ameliorate environmental and occupational health problems of major public significance. The Fogarty International Center of the National Institutes of Health sponsors the program, which focuses on tailoring training to the host countries' needs and conditions. The program's centerpiece is the Selikoff Fellowship, which had been awarded to 15 Fellows by 1998. Each Fellow spends three one-month training periods in New York, interspersed with distance learning, and, with the help of a mentor, completes a research project in the home country. Details of the program are provided.     

第六届环境与职业医学国际学术研讨会 10月16－18日 中国苏州 征文通知

环境与人类健康息息相关。环境医学与职业医学的交叉融合,是近年来全球性的发展趋势;环境与职业医学也是卫生领域研究最为活跃的重要学科之一。     

Evaluation of a primary health care program for the poor

This paper examines the success in implementing a major program involving a partnership between public and private providers to deliver primary health care services to the poor. In 1985, the 69th Texas Legislature passed the Primary Health Care Services Act, authorizing the Texas Department of Health to contract for or directly provide primary health care services in those parts of the state that are medically underserved and have large numbers of people in poverty. This paper evaluates the potential impact of the projects with respect to access and cost. The study revealed that the basic concept of allowing local public and private providers to develop projects reflecting their community's unique needs and resources was successful. The approach lead to a wide variety of different types of projects, but the basic goals and activities of the projects are consistent with the legislation. The evaluation identified three major program areas that could be improved: (1) patient monitoring and follow-up to ensure the accessibility of the priority primary care services, (2) the need for the development of projects in other high need areas of the state, and (3) greater efficiency in service delivery.Charles E. Begley, Ph.D. is an Assistant Professor at the School of Public Health, The University of Texas Health Science Center at Houston, P.O. Box 20186, Houston, Texas 77225.Lu Ann Aday, Ph.D. is an Associate Professor at the School of Public Health, The University of Texas Health Science Center at Houston.Roy McCandless is a Faculty Associate, Center for Health Policy Studies, School of Public Health, The University of Texas Health Science Center at Houston.The research on which this paper is based was supported by the Bureau of Dental and Chronic Disease Prevention, Texas Department of Health. The authors wish to acknowledge the substantial contributions of Margaret Frank, M.H.S. and Kiyoko Parrish, M.P.H., Faculty Associates with the Center for Health Policy Studies, in the development and conduct of this research.     

Innovation in International Training in Occupational and Environmental Health: Challenging Unspoken Assumptions

Abstract

The Department of Community and Preventive Medicine of the Mount Sinai School of Medicine, in collaboration with Queens College of the City University of New York, is conducting a research training program in cooperation with partner institutions in Mexico, Brazil, and Chile to assist them to develop an enhanced capacity to identify, document, and ameliorate environmental and occupational health problems of major public significance. The Fogarty International Center of the National Institutes of Health sponsors the program, which focuses on tailoring training to the host countries' needs and conditions. The program's centerpiece is the Selikoff Fellowship, which had been awarded to 15 Fellows by 1998. Each Fellow spends three one-month training periods in New York, interspersed with distance learning, and with the help of a mentor, completes a research project in the home country. Details of the program are provided.     

The Development of a Master of Public Health Program with an Initial Focus on Urban and Immigrant Health at the State University of New York,Downstate Medical Center

The State University Downstate Medical Center initiated a Master of Public Health (MPH) degree program in July 2001 following planning efforts that began in 1995. Twelve Students entered the program in June 2002. Currently, eighty students are enrolled in the program and eighteen have graduated from it in 2004 and 2005. With an initial focus on urban and immigrant health, the program aims to train public health professionals who can assist in addressing through population-based interventions the health issues of Brooklyn’s 2,465,326 people, of whom 38.5% are immigrants to the United States. Starting with four courses in the summer 2002 semester, the program now offers twenty-four courses over the three semesters of the academic year. The program is housed in the Department of Preventive Medicine and Community Health of the College of Medicine and is part-time in nature for most students. In addition to completing required course work, students must also complete a 250-hour practicum experience in which they apply theoretical knowledge in a public health practice setting. Student practicum experiences play a vital role in linking the program to communities and serve as conduits for the initiation of further community based collaboratives. This article describes the challenges encountered in initiating an MPH program in an academic medical center, the importance of both intramural and community support to its success, and the vital role it plays in addressing the health issues of various communities. The program became a leading priority of the Strategic Plan of the Downstate Medical Center in 2000, and received the full support of Downstate’s then new president, Dr. John C. LaRosa. This prioritization and support proved essential to the rapid development of the program. The Downstate MPH program offers a concurrent degree to medical students who are able to complete both degrees in a four year period. The Alumni Fund of the College of Medicine provides each MD/MPH student with a one-time scholarship which covers a quarter of the MPH tuition. Concurrent MPH degrees are also offered for graduate students enrolled in occupational therapy, nursing, and several other health programs. The Council on Education for Public Health (CEPH) conducted an accreditation site visit of the Downstate MPH program in December 2004. On June 10, 2005, the CEPH Board accredited the program for 5 years. Pascal James Imperato, MD, MPH & TM is Distinguished Service Professor and Chair, Department of Preventive Medicine and Community Health and Director of the Master of Public Health Program, SUNY Downstate Medical Center; Judith H. LaRosa, PhD, RN is Professor of Preventive Medicine and Community Health and Deputy Director of the Master of Public Health Program, SUNY Downstate Medical Center; Leslie Schechter, MA is the Administrator for the Department of Preventive Medicine and Community Health and the Master of Public Health Program, SUNY Downstate Medical Center.     

Prioritization of occupational sentinel health events for workplace health and hazard surveillance: the Pan American Health Organization experience

Within the ongoing strategy of the Workers' Health program at the Pan American Health Organization on strengthening surveillance in the field of workers' health in the Americas (the Region), a project was conducted in July 1999 in Washington, D.C. The objectives of the project were to discuss the problems found in the surveillance of workers' health, to develop a methodology and use it to prioritize and select the top three occupational sentinel health events for incorporation into the surveillance systems in the Region, and to develop the initial protocols for establishing the surveillance systems for the three chosen occupational sentinel health events. The Pan American Health Organization invited 24 occupational health experts from the Region to participate in the project. Over an intensive 3-day period, the experts heard reports of workplace surveillance activities in the various countries in the Region; developed prioritization methods; identified and prioritized a list of occupational sentinel health events; and developed three surveillance protocols, one each for occupational fatal injuries, pesticide poisoning, and low back pain. The results on the prioritization of occupational sentinel health events and the development of surveillance protocols are reported in this article.     

Toward a National Core Course in Agricultural Medicine and Curriculum in Agricultural Safety and Health: The “Building Capacity” Consensus Process

ABSTRACT

The agricultural industry poses specific hazards and risks to its workers. Since the 1970s, the University of Iowa has been establishing programs to educate rural health care and safety professionals who in turn provide education and occupational health and safety services to farm families and farm workers. This program has been well established in the state of Iowa as a program of Iowa’s Center for Agricultural Safety and Health (I-CASH). However, the National 1989 Agriculture at Risk Report indicated there was a great need for agricultural medicine training beyond Iowa’s borders. In order to help meet this need, Building Capacity: A National Resource of Agricultural Medicine Professionals was initiated as a project of the National Institute for Occupational Safety and Health (NIOSH)-funded Great Plains Center for Agricultural Health in 2006. Before the first phase of this project, a consensus process was conducted with a group of safety and health professionals to determine topics and learning objectives for the course. Over 300 students attended and matriculated the agricultural medicine course during first phase of the project (2007–2010). Beginning the second phase of the project (2012–2016), an expanded advisory committee (38 internationally recognized health and safety professionals) was convened to review the progress of the first phase, make recommendations for revisions to the required topics and competencies, and discuss updates to the second edition of the course textbook (Agricultural Medicine: Occupational and Environmental Health for the Health Professions). A formal consensus process was held and included an online survey and also a face-to-face meeting. The group was charged with the responsibility of developing the next version of this course by establishing best practices and setting an agenda with the long-term goal of developing a national course in agricultural medicine.     

Developing regional workplace health and hazard surveillance in the Americas.

An objective of the Workers' Health Program at the Pan American Health Organization (PAHO) is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning, and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions.     

Adolescent Social Action Program: Involvement of Occupational Therapy Students in an Innovative Health Promotion Program

Health promotion is a promising but underutilized area of occupational therapy practice. In order for occupational therapy practitioners to increase their involvement in wellness and prevention programs, it is necessary for students to gain relevant fieldwork experience. This article describes the involvement of occupational therapy undergraduate students at the University of New Mexico in a health promotion program targeting youth. The program is based on an empowerment model emphasizing active learning methods and involvement of participants in all phases of the program. Specific examples of occupational therapy student projects are identified, and implications for future practice are discussed.     

某建筑工程机械生产项目职业病危害预评价

目的识别、评价、控制建设项目可能产生的职业病危害因素,防治职业病,保护劳动者健康,为卫生行政部门审批建设项目提供科学依据。方法选择与建设项目类似的工程进行类比调查,采用类比法、经验法及检查表法相结合的原则进行评价。结果该建设项目的选址与总体布局、生产设备布局、职业病防护设施设计、卫生辅助用室设置等符合国家有关规定;该项目生产过程中存在和产生的主要职业病危害因素有电焊烟尘、锰及其化合物、甲苯等漆料组成物、一氧化碳、氮氧化物、臭氧,紫外线、噪声、高频电场等。类比检测结果显示,噪声有5个点超标,合格率为78.3%,粉尘和化学毒物均符合要求。结论拟建设项目属于职业病危害严重的建设项目。在生产过程中可能产生的职业病危害是可以预防的,从职业卫生角度分析该项目是可行的。     

环境与人类和谐发展：公共卫生的重要角色——第五届环境与职业医学国际学术研讨会纪要

2010年4月7—10日,以“环境与健康——气候·城市·职业”为主题的“第五届环境与职业医学国际学术研讨会”在四川省都江堰市召开。此次国际研讨会由上海市疾病预防控制中心、上海市预防医学研究院和《环境与职业医学》杂志编委会主办,加州中国科研合作项目（美国国立卫生研究院资助）、美国疾控中心环境卫生中心、美国《环境与健康展望》杂志和四川省都江堰市卫生局合办,42位中外专家和200多名代表出席会议。与会者就“生态、气候与健康”、“城市与健康”、“职业与健康”、“暴露与评估”、“环境铅暴露与健康”等主题进行了深入交流。本次研讨会的顺利举行必将促进环境与职业医学乃至公共卫生学科的持续发展,为科技和经济发展、构建和谐社会服务。     

某汽车制造企业技改项目职业病危害控制效果评价

目的对某汽车制造企业技改项目存在的危害因素进行检测和评价,以确保建设项目正式投产后职业病危害防护设施符合国家有关标准、规范要求,从而保护劳动者健康;同时该评价报告也为卫生行政部门对该建设项目的职业卫生竣工验收提供科学的技术依据。方法通过职业卫生调查、对作业场所存在的职业病危害因素进行检测与评价。结果该项目为职业病危害严重的建设项目,职业病危害因素控制已达到预期评价效果,基本符合《工业企业设计卫生标准》GBZ 1—2002的要求。结论技改项目的机械化与自动化程度较高,通风排毒设施齐全,职业卫生管理制度执行有力,能有效控制职业病危害的发生。     

Bahia-Carolina Program in Environmental and Occupational Health: A North-South partnership for workplace and environmental justice.

The Bahia-Carolina Program in Environmental and Occupational Health is an interdisciplinary collaborative program in research and training linking the Institute for Collective Health (ISC), the Federal University of Bahia, Brazil, and the School of Public Health, University of North Carolina at Chapel Hill. An important goal of this Fogarty Center-funded project is to improve workplace and environmental conditions and the well-being of the general population, particularly those workers in the informal sector. Major accomplishments include training taking place in the United States, training in Brazil, and support of Brazilian institutions. Brazilians studying in the United States have researched occupational risk factors for non-Hodgkin's lymphoma, the effectiveness of an environmental sanitation program, the health of refinery workers, and statistical methods for multilevel analysis, among other topics. The program also emphasizes the opportunity for U.S. faculty and students to learn from Brazilian colleagues. Challenges encountered in the collaboration process are described.     

Agricultural Occupational Health Nurse Training and Certification

ABSTRACT

The 1989 report “Agriculture at Risk: A Report to the Nation'' called for more trained health professionals to meet the manpower needs for control of occupational health and safety in farming communities. This report indicated the need for 8,000 occupational health nurses in agriculture when there were few trained professionals in this area. Iowa's Center for Agricultural Safety and Health started an agricultural health nurse training program in 1987. As its nurse-directed, hospital-based network of agricultural occupational health clinic programs expanded, and as the Iowa Department of Public Health's Occupational Health Nurse in Agricultural Communities (OHNAC) program grew, a greater need developed for formalized training and certification.

In response, a national working group convened to study the feasibility, curriculum, certification, and delivery mechanisms for such a program. The planning phase produced a “Feasibility and Recommendations'' document. A future implementation phase will finalize the curriculum and offer a workshop course featuring a modular curriculum combining distance learning with localized hands-on training. Continuing education credit and certification features will be developed, with possible partial credit towards certification in the American Board of Occupational Health Nurses, and curriculum area recognition in the American Association of Occupational Health Nurses.     

Health impact assessment in relation to other forms of impact assessment

Health impact assessment (HIA) has many advocates for its use to identify and optimize the health effects of non-healthcare interventions. It is an assessment of the health effects, positive and negative, of a project, programme, or policy. Expertise developed in the United Kingdom from a realization that health impacts are often overlooked during the planning stages of development projects but prior planning can avoid detrimental effects. Considering health impacts is now recommended in all continents; the focus has moved from less to more developed countries and upstream from projects to policies. Health impact assessment shares certain concepts and methods with risk assessment, environmental impact assessment, strategic environmental assessment, social impact assessment, and economic assessments. This paper describes the development of health impact assessment and its relation to these other forms of impact assessment.