Ethnic disparities in problem behaviour in adolescence contribute to ethnic disparities in social class in adulthood

BACKGROUND: It is important for prevention of social class disparities to know how ethnic disparities in social class arise among migrant children. We contribute to this understanding by examining the role of problem behaviour in adolescence. METHODS: Prospective observational study with 753 Dutch native and 217 Turkish migrant adolescents (11-18 year) followed for 10 years. Internalising and externalising problems were assessed in adolescence and employment status and occupational level were assessed in adulthood. The difference in odds ratios (OR) before and after adjustment for internalising and externalising problems was an indication of the predictive value of disparities in internalising and externalising problems for the development of social class disparities. RESULTS: A total of 135 (62%) of the Turkish and 602 (80%) of the Dutch adults were employed. Internalising and externalising problems were not associated with employment status. Of the employed, 65 (48%) Turkish and 179 (30%) Dutch adults worked in low-level occupations (p < 0.0001). Internalising and externalising problems were associated with both ethnicity and occupation. The OR for low-level occupation for Turkish adults was 1.78 (1.19-2.65), indicating ethnic disparities. Adjustment for internalising problems lowered the OR with 36% to 1.50 (0.97-2.31), and adjustment for externalising problems lowered it with 8% to 1.72 (1.15-2.57). Findings were similar for men and women and did not vary by age. CONCLUSIONS: Ethnic disparities in occupational level in adulthood could partly be attributed to disparities in mental health between Turkish migrants and Dutch natives in adolescence. Prevention of ethnic disparities in mental health at young age may therefore also contribute to the prevention of occupational differences in adulthood.     

艾滋病病毒职业暴露与职业防护教育的探讨

目的分析艾滋病病毒职业暴露发生的原因,总结此项教育活动,讨论此项教育的意义及措施。方法回顾性分析医院2o04～2008年艾滋病职业暴露情况与职业防护教育情况。结果经过教育培训,全院医务人员对艾滋病的防范意识普遍增强,2008年全院未发生艾滋病职业暴露的案例。结论艾滋病职业防护教育培训及相应规章制度的落实,是预防和减少艾滋病病毒职业暴露的关键。     

Psychometric properties of the Assessment of Positive Occupation 15 final version in individuals with mental illness

AimsThis study was to test the reliability and validity of the Assessment of Positive Occupational 15 (APO-15) for individuals experiencing mental illness.MethodsA sample of 408 people experiencing mental illness living in communities or admitted to hospitalized was recruited. The sample has completed demographic information, the Assessment of Positive Occupation 15 (APO-15), the Japanese version of the Self-identified Stage of Recovery Part-B (SISR-B), the Japanese version of the Recovery Assessment Scale (RAS), the General Health Questionnaire 12 (GHQ-12). APO-15 is a measure of how engaged one is in occupations that promote well-being. The final version of the APO-15 was developed by assessing the validity and reliability by mainly using confirmatory factor analysis (CFA), item response theory (IRT).ResultsThis study indicated satisfactory the validity and reliability of APO-15 in a group of individuals experiencing mental illness. CFA showed acceptable values for all indices of fit, namely comparative fit index (CFI), Tucker-Lewis index (TLI) (i.e., greater than .90), and the value of root mean square error of approximation (RMSEA) was .087, which was acceptable. The IRT showed satisfactory responses for the item slope parameter (α) and item difficulty parameter (β) in APO-15.DiscussionAPO-15 was demonstrated good psychometric properties in measuring involvement in the occupation to promote well-being in individuals experiencing mental illness. In conclusion, the APO-15 is an important tool to enable occupational therapists to assess clients who are not engaged in well-being promoting occupations and thus enable them to participate in such occupations.     

Hand eczema in 45 bakers - a clinical study

The skin of bakers is heavily exposed to dough, spices, water and detergents. This is follow-up of a previous Swedish questionnaire study showing bakers to have a 3-fold increased risk of hand eczema. The aims were to establish diagnoses and to study consequences of hand eczema. From a cohort study of 2226 bakers, a random sample among bakers reporting hand eczema was examined. Of 60 randomly selected bakers reporting a history of hand eczema, 52 attended an examination comprising a standardized interview, documentation of clinical skin signs, patch testing and prick testing with standard and bakery series, and serum analyses. In all, 45 bakers confirmed a history of hand eczema, for which 11 (24%) had been on sick leave, with a median duration of 14 weeks. 13 (29%) had changed their occupation due to skin disease, 19 had positive patch test reactions to standard contact allergens - and 5 to bakery contact allergens. 16 bakers had positive prick tests to standard allergens, 10 to bakery allergens, of whom 9 reacted to flours. Since considerable medical and social consequences of hand eczema are seen, thorough diagnosis of contact allergy and IgE-mediated allergy in bakers, as well as preventive measures, are essential.     

Intensive care unit staff nurses: predicting factors for career decisions

Aims and Objectives. The aim of this study was to understand the factors related to intention to leave their job among intensive care unit (ICU) nurses in eastern Taiwan and to make between‐group comparisons between an intention to leave and an intention to stay as well as to predict the influencing factors that affect ICU staff nurses’ intention to leave. Background. Nurses’ intention to leave their job may have an important impact on the actual turnover of nurses. The issue has always been of concern to nursing executives. Only limited empirical studies in the area have been investigated in an Asian culture context and particularly the eastern Taiwan region. Methods. A cross‐sectional predictive study was performed during 2005 with 130 nurses recruited from two ICUs at a medical centre. A researcher‐designed questionnaire based on the Cooper's model with structured interviews was used to determine each nurse's characteristics and their intention to leave their job. Multiple logistic regression analysis was employed to investigate the various factors associated with this. Results. The overall response rate was 100%; 63 (48·9%) revealed that they intended to leave their jobs. The findings were that their self‐rated health status, the number of diseases, the level of happiness, the presence of depression, job satisfaction, sleep quality, type of license and their unit were significantly associated with an intention to leave (p = 0·05–0·001). Depression and sleep quality proved to be the most significant predictors of ICU staff nurses’ intention to leave their job. Conclusions. The findings suggest that there is a need to take steps to improve nurses’ health‐related quality of life and to develop effective strategies to improve nurse retention. Relevance to clinical practice. A succinct validated instrument would help identify the important factors that predict ICU nurses’ intention to leave their job, which may result in job disengagement. Predictors found in this study may be used as outcome variables for developing such an effective method of improving nurse retention in ICUs.     

The Power of the Social Environment in Motivating Persons with Dementia to Engage in Occupation: Qualitative Findings

ABSTRACT

A key element in persons with dementia's occupational engagement is the degree to which the social environment supports participation. This article summarizes the results of a qualitative study of eight assisted living facility residents, that explored volition in persons with moderate dementia. Extensive interviewing and observation were followed by the primary researcher's engagement and documentation of each resident in therapeutic activity sessions. Data were analyzed using van Manen's phenomenological approach, and three themes emerged. One, potency of the social environment, is the focus of this article. From the eight participants, two case studies are presented, one demonstrating the positive impact of therapeutic communication and social support on volitional behavior and occupational engagement and the other demonstrating the inhibiting effect of lack of therapeutic social interaction. Each case is analyzed using Epp's (2003, Person-centred dementia care: A vision to be refined. The Canadian Alzheimer's Disease Review, 14–18) Person-Centered Care model techniques and interaction modes recommended by Taylor's (2008, The intentional relationship: Occupational therapy and use of self. Philadelphia: F.A. Davis.) Intentional Relationship Model. The article concludes with recommendations for promoting positive social interactions at the client, staff/family, and systems levels.     

Withdrawal statement

Abstract

Occupational stress is a cause of considerable morbidity, but research on work stressors has comparatively neglected the moderating effects of gender, age, ethnicity, and occupation. A workforce of 5,467 European, Maori, Pacific Islander, and Asian employees, 40 years old or older, working for 41 companies, completed a questionnaire giving details of total stressors and subcategories of stressors. Relative risks were estimated using numbers above and below median scores. There were significant associations between increased stressors and the following [with category showing highest relative risk, and corresponding relative risk (95% confidence interval)]: male gender (job scope, 1.50(1.37, 1.63)]; young age [rapport with management, 1.34(11.23, 1.46)]; administrative group (job pressure, 1.85 (1.69,2.03)]; and a negative association with Pacific Islander ethnicity [rapport with management, 0.59(0.52, 0.66)]. These findings indicate areas in a workforce to which stress-reduction interventions can be directed.     

A Psychometric Study of the Chinese Version of the Assessment of Communication and Interaction Skills

This study examined the dependability of the Assessment of Communication and Interaction Skills—Chinese version (ACIS-C) with psychiatric participants in Taiwan. A convenience sample of 101 participants diagnosed with psychiatric illness were recruited from four day-care wards in northern and eastern Taiwan. The results of the Rasch analysis showed that the ACIS-C items coalesced to form a measure of communication/interaction and the 4-point rating scale functioned as intended. The ACIS-C differentiated participants into six levels of communication and interaction skills. The findings support the conclusion that the ACIS-C is a valid and sensitive tool when used with Chinese clients. Moreover the study supports the generalizability of the Model of Human Occupation concept of communication and interaction skills to an Eastern context.