Barber-Surgeons in Military Surgery and Occupational Health in Finland, 1324-1944.

Barber-surgeons have existed as a medical profession in multiple countries for centuries. This article outlines the exciting history of the barber-surgeons in Finland, focusing on a time frame covering over 600 years, from the Middle Ages until the last barber-surgeon in Finland finished his practice during the Second World War. The barber-surgeons were the first healthcare professionals who focused on the healthcare of soldiers during times of both peace and war. They were able to treat wounds, conduct minor and even major surgeries and perform amputations. The development of the profession and the education and skills of the barber-surgeons are summed up and illuminated. New genealogical sources are also reviewed to profile the barber-surgeons as men, married and of multinational origin. This review summarizes the history of the profession, who the barber-surgeons in Finland were and where they came from. It concludes by noting that the barber-surgeons had a remarkable impact on the development of the professions of surgeons and physicians as well as on the development of occupational healthcare as a whole. However, these impacts are not sufficiently appreciated today.

Work-related diabetes distress among Finnish workers with type 1 diabetes: a national cross-sectional survey.

BACKGROUND: Diabetes distress is common among people with type 1 diabetes, but knowledge is scarce regarding the perceived burden of reconciling work with this disease. This cross-sectional study investigated work-related diabetes distress among Finnish workers with type 1 diabetes. METHODS: A questionnaire was mailed to 2500 randomly sampled 18- to 65-year-old Finns with type 1 diabetes; 49.3 % responded. Work-related diabetes distress was measured by combining worry and exhaustion in reconciling work with diabetes. Self-perceived work-related diabetes distress was evaluated in the context of physical and psychosocial work conditions, job demands, work ability, general stress, diabetes acceptance, glycosylated hemoglobin (HbA1c) level, high blood glucose maintenance at work, and depressive symptoms. The data were analyzed with the use of cross-tabulation, chi-square tests, ANOVA analysis, Spearman correlation coefficients, and structural equation modeling. RESULTS: Of the respondents, 70 % experienced work-related diabetes distress. Problems with physical work conditions (ß = 0.27), work ability (ß = -0.21), difficulty in accepting diabetes (ß = 0.18), and job demands (ß = 0.14) were found to be associated with work-related diabetes distress. This distress was strongly associated with the maintenance of a high blood glucose level at work (ß = 0.34). In turn, a high blood glucose level at work was associated with a high HbA1c level (ß = 0.29). Work-related diabetes distress and depressive symptoms had a bi-directional association (ß = 0.06 and ß = 0.14). Difficulty accepting diabetes had three-dimensional associations: work-related diabetes distress (ß = 0.18), depressive symptoms (ß = 0.13), and high HbA1c level (ß = 0.12). There was no notable association between work-related diabetes distress and general stress. CONCLUSIONS: Work-related diabetes distress is common among workers with type 1 diabetes, and it may influence metabolic control. This stress could be prevented by adapting physical work conditions. People with type 1 diabetes should also be encouraged to pursue their full educational potential, and psychological support should be provided for those with difficulty accepting their diabetes.

Interventions to reduce risky sexual behaviour for preventing HIV infection in workers in occupational settings.

BACKGROUND: The workplace provides an important avenue to prevent HIV. OBJECTIVES: To evaluate the effect of behavioral interventions for reducing HIV on high risk sexual behavior when delivered in an occupational setting. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO up until March 2011 and CINAHL, LILACS, DARE, OSH Update, and EPPI database up until October 2010. SELECTION CRITERIA: Randomised control trials (RCTs) in occupational settings or among workers at high risk for HIV that measured HIV, sexual transmitted diseases (STD), Voluntary Counseling and Testing (VCT), or risky sexual behaviour. DATA COLLECTION AND ANALYSIS: Two reviewers independently selected studies for inclusion, extracted data and assessed risk of bias. We pooled studies that were similar. MAIN RESULTS: We found 8 RCTs with 11,164 participants but one study did not provide enough data. Studies compared VCT to no VCT and education to no intervention and to alternative education.VCT uptake increased to 51% when provided at the workplace compared to a voucher for VCT (RR=14.0 (95% CI 11.8 to16.7)). After VCT, self-reported STD decreased (RR = 0.10 (95% CI 0.01 to 0.73)) but HIV incidence (RR=1.4 (95% CI 0.7 to 2.7)) and unprotected sex (RR=0.71 (0.48 to 1.06)) did not decrease significantly. .Education reduced STDs (RR = 0.68 (95%CI 0.48 to 0.96)), unprotected sex (Standardised Mean Difference (SMD)= -0.17 (95% CI -0.29 to -0.05), sex with a commercial sex worker (RR = 0.88 (95% CI 0.81 to 0.96) but not multiple sexual partners (Mean Difference (MD) = -0.22 (95% CI -0.52 to 0.08) nor use of alcohol before sex (MD = -0.01 (95% CI of -0.11 to 0.08). AUTHORS' CONCLUSIONS: Workplace interventions to prevent HIV are feasible. There is moderate quality evidence that VCT offered at the work site increases the uptake of testing. Even though this did no lower HIV-incidence, there was a decrease in self-reported sexual transmitted diseases and a decrease in risky sexual behaviour. There is low quality evidence that educational interventions decrease sexually transmitted diseases, unprotected sex and sex with commercial sex workers but not sex with multiple partners and the use of alcohol before sex.More and better randomised trials are needed directed at high risk groups such as truck drivers or workers in areas with a very high HIV prevalence such as Southern Africa. Risky sexual behaviour should be measured in a standardised way.