A Concise Occupational Mental Health Screening Tool for South African Workplaces.

Mental health in the workplace is becoming of ever greater importance. General occupational health surveillance programmes are already in widespread use, with established referral systems for treatment and rehabilitation, and the same mechanisms could be expanded to include mental health screening and intervention. This study aimed to develop a concise composite mental health screening tool, based on analysis of existing data, for application in routine occupational health surveillance in South Africa. Data from workplace occupational health surveillance programs from 2,303 participants were analysed. Participants completed a number of questions/scaled items collated into a survey format, and partook in an interview with a psychologist. The data was analysed using frequency of positive self-reports, Chi square to calculate associations with outcomes, Receiver Operator Characteristic curve analysis to explore predictive ability, and binomial logistic regression to calculate the relative contribution of markers to outcomes. An exploratory factor analysis was further conducted on identified items. A general workplace model with 14 markers (and a maritime workplace model with 17 markers) were identified. The factor analysis suggested their organisation into five domains (similar for both models), namely neurocognitive health, common mental disorders, history of adaptation in occupational specific contexts, family-work interface, and stress overload. The study's data-driven approach proposed a concise composite screener with less than 50 items, comprising five domains. This tool appears useful in identifying employees at risk for workplace injuries or poor mental health outcomes, and could be applied to related workplace settings in South Africa.

Associations Between Adverse Underwater Events and ADHD Diagnosis Among Military Divers.

Objective: Adult ADHD (A-ADHD) has been associated with an increased risk of accidents and workplace injuries. ADHD within professional diving may have major potential occupational health and safety implications, as accidents underwater may have severe consequences. The study investigated any association of increased risk for adverse underwater incidents with an ADHD diagnosis. Method: This analysis used retrospective records from 156 navy divers and computed an odds ratio using cases of ADHD and cases of underwater accidents. Results: Although the odds ratio was increased, it failed to reach significance. Conclusion: We do not yet have statistical evidence suggesting that the risk for adverse underwater events is significantly increased among the ADHD group in this sample of navy divers. Sufficiently powered studies are required to further address the potential risk of A-ADHD in working divers.

Post-exposure prophylaxis protocol for exposure to blood-borne pathogens: an intervention to improve knowledge and practice among medical students in a South African hospital

Background:Globally, approximately three million healthcare workers experience a percutaneous injury each year. Medical students are at a particularly high risk of exposure to blood-borne pathogens. Despite this, the rate of non-reporting is still high. Objectives: The objectives of this study were to describe and improve the knowledge and practice of the post-exposure prophylaxis (PEP) protocol among medical students, through the implementation of quality-improvement interventions, with a view to improving the protocol. Methods: This was an intervention study conducted among third- to fifth-year students, in 2015 and 2016. The quality-improvement interventions took place over 11 months and included the issuing of laminated protocols, posters and lectures. Data from survey questionnaires were used to quantify the impact of these interventions. Student practice was measured by the number of correct steps of the protocol completed. McNemar and Wilcoxon signed-rank tests were used to test differences in the paired categorical data. Results: Of approximately 750 students who participated in the study intervention, 407 returned the initial questionnaire and 148 returned the post-intervention survey questionnaire. Eighty-six students (21.1%) completed both questionnaires. The blood-borne pathogen exposure rate prior to the intervention period was 28.0%. In the paired group, reporting of exposures increased from 12.2% in 2015 to 31.3% in 2016. Knowledge of the PEP protocol increased significantly in the paired group, from 17.4% to 40.2% (p < 0.001). Prior to the intervention, 91.7% completed fewer than half of the steps of the PEP protocol. This decreased significantly to 69.4% in the paired group, post-intervention (p = 0.03). Conclusion: Practice of the PEP protocol significantly improved after the intervention was implemented. In addition, there was a significant improvement in the knowledge of students about postexposure management. However, many exposures were still unreported post-intervention, indicating that more work is needed to improve reporting behaviour

Effect of a Faith-Based Education Program on Self-Assessed Physical, Mental and Spiritual (Religious) Health Parameters.

The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire's (SAQ's) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI). Pre-attendance SAQ (S1) was repeated immediately post-FBEP (S2), at 30 days (S3), 90 days (S4) and after 1 year (S5). Of 655 invited, 274 (42 %) succeeded, 242 (37 %) failed and 139 (21 %) declined to complete S1. Of the 274, 37 (14 %) were excluded at on-site interview; 26 (9 %) never attended the FBEP (i.e., controls: 5♂; 21♀; 27-76 years); and 211 (77 %) participated (i.e., cases: 105♂; 106♀; 18-84 years) and were analyzed over time: 211 (S1); 192 (S2); 99 (S3); 52 (S4); 51 (S5). IRB approval was via the Human Research Ethics Committee of Stellenbosch University. DUREL showed significant, sustained changes in Intrinsic Religiosity. N-RCOPE showed significant, lasting improvement. In others, median values dropped significantly immediately after the FBEP (S1:S2) for STAI-State p < 0.0001; PSS p < 0.0001; BIPQ p < 0.0001; and CES-D p < 0.0001; and at 1 month (S1:S3) for STAI-Trait p < 0.001; all changes were sustained (S3 through S5). This FBEP produced statistically and clinically significant changes; these lasted in those followed up >1 year.

Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings.

BACKGROUND: Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. AIM: To evaluate the biological contamination of routinely cleaned mattresses in both high- and low-resource settings. METHODS: In this two-stage observational study, routine manual bed cleaning was evaluated at two university hospitals using adenosine triphosphate (ATP). Standardized training of cleaning personnel was achieved in both high- and low-resource settings. Qualitative analysis of the cleaning process was performed to identify predictors of cleaning outcome in low-resource settings. FINDINGS: Mattresses in low-resource settings were highly contaminated prior to cleaning. Cleaning significantly reduced biological contamination of mattresses in low-resource settings (P < 0.0001). After training, the contamination observed after cleaning in both the high- and low-resource settings seemed comparable. Cleaning with appropriate type of cleaning materials reduced the contamination of mattresses adequately. Predictors for mattresses that remained contaminated in a low-resource setting included: type of product used, type of ward, training, and the level of contamination prior to cleaning. CONCLUSION: In low-resource settings mattresses were highly contaminated as noted by ATP levels. Routine manual cleaning by trained staff can be as effective in a low-resource setting as in a high-resource setting. We recommend a multi-modal cleaning strategy that consists of training of domestic services staff, availability of adequate time to clean beds between patients, and application of the correct type of cleaning products.

International HIV Dementia Scale: Screening for HIV-Associated Neurocognitive Disorders in Occupational Settings

This study investigated whether the International HIV Dementia Scale (IHDS) can be used to screen for milder forms of HIV-associated neurocognitive disorder (HAND) in occupational health settings. It explored first; the effect of demographic variables on IHDS performance in a sample of HIV-negative employees and second; the extent to which the IHDS can differentiate between milder forms of HAND in HIV-infected employees. Data from 476 HIV-negativeand 90 HIV-positive individuals indicated that; although clinicians need to be sensitive to the effect of education and test-language proficiency; separate norms based on socio-demographic variables are not required in this context; and that the IHDS shows promise for identifying milder forms of HAND in this HIV-positive sample; with ?10 the recommended cut-off for further referral. In conclusion; there is support for the IHDS to screen for HAND where this may impact on safety-critical tasks in the workplace

Subjective Narcosis Assessment Scale: measuring the subjective experience of nitrogen narcosis.

BACKGROUND: The interaction of subjective experiences and objective measures of neuropsychological performance during hyperbaric exposure has received less attention in the literature, in part due to the shortage of available and appropriately standardized measures. OBJECTIVE: This study aimed to describe the psychometric properties of a modified version of the Subjective High Assessment Scale when used in the hyperbaric context, by exploring internal reliability, factor structure, associations with psychological variables and simple cognitive delayed recall, and the effect of task focus on the recall of subjective experience. METHOD: Seventy qualified divers completed dry hyperbaric chamber dives to 607.95 kPa, and completed ratings of their subjective experiences. Some also completed a delayed recall task and psychological measures prior to their dives. RESULTS: The scale displayed good internal consistency, with four meaningful factors emerging. It showed some significant but small associations with trait anxiety and transient mood states, and a small to moderate correlation with recall performance. There was no significant effect of task focus on self-report of subjective experiences. CONCLUSION: The modified scale, renamed the Subjective Narcosis Assessment Scale here, has useful psychometric properties, and promising potential for future use.

Nitrogen narcosis and tactile shape memory in low visibility.

OBJECTIVE: Commercial diving often occurs in low visibility, where divers are reliant on their tactile senses. This study examined the effect of nitrogen narcosis on tactile memory for shapes as well as the influence of psychological and biographical factors on this relationship. METHOD: This crossover study tested 139 commercial divers in a dry hyperbaric chamber at 101.325 and 607.95 kPa (1 and 6 atmospheres absolute/atm abs). Divers memorized shapes while blindfolded, using their tactile senses only. Delayed recall was measured at the surface after each dive. Psychological and biographical data were also collected. RESULTS: A significant effect of hyperbaric pressure on tactile memory was demonstrated, and a further effect of sequence of testing found. Thus, divers' delayed shape recall deteriorated by 8% after learning material at depth, compared to learning on the surface. There were also significant but small effects of psychological and biographical markers on tactile memory performance, with lower trait anxiety associated with better recall, and lower education associated with poorer recall. CONCLUSION: The findings emphasize the importance of utilizing other forms of recording of events or objects at depth, particularly in conditions of low visibility during deeper diving, to aid memory encoding and subsequent recall at the surface.