The associations between occupational health and safety management system programming level and prior injury and illness rates in the U.S. dairy industry.

U.S. dairy workers suffer occupational injuries and illnesses at rates higher than the national average. Occupational health and safety management systems (OHSMS) have been proposed as a way to reduce injuries and illnesses for businesses of all types and sizes. The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing an OHSMS to U.S. businesses. As part of this service, the consultants determine the level of OHSMS programming using the Safety and Health Program Assessment Worksheet (Revised OSHA Form 33). A total of 167 dairy industry records were obtained from OSHA. Forty-five of those records had both injury rate and OHSMS data. Using these records, a Spearman Rank-Order correlation was used to determine the strength and significance of the associations between prior injury rates and OSHA measured OHSMS programming level for dairy operations. Additional analyses were conducted to examine potential relationships between workforce size, injury rates, and OHSMS programming levels. There was a negative correlation between OHSMS programming level and injury rates, both for the overall OHSMS and by OHSMS component. Management Leadership was the OHSMS component most strongly associated with lower injury and illness rates. OHSMS interventions, as part of a comprehensive risk management approach for the U.S. dairy industry, may be warranted to help reduce the unacceptable number of injury and illnesses in the U.S. dairy industry. Further research is needed to determine if similar relationships between OHSMS programming and injury rates occur in other industries.

Development and Validity Testing of the School Health Score Card.

BACKGROUND: The objective of this study was to develop the School Health Score Card (SHSC) and validate its psychometric properties. METHODS: The development of the SHSC questionnaire included 3 phases: item generation, construction of domains and items, and field testing with validation. To assess the instrument's reliability and validity, we recruited 15 middle schools and 15 high schools in the Republic of Korea. RESULTS: We developed the SHSC questionnaire of 158 items categorized into 5 domains: (1) Governance and Infrastructure, (2) Need Assessment, (3) Planning, (4) Health Prevention and Promotion Program, and (5) Monitoring and Feedback. All SHSC domains and subdomains demonstrated acceptable reliability with good internal consistency. Each domain and subdomain except for "Planning" was associated significantly with students' health status. Most subdomains, including school health philosophy, school policy, communication, the evaluation system, and monitoring, were significantly and negatively associated with student absence. CONCLUSIONS: The SHSC shows significant association with the overall student health and can be useful in assessing comprehensive school health programs.

Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

Gestão e processos de trabalho nos Centros de Testagem e Aconselhamento de Porto Alegre-RS na perspectiva de seus aconselhadores / Management and work processes in Voluntary Counseling and Testing Services in Porto Alegre city, Brazil, in the perspective of their counselors

O estudo objetivou avaliar o trabalho nos Centros de Testagem e Aconselhamento (CTAs) do município de Porto Alegre-RS na perspectiva de seus aconselhadores. Tratou-se de pesquisa qualitativa envolvendo a realização de seis grupos focais com 13 aconselhadoras dos três CTAs do município. Os relatos foram submetidos à análise de conteúdo qualitativa, resultando na categoria temática central Conjugações entre gestão e processos de trabalho nos CTAs. Na visão das aconselhadoras, os serviços são essenciais para o diagnóstico e a prevenção em HIV/Aids e contribuem muito para a efetivação dos atendimentos nessa área. Contudo, os serviços estariam vivendo uma crise quanto ao seu papel, em função da expansão do aconselhamento e da testagem anti-HIV para a rede básica de saúde. Essas mudanças trouxeram angústias e incertezas, principalmente pela falta de diálogo com as esferas gestoras e pela ausência de diretrizes claras para o trabalho no contexto das novas políticas nacionais. Os achados também evidenciaram a preocupação com a qualidade e a forma como o aconselhamento será realizado na Atenção Básica, bem como a necessidade de mais profissionais para o atendimento em HIV/Aids e de consultas com especialidades médicas. Acredita-se que estratégias de gestão participativa poderiam contribuir no redirecionamento da atuação dos CTAs, fortalecendo o matriciamento da testagem e do aconselhamento em HIV e reforçando os CTAs na atenção de maior complexidade e como formadores de recursos humanos na área.

This qualitative study aimed to assess the work in Voluntary Counseling and Testing Services (VCT) in Porto Alegre, Brazil in the perspective of their counselors. It was conducted six focus groups with 13 counselors from the three VCT services in the city. Qualitative content analysis of the reports resulted in a central theme named Joining management and work processes in the VCT services. Counselors have emphasized that services are essential for HIV/AIDS diagnosis and prevention, and contributed significantly to effective healthcare. However, VCT services were facing a crisis regarding its role in the healthcare system since counseling and HIV testing activities were being extended as a responsibility of primary health care. These changes have brought anxiety and uncertainness among counselors, especially because the poor relationships with management levels and the lack of clear guidelines in the new policy context. Findings also pointed out counselors' concerns about the quality of counseling offered in the primary health care services, the lack of professionals to HIV/AIDS healthcare and the lack of medical specialist appointments. We endorsed that participatory management strategies could help to redirect VCT services activities, strength the matrix support testing and counseling for HIV and value these services as specialized healthcare providers and human resources reference for training in the area.