for the seminar 3

HEALTH

(1)Institute of Sanitary Engineering and Water Pollution Control, University of Natural Resources and Applied Life Sciences Vienna, Muthgasse 18, 1190 Vienna, Austria

Received: 3 December 2008 Accepted: 14 December 2008 Published online: 1 April 2009

Responsible editor: Walter Gige

(2)Armodafinil for Treatment of Excessive Sleepiness Associated With Shift Work Disorder: A Randomized Controlled Study

Charles A. Czeisler,

James K. Walsh,

Keith A. Wesnes,

Sanjay Arora,

andThomas Roth

Mayo Clin Proc. November 2009 84(11):958-972; doi:10.4065/84.11.958

(3)GENDER ISSUES IN HEALTH CARE

Women's perception of intrapartal care in relation to WHO recommendations

Ann-Kristin Sandin-Bojö, Bodil Wilde Larsson and Marie-Louise Hall-Lord

Authors: Ann-Kristin Sandin-Bojö, PhD, RNT, RM, Senior Lecturer, Department of Nursing, Karlstad University, Karlstad, Sweden; Bodil Wilde Larsson, PhD, RNT, Professor, Department of Nursing, Karlstad University, Karlstad, Sweden; Marie-Louise Hall-Lord, PhD, RNT, Professor, Department of Nursing, Gjovik University College, Gjovik, Norway and Associate Professor, Department of Nursing, Karlstad University, Karlstad, Sweden

Correspondence to Ann-Kristin Sandin-Bojö, Department of Nursing, Karlstad University, S-651 88 Karlstad, Sweden. Telephone: 00 467 002 492.
E-mail: fia.bojo@kau.se

KEYWORDS

birth • intrapartal care • midwifery • nurses • nursing • women

ABSTRACT

Background. The aim of intrapartal care in normal birth is to achieve a healthy mother and child using the least possible number of interventions that is compatible with safety.

Aim. The aims of this study were to elucidate women's perception of intrapartal care and women's perceptions of normal birth.

Methods. A questionnaire developed from the WHO's recommendations for care in normal birth was answered by 138 (response rate 66·0% Swedish women. The women were asked to evaluate items in two ways: their perceived reality of care received and the subjective importance of each item.

Results. Most women reported receiving care in the category (A) practices that are good and should be encouraged. However, women to a minor degree reported assessment for physical health, enquiring about support needs and pain assessment on admission. Many women received electronic foetal monitoring, repeated vaginal examinations, oxytocin augmentation and suturing after birth which fall under the category (B) practices that are harmful, (C) insufficient evidence exists and (D) practices frequently used inappropriately. The women who reported 'Yes' for perceived reality also reported high subjective importance for those items regardless of category A–D. Eighty-four per cent of the women perceived that they had a normal delivery.

Conclusion. The result suggests that women have great trust that the care midwives give them is the best care. Midwives, therefore, have an ethical responsibility to keep themselves informed about the best evidence-based care and to implement critical reviewing of their practice as part of continuing professional development. The women's perceptions of a normal birth allows for a wide range of interventions.

Relevance for clinical practice. The result emphasises the importance of midwives' knowledge of evidence-based care and how to implement this into practice. Further research should include elucidation of the meaning of normal childbirth to childbearing women.

(4)A comparison of mental health legislation from diverse Commonwealth jurisdictions

[Sponsored Article]

E.C. Fistein^{a, ,} , A.J. Holland^a, I.C.H. Clare^a and M.J. Gunn^b

^aCambridge Intellectual and Developmental Disabilities Research Group, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 8AH, UK

^bDepartment of Law, University of Derby, Kedleston Road, Derby, DE22 1GB, UK

Available online 19 March 2009.

Abstract

Introduction

In the regulation of involuntary treatment, a balance must be found between duties of care and protection and the right to self-determination. Despite its shared common roots, the mental health legislation of Commonwealth countries approaches this balance in different ways. When reform is planned, lessons can be learned from the experiences of other countries.

Method

Criteria for involuntary treatment used in a sample of 32 Commonwealth Mental Health Acts were compared using a framework developed from standards derived from the Universal Declaration of Human Rights. Reasons for non-compliance were considered and examples of good practice were noted. Changes in the criteria used over time and across areas with differing levels of economic development were analysed.

Results

1. Widespread deviation from standards was demonstrated, suggesting that some current legislation may be inadequate for the protection of the human rights of people with mental disorders. 2. Current trends in Commonwealth mental health law reform include a move towards broad diagnostic criteria, use of capacity and treatability tests, treatment in the interests of health rather than safety, and regular reviews of treatment orders. Nevertheless, there are some striking exceptions.

Discussion

Explanations for deviation from the standards include differing value perspectives underpinning approaches to balancing conflicting principles, failure to keep pace with changing attitudes to mental disorder, and variations in the resources available for providing treatment and undertaking law reform. Current good practice provides examples of ways of dealing with some of these difficulties.

Keywords: Involuntary treatment; Autonomy; Human rights; Legislation

(5)Spreading good ideas: A case study of the adoption of an innovation in the construction sector

Desre Kramer^{a, b, ,} , Philip Bigelow^{a, b}, Peter Vi^c, Enzo Garritano^c, Niki Carlan^d and Richard Wells^{a, b}

^aCentre of Research Expertise for the Prevention of Musculoskeletal Disorders, Department of Kinesiology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada

^bInstitute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada

^cConstruction Safety Association of Ontario, 21 Voyager Court South, Etobicoke, ON, M9W 5M7, Canada

^dDepartment of Sociology and Anthropology University of Windsor, 401 Sunset Ave., Windsor ON, N9B 3P4, Canada

Received 20 September 2007;

accepted 2 September 2008.

Available online 6 November 2008.

Abstract

A health and safety association collaborated with two research centres to examine the dissemination of knowledge of an ergonomic intervention by opinion leaders in the construction sector. The intervention was a hydraulic ladder lift that aided with loading and unloading of ladders off van roofs. Thirteen companies, with five to 900 employees, were involved. The van operators informed workmates not employed by their companies but who worked on the same site as them about the intervention. The opinion leaders informed decision makers within their companies which led to commitments to purchase similar units. They also gave presentations at prearranged health and safety meetings, where attendees indicated that they thought the intervention sounded like a good idea. In this way, knowledge of the innovation reached at least 32 more companies and potentially several thousand other employees. The study showed the potential for workplace change to be exponential.

Keywords: Diffusion of innovations; Prevention of musculoskeletal disorders; Workplace intervention research; Construction sector