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Psychiatry/Psychology
Historical Perspective on Medical Marijuana The Chinese Emperor Shen Nung, in 2737 B.C., described the therapeutic use of marijuana for joint pain, constipation, malaria, and childbirth. Therapeutic and religious use achieved great popularity in India around 1000 B.C. Medicinal use of marijuana continued, and spread to Africa, the Middle East, and the Arabian Peninsula into the 18th century. Marijuana was introduced into western medicine by a physician, W.B. O'shaughnessy who, in 1839, described its use for pain control, muscle relaxation, appetite stimulation, and as a treatment for nausea, and for seizures. The psychiatrist Moreau, in 1845, published an article describing the use of marijuana in his patients. In 1850, marijuana was added to the U.S. Pharmacopoeia. Information regarding medical uses of marijuana disseminated throughout North America and Europe. By 1900, more than 100 scientific articles had been published on medical marijuana. Marijuana extracts were being marketed by prominent pharmaceutical companies. Use of marijuana declined in the U.S. from 1900 through the 1930s due to difficulty in standardizing preparations, development of alternative "mainstream" pharmaceuticals, and taxation by the Federal Marijuana Tax Act of 1937. By the 1930s, there were at least 2000 medicines, with over 280 manufacturers. Marijuana was removed from the U.S. Pharmacopoeia in 1942. In 1970, The Controlled Substances Act classified marijuana as a "Schedule 1" drug, in the same category as heroin.1 Mechanism of Action of Marijuana Marijuana is a synonym (slang) for cannabis, which is derived from the marijuana plant, Cannabis sativa. The primary active constituents in the marijuana plant are Delta9- tetrahydrocannabinol (THC) and Cannabidiol (CBD).2 The human body has a receptor-signaling system for marijuana known as the Endogenous Cannabinoid System (ECS). The ECS has two types of receptors that activate very different bodily functions: CB1 receptors are very abundant in the brain, and solely mediate the behavioral, analgesic, and euphoric effects of marijuana (THC) (e.g., memory, cognition, perception, and pain). CB2 receptors are not very abundant in the brain, but are highly expressed in the gut and immune cells where they regulate inflammation and immune function. Cannabidiol (CBD) activates these receptors (e.g., anti-inflammatory, antiseizure, anti-nausea, and anti-anxiety).
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- Health & Medicine > Therapeutic Area > Neurology (1.00)
- Health & Medicine > Therapeutic Area > Infections and Infectious Diseases (1.00)
- (3 more...)
Labeling is Easy: Dig Deeper to Change Behavior It's quite easy to give ourselves a label, isn't it? We look at our behavior, and we look at how it affects others, and we give ourselves a label. I live up in the mountains of North Carolina and drive back roads all the time. Last summer I was driving in a city, was looking around at the unfamiliar surroundings, and drove right under the traffic light into an intersection. Just in case I wasn't aware of my error, a guy in a big Bronco SUV blasted his horn and pulled beside me staring angrily. I looked at him and pointed to my head and mouthed "Stupid". He seemed to agree and the confrontation was over. I had interpreted my own behavior with a label, "Stupid", and that simple adjective seemed appropriate. In fact, labeling is quite popular in modern business where management training often involves some personality test like the MBTI where we learn everyone's label in hopes of better collaboration. "I'm an Introvert which explains my discomfort working in big teams." "I'm a Judger which explains why I'm so critical." Somehow these labels seem to be the magic elixir that make business work better. But they don't. Everyone goes back to the same environment and acts the same way, nothing changes. We overuse labels when dealing with the safety of our work crews and managers. The implication is: if workers can't follow rules and procedures that are clearly in the manuals and training, and then they get hurt, they're "Stupid", "Noncompliant", or "Lazy" or "___________" (you can fill in the blank - please keep it rated "PG"). The problem is that you can't fix a label. All the exhortations in the world emphasizing "Don't BE this" won't work. But we do that in our training, in our incident investigation summaries shared with workers, and in our personal conversations. But nothing changes. And you get frustrated. You can't fix it. You're left with nothing, except getting more and more upset. Instead, consider what behavioral science tells us. Instead of asking a person to BE something, focus on how you can help them DO what is required to be safe. Don't pretend and try to change someone. Leave that arrogance behind. Instead, be a servant.
- Education (0.93)
- Transportation > Ground > Road (0.86)
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (0.69)
- Health & Medicine > Therapeutic Area > Neurology (0.68)
Introduction The declining health status of today's workforce has decreased the predictive value of risk assessment practices in Occupational Health and Safety (OHS), and has contributed to an emerging issue threatening workforce safety. Common risk assessment practices used across industries do not consider today's escalation in debilitating medical conditions among workers and the resulting increase in likelihood and severity of injury for the general workforce population. This paper will serve to expand the OHS professional's knowledge base regarding workforce health and raise awareness of this issue. Risk assessment is an essential component of any comprehensive safety and health program. This practice has been effective in reducing the likelihood of injury, illness or accident before such an adverse event is experienced. This fundamental practice has contributed to the standardization of safety practices through attempting to address the multitude of factors contributing to potential injury, illness or accident. Although necessary and utilized widely, the process of identification of potential harm to workers through risk assessment practices is losing effectiveness. This is a bold statement; however, we must acknowledge there is a glaring omission across the most commonly used risk assessment practices today: the underlying health status of the worker. A critical contributor, underlying health, is not considered in any of the commonly used risk assessment practices and therefore the physical and mental condition of the worker is assumed a constant in risk prediction. Yet this single unaccounted for factor is quite varied across individuals and one of the largest contributors to injury, illness and accident in the workplace. Underlying Health as a Deterrent to Workforce Safety and Productivity Health risk factors are physiological conditions or lifestyle habits, such as hypertension or smoking, which can negatively impact physical or cognitive functioning. Underlying health risk factors are associated with the increased incidence of declining health and the onset of diseases such as diabetes, heart disease or mental health issues. These health risk factors and diseases have an impact on basic human function such as potential decreased cognitive function or declining physical capacity. As a result underlying health and the presence of health risk factors are major determinants of both performance at work, and the likelihood and severity of workplace injury and illness.
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- Health & Medicine > Consumer Health (1.00)
- Health & Medicine > Therapeutic Area > Cardiology/Vascular Diseases (0.87)
- (2 more...)
Introduction The workforce is a complex organism that presents multiple challenges for environment, health and safety (EH&S) professionals. The need to determine whether an applicant or employee is physically and mentally fit for work is a common confounder. While this responsibility often falls outside their comfort zone, it is possible for EH&S professionals who lack medical training to confidently engage the fitness-for-work assessment process. This paper provides guidance based on best clinical practices and more than three decades of experience in injury prevention and management. It is divided into four sections:Quantifying the value of fitness-for-work assessments. Implementing the assessment process. Complying with applicable rules and regulations. Adopting a comprehensive policy. Quantifying the Value of Fitness-for-Work Assessments A growing number of employers consider fitness-for-work (FFW) assessments an essential contributor to their organization's comprehensive environment, health and safety (EH&S), sustainability and risk management efforts. The inherent value of an objective assessment becomes even more apparent when one considers workforce characteristics that increase injury risk and are largely out of the control of managers. Such factors include aging, comorbid conditions, poor sleep habits and fatigue, smoking, depression and substance abuse. Definition A FFW assessment is a medical examination designed to assess whether an employee or job applicant has the physical, mental and emotional capacity to perform assigned tasks in a competent manner – and in a way that does not unreasonably threaten safety, health or property.
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- Health & Medicine > Health Care Providers & Services (1.00)
- Health & Medicine > Consumer Health (1.00)
- (4 more...)
- Health, Safety, Environment & Sustainability > Health > Ergonomics (0.48)
- Health, Safety, Environment & Sustainability > HSSE & Social Responsibility Management > HSSE reporting (0.47)
- Health, Safety, Environment & Sustainability > Health > Noise, chemicals, and other workplace hazards (0.46)
- Health, Safety, Environment & Sustainability > Safety > Human factors (engineering and behavioral aspects) (0.34)
Introduction When organizations think of "fit for duty", they often think of drug and alcohol impairment. But what about fatigue impairment? Physical impairment? Psychological impairment? And what about the flip side… fit for worker? The purpose of this paper is to introduce how technology and metrics, combined with human factors, is redefining the Fit for Duty landscape. Why Do We Test? Perhaps the most important question to ask is this; why do we need to test for fitness at all? Looking back at the industrial revolution, it used to be that someone would create a job and hire someone else to do it. It was pretty cut and dry. You show up at a given time, leave at a given time, and in between, do whatever was asked of you. Occasionally workers would get hurt. Occasionally workers would get fired with no explanation. If you showed up with alcohol on your breath, it was at the discretion of the company to let you work that day. Or ever again. Today, we have an obligation to determine if a worker is fit for duty. We have to consider the impact on the health and safety of the worker themselves and those of their co-workers. We may even have to consider the health and safety of society at large. Now, work is much more structured and regulated. Employees are required to perform to work standards and they have an obligation to present themselves in a fit state at the start of their shift and throughout the work period. Basically, we design a job and then screen people to fit that job. Defining "FIT" Part of the challenge is that different industries and even different disciplines are using the term "fit for duty" with different meanings and in different contexts. In most cases, fit has been subjectively defined, making it a challenge for HR departments and OHS professionals to manage. How do we find common medical and legal ground?
- Transportation > Ground > Road (1.00)
- Law (1.00)
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- (3 more...)
Introduction Sleep deprivation, health risks and chronic conditions are often managed reactively due to on-the-job injury, errors and poor performance. These comorbidities are a common cause of claims (medical, workers compensation, disability, etc.) and when well-managed can control costs. Sleep is a fundamental homeostatic biological process, which effectively means one MUST sleep in order to live. The normal human and quite frankly all animals have a circadian rhythm which in the human means we are programmed to have sleep/wake stability. This results in an awake state during daylight and sleep at night. Without adequate quantity, quality and continuity of sleep, there is impairment which includes alteration in executive cognitive function, sleepiness, fatigue, mood changes, and metabolic, endocrine, cardiovascular and immune abnormality. Some of the cognitive changes include inattention, lapses in alertness, errors of commission and omission, memory impairment, delayed reaction time, multitasking impairment, irritability and low motivation. Lack of sleep has many causes as well as many manifestations resulting in physical and mental issues. Causes of sleep deprivation can include common sleep disorders such as obstructive sleep apnea (OSA), insomnia, restless legs syndrome (RLS), periodic limb movement disorder, central (primary) CNS sleepiness, circadian misalignment and behavioral insufficient sleep. These disorders may reduce total sleep time or impact the quality of sleep. Sleep Deprivation and the Work Environment In the work environment sleep deprivation leads to fatigue-related accidents, absenteeism, low productivity and potential for co-morbid mental and physical disorders. Sleep deprivation/disorders and underlying health risks directly impact employee safety in many environments including but not limited to high risk or transportation-related jobs. Identifying and addressing sleep deprivation in the workplace reduces the incidence of errors and improves overall productivity and health. According to studies there is a nearly three-fold increased risk for occupational accidents reported in shift workers compared with day workers with increased risk of accidents reported in healthcare workers, police, and commercial drivers and in shift workers on the job and during the commute home. The risk for vehicle, aviation and industrial accidents is highest at night, especially in the early morning hours.
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- Health & Medicine > Therapeutic Area > Neurology (1.00)
The Issue Most employers are finding out about a harsh reality that they must come to grips with in their organizations—the aging work force. Those of us in the safety profession are going to be affected dramatically, and we need to get involved now in order to get ahead of this trend before it is too late. The U.S. Department of Labor statistics shows that over the past decade, workers in the 45 to 55 year-old category have increased 49% and now make up 44% of the workforce. The age group over 55 has grown to 21% of the workforce. Another major factor with the American workforce is that it is getting more and more obese. In fact, nearly 35% of the American workforce is considered obese. By some accounts, that percentage is actually higher. As a glimpse into the future, a 2013 Gallup poll revealed that 37% of working age respondents indicated they expect to work beyond age 65. Gallup reported that only 22% responded the same way in 2003 and only 16% in 1995. Given this projected "aging" of America's workforce, are America's employers prepared to effectively address the associated increase in workers' compensation (WC) claims? An aging and overweight workforce could spell disaster if we do not act accordingly. Research indicates that there is a negative impact on heath and function of employees that are getting older and are obese. Obesity doubles work limitations, elevates the heart rate, increases blood pressure, and reduces lung function. It slows reaction times and decreases range of motion. The aging workforce has decreased strength, reduced muscle mass,4 reduced fitness levels, lower aerobic capacity, increased body fat (double in many cases), poor visual acuity, poorer audio acuity, and slower cognitive speed and function. Compile obesity and aging together, and the effects are exponential. To be blunt, your employees are not able to do the task they once did. They will be slower in doing a task, need more rest periods, require better lighting at work stations, need limited lifting requirements, require sit/stand work stations options, and need more time for recovery in the event of an injury. The question you and your organizations need to ask yourself is will we be able to make these adjustments and still be productive, have a quality product, and achieve our safety goals. If the answer is no, then you need to start developing a program to get ahead of the curve.
- Questionnaire & Opinion Survey (0.67)
- Research Report > New Finding (0.66)
- Health & Medicine > Consumer Health (1.00)
- Banking & Finance (1.00)
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (0.69)
- (4 more...)
Abstract Psychosocial risks are a challenging issue in occupational safety and health. They have an impact at several different levels: the individual, the group or organization, and even nationally and globally. Problems caused by psychosocial risks are not usually a simple consequence of work. However, employees spend a large proportion of their lives at work, and this means that it is important for organisations to promote a good work/life balance to help employees achieve better quality working lives. It would also be useful to stop the differentiation between 'work' and the ‘rest of living.’ Occupational Safety and Health (OSH) professionals can help by raising awareness of psychosocial risks, carrying out risk assessments with the involvement of both managers and workers (as psychosocial risks are related to how work is organised), and supporting improved wellbeing at work. If a problem is just viewed from a medical point of view, then the solution usually focuses on medical treatment. It may therefore be more appropriate to view health as a continuum rather than a dichotomy. A bio psychosocial model, which considers the worker, their health problem and their environment, both at work and home could be more useful. OSH practitioners should therefore advocate a holistic, proactive approach to managing psychosocial risks, working in partnership to:tackle the effects of psychosocial risks address the impact of these risks on employees' capacity to work, providing support and rehabilitation for those for those with resulting mental health issues and physical disabilities. promote healthier lifestyles and wellbeing to help improve the general health of the workforce. Promoting wellbeing can also offer health and safety professionals a fresh approach to getting health and safety on the agenda. It can help to increase business performance by engaging and motivating employees, improve recruitment and retention and address sickness absence and associated costs. It also provides good opportunities for health and safety professionals to work more closely with other professionals and to develop their own competence. An example of this co-operation can be seen with the IOSH/HWL Train 2015 Challenge, which aimed to raise awareness and improve understanding of psychosocial risks in the workplace.
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- Health & Medicine > Consumer Health (1.00)
Introduction Organizations across America are experiencing a unique workforce situation —the "rise of the wise", aka aging workers, alongside an influx of younger workers while at the same time facing the fact that the overall health and fitness level of workers of all ages is one of the lowest, if not the lowest, ever. Providing the appropriate work environment and work task design to keep the both age groups safe and healthy can be a challenge in and of itself. Add to that the obesity crisis with its side effects of diabetes, cardiovascular disease and musculoskeletal disorders the situation can almost seem overwhelming. Organizations have implemented wellness programs as a way to improve the health of their workforce and thereby reduce the costs that are inherent to "unwell" workers—medical costs, lower productivity, higher rate of absenteeism, etc. These wellness programs typically rely on some sort of financial incentive to engage their employees in the program. Unfortunately, despite using incentives, participation rates are far from 100%. This begs the question: Is there another way to improve employee wellness that doesn't rely on bribes (incentives)? The answer just may be found by using the same principles, strategies and tactics that are used to error and injury proof work tasks, i.e. the use of human factors and ergonomics (HF/E) to design wellness into the work and the work environment. Characteristics of Today's Workforce There are four key characteristics of today's workforce that greatly impacts employee health, wellness and safety. Age When you look at today's workforce, what do you see? What do you see at your company? What is the mix of younger, middle and older workers? According to the Bureau of Labor Statistics, the largest group of workers are between the ages of 25–54, the next largest group are those over age 54 and the smallest group is those under age 24. The fastest growing age group over the past 30 years is those over age 55. Here are some facts that show the change in the age of the workforce, specifically the increase in the number of older workers. This is what I refer to as the "The Rise of the Wise".
- Health & Medicine > Therapeutic Area > Psychiatry/Psychology (1.00)
- Health & Medicine > Consumer Health (1.00)
- Government > Regional Government > North America Government > United States Government (1.00)
- Health & Medicine > Therapeutic Area > Cardiology/Vascular Diseases (0.87)
Abstract Wellness is about the person and decisions they make about their health, safety and well-being both on and off the job. However, conflicts can arise in the occupational (health protection) and non-occupational (health promotion) side of the wellness. For example, positive steps can be made in off-site wellness but if the design of jobs, tasks, equipment and the organization do not to match the capability and limitations of the worker then we have a wellness conflict. This paper will begin with an overview of wellness including the dimensions of wellness and impact on workers compensation claims frequency and costs. Integrated approaches to wellness will be described and an evidence-based integrated wellness continuum will be introduced. This wellness continuum will highlight specific safety and ergonomic interventions critical to the success of occupational wellness initiatives. Finally, an Integrated Health and Wellness roadmap will be provided offering guidelines for implementing health promotion and health protection interventions. What is Wellness? Wellness has been described in different ways by many different people over the years varying from basic approaches of physical health and lifestyle to more expanded approaches that include multiple dimensions. There is no universally accepted definition of wellness. Many websites simply define wellness as "the state or condition of being in good physical and mental health" (). Charles B. Corbin, Ph.D. and Robert P. Pangrazi, Ph.D. of Arizona State University in their 2001 paper entitled "Toward a Uniform Definition of Wellness: A Commentary" recognized the absence of a clear definition of wellness has resulted in confusion and misinformation on what is and is not wellness. Their proposed uniform definition of wellness is as follows: "Wellness is a multidimensional state of being describing the existence of positive health in an individual as exemplified by quality of life and a sense of well-being." While there is disagreement on the exact number or even types of dimensions, there is general agreement among professionals that wellness is multidimensional. Wellness addresses the whole person with "wellness" and "wellbeing" often used interchangeably. The sub-dimensions of wellness described below are adapted from multiple public internet sites but notably Swarbrick, 2006:
- Research Report > New Finding (1.00)
- Research Report > Experimental Study (0.68)