Debra K. Olson

Incidence, prevalence, and variables associated with low back pain in staff nurses

The morbidity, lost work time, and interference with effective work due to low back pain are markedly underestimated when only employee health service data are used. Injured subjects averaged more years of generic, orthopedic, and rehabilitation nursing experience than the non-injured group. Of the studied nurses who experienced work related low back pain within the past 6 months, 78% did not report it to management. More attention should be given to adequate staff availability for shared lifting activities, better design and use of mechanical lifting aids, and further research in how to safely perform tasks from the side of the bed.

Pesticide poisoning surveillance through regional poison control centers

The purpose of this study is to describe pesticide exposure in the population of callers to Minnesota Regional Poison Centers. Case files from 1988 reporting pesticide exposure to humans were identified in cooperation with the Minnesota Center for Health Statistics. Data analysis was conducted by computer using SAS statistical package. Of the 1,428 case files indicating pesticide as the primary substance of exposure to Minnesota residents, a mean age of 5 years (range, one month to 85 years) was identified; 50 percent of all cases were below age 3 years. Males accounted for 1.3 times as many cases as females. Insecticide was identified in the largest percentage of case files (74 percent) followed by herbicide (12 percent), rodenticide (11 percent) and fungicide-nonmedicinal (3 percent). Ingestion was the most common route of exposure; 85 percent of all calls originated from a residence. While insecticides are still the most common types of pesticide call, herbicide has surpassed insecticide in production and sales in the US. In this study, herbicide type exposure calls present a much different picture than other pesticide types. The usefulness of poison control centers for examination of pesticide poisoning is explored. Since reporting occurs coincidental with the exposure and its associated symptoms, each pesticide poisoning report could potentially serve as a true sentinel health event.

Health Hazards Affecting the Animal Confinement Farm Worker

F arming is a dynamic process. Occupational exposures change as the production process, equipment, weather, and conditions change. Farming also is unique, as it represents one of the few occupations in which many of the workers live where they work (Connon, 1993; Pratt, 1990). Understanding the magnitude of agricultural health and safety issues is complicated by the difficulty in identifying the total work force. There are few uniformly accepted definitions of farm, farmer, or farm worker (Cordes, 1991; Pratt, 1990). The U.S. Bureau of Labor Statistics (1990) reported 13.1 million persons in the United States in 1989 who derived at least part of their income from farming. Of these, 6 million were family members living and, in many cases, working on the farm. An estimated 3 million of these men, women, and children are migrant or seasonal work-

The Evidence Base for Effectiveness of Preparedness Training: A Retrospective Analysis

Objectives. In 2007, the Centers for Disease Control and Prevention (CDC) commissioned an Evidence-Based Gaps Collaboration Group to consider whether past experience could help guide future efforts to educate and train public health workers in responding to emergencies and disasters. Methods. The Group searched the peer-reviewed literature for preparedness training articles meeting three criteria: publication during the period when CDCs Centers for Public Health Preparedness were fully operational, content relevant to emergency response operations, and content particular to the emergency response roles of public health professionals. Articles underwent both quantitative and qualitative analyses. Results. The search identified 163 articles covering the topics of leadership and command structure (18.4%), information and communications (14.1%), organizational systems (78.5%), and others (23.9%). The number of reports was substantial, but their usefulness for trainers and educators was rated only “fair” to “good.” Thematic analysis of 137 articles found that organizational topics far outnumbered leadership, command structure, and communications topics. Disconnects among critical participants—including trainers, policy makers, and public health agencies—were noted. Generalizable evaluations were rare. Conclusions. Reviews of progress in preparedness training for the public health workforce should be repeated in the future. Governmental investment in training for preparedness should continue. Future training programs should be grounded in policy and practice needs, and evaluations should be based on performance improvement.

Lifelong Learning for Public Health Practice Education : A Model Curriculum for Bioterrorism and Emergency Readiness

In 2002, the University of Minnesota School of Public Health (UMNSPH) adopted an approach that supports basic, advanced, and continuing education curricula to train current and future public health workers. This model for lifelong learning for public health practice education allows for the integration of competency domains from the Council on Linkages Between Academia and Public Health Practices core public health workforce competency levels and the Centers for Disease Control and Preventions Bioterrorism and Emergency Readiness Competencies. This article describes how UMNSPH has implemented the model through coordination with state planning efforts and needs assessments in the tristate region of Minnesota, North Dakota, and Wisconsin. In addition, we discuss methods used for credentialing practitioners who have achieved competency at various levels of performance to enhance the capacity of the public health preparedness systems.

Competencies most valued by employers--Implications for master's-prepared occupational health nurses.

Educational institutions seek to prepare students to compete for positions in the workplace with a competency-based education. Employers are important stakeholders in the preparation of occupational health nurses. Competencies considered most valuable by employers will affect their hiring decisions. This study identifies competencies valued by employers in the workplace.

Use of the North American guidelines for children's agricultural tasks with Hmong farm families

This literature review synthesizes available studies on Hmong agricultural practices, patterns of childhood growth and development of Hmong children in the context of injury prevention, and potential application or adaptation of the North American Guidelines for Childrens Agricultural Tasks (Lee and Marlenga, 1999) for Hmong children working in the U.S. Data from qualitative interviews, focus groups, case studies, and surveys were collected, categories were determined, and themes were identified. Field tools and practices, gender roles, and reasons for farming were examined, as well as physical and cognitive development of Hmong children and Hmong parenting techniques to describe factors related to farm task assignment of children. Current agricultural practices of Hmong in the U.S. can be described as generally small-scale operations that use mainly hand tools, manual labor, and local direct-marketing techniques. Specific practices include thinning, weeding, and hoeing; carrying tools, buckets, or baskets; setting plant supports; and watering. Hmong children appear to be given greater amounts of responsibility at earlier ages than North American children. Hmong parenting practices, as would be used in task assignment, are somewhat more authoritarian-based and lead to psychosocial skills that are more group-oriented than individual-oriented. Hmong children were found to be shorter than children in the U.S. of the same ages. This review suggests that the NAGCAT cannot be literally translated and disseminated to Hmong farming families as an injury prevention intervention. Further information is needed about what farm tasks Hmong children do and how Hmong parents assign those tasks to children.

Public Health and Terrorism Preparedness: Cross-Border Issues

On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the “Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable.” The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

Using gaming simulation to evaluate bioterrorism and emergency readiness education

Objective. We performed an outcome evaluation of the impact of public health preparedness training as a group comparison posttest design to determine the differences in the way individuals who had participated in training performed in a simulated emergency. Methods. The Experimental Group 1 included students who had graduated from or were currently enrolled in the bioterrorism and emergency readiness (BT/ER) curriculum at the University of Minnesota School of Public Health. The comparison groups included individuals who had access to the Internet and were aware of the 2006 online simulation Disaster in Franklin County: A Public Health Simulation. The evaluation process employed surveys and the gaming simulation as sources for primary data. Results. Participants in the BT/ER curriculum (p=0.0001) and other participants completing at least 45 hours of training in the past year (p=0.0001) demonstrated higher effectiveness scores (accuracy of chosen responses within the simulation) than participants who did not report significant amounts of training. Conclusions. This evaluation research demonstrated that training is significantly associated with better performance in a simulated emergency using gaming technology.

Demonstrating Excellence in the Scholarship of Practice-Based Service for Public Health

Practice-based scholarship in public health addresses community health issues. The accredited schools of public health (SPHs) have played a significant role in defining and implementing the multidisciplinary, interprofessional, ecological approach to improving the health and safety of communities through academic public health practice. These schools have addressed the challenges raised by the Institute of Medicine for enhancing academic-practice linkages. The Association of Schools of Public Health (ASPH) established the Council of Public Health Practice Coordinators (Practice Council), whose members are delegates from each of the SPHs accredited by the Council on Education for Public Health (CEPH); there were 40 as of 2008. The Practice Councils priorities are to (1) promote greater commitment to scholarship in public health practice-based research, teaching, and service within SPHs, and (2) facilitate recognition and reward for practice-based scholarship in academic institutions. Extensive alignment of efforts by the Practice Council, SPHs, federal agencies, private institutions, and the practice sector have invigorated scholarship in academic public health practice.