Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

Background: Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers.Methods: An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared.Results: The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers.Conclusions: Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this. © 2013 van Dongen et al.; licensee BioMed Central Ltd

Noise annoyance and perceived environmental quality. Inventory 2003

The most annoying source of noise in the Netherlands is road traffic. Of the Dutch population aged 16 years and older 29% is severely annoyed by this type of noise. Second and third most annoying noise sources are air traffic and neighbours (both 12% severely annoyed). Mopeds are the most annoying source of road traffic noise. Nineteen percent of the Dutch population is severely annoyed by the noise of mopeds, followed by motorbikes (11% severely annoyed) and lorries (10% severely annoyed). The severe annoyance from mopeds, highways and building and demolition sites exhibits a rising trend since 1993. For military planes, cars and busses severe annoyance has declined since 1993. In addition to noise annoyance, mopeds are the most important source of sleep disturbance; 7% of the respondents report severe sleep disturbance by moped noise. The (loud and reckless) behaviour of moped drivers is also an important source of annoyance. These are some results from a periodic national survey on annoyance, sleep disturbance, risk perception and of the quality of the living environment. In general, Dutch inhabitants are satisfied with their homes and residential areas. The average score for satisfaction with the residential area is 7,7 on a scale from 0-10. People are most dissatisfied with parking facilities in the neighbourhood (18%), public transport (16%) and space for playgrounds in the neighbourhood (12%). In comparison with the last survey (in 1998), residential satisfaction has increased.Naar schatting zijn 3,7 miljoen Nederlanders van 16 jaar en ouder (29%) ernstig gehinderd door het geluid van wegverkeer. Na wegverkeer veroorzaken vliegverkeer en buren het vaakst ernstige hinder (beide 12%). Bromfietsen staan met 19% ernstige hinder op de eerste plaats in de top tien van meest hinderlijke geluidbronnen. Op de tweede en derde plaats volgen motoren (11% ernstige hinder) en vrachtauto's (10% ernstige hinder). Ernstige hinder door het geluid van bromfietsen, snelwegen en bouw- en sloopterreinen vertoont vanaf 1993 een stijgende trend. Voor militaire vliegtuigen, personenauto's en bussen is er sprake van een dalende trend. Brommers zijn naast geluidhinder ook de belangrijkste bron van slaapverstoring. Bij 7% van de respondenten wordt de slaap ernstig verstoord door het geluid van brommers. Naast geluid blijkt met name het (roekeloos en luidruchtig) gedrag van bromfietsrijders een belangrijke hinderbron. Dit zijn enkele bevindingen uit een periodiek landelijk onderzoek naar de verstoringen van de leefomgeving. Er is ook gevraagd naar de tevredenheid met de woonomgeving. Nederlanders zijn in het algemeen tevreden met hun woning en woonomgeving. Deze wordt beoordeeld met een gemiddelde van 7,7 op een schaal van 0-10. Het meest ontevreden is men over de parkeergelegenheden in de buurt (18%), het openbaar vervoer (16%) en de ruimte voor speelgelegenheid in de buurt (12%). Ten opzichte van de vorige peiling in 1998 is de tevredenheid over de woning en de woonomgeving toegenomen

Noise annoyance and perceived environmental quality. Inventory 2003

Naar schatting zijn 3,7 miljoen Nederlanders van 16 jaar en ouder (29%) ernstig gehinderd door het geluid van wegverkeer. Na wegverkeer veroorzaken vliegverkeer en buren het vaakst ernstige hinder (beide 12%). Bromfietsen staan met 19% ernstige hinder op de eerste plaats in de top tien van meest hinderlijke geluidbronnen. Op de tweede en derde plaats volgen motoren (11% ernstige hinder) en vrachtauto's (10% ernstige hinder). Ernstige hinder door het geluid van bromfietsen, snelwegen en bouw- en sloopterreinen vertoont vanaf 1993 een stijgende trend. Voor militaire vliegtuigen, personenauto's en bussen is er sprake van een dalende trend. Brommers zijn naast geluidhinder ook de belangrijkste bron van slaapverstoring. Bij 7% van de respondenten wordt de slaap ernstig verstoord door het geluid van brommers. Naast geluid blijkt met name het (roekeloos en luidruchtig) gedrag van bromfietsrijders een belangrijke hinderbron. Dit zijn enkele bevindingen uit een periodiek landelijk onderzoek naar de verstoringen van de leefomgeving. Er is ook gevraagd naar de tevredenheid met de woonomgeving. Nederlanders zijn in het algemeen tevreden met hun woning en woonomgeving. Deze wordt beoordeeld met een gemiddelde van 7,7 op een schaal van 0-10. Het meest ontevreden is men over de parkeergelegenheden in de buurt (18%), het openbaar vervoer (16%) en de ruimte voor speelgelegenheid in de buurt (12%). Ten opzichte van de vorige peiling in 1998 is de tevredenheid over de woning en de woonomgeving toegenomen.The most annoying source of noise in the Netherlands is road traffic. Of the Dutch population aged 16 years and older 29% is severely annoyed by this type of noise. Second and third most annoying noise sources are air traffic and neighbours (both 12% severely annoyed). Mopeds are the most annoying source of road traffic noise. Nineteen percent of the Dutch population is severely annoyed by the noise of mopeds, followed by motorbikes (11% severely annoyed) and lorries (10% severely annoyed). The severe annoyance from mopeds, highways and building and demolition sites exhibits a rising trend since 1993. For military planes, cars and busses severe annoyance has declined since 1993. In addition to noise annoyance, mopeds are the most important source of sleep disturbance; 7% of the respondents report severe sleep disturbance by moped noise. The (loud and reckless) behaviour of moped drivers is also an important source of annoyance. These are some results from a periodic national survey on annoyance, sleep disturbance, risk perception and of the quality of the living environment. In general, Dutch inhabitants are satisfied with their homes and residential areas. The average score for satisfaction with the residential area is 7,7 on a scale from 0-10. People are most dissatisfied with parking facilities in the neighbourhood (18%), public transport (16%) and space for playgrounds in the neighbourhood (12%). In comparison with the last survey (in 1998), residential satisfaction has increased.Berg M van den VROM-DGM-LM

False results caused by solvent impurity in tetrahydrofuran for maldi tof ms analysis of amines

\u3cp\u3eTetrahydrofuran (THF) is one of the most frequently used solvents in the MALDI TOF MS analysis of synthetic compounds. However, it should be used with caution because a trace amount of 4-hydroxybutanal (HBA) might be generated and accumulated in THF during storage. Since only a tiny amount of analytes is required in MALDI MS measurements, a trace amount of HBA might have a significant effect on the MS results. It was found that HBA will quickly react with primary and secondary amino compounds, leading to false results about the sample composition with an extra series of ions with additional mass of 70 Da in between. The formation of HBA can be inhibited by butylated hydroxytoluene (BHT) antioxidant. Therefore, when THF is required as the solvent for sample preparation, it is strongly recommended to use a BHT-stabilized one, at least for the analysis of compounds with amino groups. [Figure not available: see fulltext.]\u3c/p\u3

Dehydrogenation of tertiary amines in matrix-assisted laser desorption/ionization time-of-flight mass spectrometry

In the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) analysis of various compounds synthesized in our laboratory, strong [M - H]+ ion peaks were often observed for the molecules with tertiary amino groups. In this work, the MALDI TOF MS behavior of two groups of compounds that incorporate tertiary amino moieties was investigated. One group is bisurea dimethylanilines (BUDMAs) prepared for the study of molecular recognition in thermoplastic elastomers, and the other group is the poly(propylene imine) diaminobutane dendrimers. The results clearly demonstrate the appearance of the [M - H]+ ions. In order to understand the possible mechanisms for the generation of these ions, a series of model compounds, ranging from primary to tertiary amines, were investigated. Unlike the tertiary amines, no [M - H]+ ion peaks were recorded for the primary amines, and only barely detectable ones, if any, for some secondary amines. It appears that the tertiary amino groups play an important role in the formation of these ions. In addition to MALDI TOF MS analysis, these samples were also applied to electrospray ionization (ESI) MS where no [M - H] + ions were observed. The results indicate that the generation of [M - H]+ ion is due to the unique MALDI conditions and is likely to be formed via dehydrogenation of a protonated tertiary amine resulting in an N=C double bond. The absence of [M - H]+ ion peaks for the primary and secondary amines is probably because upon their formation these ions could easily transfer one proton to the corresponding amines in the MALDI gas-phase plume, yielding neutral imines that cannot be detected by MS. Copyright -© 2008 John Wiley & Sons, Lt

Validation of a food-frequency questionnaire for Flemish and Italian-native subjects in Belgium : the IMMIDIET study

Objective: To validate an integrated food-frequency questionnaire (FFQ) developed to assess habitual food intake of Flemish and Italian-native subjects in Belgium as part of the European Collaborative Dietary Habit Profile in European Communities With Different Risk of Myocardial Infarction: the Impact of Migration as a Model of Gene/Environment Interaction (IMMIDIET Project). Methods: The semiquantitative FFQ contained 322 items on food and food preparation. FFQs filled by a sample (n = 70) of the Flemish-Flemish and Flemish-Italian IMMIDIET subpopulations were randomly selected. Five 24-h recalls, administered over a period of 1 y by the same sample, served for validation. Energy and macronutrients were calculated using the Dutch NEVO and the Belgian NUBEL food composition tables. Intakes of energy and macronutrients estimated by the FFQ and repeated 24-h recall, respectively, were compared by means of correlation coefficients, classification into quartiles, and Bland-Altman plotting. Results: The FFQ overestimated intake of energy and most macronutrients by 40-70%. This overestimation largely disappeared when values were expressed as energy percentage. Correlations ranked from 0.40 to 0.60 for energy and most macronutrients (median 0.53); correlations were lower (null to 0.41) for fat and higher (up to 0.90) for alcohol. Classification in quartiles of intake showed good agreement: 83% were classified in the same or adjacent quartile of energy, and 66-90% for macronutrients. Correlations and classification of macronutrient intake into quartiles remained similar when macronutrients were expressed as energy percentage. Stratification according to ethnic subgroup, age, body mass index, or social status showed no differences. Conclusion: The IMMIDIET FFQ is a valuable tool for studies of the role of energy and macronutrients in disease etiology or outcome, but less suitable for estimating absolute intake levels. (C) 2011 Elsevier Inc. All rights reserved