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BACKGROUND: Workplace modified duty programs may provide reasonable accommodations to employees who have partial temporary job disability and could work on duty accommodations until they fully recover. However, little is known about the implementation barriers and effectiveness of such programs. OBJECTIVE: This study is aimed at evaluating the implementation of a modified duty program for employees in an oncology center. METHODS: A modified duty program for employees working at the Bank of Cyprus Oncology Center, a non profit organization with 200 employees located in the Republic of Cyprus was evaluated based on the health records of the occupational medicine department. RESULTS: Employees' participation in the program was 3%. A total of 12 employees participated (6 each year). The participants were all women and the mean participation period was 21.6 days (range 10 - 65 days). The two most frequent reasons for a modified duty assignment were pregnancy and back pain. Employees were assigned either on limited duties or on a combination of limited duties and reduced work hours. Employees reported being very satisfied with their participation based on a follow-up narrative oral assessment. CONCLUSION: The small participation rate does not allow for advanced statistical analyses. Further studies from larger organizations are urgently needed to evaluate the effectiveness of modified duty programs. The development of a legal framework for such modified duty programs in Cyprus as well as internationally may promote their implementation in order to facilitate the effective management of temporary partial job disability for the benefit of both employees and businesses. [ABSTRACT FROM AUTHOR]

Objective: To examine the use of electronic medical records (EMRs) among US occupational medicine physicians (OMPs). Methods: An electronic- and paper-based survey was conducted among OMPs using an anonymous self- administered questionnaire. Results: The OMPs reported using an EMR for billing purposes only (14.6%), clinical purposes only (27.8%), or both (39.3%) with the total EMR use of 81.7%. About 60% were satisfied with their EMRs, and 64% to 66% believed that EMRs improve safety and quality of medical care. Among OMPs not using EMR, 17% reported that they were likely to adopt an EMR in the year after the survey, whereas 47% were very unlikely to do so. Conclusions: Occupational physicians' use of EMRs was relatively high. They also seemed to be satisfied with their EMRs and believed that EMRs improve both safety and quality of clinical care. [ABSTRACT FROM AUTHOR]

Background Heart disease causes 45% of the deaths that occur among U.S. firefighters while they are on duty. We examined duty-specific risks of death from coronary heart disease among on-duty U.S. firefighters from 1994 to 2004.Methods We reviewed summaries provided by the Federal Emergency Management Agency of the deaths of all on-duty firefighters between 1994 and 2004, except for deaths associated with the September 11, 2001, terrorist attacks. Estimates of the proportions of time spent by firefighters each year performing various duties were obtained from a municipal fire department, from 17 large metropolitan fire departments, and from a national database. Odds ratios and 95% confidence intervals for death from coronary heart disease during specific duties were calculated from the ratios of the observed odds to the expected odds, with nonemergency duties as the reference category. Results Deaths from coronary heart disease were associated with suppressing a fire (32.1% of all such deaths), responding to an alarm (13.4%), returning from an alarm (17.4%), engaging in physical training (12.5%), responding to nonfire emergencies (9.4%), and performing nonemergency duties (15.4%). As compared with the odds of death from coronary heart disease during nonemergency duties, the odds were 12.1 to 136 times as high during fire suppression, 2.8 to 14.1 times as high during alarm response, 2.2 to 10.5 times as high during alarm return, and 2.9 to 6.6 times as high during physical training. These odds were based on three estimates of the time that firefighters spend on their duties.Conclusions Certain emergency firefighting duties were associated with a risk of death from coronary heart disease that was markedly higher than the risk associated with nonemergency duties. Fire suppression was associated with the highest risk, which was approximately 10 to 100 times as high as that for nonemergency duties. [ABSTRACT FROM AUTHOR]

Background: Coronary heart disease (CHD) is responsible for 45% of on-duty deaths among United States firefighters. We sought to identify occupational and personal risk factors associated with on-duty CHD death. Methods: We performed a case-control study, selecting 52 male firefighters whose CHD deaths were investigated by the National Institute for Occupational Safety and Health. We selected two control populations: 51 male firefighters who died of on-duty trauma; and 310 male firefighters examined in 1996/1997, whose vital status and continued professional activity were re-documented in 1998. Results: The circadian pattern of CHD deaths was associated with emergency response calls: 77% of CHD deaths and 61% of emergency dispatches occurred between noon and midnight. Compared to non-emergency duties, fire suppression (OR = 64.1, 95% CI 7.4-556); training (OR = 7.6, 95% CI 1.8-31.3) and alarm response (OR = 5.6, 95% CI 1.1-28.8) carried significantly higher relative risks of CHD death. Compared to the active firefighters, the CHD victims had a significantly higher prevalence of cardiovascular risk factors in multivariate regression models: age ≥ 45 years (OR 6.5, 95% CI 2.6-15.9), current smoking (OR 7.0, 95% CI 2.8-17.4), hypertension (OR 4.7, 95% CI 2.0-11.1), and a prior diagnosis of arterial-occlusive disease (OR 15.6, 95% CI 3.5-68.6). Conclusions: Our findings strongly support that most on-duty CHD fatalities are work-precipitated and occur in firefighters with underlying CHD. Improved fitness promotion, medical screening and medical management could prevent many of these premature deaths. [ABSTRACT FROM AUTHOR]

Presents a study that evaluated the association between hypertension and changes in employment status among hazardous materials firefighters in Massachusetts. Measurement of the blood pressure of the firefighters; Examination of the risk of an adverse event before the next follow-up examination based on the blood pressure measurement; Analysis of the prevalence of hypertension among the firefighters; Limitations of the study.

Objective To examine and compare the research productivity of the European Union, the four "candidate" countries (those currently waiting to join the EU), and the United States in several fields of biomedical sciences. Design A retrospective observational study--bibliometric analysis. Data sources Manuscripts published by authors from each country separately and from each group of countries for the period 1994 to 2004 and included in the Essential Science Indicators database of the Institute of Scientific Information. Main outcome measures Number of published articles and number of citations, adjusted for gross domestic product and population size. Results 1 485 749 articles were published by authors from the EU compared with 1 356 805 from the US. The research productivity of the first 15 countries to join the EU, adjusted for population, was lower (76%) than that of the US--and even lower (66%) when the 10 newest EU countries were included in the analysis. Conclusion The newest EU members and the EU candidate countries need further help and resources to increase their productivity, thereby improving the productivity of the EU as a whole. [ABSTRACT FROM AUTHOR]

Objective: A systematic literature review and meta-analysis was conducted on the association between firefighting and cancer., Methods: A comprehensive literature search of databases including Medline, EMBASE, Biosis, NIOSHTIC2, Web of Science, Cancerlit, and HealthStar, for the period between 1966 to January 2007, was conducted. We also retrieved additional studies by manual searching., Results: A total of 49 studies were included in the meta-analysis. We found statistically significant associations between firefighting and cancers of bladder, brain and CNS, and colorectal cancers, consistent with several previous risk estimates. We also found statistically significant associations of firefighting with non-Hodgkin's lymphoma, skin melanoma, prostate, and testicular cancer. For kidney, Hodgkin's lymphoma, leukemia, lymphosarcoma and reticulosarcoma, multiple myeloma, and pancreatic cancer, we found some statistically significant but less consistent results. For all other cancers evaluated (esophageal, laryngeal, oral and pharyngeal, liver and gallbladder, lung, lymphatic and hematopoietic, non-melanoma skin cancer, stomach, and urinary cancer) we did not find any statistically significant associations., Conclusions: Although our meta-analysis showed statistically significant increased risks of either cancer incidence or mortality of certain cancers in association with firefighting, a number of important limitations of the underlying studies exist, which, precluded our ability to arrive at definitive conclusions regarding causation.

The scientific community invests significant resources on HIV/AIDS research to confront the current epidemic. We reviewed the medical literature in order to evaluate the contribution of different world regions on HIV/AIDS research during the past 18 years. We retrieved articles, using an elaborate methodology, from three journals focusing on HIV/AIDS between 1986 and 2003, indexed in the Journal Citation Reports (JCR) and the Web of Science databases of the Institute for Scientific Information (ISI). Comparisons were made by dividing the world into nine geographic regions, and by using the human development index (HDI) categorization. A total of 9502 articles on HIV/AIDS were retrieved from three AIDS journals over an 18-year study period. The United States and Western Europe together and five developed out of nine world regions made up a striking 83% and 92% of the world's research production on HIV/AIDS, respectively. Scientists from the developing world participated in 10.4% of the articles published during 1986-1991, 14.7% during 1992-1997, and 21.3% during 1998-2003. Researchers from countries included in the high, medium, and low HDI category produced 2240, 9, and 15 articles per billion population, respectively. About half of articles originating in Latin America and the Caribbean and half in Asia were produced in collaboration with the United States. However, 40% of articles from Africa and 58% from Eastern Europe were produced in cooperation with Western Europe. Collaboration between researchers within developing regions was negligible. The vast majority of the world's research on AIDS is produced in the developed world. Although research production was minimal in the developing world, we found that regions included in the low and medium HDI categories showed a higher proportion of increase in research productivity than the developed countries. International collaborations should significantly increase and expand beyond the traditional cultural and political lines of international relationships.

We summarized the findings of several studies of ours to compare the quantity and quality of published research from around the world for the years 1995 to 2003. We evaluated the number of articles published and their mean journal impact factor. We also studied the research productivity of various areas adjusted for gross domestic product (GDP) and population. We found that Western Europe leads the world in published research on infectious diseases-microbiology (82,342 articles [38.8%]) and in cardiopulmonary medicine (67,783 articles [39.5%]), whereas the United States ranks first in the fields of preventive medicine, public health and epidemiology both in quantity (23,918 articles [49.1%]) and quality of published papers. However, after adjustments for GDP, Canada ranked first, with the United States and Oceania following closely behind. All of the developing regions had only small research contributions in all of the biomedical fields examined.

We evaluated all articles published by different world regions in the top 50 biomedical journals in the database of the Journal Citation Reports-Institute for Scientific Information for the period between 1995 and 2002. The world was divided into 9 regions [United States of America (the U.S.), Western Europe, Japan, Canada, Asia, Oceania, Latin America, and the Caribbean, Eastern Europe, and Africa] based on a combination of geographic, economic and scientific criteria. The number of articles published by each region, the mean impact factor, and the product of the above two parameters were our main indicators. The above numbers were also adjusted for population size, gross national income per capita of each region, and other factors. Articles published from the U.S. made up about two-thirds of all scientific papers published in the top 50 biomedical journals between 1995 and 2002. Western Europe contributed approximately a quarter of the published papers while the remaining one-tenth of articles came from the rest of the world. Canada, however, ranked second when number of articles was adjusted for population size. The U.S. is by far the highest-ranking country/region in publications in the top 50 biomedical journals even after adjusting for population size, gross national product, and other factors. Canada and Western Europe share the second place while the rest of the world is far behind.

Objective: To evaluate the contribution of different world regions in cardiovascular research production., Methods: The world was divided into 9 regions based on a combination of geographic, economic and scientific criteria. Using the Medline database, we retrieved articles from 77 journals included in the "Cardiac and Cardiovascular Systems" category of the "Journal Citation Reports" database for the period 1995-2002. We then, estimated the total number of publications, their mean impact factor, the product of these two parameters, the research productivity per billion of US dollars spent on research and development, and the research productivity per number of scientists-years in research and development for different world regions., Results: Data on the country of origin for the authors was available for 86,711 out of 87,939 retrieved articles (98.6%). The majority of articles published between 1995-2002 were originated from Western Europe (39.4%) and the USA (37.1%). The USA, Oceania and Canada had the highest mean impact factor of published articles and Eastern Europe had the lowest. The research productivity per unit of expenditure for research and development was found to be significantly higher for Canada compared to the USA and Western Europe while the rate of increase in the number of published articles was higher in Eastern Europe, Latin America and the Caribbean, and Asia. The research contribution of Africa in the number of published articles was notably very low (0.3%)., Conclusions: The data suggest a promising trend: developing world regions, with the important exception of Africa, achieved a higher rate of increase in the number of published articles in the studied period.