Participation for understanding: an interactive method

INTRODUCTION: There are many available models that help evaluate the effectiveness of safety and health measures, but many are complex and require input from many departments within an organization. There is a need to develop a more user-friendly model. METHOD: A participative model was developed that involves face-to-face interviewers with workers, maintenance department, purchasing department and health and safety experts. They were asked about costs, efforts, benefits, and effects of gauging the effects of prevention efforts. RESULTS: Cost effectiveness analyses are essential in all cases and can include whatever the end-user requires, whether it is a small or lasting improvement. Having management participate helps validate the data. CONCLUSIONS: Organizations who collaborate with someone with at least some skill in cost-benefit evaluations will find that they will be able to establish policies and procedures from the data. The end result is a calculation that is understood by all involved.     

Prenatal diagnosis in advanced maternal age. Amniocentesis or CVS,a patient's choice or lack of information?

Ninety-six women of advanced maternal age were interviewed about the way they obtained information on prenatal diagnosis and about how the decision was made as to what procedure was to be performed (transabdominal chorionic villus sampling (TA-CVS) or amnio-centesis). In the CVS group, women visited their physician or midwife earlier in pregnancy (mean 7.1 weeks) than those in the amniocentesis group (mean 10.7 weeks). The availability of prenatal diagnosis was not mentioned during the first antenatal visit in 55 per cent of women from the amniocentesis group as opposed to 25 per cent from the TA-CVS group. Approximately 40 per cent of women eligible for prenatal diagnosis did not receive any information from the referring body prior to counselling at our centre. Only 29 per cent of women who underwent amniocentesis had actually chosen this procedure; 71 per cent were too late to undergo TA-CVS at 12 weeks. It is concluded that information to the patient must be improved in order to ensure early referral for prenatal diagnosis.