OSHA issued voluntary training guidelines in 1992. These guidelines serve as a model for trainers to use in developing, organizing, evaluating, and editing their safety training programs. It is important for trainers to tailor the OSHA guidelines to their specific work site so that the training is relevant to the specific working conditions and not just a long generalized informational session.

Many standards promulgated by OSHA explicitly require the employer to train employees in the safety and health aspects of their jobs. Other OSHA standards make it the employer’s responsibility to limit certain job assignments to employees who are “certified,” “competent,” or “qualified”—meaning that they have had special previous training, in or out of the workplace. The term “designated” personnel means selected or assigned by the employer or the employer’s representative as being qualified to perform specific duties. These requirements reflect OSHA’s belief that training is an essential part of every employer’s safety and health program for protecting workers from injuries and illnesses.

OSHA’s training guidelines follow a model that consists of:

- A. Determining if Training is Needed

- B. Identifying Training Needs

- C. Identifying Goals and Objectives

- D. Developing learning activities

- E. Conducting the training

- F. Evaluating program effectiveness

- G. Improving the program

- H. Training must align with job tasks.

- A. Determining if training is needed

You first have to determine if a situation can be solved using training. Training, or retraining as the case may be, could be required by an OSHA standard. Training is an effective solution to problems such as employee lack of understanding, unfamiliarity with equipment, incorrect execution of a task, lack of attention, or lack of motivation. Sometimes, however, the situation cannot be mitigated through the use of training and other methods, such as the establishment of engineering controls, may be needed to ensure worker safety.

- B. Identifying training needs

A job safety analysis and/or a job hazard analysis should be conducted with every employee so that it is understood what is needed to do the job safely and what hazards are associated with the job. A safety trainer may observe the worker in his/her environment to adequately assess the worker's training needs. Certain employees may need extra training due to the hazards associated with their particular job. These employees should be trained not only on

how to perform their job safely but also on how to operate within a hazardous

environment.

- C. Identifying Goals and Objectives

It is important for the Trainer to identify necessary training material. It is equally important that the trainer identify training material that is not needed to avoid unnecessary training and frustration from their trainees.

At the beginning of every safety training session the trainer should clearly iterate the objectives of the class. The objectives should be delivered using action oriented words like: the employee... "will be able to demonstrate" or "will know when to"... which will help the audience understand what he/she should know by the end of the class or what to information to assimilate during the class. Clearly established objectives also help focus the evaluation process on those skill sets and knowledge requirements necessary to perform the job safely.

- D. Developing Learning Activities

Training should be hands-on and simulate the job as closely as possible. Trainers can use instructional aids such as charts, manuals, PowerPoint presentations, and films. Trainers can also include role-playing, live demonstrations, and round-table group discussions to stimulate employee participation. Games like "what's wrong with this picture" (it is usually good to use pictures of situations found at their specific location)" or "safety jeopardy" can be useful ways to make the training fun yet educational.

- E. Conducting the Training

Trainers should provide employees with an overview of the material to be learned and relate the training to the employees' experiences. Employers should also reinforce what the employees have learned by summarizing the program's objectives and key points of training. At the beginning of the training program, the trainer should show the employees why the material is important and relevant to their jobs. Employees are more likely to pay attention and apply what they've learned if they know the benefits of the training.

- F. Evaluating Program Effectiveness

Evaluation will help employers or supervisors determine the amount of learning achieved and whether an employee’s performance has improved on the job. Among the methods of evaluating training are:

- (1) Student opinion. Questionnaires or informal discussions with employees can help employers determine the relevance and appropriateness of the training program

- (2) Supervisors’ observations. Supervisors are in good positions to observe an employee’s performance both before and after the training and note improvements or changes

- (3) Workplace improvements. The ultimate success of a training program may be changes throughout the workplace that result in reduced injury or accident rates

- (4) Formal assessments. Practical and written exams also assist in evaluating understanding of training material. For example, for a lift-truck operator, a written and a practical exam would identify areas of training that may need to be revisited. Furthermore administering a pre-test and post-test will establish a knowledge base line or reference point to measure training effectiveness.

- G. Improving the Program

As evaluations are reviewed, it may be evident the training was not adequate and that the employees did not reach the expected level of knowledge and skill. As the program is evaluated, the trainer should ask:

- (1) If a job analysis was conducted, was it accurate?

- (2) Was any critical feature of the job overlooked?

- (3) Were the important gaps in knowledge and skill included?

- (4) Was material already known by the employees intentionally omitted?

- (5) Were the instructional objectives presented clearly and concretely?

- (6) Did the objectives state the level of acceptable performance that was expected of employees?

- (7) Did the learning activity simulate the actual job?

- (8) Was the learning activity appropriate for the kinds of knowledge and skills required on the job?

- (9) When the training was presented, was the organization of the material and its meaning made clear?

- (10) Were the employees motivated to learn?

- (11) Were the employees allowed to participate actively in the training process?

- (12) Was the employer’s evaluation of the program thorough?

Effective safety training is an unofficial phrase used to describe the training materials designed to teach occupational safety and health standards developed by the United States government labor organization, Occupational Safety and Health Administration (OSHA). OSHA has produced many standards and regulations that affect employers and employees in the United States. United States employers have a legal responsibility to educate employees on all workplace safety standards and the hazards that their employees may face while on the job, and providing effective safety training meets that responsibility.

While needlestick injuries have the potential to transmit bacteria, protozoa, viruses and prions, the risk of contracting hepatitis B, hepatitis C, and HIV is the highest. The World Health Organization estimated that in 2000, 66,000 hepatitis B, 16,000 hepatitis C, and 1,000 HIV infections were caused by needlestick injuries. In places with higher rates of blood-borne diseases in the general population, healthcare workers are more susceptible to contracting these diseases from a needlestick injury.

Hepatitis B carries the greatest risk of transmission, with 10% of exposed workers eventually showing seroconversion and 10% having symptoms. Higher rates of hepatitis B vaccination among the general public and healthcare workers have reduced the risk of transmission; non-healthcare workers still have a lower HBV vaccine rate and therefore a higher risk. The hepatitis C transmission rate has been reported at 1.8%, but newer, larger surveys have shown only a 0.5% transmission rate. The overall risk of HIV infection after percutaneous exposure to HIV-infected material in the health care setting is 0.3%. Individualized risk of blood-borne infection from a used biomedical sharp is further dependent upon additional factors. Injuries with a hollow-bore needle, deep penetration, visible blood on the needle, a needle located in a deep artery or vein, or a biomedical device contaminated with blood from a terminally ill patient increase the risk for contracting a blood-borne infection.

After a needlestick injury, certain procedures must be followed to minimize the risk of infection. Lab tests of the recipient should be obtained for baseline studies, including HIV, acute hepatitis panel (HAV IgM, HBsAg, HB core IgM, HCV) and for immunized individuals, HB surface antibody. Unless already known, the infectious status of the source needs to be determined. Unless the source is known to be negative for HBV, HCV, and HIV, post-exposure prophylaxis (PEP) should be initiated, ideally within one hour of the injury.

If the status of the source patient is unknown, their blood should be tested for HIV as soon as possible following exposure. The injured person can start antiretroviral drugs for PEP as soon as possible, preferably within three days of exposure. There is no vaccine for HIV. When the source of blood is known to be HIV positive, a 3-drug regimen is recommended by the CDC; those exposed to blood with a low viral load or otherwise low risk can use a 2-drug protocol. The antivirals are taken for 4 weeks and can include nucleoside reverse transcriptase inhibitors (NRTIs), nucleotide reverse transcriptase inhibitors (NtRTIs), Non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), or fusion inhibitors. All of these drugs can have severe side effects. PEP may be discontinued if the source of blood tests HIV-negative. Follow-up of all exposed individuals includes counseling and HIV testing for at least six months after exposure. Such tests are done at baseline, 6 weeks, 12 weeks, and 6 months and longer in specific circumstances, such as co-infection with HCV.

The girls underwent a six-week period for physical therapy and recovery. Maria and Teresa are now able to walk independently and are starting to form their own individual personalities. The girls were able to return to the Dominican Republic and often return to the United States for follow-up care.

International Organization for Standardization helps set standards for monitoring environments, analyzing data, and interpreting results.

The PIE principles were in place for the "not yet diagnosed nervous" (NYDN) cases:

- Proximity – treat the casualties close to the front and within sound of the fighting.

- Immediacy – treat them without delay and not wait until the wounded were all dealt with.

- Expectancy – ensure that everyone had the expectation of their return to the front after a rest and replenishment.

United States medical officer Thomas W. Salmon is often quoted as the originator of these PIE principles. However, his real strength came from going to Europe and learning from the Allies and then instituting the lessons. By the end of the war, Salmon had set up a complete system of units and procedures that was then the "world's best practice". After the war, he maintained his efforts in educating society and the military. He was awarded the Distinguished Service Medal for his contributions.

Effectiveness of the PIE approach has not been confirmed by studies of CSR, and there is some evidence that it is not effective in preventing PTSD.

US services now use the more recently developed BICEPS principles:

- Brevity

- Immediacy

- Centrality or contact

- Expectancy

- Proximity

- Simplicity

Figures from the 1982 Lebanon war showed that with proximal treatment 90% of CSR casualties returned to their unit, usually within 72 hours. With rearward treatment only 40% returned to their unit. It was also found that treatment efficacy went up with the application of a variety of front line treatment principles versus just one treatment. In Korea, similar statistics were seen, with 85% of US battle fatigue casualties returned to duty within three days and 10% returned to limited duties after several weeks. Though these numbers seem to promote the claims that proximal PIE or BICEPS treatment is generally effective at reducing the effects of combat stress reaction, other data suggests that long term PTSD effects may result from the hasty return of affected individuals to combat. Both PIE and BICEPS are meant to return as many soldiers as possible to combat, and may actually have adverse effects on the long term health of service members who are rapidly returned to the front-line after combat stress control treatment. Although the PIE principles were used extensively in the Vietnam War, the post traumatic stress disorder lifetime rate for Vietnam veterans was 30% in a 1989 US study and 21% in a 1996 Australian study. In a study of Israeli Veterans of the 1973 Yom Kippur War, 37% of veterans diagnosed with CSR during combat were later diagnosed with PTSD, compared with 14% of control veterans.

The time workers spend in hot environments should be limited, with an increase of recovery time spent in cool environments. Use of more efficient procedures and tools is beneficial to reducing metabolic demands of the job. Heat tolerance may be increased by implementing a heat tolerance plan and increasing physical fitness. Employees should be trained to recognize and treat the early signs and symptoms of heat illnesses, and employers should provide cool water for employees.

The Simulator Sickness Questionnaire (SSQ) is currently the standard for measuring simulator sickness. The SSQ was developed based upon 1,119 pairs of pre-exposure/post-exposure scores from data that were collected and reported earlier. These data were collected from 10 Navy flight simulators representing both fixed-wing and rotary-wing aircraft. The simulators selected were both 6-DOF motion and fixed-base models, and also represented a variety of visual display technologies. The SSQ was developed and validated with data from pilots who reported to simulator training healthy and fit.

The SSQ is a self-report symptom checklist. It includes 16 symptoms that are associated with simulator sickness. Participants indicate the level of severity of the 16 symptoms that they are experiencing currently. For each of the 16 symptoms there are four levels of severity (none, slight, moderate, severe). The SSQ provides a Total Severity score as well as scores for three subscales (Nausea, Oculomotor, and Disorientation). The Total Severity score is a composite created from the three subscales. It is the best single measure because it provides an index of the overall symptoms. The three subscales provide diagnostic information about particular symptom categories:

- Nausea subscale is made up of symptoms such as increased salivation, sweating, nausea, stomach awareness, and burping.

- Oculomotor subscale includes symptoms such as fatigue, headache, eyestrain, and difficulty focusing.

- Disorientation subscale is composed of symptoms such as vertigo, dizzy (eyes open), dizzy (eyes closed), and blurred vision.

The three subscales are not orthogonal to one another. There is a general factor common to all of them. Nonetheless, the subscales provide differential information about participants' experience of symptoms and are useful for determining the particular pattern of discomfort produced by a given simulator. All scores have as their lowest level a natural zero (no symptoms) and increase with increasing symptoms reported.

Specific treatments are not mentioned. The affected person may go to a medical clinic that specializes in sexual health. If no medical problems are found, therapy may be used to help deal with stress, or anxiety medicines may be used.

Disorders, who they affect, and how they affect are different within each culture. In order to diagnose someone, it is necessary to make the effort to understand their home culture. Whether it is a culture bound syndrome or not, a person’s background determines how they see and interpret their own symptoms and how it must be treated.

For every 200,000 live births, conjoined twins are born. Conjoined twins are identical and of the same sex one hundred percent of the time and are more common in females than in males. For surgical separations the survival rate of at least one twin surviving is approximately 75%.

There are many methods of preventing or reducing industrial injuries, including anticipation of problems by risk assessment, safety training, control banding, personal protective equipment safety guards, mechanisms on machinery, and safety barriers. In addition, past problems can be analyzed to find their root causes by using a technique called root cause analysis. A 2013 Cochrane review found low-quality evidence showing that inspections, especially focused inspections, can reduce work-related injuries in the long term.

Within the qigong community, there are specific treatments believed to be effective for addressing different forms of Zou huo ru mo. In particular, depending upon somatic versus psychological symptoms, and whether the condition is considered temporary or an intrinsic mental disorder, self-correction treatments can involve relaxation, walking, self-vibrating, self-patting, and self-massage; whereas clinical treatments can involve psychological counseling, expert guidance of practice, acupuncture, massage, "external qi" treatments, and symptomatic correction

Chinese folk beliefs hold that the Yin (Chinese: 陰) represents femininity, slow, cold, wet, passive, water, the moon, and nighttime. And that Yang represents masculinity, fast, dry, hot, aggressive, fire, the sun, and daytime.

Loss of yang would result in an abundance of Yin. It is also believed that if a case of Shenkui is severe enough, it could result in death.

Informal or incomplete education about sexual health in China leaves a lot of room for folk beliefs to thrive. Often, advertisements support such beliefs to encourage use of traditional medicines. In Chinese folk beliefs, the loss of semen can cause imbalance in the body, leaving you with aches and pains and trouble performing.

In the second edition of the Chinese Classification of Mental Disorders (CCMD-2) published by the Chinese Society of Psychiatry the diagnosis of “Qigong Deviation Syndrome” is based upon the following criteria:

- The subject being demonstrably normal before doing qigong exercises

- Psychological and physiological reactions appearing during or after qigong exercises (suggestion and autosuggestion may play an important role in these reactions)

- Complaints of abnormal sensations during or after qigong exercises

- Diagnostic criteria do not meet other mental disorders such as schizophrenia, affective disorder, and neurosis.

A number of measurements exist to assess exposure and early biological effects for organophosphate poisoning. Measurements of OP metabolites in both the blood and urine can be used to determine if a person has been exposed to organophosphates. Specifically in the blood, metabolites of cholinesterases, such as butyrylcholinesterase (BuChE) activity in plasma, neuropathy target esterase (NTE) in lymphocytes, and of acetylcholinesterase (AChE) activity in red blood cells. Due to both AChE and BuChE being the main targets of organophosphates, their measurement is widely used as an indication of an exposure to an OP. The main restriction on this type of diagnosis is that depending on the OP the degree to which either AChE or BuChE are inhibited differs; therefore, measure of metabolites in blood and urine do not specify for a certain OP. However, for fast initial screening, determining AChE and BuChE activity in the blood are the most widely used procedures for confirming a diagnosis of OP poisoning. The most widely used portable testing device is the Test-mate ChE field test, which can be used to determine levels of Red Blood Cells (RBC), AChE and plasma (pseudo) cholinesterase (PChE) in the blood in about four minutes. This test has been shown to be just as effective as a regular laboratory test and because of this, the portable ChE field test is frequently used by people who work with pesticides on a daily basis.

Simulator sickness is a subset of motion sickness that is typically experienced by pilots who undergo training for extended periods of time in flight simulators. Due to the spatial limitations imposed on these simulators, perceived discrepancies between the motion of the simulator and that of the vehicle can occur and lead to simulator sickness.

It is similar to motion sickness in many ways, but occurs in simulated environments and can be induced without actual motion. Symptoms of simulator sickness include discomfort, apathy, drowsiness, disorientation, fatigue, vomiting, and many more.

These symptoms can reduce the effectiveness of simulators in flight training and result in systematic consequences such as decreased simulator use, compromised training, ground safety, and flight safety. Pilots are less likely to want to repeat the experience in a simulator if they have suffered from simulator sickness and hence can reduce the number of potential users. It can also compromise training in two safety-critical ways:

1. It can distract the pilot during training sessions.

2. It can cause the pilot to adopt certain counterproductive behaviors to prevent symptoms from occurring.

Simulator sickness can also have post-training effects that can compromise safety after the simulator session, such as when the pilots drive away from the facility or fly while experiencing symptoms of simulator sickness.

Slips, trips and falls account for over a third of all injuries that happen at work. Incorrect handling of items was the most common cause of injuries that led to absences from work of more than 7 days. Upper limb injuries represented 47.3% of workplace injuries in 2010-2011, the most common area injured.

In all, over 1,900,000 working days were lost in 2013/2014 due to slips, trips and falls.

Concussions are proven to cause loss of brain function. This can lead to physical and emotional symptoms such as attention disorders, depression, headaches, nausea, and amnesia. These symptoms can last for days or week and even after the symptoms have gone, the brain still won't be completely normal. Players with multiple concussions can have drastically worsened symptoms and exponentially increased recovery time.

Researchers at UCLA have, for the first time, used a brain-imaging tool to identify a certain protein found in five retired NFL players. The presence and accumulation of tau proteins found in the five living players, are associated with Alzheimer's disease. Previously, this type of exam could only be performed with an autopsy. Scientists at UCLA created a chemical marker that binds to the abnormal proteins and they are able to view this with Positron Emission Tomography (PET) scan. Researcher at UCLA, Gary Small explains, "Providing a non-invasive method for early detection is a critical first step in developing interventions to prevent symptom onset and progression in CTE".

Concussions and other types of repetitive play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player suicides and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, and also sleep disturbances.

The list of ex-NFL players that have either been diagnosed "post-mortem" with CTE or have reported symptoms of CTE continues to grow.

1. SCAN is the most common tool for diagnosing APD, and it also standardized. It is composed for four subsets: discrimination of monaurally presented single words against background noise, acoustically degraded single words, dichotically presented single words, sentence stimuli. Different versions of the test are used depending on the age of the patient.

2. Random Gap Detection Test (RGDT) is also a standardized test. It assesses an individual’s gap detection threshold of tones and white noise. The exam includes stimuli at four different frequencies (500, 1000, 2000, and 4000 Hz) and white noise clicks of 50 ms duration. It is a useful test because it provides an index of auditory temporal resolution. In children, an overall gap detection threshold greater than 20 ms means they have failed.

3. Gaps in Noise Test (GIN) also measures temporal resolution by testing the patient's gap detection threshold in white noise.

4. Pitch Patterns Sequence Test (PPT) and Duration Patterns Sequence Test (DPT) measure auditory pattern identification. The PPS has s series of three tones presented at either of two pitches (high or low). Meanwhile, the DPS has a series of three tones that vary in duration rather than pitch (long or short). Patients are then asked to describe the pattern of pitches presented.

The International Olympic Committee recommends the eucapnic voluntary hyperventilation (EVH) challenge as the test to document exercise-induced asthma in Olympic athletes. In the EVH challenge, the patient voluntarily, without exercising, rapidly breathes dry air enriched with 5% for six minutes. The presence of the enriched compensates for the losses in the expired air, not matched by metabolic production, that occurs during hyperventilation, and so maintains levels at normal.

Encopresis: The most common cause of Encopresis is constipation. When a child becomes constipated, feces build up in and stretch the rectum. This stretching causes the nerve endings to become dull. The child may not feel when he or she needs to eliminate the feces or if the waste is coming out. Inside the rectum, the feces could become too large or solid to eliminate without feeling pain. While the mass of feces is stuck in the child's rectum, liquid feces could leak from around the mass and out of the child's body. The main causes of constipation are diet, lack of sufficient amounts of water, stress, not enough exercise, and inconsistent bathroom routines.

Enuresis: The cause of Enuresis is thought to be unclear and usually is attributed to many factors.

- Genetic- there is a genetic component within Enuresis and it tends to run in families.

- Inability to feel that the bladder is full and be aroused from sleep.

- Insufficient size of bladder- the child's bladder is too small to contain the amount of urine produced.

- Psychological Factors- these are not main factors that contribute to Enuresis, but stress may be a cause.

- Maturational Delay- the child's recognition that the bladder is full and he or she needs to go to the bathroom is a developmental issue. Many children with Enuresis will develop this skill as they grow older.

Physical and emotional changes are often the most indicative symptoms of feeding and eating disorders of infancy or early childhood. The child's growth and development may be delayed due to the lack of necessary nutrients. The child will usually weigh much less than other children. Withdrawal and irritability are often associated with children that are malnourished.