A study of Cross-Cultural Care for the Foreign Elderlies in Okinawa / 国際保健医療

Introduction  The purpose of this study was to reveal the current conditions of the nursing care system for elderly and determine the problems concerning the cross-culture care practice. Methods  This study is a qualitative and descriptive research. We conducted a semistrustured interview study including six foreign sresidents in Okinawa who provided consent to participate in the study.  After recording verbatim and extracting the contents related to elderly nursing care, We coded these contents into each semantic unit to extract the themes by repeating the reorganization/integration while considering the similarity of the contents. Results  We extracted 126 codes as a narration related to nursing care and generated. 61 subcategories and 17 categories. Next,we extracted the following nine themes: 1） struggles overcoming the language barrier. 2） anxieties over symptom control or treatment of their illnesses. 3） a financial burden for receiving satisfactory medical treatment. 4） a sense of security with someone who understands their language, 5） affection by overcoming language barriers. 6） a cross-cultural environment in which they can choose their own living condition, 7） a sense of appreciation for care services that assist in achieving life stability. 8） adaptation to the cross-cultural life and attachment to Okinawa,and 9） life supported by religion, and the method of burial according to religion.Conclusion  The prpbrems should be resolved through 1） care service restructuring with the involvement of the recipients. 2） utilizing their community where they can share cultural connection, 3） fostering an interculture environment, 4） supporting caregivers, and 5） supporting an ideal end-of-life care with religion.

El medio abierto en España como vía de acceso a una expulsión tras la reforma de la LO 1/2015 / The open institution system in Spain as the access path to an expulsion following the reform of Organic Law LO 1/2015 / O meio aberto na Espanha como via de acesso a uma expulsão após a reforma da LO 1/2015

Resumen Se analiza la aplicación de las instituciones del tercer grado y de la libertad condicional a infractores extranjeros, tras la reforma operada en el art. 89 del Código Penal español por la LO 1/2015, para poner de manifiesto que nos encontramos ante una modificación que utiliza ambas herramientas como vías de acceso a la expulsión de infractores extranjeros, en lugar de como vías útiles para su reinserción. Para ello, se parte del estudio del declive que ha sufrido la reinserción social en España a raíz de diversas medidas legales que el legislador ha venido adoptando, principalmente desde el año 2003, así como del análisis e interpretación de sentencias de la Audiencia Provincial española, en aras de conocer los criterios que siguen al aplicar la libertad condicional y el tercer grado a los condenados extranjeros. Se llegó a la conclusión de que se trata de medidas que no son proclives a la reinserción social de los infractores extranjeros, puesto que, en vez de utilizarse para reinsertarlos en la sociedad, se emplean para practicar su expulsión.

Abstract The application of both third grade institutions and probation/parole to foreign offenders after the reform introduced in art. 89 of the Spanish Criminal Code by organic law la LO 1/2015, in order to make clear that we are facing an amendment that uses both tools as access paths to the expulsion/deportation of foreign offenders, in lieu of useful ways for their reintegration. For this purpose, it was necessary to begin studying the decline suffered by social reintegration in Spain due to diverse legal measures that legislator have been adopting, particularly since year 2003, as well as the analysis and construction of Spanish Provincial Court judgments, in favor of getting to know those criteria following the application of conditional release/probation/parole and the third grade to convicted foreigners. The conclusion reached is that we are dealing with measures that are neither nor keen on the social reintegration of foreign offender, since in lieu of being used to reinsert them into society, they serve to put their expulsion into practice.

Resumo Analisa-se a aplicação das instituições do terceiro grau e da liberdade condicional aos infratores estrangeiros, após a reforma operada no artigo 89 do Código Penal espanhol pela LO 1/2015, para mostrar que ficamos perante uma modificação que usa ambas as ferramentas como vias de acesso à expulsão dos infratores estrangeiros, em vez de como vias úteis para sua reinserção. Para este efeito, partimos do estudo do declínio sofrida pela reinserção social em Espanha em consequência das medidas legais diversas que o legislador tem adotado, principalmente do ano 2003, assim como da análise e a interpretação das sentenças da Audiência Provincial espanhola, em favor de conhecer os critérios que seguem ao aplicar a liberdade condicional e o terceiro grau aos condenados estrangeiros. Pôde se concluir que trata-se de medidas que não são suscetíveis à reinserção social dos infratores estrangeiros, porque em vez de ser usado para sua reinserção na sociedade, são usadas para praticar sua expulsão.

Distribution of HIV-1 subtypes among foreign patients, in Guangzhou, between 2008 and 2010, and in 2015 / 中华流行病学杂志

Objective To understand the characteristic of subtype distribution among foreigners who were living with HIV-1,in Guangzhou.Methods HIV-1 RNAs were extracted from 114 serum specimens in foreigners diagnosed with HIV-1 infections between 2008 and 2010,and in 2015.Partial pol gene of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) with nucleotide sequenced.Subsequently,phylogenetic tree was reconstructed using the pol sequences of samples and references.Results Among all the 114 samples,57.9％ were from males and 42.1％ from females,with an average age as 35.21 years old and the standard deviation as 9.63 years.A total of 6.8％ of the samples were from Africans.The top three subtypes were identified as CRF02_AG,subtype G and subtype C,accounted for 30.7％,14.9％ and 12.3％ respectively.Compared with samples gathered from 2008 to 2010,the proportions of subtype A1 and CRF01_AE significantly increased,while the other subtypes significantly decreased in 2015 (x 2=37.570;P=0.013,99％ CI:0.010-0.016).Proportions of CRF01_AE and subtype G among males outnumbered the females but the proportions of subtype A1,CRF02_AG and URF among females appeared the other way round (x2=15.528;P=0.029,99％CI:0.024-0.033).Proportions of CRF02_AG and subtype G among HIV-1 positive Africans were larger than those from other Southeast Asian countries or areas,However,the proportion of CRF01_AE among HIV-1 positive patients from Southeast Asian countries was higher than those patients from other areas (x2=39.399;P=0.009,99％ CI:0.006-0.011).The rates of resistance to any drug of protease inhibitors (PIs),reverse transcriptase inhibitors (RTIs),as well as to PIs,NRTIs,and NNRTIs alone,were 21.9％,12.3％,6.1％ and 7.0％,respectively.One of nine CRF01_AEs from the HIV-1 positive patients were found closely clustered in those phylogenetic tree (bootstrap=0.855) samples,collected from local patients in Guangzhou.Conclusions Our findings showed that these foreign subtypes had been spread to the natives,more from the Africans than from the other areas,in Guangzhou.These types of viruses were different from the strains identified locally,suggesting that they might have been brought in by foreigners living with HIV-1,in Guangzhou.Programs related to care,support and behavioral intervention for HIV positive foreigners living in Guangzhou,should be strengthened.

Distribution of HIV-1 subtypes among foreign patients, in Guangzhou, between 2008 and 2010, and in 2015 / 中华流行病学杂志

Objective To understand the characteristic of subtype distribution among foreigners who were living with HIV-1,in Guangzhou.Methods HIV-1 RNAs were extracted from 114 serum specimens in foreigners diagnosed with HIV-1 infections between 2008 and 2010,and in 2015.Partial pol gene of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) with nucleotide sequenced.Subsequently,phylogenetic tree was reconstructed using the pol sequences of samples and references.Results Among all the 114 samples,57.9％ were from males and 42.1％ from females,with an average age as 35.21 years old and the standard deviation as 9.63 years.A total of 6.8％ of the samples were from Africans.The top three subtypes were identified as CRF02_AG,subtype G and subtype C,accounted for 30.7％,14.9％ and 12.3％ respectively.Compared with samples gathered from 2008 to 2010,the proportions of subtype A1 and CRF01_AE significantly increased,while the other subtypes significantly decreased in 2015 (x 2=37.570;P=0.013,99％ CI:0.010-0.016).Proportions of CRF01_AE and subtype G among males outnumbered the females but the proportions of subtype A1,CRF02_AG and URF among females appeared the other way round (x2=15.528;P=0.029,99％CI:0.024-0.033).Proportions of CRF02_AG and subtype G among HIV-1 positive Africans were larger than those from other Southeast Asian countries or areas,However,the proportion of CRF01_AE among HIV-1 positive patients from Southeast Asian countries was higher than those patients from other areas (x2=39.399;P=0.009,99％ CI:0.006-0.011).The rates of resistance to any drug of protease inhibitors (PIs),reverse transcriptase inhibitors (RTIs),as well as to PIs,NRTIs,and NNRTIs alone,were 21.9％,12.3％,6.1％ and 7.0％,respectively.One of nine CRF01_AEs from the HIV-1 positive patients were found closely clustered in those phylogenetic tree (bootstrap=0.855) samples,collected from local patients in Guangzhou.Conclusions Our findings showed that these foreign subtypes had been spread to the natives,more from the Africans than from the other areas,in Guangzhou.These types of viruses were different from the strains identified locally,suggesting that they might have been brought in by foreigners living with HIV-1,in Guangzhou.Programs related to care,support and behavioral intervention for HIV positive foreigners living in Guangzhou,should be strengthened.

Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients

PURPOSE: This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. METHOD: Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. RESULTS: The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. CONCLUSION: Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved.

Comparison of features and outcomes of perforated peptic ulcer between Malaysians and foreigners

Background: Perforated peptic ulcers (PPU) present as serious surgical emergencies that carry high mortality and morbidity. Foreigners with PPU are also managed in our hospital setting. Their inclusion significantly alters the trend and pattern of PPU seen in Malaysia. Aim: To compare per-operative and post-operative features and outcomes of perforated peptic ulcers between Malaysians and foreigners. Material and Methods: This was an analytical crosssectional study. All patients who underwent repair of perforated peptic ulcer disease during a 6-year period were included. 50 consecutive patients’ records with perforated peptic ulcer were analysed. Data were collected from operation theatre database and hospital medical records. Chi square and t test were performed using SPSS statistical software. Results: Total of 50 patients, of which 30 were Malaysians and 20 were foreigners. The mean age of Malaysian patients was 58.3 ± 15.2 years whereas the mean age for foreign patients was 30.3 ± 6.7 years, with foreign patients being significantly younger than local patients. Foreigners had significantly smaller ulcers with only 5% of them having ulcers more than 1cm while 36.7% of Malaysian patients had ulcers more than 1cm. Post-operative complications are significantly higher in Malaysian patients (p<0.05) with 40% of Malaysian patients and 10% of foreign patients developing post-operative complications. Conclusion: Foreign patients are younger with significantly smaller perforated ulcers and better post-operative outcomes.

Um olhar sobre as autorizações de permanência a estrangeiros no Brasil, entre 2005 e 2011 / A portray on foreigners authorized to come to Brazil, from 2005 to 2011 / Una mirada sobre los extranjeros autorizados a entraren en Brasil, entre 2005 y 2011

A proposta geral desse artigo é apresentar uma análise descritiva dos estrangeiros autorizados a se estabelecer temporária ou permanentemente no Brasil, durante o período de 2005 a 2011, bem como sua relação com a política migratória brasileira. Para isso, foram utilizados os microdados da Coordenação Geral de Imigração (CNIg) do Ministério do Trabalho e Emprego. Considerando a literatura apresentada, o intuito é identificar se há uma tendência de seletividade dos estrangeiros autorizados a entrarem no país. Apesar de tal fato não poder ser testado, pois não se dispõe de informações sobre o perfil dos candidatos que tiveram seus pedidos de autorizações negados, é possível inferir sobre tal questão a partir dos dados analisados. Os resultados mostram que as autorizações concedidas são majoritariamente para trabalhadores profissionais e investidores, homens, altamente qualificados e de países, em geral, mais desenvolvidos (norte-americanos, europeus e asiáticos), com destino para o Sudeste. Esse perfil dos autorizados pode ser explicado, em parte, pela política migratória brasileira, que continua a ser restritiva e seletiva. Embora não se possa identificar a origem da seletividade – se o governo brasileiro, o mercado de trabalho (de origem e/ou de destino), ou as próprias solicitações dos estrangeiros –, verifica-se que a política migratória brasileira assegura tal seletividade, independentemente de quem venha a ser o agente dessa ação...

The main purpose of this article is to bring a descriptive analysis about foreigners who are authorized to stay in Brazil in a temporary or permanent term, from 2005 to 2011; and to highlight its relation to Brazilian migration policy. As such, we worked with microdata from Brazilian Migration General Coordination (CNIg), at the Work and Employ Ministry. Based on the presented bibliography, our aim is to identify the existence of a selectivity tendency regarding the authorization of foreigners who accomplish to come to Brazil. Although, we cannot test this selectivity fact, as the information regarding the migrant profile, who had his/her authorization declined, is not available; we can infer this point from the data collected. The results show that the majority of issued authorizations refers to professional workers and investors, men, highly skilled, from developed countries (in general Americans, Europeans and Asians), and towards Brazilian Southeast. This profile of authorized migrants could be partially explained by Brazilian migration policy which remains restrictive and selective. Although it is not possible to identify the source of this selectivity – whether the Brazilian government, the labor market (for origin and destination), or just the specificities of foreigners' requests – Brazilian migration policy ensures this selectivity, regardless of whom could be the agent of this action...

La propuesta dese artigo es presentar un análisis descriptivo de los extranjeros autorizados a establecerse de manera temporaria o permanente en Brasil, por el período de 2005 a 2011, y su relación con la política de migración brasileña. Para eso, utilizamos los microdatos de la Coordinación General de la Migración (CNIg), del Ministerio del Trabajo y Empleo. Considerando la literatura presentada, nuestro intento es identificar si hay una tendencia a la selectividad de los extranjeros que entran en el país. Aunque no podamos testar tal facto, una vez que no tenemos las informaciones sobre los perfiles de los candidatos que tuvieron sus solicitudes negadas, es posible inferir tal cuestión por los datos analizados. Los resultados enseñan que los tipos de autorización concedidos son, en su mayoría, para trabajadores profesionales y inversores, hombres altamente cualificados, de países, en general, desarrollados (estadounidenses, europeos y asiáticos), y con destino al Sudeste del país. Este perfil de autorizados puede ser explicado, en parte, por la política de migración brasileña que continua a ser restrictiva y selectiva. Aunque no se pueda identificar la fuente de la selectividad - si el gobierno brasileño, el mercado de trabajo (origen y / o destino), o las propias solicitudes de los extranjeros - la política de inmigración brasileña asegura tal selectividad independientemente de quién sea el agente de esta acción...

Nurses' Prejudice toward Foreigners: Focus Group Interviews / 재활간호학회지

PURPOSE: This study aimed to explore and describe nurses' prejudice toward foreigners. METHODS: The participants in the current study were 16 nurses who had worked in university hospitals. Data were collected using focus group interviews and an inductive content analysis was conducted with three focus groups. RESULTS: The contents with regard to prejudice toward foreigners were categorized into three themes: prejudice formation, triggers of prejudice and prejudiced behaviors. The participants' prejudice toward foreigners as instigated by appearances, attitudes, or the national economic statuses of foreigners were added to the prejudice which had been formed previously. Prejudiced behaviors included discriminative attitudes, devotion withdrawal, defensive behavior, or derision. CONCLUSION: The findings of this study indicate that nurses may have positive or negative prejudices toward certain foreigners, which can affect their nursing practice. These findings also warrant the development of programs designed to increase awareness of and reduce nurses' prejudice toward foreigners.

Comparison between Natives and Foreigners who Visited an Emergency Center due to Suicidal Attempt

PURPOSE: In an effort to determine the characteristics of foreign suicides who visit an emergency center, this study analyzed suicidal attempt between natives and foreigners. METHODS: We conducted a retrospective analysis of 1,218 Korean and 149 foreign suicidal attempters who visited a regional emergency center from January 1, 2009 to December 31, 2013. We compared two groups according to age, sex, selected suicidal methods, past psychiatric history, medical examination and treatment acceptance, elapsed time to visit an emergency center after suicidal attempt, emergency center residence time, and hospitalization period. RESULTS: No difference in medical exam acceptance and tetanus vaccination was observed between the two groups. However, we found a difference in hospitalization acceptance. The prevalence rate of psychiatric disorders was lower in foreign suicides, and the refusal rate of psychiatric treatment was higher in foreign patients. CONCLUSION: In foreign suicides, social support including finance is required for easy access to health care service. In addition, more active interdisciplinary cooperation with the department of psychiatry and close observation is needed.

Present situation and challenges of medical interpreters in Japan:Results of a questionnaire survey / 国際保健医療

<B>Introduction</B><BR>The questionnaire survey was conducted among medical interpreters to clarify the duties of medical interpreters and the contents of training programs, and to analyze the challenges in practice.<BR><B>Methods</B><BR>The self-reported questionnaires were distributed to NPOs of medical interpreters, local international exchange associations, and hospitals with medical interpreters. They were directly collected to authors and analyzed.<BR><B>Results</B><BR>The number of valid responses was 284 (response rate: 33.4%). 46.1% of the respondents had worked as medical interpreters for 5 years or more. There were a few fulltime workers and 76.4% worked as a part-time interpreters. The respondents could interpret 14 languages including sign language. Only 8.5% of them had worked more than 20 times per month, while 68.3% worked less than 4 times per month. 54.4% of the respondents have had training of medical interpreting for more than 20 hours. The respondents answered their difficulties as medical interpreters between medical providers and foreign patients.<BR><B>Discussions</B><BR>This study was targeted at medical interpreters and revealed that many medical interpreters were working at hospitals and other health facilities. The training programs to develop knowledge, skills and ethical conduct are urgently needed to establish the professionalism of medical interpreters. The coordinators are essential to advocate the roles of medical interpreters to medical providers and foreign patients, and to support medical interpreters.

The current situation and issues in the maternal and child health services provided by public health nurses to foreigners residing in Japan / 国際保健医療

<B>Introduction</B><BR>Compared to Japanese nationals, foreigners residing in Japan have a poor rate of maternal and child mortality and utilization of maternal and child health services. In this study, we examine the maternal and child health services provided by public health nurses to foreigners residing in Japan.<BR><B>Methods</B><BR>Questionnaires were administered to public health nurses working at local health centers in Aichi prefecture.<BR><B>Results</B><BR>Among the respondents, 4.5% were satisfied with the support system offered to foreigners residing in Japan, and 41.5% had offered their services to foreigners residing in Japan with various ideas. The following factors significantly affected satisfaction in public health nurses: acceptance by foreigners residing in Japan of the home of a newborn and maternal and child health check-ups (P=0.037, P=0.001, respectively), utilization of translators (P=0.002), and adopting a positive attitude towards providing health care services to foreigners residing in Japan (P=0.028).<BR><B>Conclusions</B><BR>Public health nurses in Japan are not satisfied with the health care services they offer foreigners residing in Japan. The results of this study suggest that it is important to provide them with multilingual materials and help them develop a positive attitude towards offering health care services to foreigners residing in Japan.

Adaptability and Preference to Korean Food with Foreigners Who Reside in Seoul, Korea / 대한지역사회영양학회지

The purpose of this study was to investigate the Korea-resident foreigners's adaptability and preference to Korean foods. The survey was carried out among 144 foreigners living in Seoul, Korea (male 57, female 87; from the East 109, from the West 35). Based on the first impression of Korean food, 'spicy', 'strong taste of seasoning', 'salty' were most common. About 90 percent of the foreigners adapted to Korean food in six months. It took more time to adapt to Korean food for Western people, compared to people from the East. Factors that influenced their adaption to Korean food were shown to be 'efforts by myself' and 'from friends'. Foreigners posited positive attitude toward Korean food according to their answers like 'nutritionally great food' and 'food with interesting ways of eating'. Westerners appeared to be more satisfied with Korean food. 'Too strong seasoning taste' and 'too sweet' were pointed out for further improvements. Beef Bulgogi, (Korean) fruit, Beef Ribs, Pork Ribs, and Grilled Pork Belly in order were foreigners' favorite foods, but Soju, Korean Sausage, Sliced Rice Cake Soup, Radish Kimchi and Vegetable Side Dishes were not. Taken together, the adaptability and preference to Korean foods to foreigners were different according to the gender and cultural background. Target marketing strategy of Korean Foods should be considered for foreign customers.

A Survey of the Awareness and Ability of Health Care Providers to Cope with Language Barriers at Medical Facilities in Hyogo, Japan / 国際保健医療

<B>OBJECTIVE:</B><br>This study aims to examine the awareness and ability of health care providers to cope with language barriers at medical facilities in Hyogo Prefecture, Japan, and to clarify the issues concerning health care for foreigners.<br><B>METHODS:</B><br>In total, 2100 copies of self-report questionnaires on issues of health care for foreigners were mailed to health care providers of 352 hospitals in Hyogo. The survey was conducted from February to March 2010.<br><B>RESULTS:</B><br>The response rate of medical facilities was 21.6% (76/352), whereas that of the health care providers was 15.2% (320/2100). Approximately 10% hospitals handled foreign patients at least once per month, and they dealt with patients using several languages, including English, Chinese, Korean, and others. The providers' main issue was communication with their foreign patients. The documents and booklets for guidance regarding some health care procedures at the hospitals were also poorly prepared. It is therefore exceedingly necessary for hospitals to provide common documents in different languages; moreover, the government or local authorities should arrange for public medical interpretation services.<br><B>DISCUSSION:</B><br>Medical facilities in Hyogo have been struggling to improve their linguistic capabilities, and it is difficult to indicate whether public organizations concerned with medical interpretation are being recognized. Efforts on the part of medical facilities and local and national governments, as well as cooperation of nonprofit organizations, are immensely essential to resolve the issue of multilingual health care. This survey suggests that to help people with diverse languages, the health care system in Japan should be improved rapidly, particularly with regard to the establishment of licensed professional medical interpreters.

Extranjeros no residentes y cobertura de salud. Un conflicto entre principios / Non-resident foreigners and health care coverage. A conflict of principles

La atención de extranjeros no residentes en hospitales públicos de alta complejidad es un problema de salud pública presente en la Argentina desde hace mucho tiempo, pero que se ha agravado en los últimos años. Es un tema sobre el que no se ha profundizado y sobre el cual no se encuentra bibliografía. El objetivo del presente estudio fue describir los motivos de internación y la ocupación de camas en el Hospital Garrahan, de niños extranjeros no residentes durante el año 2006, y comparar los resultados obtenidos con los mismos datos correspondientes al año 2004 para observar la tendencia. Material y Métodos: Se obtuvieron mediante registros informáticos todos los datos de los pacientes extranjeros hospitalizados en dos períodos: desde el 1 de enero al 31 de diciembre de los años 2004 y 2006 respectivamente. Se analizaron el número de camas ocupadas por extranjeros, en los diferentes sectores de internación durante los años 2004 y 2006. Resultados: Durante en año 2004 se internaron 389 niños extranjeros no residentes, con edades comprendidas entre 1 mes y 19 años. (2,1% de los egresos anuales) Durante el año 2006 se internaron un total de 1446 niños En el primer período (2004 )los días totales de internación de estos niños fueron 3.828 mientras en el año 2006 el número total de días de internación ascendió a 7.329 días, que significa un incremento del 91% con respecto al 2004, siendo el área donde se observó el aumento más importante la correspondiente a cuidados intermedios y moderados(CIM): 5.335 días (72,7%). Conclusiones: Dada la magnitud del problema, se deben pensar soluciones viables a mediano y largo plazo, pero el reconocimiento del problema es la primera etapa necesaria para su solución (AU)

Health care for non-resident foreigners at public tertiary care hospitals has been a public health problem for many years and has aggravated over the past time. However, the subject has not been the subject of debate no articles regarding this topic have been published in the literature The aim of the present study was to describe the reasons for admission and occupation of hospital beds in the Garrahan Hospital of non-resident foreign children during 2006 and to compare these results with data from 2004 to observe if there is a trend. Material and Methods: From computerized records all data of foreign patients hospitalized during two different periods were obtained: Between January 1 and December 31 of 2004 and 2006, respectively. The number of beds occupied by foreigners in different in-patient sectors during 2004 and 2006 was analyzed. Results: In 2004, 389 non-resident foreign children aged between 1 month and 19 years were admitted (2.1% of the yearly discharges). In 2006 a total of 1446 children were admitted. In the first period (2004), the total number of hospital days of these children was 3828, while in 2006 the total number of hospital days increased to 7329, a 91% increased compared to 2004. The highest increase was observed in the area of intermediate and moderate care (CIM): 5335 days (72.7%). Conclusions: Given the size of the problem, adequate medium- and long-term solutions should be developed, however, recognition of the problem is the first necessary step (AU)

Tuberculosis en grupos de riesgo en la región metropolitana: 2008 / Tuberculosis in risk groups within region metropolitana, Chile, 2008

Several risk factors have been identified of becoming ill of tuberculosis. This article estimates the importance of risk groups associated with tuberculosis within the Metropolitan Region of Chile in 2008. The incidence rate of tuberculosis for the Metropolitan Region was 14.19 per 100.000 inhabitants, being much higher in people with HIV (380,5), in homeless people (218. 7), in convicts (213.4), contacts of tuberculosis patients (104.5) , foreigners (37.5) and in elderly people (32.8). All of these risk groups have a significant association with tuberculosis and their odds ratios ranged from 29 (HIV) to 2.6 (elderly people). In spite of being few cases, the risk of becoming ill of tuberculosis in people belonging to risk groups such as HIV, homeless, convicts and foreigners is higher in comparison with the rest of the population. The elderly people also have a risk higher than the rest of population, representing 18.8 percent of the tuberculosis cases in the region.

Se han identificado diversos factores de riesgo de enfermar de tuberculosis. Este artículo estima la importancia de los grupos de riesgo asociados a tuberculosis dentro de la Región Metropolitana de Chile en 2008. La tasa de incidencia de tuberculosis para la Región Metropolitana fue de 14,19 por cien mil habitantes, siendo mayor en las personas con VIH (380,5), en personas en situación de calle (218,7), reos (213,4), contactos de pacientes con tuberculosis (104,5), en extranjeros (37,5) y en adultos mayores (32,8). Todos ellos con asociación significativa y odds ratio entre 29 (VIH) y 2,6 (adultos mayores). A pesar de ser pocos casos, el riesgo de enfermar de tuberculosis en personas con VIH, personas en situación de calle, reos y extranjeros es elevado en comparación con el resto de la población. También con un riesgo elevado se encuentran los adultos mayores, que representan el 18,8 por ciento de las personas con tuberculosis en la región.

Difference in Management Between Native Koreans and Foreigners with Penetrating Wounds In the Emergency Room

PURPOSE: With the increasing numbers of foreign residents in Korea, the need for an emergency medical care system for foreign patients seems to be growing. Sometimes, a foreigner admitted to an emergency room is not treated sufficiently due to the absence of insurance, facility in the Korean language, and a guardian. The management of a foreigner with trauma in the ER is difficult due to various problems such as social and economic status. The purpose of this study was to investigate the current management status of foreigners with penetrating wounds in the emergency room. METHODS: This study is an analysis of 580 patients that were diagnosed with penetrating wounds in one teaching Hospital from Jan. 1, 2008 to Dec. 31, 2008. We analyzed results according to nationality, alcohol ingestion, intentional or accidental trauma, trauma mechanism, injury severity, management time in the ER, and outcome in the ER. RESULTS: Of the total 580 patients, 486 patients (83.8%) were native Koreans and 94 patients (16.2%) were foreigners. According to the Revised Trauma Score, the average score of native Korean patients was 7.808, and the average score of foreign patients was 7.638. Of native Korean patients, 22.6% had knife wounds while 38.3% of foreign patients did. Of native Korean patients, 17.3% experienced intentional trauma while 33.0% of the foreign patients did. Of native Korean patients, 22.5% had ingested alcohol while 49.4% of the foreigners had. Of native Korean patients, 10.5% were admitted while 7.6% of the foreign patients were. Of native Korean patients, 14.2% were discharged against medical advice (DAMA), while 18.5% of foreign patients were. Of native Korean patients, 1.2% ran away while 8.7% of the foreign patients did. CONCLUSION: Stabbing was the most common cause of penetrating wounds in foreigner patients in this study. Intentional trauma was more common in foreigners with penetrating wounds than in native Koreans. The severity was higher in foreigners with penetrating wounds than it was in native Koreans, and patients who ran away or were discharged against medical advice were more commonly foreigners with penetrating wounds. Social insurance or policy is needed for the management of foreigners with penetrating wounds.

The Health and Social Situation of the Foreigners Living in Japan / 国際保健医療

 The foreigner's population in whole Japan is increasing up to 2.5%, while in Shizuoka prefecture it is 3.0% in Hamamatsu it is much higher up to 5.3%.<br> Health problem is a major item in the daily life, while about 36% of this category has not any health insurance, in order to receive the medical services in the medical facilities.<br> Community participation is an essential factor for the foreigners, in order to be in touch with the Japanese mothers and children. The lack of this kind of coordination may some time result difficulties in education of the children, regular health check and medical care of the foreign families.<br> Results: Among 220 patients sixty four percent of all patients had medical insurance, while remaining 36% had to pay for the whole expenses. Among those who had medical insurance 50% of acute diseases, and 60.6% of chronic diseases responded to continuous treatment, while in self-payment category only 40% of acute cases, and 21.6% of the chronic cases had efficient compliance.<br> The compliance to the treatment in both acute and chronic diseases were higher in those foreigner patients who had medical insurance. In those who had not any insurance poorly compliance to continuous treatment were obtained.<br> Conclusively community participation as well as, medical insurance for foreigner patients is a necessary item for living in Japan, in order to support their healthy and happy life.

Traditional Health Behavior of foreigners living in Japan / 国際保健医療

Introduction<br>Folk medicine is practiced in most countries for the purpose of treating illnesses, preventing from ailments and promoting health. When people immigrate, they bring and practice their medical experience and knowledge in the new country. They integrate their culture and traditional medical practices to those of their new home country.<br>Methods<br>Forty five foreigners from three different countries i.e. China, Philippine, Brazil, living in Japan were interviewed in-depth, in order to compare the differences of their traditional health behavior.<br>Results<br>The results show that Chinese have more knowledge, practice traditional health behavior more and suffer less from ailments than Philippinos and Brazilians, during the one year period prior to the date of interview. Most respondents practice traditional health behavior for health promotion and prevention from ailments while they chose either traditional or modern medicine for treatment according to the symptoms or diseases. All respondents consciously took certain drinks for promoting and maintaining their health. Only Chinese practice the "hot-cold" classification in illness management and diet. The concepts of opposition and balance are only some of the several approaches used in treating illnesses. Philippinos and Chinese use traditional health practices for maternal and child care more than Brazilians. More than 30% of Philippinos suffered from severe morning sickness and 20% of them gained excess weight rapidly during pregnancy. Respondents from all three countries took special traditional meals to recover from tiredness and produce adequate breast milk after childbirth.<br>Conclusions<br>All three different groups have integrated their own traditional health behavior to the Japanese life style not only for promotion and prevention from illnesses but also to complement medical services in Japan. It was found that some traditional practices were in common and others were very unique among the three countries. Suggestions for further research are made.