Epidemiological investigation on a cluster epidemic of COVID-19 in Taizhou， Zhejiang Province / 上海预防医学

Objective:To analyze the epidemiological characteristics of a family and workplace clustering of COVID-19， identify the source of infection and the transmission chain， and provide evidence for prevention and control of COVID-19 pandemic. Method:Field epidemiological method was used to conduct the investigation of confirmed cases and close contacts in this cluster. Data were analyzed with descriptive method. Real-time fluorescent quantitative PCR （RT-PCR） was used to detect the novel coronavirus nucleic acid in the collected respiratory tract samples. Results:A total of 18 epidemiological related cases were collected including 16 confirmed cases and 2 cases of asymptomatic infections. The involved places included 1 beauty clinic workplace and 3 families. Seven cases were males and 11 cases were females， with the minimum， maximum and median age of 3， 65 and 32 years old， respectively. Among them， the employees attack rate was 9.80% （10/102）， the family attack rate was 7.70% （5/78）， and the customer attack rate was 0.58% （1/173）. Positive nucleic acid test result in the respiratory tract sample of asymptomatic infection lasted for more than 2 months. Conclusions:The cause of this clustered COVID-19 epidemic is that the workplace environment is relatively closed with clustering crowds， and the source of imported infection is not discovered in time， which lead to a point-source outbreak and spread through family close contacts and clustering.

Adesão aos equipamentos de proteção individual entre trabalhadores de saúde que sofreram acidentes com material biológico / Adherence to standard precautions among health care workers exposed to accidents with biological material

Objetive:To analyze the adhesion to Individual Protection Equipment among health workers who have suffered accidents with biological material. Method:This is a retrospective, quantitative epidemiological study carried out in a hospital of medium complexity between October 2010 and December 2013. Results:The inadequacy of the use of the Individual Protection Equipment during the procedure was more prevalent in people aged up to 29 years-old and inprofessionals of the nursing team. Misuse of equipment was also more prevalent among people who suffered accidents during invasive and bloody procedures. Conclusion:The low adherence or inadequacy of the use of Personal Protective Equipment has been observed and can be linked to both individual and related aspects of employers' institutions.

Objetivo: Analisar a adesão aos Equipamentos de Proteção Individual entre trabalhadores de saúde que sofreram acidentes com material biológico. Método: Trata-se de um estudo epidemiológico, retrospectivo, quantitativo, realizado em um hospital de média complexidade, no período de outubro de 2010 a dezembro de 2013. Resultados: A inadequação do uso dos Equipamentos de Proteção Individual durante a realização do procedimento foi mais prevalente em pessoas com idade até 29 anos e em profissionais da equipe de enfermagem. O uso incorreto dos equipamentos também foi mais prevalente entre as pessoas que sofreram acidentes durante os procedimentos invasivos e com sangue. Conclusão: A baixa adesão ou a inadequação na utilização dos Equipamentos de Proteção Individual foi observada e pode estar vinculada tanto a aspectos individuais como a relacionados as instituições empregadoras.

Cancer Survivors and Returning to Work Perspectives from Occupational Health Physicians in Korea

BACKGROUND: This study was conducted from an occupational health perspective to document cancer survivors' ability to return to work, the role of clinical care, and the current status of effective return-to-work. METHODS: This cross-sectional study was conducted to evaluate the experiences and opinions of occupational health physicians (OHPs) regarding cancer survivors' return-to-work. A self-reported survey was conducted from December 30, 2015, to January 30, 2016, targeting 337 OHPs. Questions included: 1) treatment experiences of survivors in the words of OHPs, 2) current status of the assessments of fitness for work of cancer survivors, 3) experiences associated with workplace and treatment, and 4) problems of returning to work and overcoming system. RESULTS: Only 25% of the respondents said that they had experience treating cancer survivors, and the average number of patients was 12.6 per annum, which indicated that few cancer survivors were treated. Eleven cases included conducting assessment of fitness for work. There were 17 respondents who did not treat cancer survivors. Both those who had and did not have experience in treating survivors showed higher musculoskeletal system disorders (53.8 vs. 63.5) than cancer (15.5 vs. 11.2) in terms of frequency of the diseases in the assessment of fitness for work. Most respondents said that OHPs evaluate the current role appropriately and preferred OHPs in the future. They responded that OHPs found it difficult to treat cancer survivors, and it was psychologically tough to communicate with them (61.4%). Regarding the association of patient rehabilitation with workplaces, 48.9% said that workplaces provide inadequate support. CONCLUSION: As a preliminary study, we found that OHPs were found to have little experience in treating cancer survivors and undergo difficulties owing to poor collaboration with workplaces and communication with patients. This study will provide basic data for future studies to promote cancer survivors' return to workplaces.

Occupational Risk Factors for Prostate Cancer: A Meta-analysis

Prostate cancer is the second most common cancer in men worldwide. There are many occupational factors that have been suggested to cause prostate cancer. Our aim was to evaluate the evidence for causality by a literature review of occupational factors. We searched literature in Medline and SCOPUS from 1966 to June 30, 2015 to identify occupational risk factors for prostate cancer. The following risk factors were selected: farmers/agricultural workers, pesticides – whole group, and separately organophosphate and organochlorine pesticides, carbamates and triazines, cadmium, chromium, cutting fluids, acrylonitrile, rubber manufacturing, whole body vibration, shift work, flight personnel, ionizing radiation, and occupational physical activity. For each factor a literature search was performed and presented as meta-analysis of relative risk and heterogeneity (Q and I² index). A total of 168 original studies met the inclusion criteria with 90,688 prostate cancer cases. Significantly increased risks were observed for the following occupational exposures: pesticides (metaRR = 1.15, 95% confidence interval [CI] = 1.01–1.32; I² = 84%), and specifically group of organochlorine pesticides (meta relative risk [metaRR] = 1.08, 95% CI = 1.03–1.14; I² = 0%), chromium (metaRR = 1.19, 95% CI = 1.07–1.34; I² = 31%), shift work (metaRR = 1.25, 95% CI = 1.05–1.49; I² = 78%) and pilots (metaRR = 1.41, 95% CI = 1.02–1.94; I² = 63%) and occupational physical activity in cohort studies (metaRR = 0.87, 95% CI = 0.81–0.94; I² = 0%). The literature review supports a causal association for a few of the previously suggested factors.

Effects of hydration practices on the severity of heatrelated illness among municipal workers during a heat wave phenomenon

@#Introduction: The continue rise in temperatures due to climate change increases the risk of heat-related illness (HRI) among outdoor workers. This study aims to evaluate the effects of hydration practices on the severity of HRI during a heat wave episode among municipal workers in Negeri Sembilan. Method: A cross-sectional study was performed in March and April 2016. The outdoor temperatures were measured using the wet-bulb globe temperature (WBGT) tool. The participants completed a self-administered questionnaire containing sociodemographic factors prior to work shift; while working profile, hydration practices, and HRI symptoms at the end of work shift. The hydration status of the respondents was assessed by direct observation of their urine colour. Multiple logistic regression was performed to ascertain the effects of age, working profile, hydration practice, history of previous HRI, and hydration status on the likelihood that outdoor workers having moderate to severe HRI. Results: A total of 320 respondents completed the questionnaire. The mean (standard deviation) outdoor workplace temperature was 30.5°C (SD 0.53°C). The percentage of respondents who experienced moderate to severe HRI was 44.1%. The likelihood that outdoor workers experienced moderate to severe HRI symptoms was associated with irregular fluid intake [odds ratio (OR): 16.11, 95% confidence interval (95%CI): 4.11; 63.20]; consumption of non-plain water (OR: 5.92, 95%CI: 2.79; 12.56); dehydration (OR: 3.32, 95%CI: 1.92; 5.74); and increasing outdoor workplace temperature (OR: 1.85, 95%CI: 1.09; 3.11). Conclusion: Irregular drinking pattern and non-plain fluid intake was found to have a large effect on HRI severity among outdoor workers exposed high temperatures during a heat wave phenomenon.

La nueva epidemia: agresión hacia médicos en el ámbito laboral / The new epidemic: aggression against physicians in work places

Objetivos: Describir la prevalencia de eventos de agresión laboral contra médicos en la ciudad de Rosario y alrededores ocurridos en el último año. Determinar las características de los hechos de violencia y analizar la relación entrelos mismos y las características de la población médica.Materiales y Métodos: Estudio observacional, descriptivo y analítico, prospectivo; elaborado a partir de encuestascerradas on-line, realizadas de manera consecutiva a médicos que ejercieran en Rosario, Villa Gobernador Gálvez yGranadero Baigorria; del 18/07/2017 al 24/07/2017. Muestreo de tipo consecutivo, probabilístico, aleatorio simple. Se calculó un tamaño muestra de 350 encuestas.Resultados: Se incluyeron 351 encuestas. Hombres en 33% (n=115) y mujeres en 67% (n=236). El 23,1% (n=81)pertenecía al medio privado; 35% (n=123) al público; 41,6% (n=146) ambos y 0,3% (n=1) NS/NC. El 80,1%(n=281) presentó un episodio de agresión en el último año, de los cuales 86,8% (n=244) fue verbal y 13,2%(n=37) física-verbal. La agresión, pudiendo identificarse más de un agresor, fue realizada por familiar del pacienteen 94%(n=237), paciente 66% (n=166), personal de salud no médico 33% (n=83) y 26% (n=67) por un colega.El sitio de agresión más frecuente fue la guardia externa. Las mujeres padecieron mayor cantidad de eventos deagresión. Las especialidades más agredidas fueron Obstetricia y Pediatría. Se identificaron como factores de riesgo:sexo femenino (p=0,01; OR=2; IC95%=1,1-3,4), ejercicio profesional en guardia externa (p<0,0001; OR=3,2;IC95%=1,8-5,8) y la especialidad pediatría (p=0,016; OR=1,2; IC95%=1,2-1,3)... (AU)

Purposes: Estimation of the prevalence of aggression events against physicians in the workplace in the city of Rosario and environmentsin last year. Description of the violence events and how they are related with the medical population characteristics.Materials and methods: This is an observational, descriptive and analytic, prospective research. Performed withphysicians working in Rosario, Villa Gobernador Gálvez and Granadero Baigorria cities, Santa Fe, Argentina in base ofclosed on line surveys in a consecutive way. The evaluation included the period from July 18th to July 24th, 2017. Thesample was consecutive, probabilistic and simply randomized. The calculated sample size was 350 surveys.Results: 351 surveys were included, 33% males (n=115) and 67% females (n=236). 23% (n=81) from privateinstitutions, 35% (n=236) public ones, 41,6% both (n=146) both and unknown / unanswered 0,3% (n=1). 80%(n=281) presented an episode of aggression in the previous year, of which 86% (n=244) was verbal and 13,2% (n=37)physical and verbal. The aggression was performed by a patient`s relative in 94% (n=237), the patient in 66% (n=166),non-medical health personnel 33% (n=83) and 26% (n=67) by a colleague. The most frequent place of aggression wasemergency room. The women suffered a higher frequency of aggression. Obstetrics and pediatrics were the specialties moreinvolved. The risk factors were: female sex (p=0.01; OR=2; CI95%=1,1-3,4); working in emergency room (p<0,0001;OR=3,2; IC95%=1,8-5,8 and the specialty of pediatrics (p=0,016; OR=1,2; CI95%=1,2-1,3)... (AU)

Application of Assessment Tools to Examine Mental Health in Workplaces: Job Stress and Depression

Despite the fact that the lifetime and yearly prevalence rates of mental illness continue rising, such diseases have only been acknowledged as involved in workplace health issue since the 2000s. Additionally, while the number of recognized cases of mental illnesses is rather low compared to their prevalence, they have a high likelihood of causing significant problems, including fatalities. Many workers are terrified of losing their jobs due to mental illness and therefore attempt to hide their mental health problems. For this reason, clinicians involved in occupational and environmental medicine should focus on interviews or screenings to identify such hidden mental health problems. More specifically, it would be helpful to evaluate job stress and depression in workplaces to ensure appropriate preventive actions and thereby reduce the prevalence of mental illness. Job stress not only causes mental illness and dissatisfaction with work, but also can increase the prevalence and morbidity of medical diseases, as well as other physical health problems. Depression is a major contributor to work loss and absence with effects surpassing almost all of the chronic medical disorder. These facts show why measure of job stress and depression should be highlighted in the occupational settings. This article introduces a variety of assessment tools to examine mental health, particularly stress and depression, in workplaces. These tools can be used by clinicians or professionals involved in the mental health, occupational safety, or health service fields for running diagnostics or screening tests.

Relationships among Self-esteem, Social Support, Nursing Organizational Culture, Experience of Workplace Bullying, and Consequence of Workplace Bullying in Hospital Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify relationships among self-esteem, social support, nursing organizational culture, experience of workplace bullying, and the consequences of workplace bullying in hospital nurses, and then to provide basic information for developing workplace bullying prevention programs. METHODS: Participants were 122 hospital nurses from three general hospitals. Data collection was done during April and May 2015. Data were collected using self-report questionnaires which were used to identify participants' characteristics, self-esteem, social support, nursing organizational culture, and workplace bullying. RESULTS: Approximately one quarter of the nurses had experienced workplace bullying in the past six months. Hierarchical regression analysis showed that experience of workplace bullying (β=.45) and self-esteem (β=-.31) explained 53.3% of the variance in consequences of workplace bullying. CONCLUSION: Based on the findings that experiencing workplace bullying and having a low self-esteem were likely to increase workplace bullying in hospital nurses, there is a need to develop prevention and intervention programs on avoiding or dealing with workplace bullying.

Adaptación y validación psicométrica de la Escala de Clima Social Organizacional (WES) de Moos en México / Adaptation and Psychometric Validation of the Moos' Work Environmental Scale (WES) in Mexico

El propósito de este estudio fue generar un instrumento que permita medir el clima social organizacional en el entorno mexicano de manera confiable y válida. Para lo cual, se adaptó la Escala de Clima Social Organizacional (WES) versión en español (Moos, 2008), conformada por 90 reactivos con 6 opciones de respuesta; para realizar su validación psicométrica se aplicó a 490 trabajadores mexicanos, de entre 18 y 66 años de edad, 261 mujeres y 229 hombres con diferentes grados de escolaridad. Se llevaron a cabo análisis para conocer el poder discriminativo de los reactivos; la confiabilidad y la estructura factorial válida para la población laboral nacional. La escala final estuvo constituida por 18 reactivos, organizados en tres factores y un indicador: Clima laboral, Aspectos físicos, Normatividad organizacional y el indicador Cambio.

The objective of this research was to generate a standardized that assessed organization social climate in Mexican population. Was used The Work Environmental Scale, Spanish version (Moos, 2008), to be adapted. The scale include 90 items, with six options for answers. The scale was applied to 490 Mexican employees in order to obtain its psychometrical validation. The distribution was as follow: age between 18 and 66; 261 women and 229 men; diverse school levels. A proper analysis took place in order to learn about the items discriminative power, reliability and valid factorial structure for the Mexican worker population. The final scale was conformed by 18 items organized by three factors and one indicator as follow: 1) work environment, 2) physical aspects of the work place, 3) organization rules and regulations and 4) the change indicator.

Occupational and environmental medicine: A discipline to pursue in this millennium

As the world is moving towards industrialization, there is an increasing awareness of environmental influences on the health and safety of workers, and in communities near industrial establishments. The Philippines in its endeavor to become a newly industrialized country, is increasingly confronted with problems regarding health and safety of workers, and with the environmental health impact of industrialization on nearby communities.

Adultery: meanings and interpretations as professional misconduct, civil and criminal offence in India.

Forensic medicine teachers taught topic of ‘adultery’ to medical students as one of the sexual offences, medicolegal aspect of marriage, and as professional misconduct, which is part of medical ethics. The question is of safeguarding / protecting socio-ethical value of our society and honour of medical profession. Section 497 IPC came into existence during the British Rule. It is said that it is against Indian cultural values and not much less than a slander. Therefore, in independent India it is totally unfair to allow continuing Section 497 IPC in its present form. This paper deals with definition, meanings and interpretations of the term ‘adultery’ used in different context in medical profession so that clear concept can be understood by every member of medical fraternity. Thus, help in preventing unnecessary problems faced by doctors in day to day practice.

Pruebas de funcionamiento hepático: ¿indicador de riesgo laboral en enfermeras quirúrgicas? / Hepatic function test: Labor risk in surgical nurses?

Introducción: la hepatotoxicidad de los halogenados produce síndromes de características clínicas y hallazgos de laboratorio similares a la hepatitis viral. Objetivo: determinar si las enfermeras quirúrgicas presentan alteraciones de la función hepática en comparación con alumnas del curso de enfermería quirúrgica. Material y métodos: se aplicó una encuesta a 15 enfermeras quirúrgicas y a 15 alumnas del curso postécnico en enfermería quirúrgica, para identificar los antecedentes personales, y determinar pruebas funcionales hepáticas. Resultados: edad en el grupo de enfermeras quirúrgicas y estudiante 40±3.8 y 34.4±4.6 respectivamente; antigüedad laboral 16.4 ± 4.6 y 10.8±2.8 respectivamente; 12% de las pruebas funcionales hepáticas indicaron estar alteradas en las enfermeras quirúrgicas y 19.3% en las estudiantes. Discusión: las pruebas funcionales hepáticas alteradas en el personal que labora en quirófano es producto de la exposición a los halogenados o ya ingresan con estas alteraciones. Conclusión: las enfermeras quirúrgicas presentaron menos alteraciones en las pruebas funcionales hepáticas en comparación con las alumnas, por lo que estas últimas se consideran un grupo de alto riesgo. Sin embargo, al no ser estadísticamente significativas es necesario hacer registros al inicio de la actividad laboral en áreas de exposición a halógenos y hacer seguimiento.

Introduction: the hepatotoxicidad of the halogenados produces syndromes of clinical characteristics and similar laboratory discoveries to the viral hepatitis. Objective: to determine if the surgical nurses present alterations of the hepatic function in comparison with the students of the course of surgical nurse. Material and methods: a comparative survey was applied to the surgical ones and the students, capturing the personal antecedents, and the quantification of the hepatic functional tests. Results: the age in the group of surgical nurses (N=15) and the students (n=15) were 40 ± 3.8 (Half ± DS) and 34.4 ± 4.6 respectively, the labor antiquity 16.4 ± 4.6 and 10.8 ± 2.8, 12% of the tests functional liverworts indicated to be altered in the surgical nurses and 19.3% in the students. Discussion: the tests functional liverworts altered in the personnel that works in operating theatre it is product from the exhibition to the halogenados or they already enter with these alterations. Conclusión: the surgical ones present less alterations in the hepatic functional tests than the students for what these represent a group of high risk.

Task Analysis on Foodservice, Clinical Nutrition Service in Hospital Dietetic Departments

The purpose of this research was to analyze the tasks on foodservice, clinical nutrition service in hospital dietetic departments. A survey of 30 hospital food and nutrition service departments was undertaken and detailed informations were collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows: Regarding distitian's training period, 38.6% dietitians answered that they spent 1~2 years in mastering food service management. 28.4% dietitians replied that they needed 2~3 years in learning clinical nutrition management. It was shown that 48.9% dietitians were engaged in food service management, while 26.7% were engaged in clinical nutrition and 26.7% were engaged in both. The 13 elements of food service management showed low performance level. These elements were food temperature, food intake, menu selection, contaminated substances and serving mistake and reliance on hospital food. These should be controlled with caution. The average score of dietitian's life satisfaction within the work place was 3.42 out of 5. The most dissatisfactory element was physical environment of the workplace. 5 elements for improving nutrition service activities showed low performance level with high importance score. Problem analysis showed low difference score between importance and performance level. Hospitals under contract foodservice management received higher points on clinical nutrition performance(P<.05) than hospitals under self-operated foodservice management.

A National Sample Survey of Medical Students about Their Perception and Evaluation on Medical Study, Career Plan, and Medical Care System: Part 2. Career Plan after Graduating from Medical School / 한국의학교육

A national sample survey of medical students about their perception and evaluation on medical study, career plan, and medical care system was conducted in December 1997 through January 1998. About 10% of all the medical students in 32 medical schools that had students from freshman to senior in November 1997 were systematically sampled for a questionnaire survey. Out of 1,386 students, 1,233(89.0%) had responded and 12 of them were excluded from the analysis because of incomplete response. This report is the second part of the study regarding career plan of students after graduating from medical school. Criteria of medical students for choosing specialty of medicine are professional reward and personal interest. Among the respondents, 92.2% plan to choose clinical medicine, 2.5% basic medical sciences, and 4.8% special areas of medicine such as health administration, medical engineering, forensic medicine, medical education, and health economics. If it is guaranteed that they will be a professor after training, 8.8% of them want to study special areas of medicine, and 7.3% basic medical sciences. The students who had admitted to a medical school after obtaining bachelor's degree were more prone to choose clinical medicine than other students. The most common reason for not choosing basic medical sciences was lower income than clinician. Among the students who want to be a clinician, 92.2% want to be a specialist and the preferred specialties were internal medicine 36.0%, orthopedics 9.0%, general surgery 7.7%, psychiatry 7.5%, and pediatrics 5.7%. Comparing with the findings of 1983 study, the proportions of students who want to major internal medicine and minor subjects were markedly increased and that of general surgery increased slightly while that of pediatrics was decreased. The places of work that the students prefer in the future were university hospital 43.2% (10% point increase from the finding in 1983), general hospital 37.1% and private practice 9.4% (10% point decrease from the finding in 1983). It was noticeable that some of the students want to be a medical missionary and health administrator. The students prefer their university hospital most for post-graduate training and the reason is only because it is their alma mater. One can anticipate from these findings that it will be very difficult to get basic medical scientists and primary physicians in the future.