Mayor uso de teleconsultas programadas y mensajería asincrónica del portal en atención primaria / Increased Use of Scheduled Teleconsultations and Asynchronous Portal Messaging in Primary Care

Introducción: durante la pandemia de COVID-19 hubo un auge sin precedentes de la telemedicina, probablemente por la forzada adopción de tecnología ante las medidas restrictivas. El presente estudio se propuso comparar la interacción y la comunicación entre médicos de cabecera (MC) y pacientes, antes y durante el período de pandemia, en términos de consultas ambulatorias programadas y mensajes del Portal de Salud. Materiales y métodos: corte transversal con muestreo consecutivo de turnos programados y mensajes, ocurridos entre las semanas epidemiológicas (SE) 10 y 23, de 2019 y 2020, respectivamente. Se incluyeron 147 médicos del Servicio de Medicina Familiar y Comunitaria, y una cápita de 73 427 pacientes afiliados al Plan de Salud del Hospital Italiano de Buenos Aires. Se realizó análisis cuantitativo y cualitativo. Resultados: hubo una reducción del 70% de las consultas presenciales (de 76 375 en 2019 a 23 200 en 2020) y un aumento concomitante de teleconsultas (de 255 en la SE13 a 1089 en la SE23). En simultáneo, los mensajes aumentaron sustancialmente (de 28 601 en 2019 a 84 916 en 2020), con un inicio abrupto al comienzo del confinamiento, y una tendencia decreciente a lo largo del tiempo. Antes de la pandemia, el contenido estuvo relacionado con órdenes electrónicas de estudios complementarios, control de resultados, recetas de medicación crónica y/o interconsultas a especialistas, mientras que los dominios más frecuentes durante la pandemia fueron necesidades informativas epidemiológicas, como medidas preventivas para COVID-19, vacuna antineumocócica, vacuna antigripal, casos o sospechas, resultados de hisopados, entre otras. Conclusión: el auge de las tecnologías de la comunicación e información durante la pandemia permitió dar continuidad a los procesos asistenciales en salud pese al distanciamiento físico. Hubo mayor utilización de mensajería por necesidades informativas de los pacientes, y la relación médico-paciente se ha modificado. (AU)

Introduction: during the COVID-19 pandemic, there was an unprecedented boom in telemedicine, probably due to the forced adoption of technology in the face of restrictive measures. This study aimed to compare the interaction and communication between general practitioners and patients before and during the pandemic based on scheduled outpatient consultations and Health Portal messages. Materials and methods: Cross-sectional study with a consecutive sampling of scheduled appointments and messages, occurring between epidemiological weeks (EW) 10 and 23 of 2019 and 2020, respectively. We included 147 physicians from the Family and Community Medicine Service and a capita of 73427 patients affiliated with the Hospital Italiano de Buenos Aires health plan. We conducted a quantitative and qualitative analysis. Results: there was a 70% reduction in face-to-face consultations (from 76375 in 2019 to 23200 in 2020) and a concomitant increase in teleconsultations (from 255 in EW13 to 1089 in EW23). Concurrently, messages increased substantially (from 28601 in 2019 to 84916 in 2020), with an abrupt onset at the beginning of confinement and a decreasing trend over time. Before the pandemic, the content involved electronic orders for complementary studies, outcome monitoring, chronic medication prescriptions, or expert consultations. The most frequent domains during the pandemic were epidemiological information needs, such as preventive measures for COVID-19, pneumococcal vaccine, influenza vaccine, cases or suspicions, and swab results, among others. Conclusion: the rise of communication and information technologies during the pandemic allowed the continuity of healthcare processes despite the physical distance. There was increased use of messaging for patients' information needs, and the doctor-patient relationship has changed. (AU)

O sexting no Brasil: a percepção sobre mensagens sexuais / Sexting en Brasil: la percepción sobre los mensajes sexuales / Sexting in Brazil: the perception about sexual messages

RESUMO. O sexting é uma prática cada vez mais frequente na sociedade atual, mas ainda há poucos estudos sobre como os brasileiros veem a troca de mensagens sexuais. O objetivo desse estudo foi investigar a percepção de brasileiros acerca do sexting e fornecer um panorama de como o fenômeno ocorre na realidade brasileira. Foi realizado um survey online com perguntas discursivas com 41 participantes sobre a dinâmica da prática e foi utilizada a análise de conteúdo para tratamento dos dados. Os resultados revelaram que algumas visões sociais são permeadas por estereótipos, como se observa em pesquisas de outros países. O sexting ainda é em muitos momentos confundido com diferentes formas de violência, apesar de estar sendo naturalizado no país e de já ser parte da experiência sexual cotidiana de muitas pessoas. Evidenciou-se que a educação sexual no contexto digital se faz necessária para que as pessoas compreendam seus direitos e reconheçam as diferenças entre sexting saudável e violências possivelmente atreladas à prática.

RESUMEN. El sexting es una práctica cada vez más frecuente en la sociedad actual, pero todavía hay pocos estudios sobre cómo algunos brasileños ven los mensajes sexuales. El objetivo de este estudio fue investigar la percepción de los brasileños sobre el sexting y proporcionar una visión general de cómo se produce el fenómeno en la realidad brasileña. Se realizó un survey online con preguntas discursivas con 41 participantes sobre la dinámica de la práctica y se utilizó el análisis de contenido para el tratamiento de datos. Los resultados revelaron que algunos puntos de vista sociales están impregnados de estereotipos, como se observó en investigaciones de otros países. El sexting aún se confunde con diferentes formas de violencia, a pesar de estar naturalizado en el país y ya es parte de la experiencia sexual diaria de muchas personas. Se hizo evidente que la educación sexual en el contexto digital es necesaria para que las personas entiendan sus derechos y reconozcan las diferencias entre el sexting saludable y la violencia posiblemente vinculada a la práctica.

ABSTRACT. Sexting is an increasingly frequent practice in today's society, but there are still few studies about the perceptions of Brazilians about sexual messages. The aim of this study was to investigate the perception of some Brazilians about sexting and provide an overview of the characteristics of the phenomenon in the Brazilian reality. An online survey was conducted with discursive questions with 41 participants about the dynamics of the practice and content analysis was used for data treatment. The results revealed that some social views are permeated by stereotypes, as observed in research from other countries. Sexting is still often confused with different forms of violence, despite being naturalized around the country and already being part of the daily sexual experience of many people. It became evident that sex education in the digital context is necessary for people to understand their rights and recognize the differences between healthy sexting practice and violence possibly linked to the messages.

Lineamientos técnicos para la gestión de correo electrónico institucional / Technical guidelines for mail management institutional electronic

El presente documento tiene como finalidad normar el uso estricto del correo electrónico institucional, incluyendo información y otros aspectos del tema. Se pretende regular la utilización de la herramienta, el tráfico de la información tanto fuera como dentro de la institución, en todos aquellos puntos de acceso a redes públicas de datos. El correo electrónico deberá considerarse como un medio de comunicación institucional, optimizando sus recursos y fomentando el flujo adecuado de la información interna; lo que permita una eficiencia, efectividad y seguridad de la información

The purpose of this document is to regulate the strict use of email institutional, including information and other aspects of the subject. It is intended to regulate use of the tool, information traffic both outside and inside the institution, in all those access points to public data networks. E-mail should be considered as a means of institutional communication optimizing its resources and promoting the proper flow of internal information; which allow an efficiency, effectiveness and security of the information

Um ano de e-mails não solicitados: o modus operandi de revistas e editoras predatórias / One year of unsolicited e-mails: the modus operandiof predatory journals and publishers

Objetivo: Quantificar, caracterizar e analisar e-mails de revistas predatórias (RP) recebidos por uma pesquisadora da área de odontologia. Materiais e métodos: E-mails recebidos em 2019 e suspeitos de serem potencialmente predatórios foram pré-selecionados. O checklist do Ottawa Hospital Research Institute (OHRI) para identificar RP biomédicas suspeitas foi aplicado, incluindo os seguintes critérios: taxa/preço de publicação (TP), fator de impacto falso, a revista estar listada no Directory of Open Access Journals (DOAJ) e no Committee on Publication Ethics (COPE). Também foram extraídas informações sobre a falta de um fator de impacto no Journal Citations Reports, endereço de contato de e-mail não afiliado à revista, linguajar lisonjeiro, citação pessoal e/ou de um artigo, link de cancelamento de inscrição do tipo unsubscribe, estar listado no catálogo atual da National Library of Medicine (NLM) e estar indexado no Medline. Resultados: Um total de 2.812 e-mails suspeitos não solicitados foram recebidos e 1.837 requisitaram algum tipo de manuscrito; entre eles, 1.751 preencheram algum critério do OHRI. Menos da metade (780/1.837, 42%) referiu-se a alguma área da odontologia. A TP mediana foi de US$ 399. Um falso fator de impacto foi mencionado em 11% (201/1.837) dos e-mails e 27% (504/1.837) correspondiam a periódicos atualmente listados no catálogo da NLM. Os periódicos listados no DOAJ e COPE enviaram 89 e-mails. Conclusão: A campanha editorial das RP, sob a forma de e-mails, foi intensa e recorrente. Os pesquisadores devem estar bem informados sobre o modus operandi das RP para proteger sua própria reputação como autores, assim como a reputação da ciência

Objectives: To quantify, characterize and analyze e-mail from predatory journals (PJ) received by an academic in dentistry. Materials and methods: E-mails received in 2019 and suspected of being potentially predatory were pre-selected. The Ottawa Hospital Research Institute (OHRI) checklist was applied to identify the suspected biomedical PJ, including the following criteria: article processing charge (APC), fake impact factor, the journal being listed in the Directory of Open Access Journals (DOAJ) and the Committee on Publication Ethics (COPE). We also extracted information on the lack of an impact factor on Journal Citations Reports, non-journal affiliated contact e-mail address, flattering language, article and/or personal citation, unsubscribe link, being listed in the National Library of Medicine (NLM) current catalog and indexed on Medline. Results: A total of 2,812 unsolicited suspected e-mails were received, and 1,837 requested some sort of manuscript; among these, 1,751 met some of the OHRI criteria. Less than half (780/1,837, 42%) referred to some area of dentistry. The median APC was US$399. A false impact factor was mentioned in 11% (201/1,837) of the e-mails, and 27% (504/1,837) corresponded to journals currently listed in the NLM catalog. Journals listed in DOAJ and COPE sent 89 e-mails. Conclusions: The email campaign from PJ was high and recurrent. Researchers should be well informed about PJ' modus operandi to protect their own reputation as authors and that of science.

Comentarios del artículo: "Niveles de sedentarismo de una institución educativa en Popayán, Colombia" / Carta al Editor

Carta al Editor

Educación a distancia de la maestría Atención Estomatológica Comunitaria durante el periodo de COVID-19 / E-learning of the Community Dental Care master's degree during COVID-19

RESUMEN Fundamento: Mantener las formas organizativas de la formación académica con métodos alternativos es una necesidad en los momentos actuales debido a la difícil situación que ha impuesto la pandemia de COVID-19. Objetivo: Describir las modalidades de educación a distancia utilizadas en la maestría Atención Estomatológica Comunitaria en tiempos de la pandemia COVID-19. Metodología: Se realizó una investigación descriptiva en la Universidad de Ciencias Médicas de Sancti Spíritus entre marzo y junio de 2020 con la aplicación de métodos del nivel teórico (analítico-sintético; inductivo-deductivo) y empírico (análisis de documentos). Resultados: El correo electrónico, el intercambio de medios electrónicos de almacenamiento, la vía telefónica, el grupo de WhatsApp y la autopreparación fueron las principales modalidades implementadas en las condiciones de restricción de movilidad y distanciamiento social que impuso la situación epidemiológica actual. Conclusiones: Las modalidades de educación a distancia utilizadas permitieron contextualizar el proceso de enseñanza-aprendizaje de la maestría a los tiempos de pandemia.

ABSTRACT Background: At present to maintain the structural forms of academic training with alternative methods is essential due to the difficult situation imposed by COVID-19. Objective: To describe the e-learning modalities used in the Community Dental Care master's degree in times of COVID-19. Methodology: A descriptive research was conducted at the Sancti Spíritus University of Medical Sciences between March and June 2020 with the application of theoretical (analytical-synthetic; inductive-deductive) and empirical (document analysis) methods. Results: E-mail, the exchange of electronic storage media, the telephone, the WhatsApp group and self-preparation were the main modalities implemented in the conditions of mobility restriction and social distance imposed by the current epidemiological situation. Conclusions: The e-learning modalities used allowed contextualizing the teaching-learning process of the master's degree to the times of pandemic.

Email vs. instagram recruitment strategies for online survey research

Abstract In this study, we describe a method for reaching a target population (i.e., dentists practicing in Brazil) to engage in survey research using traditional e-mail invites and recruitment campaigns created on Instagram. This study addresses methodological aspects and compares respondents reached by different methods. A pre-tested questionnaire was used and participants were recruited for 10 days via a source list of email addresses and two discrete Instagram organic open campaigns. A total of 3,122 responses were collected: 509 participants were recruited by email (2.1% response rate) and 2,613 by the two Instagram campaigns (20.7% and 11.7% conversion rates), respectively. Response/min collection rates in the first 24 h ranged between 0.23 (email) and 1.09 (first campaign). In total, 98.8% of all responses were received in the first 48 h for the different recruitment strategies. There were significant differences for all demographic variables (p< 0.001) between email and Instagram respondents, except for sex (p=0.37). Instagram respondents were slightly older, had more professional experience (years in practice), and a higher graduate education level than email respondents. Moreover, most email and Instagram respondents worked in the public sector and private practice, respectively. Although both strategies could collect responses from all Brazilian regions, email responses were slightly better distributed across the five territorial areas compared to Instagram. This study provides evidence that survey recruitment of a diverse, large population sample using Instagram is feasible. However, combination of email and Instagram recruitment led to a more diverse population and improved response rates.

Resumo Neste estudo, descrevemos um método para atingir uma população-alvo (dentistas atuando no Brasil) para se engajar em pesquisa do tipo enquete (survey) utilizando convites tradicionais por e-mail e campanhas de recrutamento criadas no Instagram. Este estudo aborda aspectos metodológicos e compara as pessoas entrevistadas alcançadas por diferentes métodos. Foi utilizado um questionário pré-testado e os(as) participantes foram recrutados(as) por 10 dias por meio de uma lista de endereços de e-mail e duas campanhas abertas orgânicas independentes no Instagram. Foram coletadas 3122 respostas: 509 participantes foram recrutados(as) por e-mail (taxa de resposta 2,1%) e 2613 pelas duas campanhas do Instagram (taxas de conversão 20,7% e 11,7%), respectivamente. As taxas de coleta de resposta/min nas primeiras 24h variaram entre 0,23 (e-mail) e 1,09 (primeira campanha). No total, 98,8% das respostas foram recebidas nas primeiras 48h para as diferentes estratégias de recrutamento. Houve diferenças significativas para todas as variáveis demográficas (p<0,001) entre recrutados(as) por e-mail e Instagram, com exceção de sexo (p=0,37). As pessoas recrutadas via Instagram eram um pouco mais velhas, tinham mais experiência profissional (anos na prática) e nível de pós-graduação superior às entrevistadas por e-mail. Além disso, a maioria dos entrevistados por e-mail e Instagram trabalhava no setor público e na prática privada, respectivamente. Embora ambas estratégias tenham sido capazes de coletar respostas de todas as regiões brasileiras, as respostas por e-mail foram ligeiramente melhor distribuídas nas cinco áreas territoriais em comparação ao Instagram. Este estudo fornece evidências de que o recrutamento de uma amostra de população diversificada e grande usando o Instagram é viável. No entanto, a combinação de e-mail e Instagram no recrutamento levou a uma população mais diversificada e melhores taxas de resposta.

Respuesta a la carta al editor publicada en el Vol. 21 Núm. 1 de 2019 / Respuesta a la carta al editor publicada en el Vol. 21 Núm. 1 de 2019

Estimado lector. Agradecemos su interés en el artículo "Prevalencia y determinantes sociales de malnutrición en menores de 5 años afiliados al Sistema de Selección de Beneficiarios para Programas Sociales (SISBEN) del área urbana del municipio de Palermo en Colombia 2017"(1).

Esperança x sofrimento nas mídias sociais: o que motiva seguidores do Instagram a seguir a temática câncer? / Hope vs. suffering on social media: what motivates people on Instagram to follow topics in cancer? / Esperanza vs sufrimiento en las redes sociales: ¿ lo que motiva a los seguidores de Instagram a seguiren la temática del cáncer?

O câncer ainda é associado a dor, morte e sofrimento, e muitos cidadãos, com medo de um diagnóstico, adotam comportamento de esquiva de médicos e exames. Com o surgimento das mídias sociais, o tema tem sido tratado em plataformas como Facebook, Twitter, Instagram, Youtube, entre outras. O objetivo deste estudo é averiguar se há um padrão de conteúdo sobre câncer que gere engajamento no aplicativo de imagens Instagram. Foram selecionados dois perfis brasileiros de instituições de câncer no Instagram, e um estudo qualitativo de análise de conteúdo de posts e comentários foi aplicado, sendo associado posteriormente a análises estatísticas. Foi selecionado todo o conteúdo de dois hospitais oncológicos brasileiros durante quatro anos, totalizando 1.935 postagens no Instagram. Além dos posts, buscamos entender o comportamento dos usuários dessas mídias quando o tema é câncer, por meio dos 2.239 comentários e dos 4.603 Emojis. Podemos afirmar que há interesse pelo tema, o qual é abordado sem preconceitos por internautas e que muitos buscam formas diferenciadas de gratificação no uso do aplicativo.

Cancer is a disease still associated with pain, death and suffering and many people, afraid of a diagnosis, adopt dodging behavior from doctors and tests. Despite this phenomenon as old as the disease, the emergence of social media has brought the topic to platforms such as Facebook, Twitter, Instagram, Youtube, among others. T77he goal of this study is to determine if there is a cancer content standard that creates more engagement on Instagram. Two Brazilian cancer institutions Instagram profiles were selected and a qualitative study of content analysis was applied, later associating it with statistical analysis. During four years, the entire contents of two Brazilian cancer hospitals were selected, totaling 1,935 posts on Instagram. In addition to the posts produced by the two institutions, we sought to understand user behavior on this media when the topic is cancer, through 2,239 comments and 4,603 Emojis. Given the fact that the two profiles attract about 120,000 users, we can affirm that there is interest on the topic, Internet users address the topic with no prejudice and many seek different ways of gratification using the app.

El cáncer es una enfermedad aún asociada al dolor, muerte y sufrimiento y muchos ciudadanos, con miedo de un diagnóstico, adoptan comportamiento de esquiva de médicos y exámenes. A pesar de ese fenómeno tan antiguo cuanto a la enfermedad, el surgimiento de las Redes Sociales trajo el tema a plataformas como Facebook, Twitter, Instagram, Youtube, entre otras. El objetivo de este estudio es averiguar si hay un estándar de contenido sobre cáncer que genera engagement en la aplicación de imágenes Instagram. Dos perfiles brasileños de instituciones de cáncer en el Instagram fueran seleccionados y un estudio cualitativo de análisis de contenido de posts y comentarios fue aplicado, asociado posteriormente a análisis estadísticos. Durante cuatro años, fue seleccionado todo el contenido de dos hospitales oncológicos brasileños, totalizando 1.935 posts en el Instagram. Además de los posts producidos por las dos instituciones, buscamos entender el comportamiento de los usuarios de esos medios cuando el tema es cáncer, a través de 2.239 comentarios y de 4.603 Emojis. Ante los dos perfiles que atraen a cerca de 120 mil usuarios, podemos afirmar que hay interés por el tema, que el tema es abordado sin prejuicios por internautas y que muchos buscan formas diferenciadas de gratificación en el uso de la aplicación.

Descripción de las herramientas de comunicación utilizadas en el área quirúrgica y la perspectiva de los instrumentadores quirúrgicos / Description of communication tools practices in the surgical area and the perspective of surgical instrumenters

La comunicación efectiva dentro de las organizaciones es uno de los factores más importantes para lograr un trabajo positivo y eficaz. Se realizó una investigación cuyo objetivo fue identificar y describir las herramientas de comunicación en el área de Quirófano Central del Hospital Italiano de Buenos Aires y las distintas perspectivas de los instrumentadores quirúrgicos respecto de su utilización. Métodos: se realizó un estudio de corte transversal con un componente de observación participativa de los medios de comunicación y una encuesta a los instrumentadores quirúrgicos de la institución. Resultados: se identificaron ocho tipos de herramientas de comunicación en el área quirúrgica. El correo electrónico (e-mail) como herramienta de comunicación es muy utilizado según los instrumentadores quirúrgicos, pero estos sugirieron otras herramientas más directas, como reuniones y capacitaciones solas o en combinación para determinados tipos de información. Conclusiones: los instrumentadores quirúrgicos utilizan una amplia gama de medios de comunicación en el área quirúrgica. La distribución de preferencias según el tipo de información indica que la elección de estos medios debería ser personalizada. (AU)

Effective communication within organizations is one of the most important factors to achieve a positive and effective work. An investigation was carried out and its objective was to identify and describe the communication tools in the surgical area of the Hospital Italiano de Buenos Aires and the different perspectives of the surgical nurses regarding its use. Methods: a cross-sectional study was carried out with a component of participative observation of the communication tools and a survey of the surgical nurses of the institution. Results: eight types of communication tools were identified in the surgical area. The implementation of email as a communication tool is widely used by surgical nurses, but they suggested other more direct tools such as meetings and training sessions alone or in combination for certain types of information. Conclusions: Surgical nurses use a wide range of communication tools in the surgical area. The distribution of preferences according to the type of information indicates that the choice of these tools should be personalized. (AU)

Opiniões e conhecimentos de acadêmicos de enfermagem sobre o aborto previsto em lei ­ estudo descritivo / Opinions and knowledge of undergraduates nursing students on abortion foreseen in law - descriptive study

Objective: analyze the opinions and knowledge that Nursing students from a public university in the Federal District (DF) have on the abortion theme provided by law. Methods:it is a quantitative study of an exploratory-descriptive type, with a cross-sectional design. A total of 46 undergraduate nursing students participated in the study. The data were collected through the application of an electronic questionnaire sent by e-mail individually to the students. Descriptive statistics were used to analyze the data, and the frequency ofthe appearance of certain elements in the participants' responses were verified. Results:as pointed out by the students, there would be a weakness in academic training regarding the subject of abortion. It was verified that the focus given to the disciplines focused on this theme are directed to social and cultural issues, leading to an appreciation of these aspects to the detriment to the other contents, which could lead to a theoretical and practical lack of preparation of these future health professionals. Conclusion:it is understood the importance of approach and discussion about these themes in the university context, since these questions have been little worked in the process of professional formation, interfering in the way students and future professionals feel qualified or comfortable in relation to this type of service.

Objetivo: analisar as opiniões e conhecimentos que os acadêmicos de Enfermagem, de uma universidade pública do Distrito Federal (DF), possuem acerca do tema do aborto previsto em lei.Métodos: trata-se de um estudo quantitativo do tipo exploratório-descritivo, com delineamento transversal. Participaram da pesquisa 46 acadêmicosdo curso de graduação em Enfermagem. Os dados foram coletados por meio da aplicação de questionário eletrônico enviado por e-mail individualmente aos estudantes. Utilizou-se estatística descritiva para a análise dos dados, verificando-se a frequência do aparecimento de determinados elementos nas respostas dos participantes.Resultados:segundo apontaram os acadêmicos, haveria uma fragilidade na formação acadêmica no que se refere ao tema do aborto.Verificou-se que oprincipal enfoque dado às disciplinas voltadas para esta temática estão direcionados às questões sociais e culturais, levando a uma valorização destes aspectos em detrimento aos demais conteúdos, o que poderia ocasionar um despreparo teórico e prático destes futuros profissionais de saúde. Conclusão:compreende-se a importância da abordagem e discussão sobre essas temáticas no contexto universitário, uma vez que essas questões têm sido pouco trabalhadas no processo de formação profissional, interferindo naforma como os estudantes e futuros profissionais sentem-se capacitados ou confortáveis em relação a este tipo de atendimento.

Controversias en el manejo de la fractura de cadera en el adulto mayor. Encuesta nacional a Traumatólogos especialistas en cirugía de cadera / Management of hip fractures in the elderly. A national survey among Chilean orthopaedic surgeons

Background: As the population ages, patients exposed to osteoporotic fractures increase, especially hip fracture, which is the most severe and costly. Aim: To characterize surgical practices in the management of hip fractures in older patients through a nationwide survey of specialized hip surgeons dedicated to the care of these patients. Material and Methods: A survey composed of 32 questions was formulated, including demographic factors, preoperative evaluation, definitive treatment, and postoperative management. It was sent to 140 specialists. 84 of them replied (61%), and 71 answers were included. Results: Eighty six percent of respondents agreed that orthogeriatric management is fundamental in the outcome of these patients, but only 73% had the collaboration of an internist or a geriatrician. Although 97% considered 72 hours or less the ideal time to perform surgery, only 52% of the respondents declared performing surgery within that timeframe, with differences between private and public system. Regarding surgical treatment, 94-98% of femoral neck fractures are treated with an arthroplasty and 98-99% of per-subtrochanteric fractures are treated with internal fixation and osteosynthesis. Osteoporosis treatment is only carried out by 51% of the respondents and with significant variation. Conclusions: This survey shows that there is agreement in surgical practice between specialists treating these patients, but clear differences in preoperative optimization, treatment timeframe, and post fracture medical treatment.

Comparison of trauma systems in Asian countries: a cross-sectional study

OBJECTIVE: This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS).METHODS: Medical directors and emergency physicians at PATOS-participating hospitals in countries across the Asia Pacific were surveyed through a standardized questionnaire. General information, trauma care system data, and trauma emergency department (ED) outcomes at each hospital were collected by email and analyzed using descriptive statistics.RESULTS: Survey data from 35 hospitals across 15 countries were collected from archived data between June 2014 and July 2015. Designated trauma centers were identified as the highest hospital level for trauma patients in 70% of surveyed countries. Half of the hospitals surveyed had special teams for trauma care, and almost all prepared activation protocol documents for these teams. Most hospitals offered specialized trauma education programs, and 72.7% of hospitals had a hospital-based trauma registry. The total number of trauma patients visiting the ED across 25 of the hospitals was 300,376. The overall survival-to-discharge rate was 97.2%; however, it varied greatly between 85.1% and 99.7%. The difference between survival-to-discharge rates of moderate and severe injury groups was highest in Taiwan (41.8%) and lowest in Thailand (18.6%).CONCLUSION: Trauma care systems and ED outcomes vary widely among surveyed hospitals and countries. This information is useful to build further detailed, systematic platforms for trauma surveillance and evidence-based trauma care policies.

Impact of Education on School Nurses' Knowledge of Inflammatory Bowel Disease

BACKGROUND/AIMS: School nurses’ knowledge of inflammatory bowel disease (IBD) has not been evaluated. We aimed to investigate school nurses’ knowledge of IBD and determine whether education could improve this knowledge. METHODS: School nurses were invited to complete self-reported questionnaires on IBD. Then, IBD specialists from tertiary referral hospitals provided a 60-minute lecture with educational brochures on two occasions, with a 3-month interval. Within 6 months after the educational interventions, school nurses were asked to complete the same IBD questionnaire via e-mail. RESULTS: Among 101 school nurses who were invited to participate, 54 nurses (53.5%) who completed two consecutive questionnaires were included in this study (median age, 45 years; range, 25 to 59 years; 100% female); 11.1% and 7.4% of the study participants had no knowledge regarding ulcerative colitis and Crohn’s disease, respectively. They had heard of IBD most frequently from doctors (33.3%), followed by internet sources (25.9%). After 6 months, the number of nurses who could explain IBD to students with over 30% confidence increased from 24 (44.5%) to 42 (77.8%) (p < 0.001). Most nurses (81.5%) reported that the educational intervention was helpful for managing students with abdominal pain or diarrhea. The number of students who received IBD-related welfare services from the Daegu Metropolitan Office of Education doubled when compared with the corresponding number during the prior educational year. CONCLUSIONS: There is room for improvement in school nurses’ knowledge of IBD. A systematic educational program on IBD should be implemented for these nurses.

Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors / 간호학회지

PURPOSE: This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.METHODS: A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.RESULTS: After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.CONCLUSION: To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

Changes in the Prevalence and Risk Factors of Erectile Dysfunction during a Decade: The Korean Internet Sexuality Survey (KISS), a 10-Year-Interval Web-Based Survey

PURPOSE: Although the prevalence of erectile dysfunction (ED) can be affected by social changes, this association has not been well evaluated. We aimed to evaluate the prevalence and risk factors of ED through a 10-year-interval web-based survey using the previous database of same group of panels, with same methodology. MATERIALS AND METHODS: We sent e-mails and surveyed the panels registered in the Internet survey agency. RESULTS: In total, 900 participants were recruited in 2016. The age-adjusted overall prevalences of self-reported ED (self-ED) and International Index of Erectile Function-5-assessed ED (IIEF-5-ED; score ≤21) in the 2016 study were 3.2% and 44.8%, respectively, which were lower than the prevalences of 8.1% (p=0.036) and 51.4% (p=0.323), respectively, in the 2006 study. The risk factors of IIEF-5-ED in their 20s and 30s in 2016 were psycho-social factors such as depression, low frequency of conversation about sex with sexual partner. The risk factors of IIEF-5-ED in their 40s to 60s in 2016 were organic factors, such as hypertension, diabetes mellitus, smoking, alcohol use, and self-reported premature ejaculation. CONCLUSIONS: Although the age-adjusted overall prevalence of self-ED has decreased during a decade, there was no difference in the age-adjusted overall prevalence of IIEF-5-ED. Psycho-social support may be important for young men with ED and overall healthcare can be helpful for elderly men with ED.

Real-time data monitoring for ulcerative colitis: patient perception and qualitative analysis

BACKGROUND/AIMS: TrueColours ulcerative colitis (TCUC) is a comprehensive web-based program that functions through email, providing direct links to questionnaires. Several similar programs are available, however patient perspectives are unexplored. METHODS: A pilot study was conducted to determine feasibility, usability and patient perceptions of real-time data collection (daily symptoms, fortnightly quality of life, 3 monthly outcomes). TCUC was adapted from a web-based program for patients with relapsing-remitting bipolar disorder, using validated UC indices. A semi-structured interview was developed and audio-recorded face-to-face interviews were conducted after 6 months of interaction with TCUC. Transcripts were coded in NVivo11, a qualitative data analysis software package. An inductive approach and thematic analysis was conducted. RESULTS: TCUC was piloted in 66 patients for 6 months. Qualitative analysis currently defies statistical appraisal beyond “data saturation,” even if it has more influence on clinical practice than quantitative data. A total of 28 face-to-face interviews were conducted. Six core themes emerged: awareness, control, decision-making, reassurance, communication and burden of treatment. There was a transcending overarching theme of patient empowerment, which cut across all aspects of the TCUC experience. CONCLUSIONS: Patient perception of the impact of real-time data collection was extremely positive. Patients felt empowered as a product of the self-monitoring format of TCUC, which may be a way of improving self-management of UC whilst also decreasing the burden on the individual and healthcare services.

Implementation of Korean Clinical Imaging Guidelines: A Mobile App-Based Decision Support System

OBJECTIVE: The aims of this study were to develop a mobile app-based clinical decision support system (CDSS) for implementation of Korean clinical imaging guidelines (K-CIGs) and to assess future developments therein. MATERIALS AND METHODS: K-CIGs were implemented in the form of a web-based application (http://cdss.or.kr/). The app containing K-CIGs consists of 53 information databases, including 10 medical subspecialties and 119 guidelines, developed by the Korean Society of Radiology (KSR) between 2015 and 2017. An email survey consisting of 18 questions on the implementation of K-CIGs and the mobile app-based CDSS was distributed to 43 members of the guideline working group (expert members of the KSR and Korean Academy of Oral and Maxillofacial Radiology) and 23 members of the consultant group (clinical experts belonging to related medical societies) to gauge opinion on the future developmental direction of K-CIGs. RESULTS: The web-based mobile app can be downloaded from the Google Play Store. Detailed information on the grade of recommendation, evidence level, and radiation dose for each imaging modality in the K-CIGs can be accessed via the home page and side menus. In total, 32 of the 66 experts contacted completed the survey (response rate, 45%). Twenty-four of the 32 respondents were from the working group and eight were from the consulting group. Most (93.8%) of the respondents agreed on the need for ongoing development and implementation of K-CIGs. CONCLUSION: This study describes the mobile app-based CDSS designed for implementation of K-CIGs in Korea. The results will allow physicians to have easy access to the K-CIGs and encourage appropriate use of imaging modalities.

Implementation of Enhanced Recovery after Surgery (ERAS) Program in Perioperative Management of Gastric Cancer Surgery: a Nationwide Survey in Korea

PURPOSE: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. MATERIALS AND METHODS: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. RESULTS: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. CONCLUSIONS: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.