Comprehensive quality assurance for intracranial radiosurgery treatments using a postal system / Garantía de calidad para tratamientos de radiocirugía intracranial usando un sistema postal

Radiosurgery is a high-precision technique for delivering, in most cases, a single highly conformal dose to a stereotactically localized target. It can be indicated for small intracranial injury treatment, using either multiple sources of 60Co (γ rays) or high energy photon beams produced by linear accelerators. In order to minimize the impact of inaccurate localization of the target or dose delivery, a rigorous Quality Assurance (QA) program must be enforced, which should include an independent auditing system. This work proposes a simple and reliable postal QA phantom to be used as an independent evaluation. In it two important parameters were verified such as, the dosimetric precision of the planning system, by comparing the absorbed doses measured in the target volume using different dosimeters (ionization chamber, films, thermoluminescent dosimeters and L-alanine dosimeters) all calibrated against a small volume ion chamber. The exact positioning of the target volume was localized using air spaces and small steel spheres to find the appropriate target coordinates. The head phantom and the instruction sheets were extensively tested and sent by mail to selected institutions. The overall results were very encouraging and suggest that the proposed phantom may be used as a postal system as part of an independent QA tool in radiosurgery.

La radiocirugía es una técnica de alta precisión para administrar, en la mayoría de los casos, una sola dosis altamente conformada en un objetivo localizado estereotípicamente. Puede estar indicado para el tratamiento de pequeñas lesiones intracraneales, utilizando múltiples fuentes de 60Co (rayos γ) o haces de fotones de alta energía producidos por aceleradores lineales. Con el fin de minimizar el impacto de la ubicación inexacta de la administración de la meta o de la dosis, se debe aplicar un riguroso programa de control de calidad (QA), que debe incluir un sistema de auditoría independiente. Este documento propone un fantoma postal de control de calidad simple y fiable que se utilizará como evaluación independiente. Se verificó dos parámetros importantes, como la precisión dosimétrica del sistema de planificación, comparando las dosis absorbidas medidas en el volumen objetivo mediante diferentes dosis (cámara de ionización, películas, dosímetros Termoluminiscentes y dosímetros de L-alanina) todos calibrados con una pequeña cámara de iones de volumen. El posicionamiento exacto del volumen objetivo se localizó utilizando espacios aéreos y pequeñas esferas de acero para encontrar las coordenadas de destino adecuadas. El fantoma principal y las hojas de instrucciones fueron ampliamente probados y enviados por correo a instituciones seleccionadas. Los resultados generales fueron muy alentadores y sugieren que el fantoma propuesto puede utilizarse como sistema postal como parte de una herramienta independiente de control de calidad en radiocirugía.

Recordatorio a través de múltiples cartas para vacunación contra influenza / Multiple mail reminders to increase adherence to influenza vaccination

INTRODUCCIÓN: Distintas intervenciones han sido propuestas para reforzar el uso de la vacuna contra la influenza. El uso de recordatorios, ya sea a través de cartas, llamadas telefónicas, panfletos o aplicaciones tecnológicas, entre otras, ha destacado dentro de aquellas orientadas a incrementar la adherencia al tratamiento. Sin embargo, su efectividad no está clara. En este resumen, que forma parte de una serie de evaluaciones de recordatorios, se abordará el envío de múltiples recordatorios enviados por correo. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta-análisis y prepara-mos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos ocho revisiones sistemáticas que en conjunto incluyeron 35 estudios primarios, de los cuales cuatro corresponden a ensayos aleatorizados que analizan el uso de múltiples recordatorios enviados por correo. Concluimos que más de un recordatorio enviado por correo probablemente aumenta la adherencia a vacunación contra influenza en pacientes mayores de 60 años, mien-tras que podría resultar en poca o nula diferencia en menores de 6 años, pero la certeza de la evidencia es baja.

INTRODUCTION: Different interventions have been proposed to reinforce the use of the influenza vaccine. The use of reminders, whether through letters, phone calls, pamphlets or technological applications, among others, has stood out among those aimed at increasing ad-herence to treatment. However, its effectiveness is not clear. In this summary, which is part of a series of reminder evaluations, we assess the use of multiple mail reminders. METHODS: We conducted a search in Epistemonikos, the largest database of systematic health reviews, which is maintained by screening multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted the data from the identified reviews, analyzed the data from the primary studies, performed a meta-analysis and prepared a summary table of the results using the GRADE method. RESULTS AND CONCLUSIONS: We identified eight systematic reviews including 35 primary studies, of which four analyze the use of more than one letter as a reminder. We conclude that the use of multiple mail reminders probably increase adherence to influenza vaccination in patients over 60; while it may make little or no difference in children under 6 years, but the certainty of the evidence is low.

Recordatorio enviado por correo postal para aumentar adherencia a vacunación contra influenza / Reminder sent by mail to increase adherence to influenza vaccination

INTRODUCCIÓN Distintas intervenciones han sido propuestas para reforzar el uso de la vacuna contra la influenza. El uso de recordatorios, ya sea a través de cartas, llamadas telefónicas, panfletos o aplicaciones tecnológicas, entre otras, ha destacado dentro de aquellas orientadas a incrementar la adherencia al tratamiento. Sin embargo, su efectividad no está clara. En este resumen, el primero de una serie de evaluación de recordatorios, se abordará el uso de un recordatorio enviado por correo. MÉTODOS Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta-análisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos ocho revisiones sistemáticas que en conjunto incluyeron 35 estudios primarios, de los cuales, 32 corresponden a ensayos aleatorizados. Concluimos que un recordatorio enviado por correo probablemente aumenta la adherencia a vacunación contra influenza en todos los grupos etarios (población adulta, mayores de 60 años y menores de 18 años).

INTRODUCTION Different interventions have been proposed to improve influenza vaccine coverage. The use of reminders, through letters, phone calls, pamphlets or technological applications, among others, has stood out among the different alternatives to increase adherence to vaccination. However, its effectiveness is not clear. In this summary, the first of a series of evaluation of reminders will address the use of a reminder sent by mail. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the identified reviews, analyzed the data from the primary studies, performed a meta-analysis and prepared a summary table of the results using the GRADE method. RESULTS AND CONCLUSIONS We identified eight systematic reviews that included 35 primary studies, of which 32 correspond to randomized trials. We concluded that a reminder sent by mail, probably increase adherence to influenza vaccination in all age groups (adult population, over 60 an under 18)

Why do some Korean parents hesitate to vaccinate their children? / 한국역학회지

OBJECTIVES: Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model.METHODS: Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared.RESULTS: Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination.CONCLUSIONS: The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.

Evaluation of symptoms and symptom combinations in histamine intolerance

BACKGROUND/AIMS: Food intolerance/malabsorption, particularly histamine intolerance (HIT), may cause nonspecific functional gastrointestinal and extraintestinal symptoms. We evaluated gastrointestinal and extraintestinal symptoms in patients with HIT. METHODS: In an analysis of outpatients' charts we identified 133 patients, who presented with recurring nonspecific functional gastrointestinal, extraintestinal symptoms, and a diamine oxidase value <10 U/mL, indicative of HIT. A standardized anonymous questionnaire with symptoms of HIT based on known symptoms and the 4 histamine receptors including gastrointestinal, cardiovascular, respiratory and skin complaints was developed, and sent by mail to the patients. RESULTS: In the 62 patients that completed the questionnaire, bloating was the most common and most serious symptom. Other commonly reported gastrointestinal symptoms were postprandial fullness, diarrhea, abdominal pain, and constipation. The presence of 2 from a list of 24 symptoms resulted in 276 various symptom combinations. From calculated 2.024 possible combinations of 3 symptoms the patients with HIT presented 1.975 combinations. CONCLUSIONS: The knowledge of this wide variability of symptoms and complex symptom combinations in patients with HIT may help to clinically recognize and diagnose HIT.

Why do some Korean parents hesitate to vaccinate their children? / 한국역학회지

OBJECTIVES: Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model. METHODS: Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared. RESULTS: Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination. CONCLUSIONS: The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.

Survey study on the Preference of Dental Medical Personnel for Dental CAD/CAM Milling Machines / 대한치과보철학회지

PURPOSE: Recently, according to the development of digital technology, computer aided design/computer aided manufacture (CAD/CAM) system is widely used for fabrication of various dental prostheses in the field of dentistry. This study aims to survey the present state and awareness of CAD/CAM system on domestic dental field, and to supply the advice for the application of the new system. MATERIALS AND METHODS: In this questionnaire survey was conducted for a total of 298 dentists, dental hygienist and dental technicians of the whole country including the dental hospital of Seoul National University for two months from November to December, 2016 through mail. RESULTS: The most important purpose to consider when purchasing a dental CAD/CAM milling machine were the performance of the milling machine (64.43%) and the use of milling machine was the highest with 49.33% of manufacturing for dental prosthesis and customized implant abutment. In addition, more than 60% of respondents answered positively about the purchase of new milling machine if the CAD/CAM milling machine was improved to satisfactory performance. CONCLUSION: This survey results show that the improved CAD/CAM milling machine would be play an important role in the dental industry in preparation for digitization and the 4th industrial revolution.

The Effect of Personality Type and Job Performance on Emotional Exhaustion and Job Satisfaction - Staff of the Center for Children's foodservice management - / 대한지역사회영양학회지

OBJECTIVES: This study examined the relationship between the personality traits and job performance of Centers for Children's Foodservice Management (CCFSM) staff on emotional exhaustion and job satisfaction. In addition, the characteristics of the center organization were examined to provide practical guidelines for the operation of the center. The aim was to determine management implications with an important meaning in human resource management to enhance the efficiency of the operation of Centers for Children's Foodservice Management (CCFSM). METHODS: Out of 207 centers, there were 1,057 employees at 173 centers who agreed to participate in the study, the questionnaire was mailed on February 17, 2017 and collected by mail on March 31, 2017. Finally, 81 centers (46.82%) participated in the survey and 493 questionnaires were used. RESULTS: Neuroticism among the five personality factors had a positive (+) influence on ‘cynicism’ and ‘exhaustion’ among the three subordinate factors of emotional exhaustion, negative (−) effects on the ‘job’ among the six subscales of job satisfaction. In addition, openness showed a negative (−) effect on ‘loss of professional confidence’ of emotional exhaustion and positive (+) relationship with the ‘job’ of job satisfaction. Agreeableness appeared to have a negative (−) effect on all factors of emotional exhaustion and a positive (+) influence on all factors of job satisfaction. As a result of analyzing the effects of job performance on emotional exhaustion and job satisfaction, the planning and operations management team showed a positive (+) influence on all factors of emotional exhaustion and negative (−) influence on all factors of job satisfaction. On the other hand, the nutrition management team showed a negative (−) influence on all emotional exhaustion factors and a positive (+) influence on the factors of job satisfaction. The hygiene management team showed a positive (+) relationship with ‘Emotional exhaustion’ among the subordinate factors of emotional exhaustion and a negative (−) influence on the ‘Educational opportunity’ of job satisfaction. CONCLUSIONS: The personality type and job performance of Centers for Children's foodservice management (ccfsm) staff significantly affected the emotional exhaustion and job satisfaction.

Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to conduct a cost effectiveness analysis of strategies designed to improve national cervical cancer screening rates, along with a distributional cost effectiveness analysis that considers regional disparities. MATERIALS AND METHODS: Cost effectiveness analysis was conducted using a Markov cohort simulation model, with quality adjusted life years as the unit of effectiveness. The strategies considered were current (biennial Papanicolaou smear cytology of females aged 20 or above), strong screening recommendation by mail to target regions (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person), regular universal screening recommendation by mail (effect, 6% increase in screening uptake; cost, 500 Korean won per person), and strong universal screening recommendation by mail (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person). Distributional cost effectiveness analysis was conducted by calculating the cost effectiveness of strategies using the Atkinson incremental cost effectiveness ratio. RESULTS: All strategies were under the threshold value, which was set as the Korean gross domestic product of $25,990. In particular, the ‘strong screening recommendation to target regions’ strategy was found to be the most cost effective (incremental cost effectiveness ratio, 7,361,145 Korean won). This was also true when societal inequality aversion increased in the distributional cost effectiveness analysis. CONCLUSION: The ‘strong screening recommendation to target regions’ strategy was the most cost effective approach, even when adjusting for inequality. As efficiency and equity are objectives concurrently sought in healthcare, these findings imply a need to develop appropriate economic evaluation methodologies to assess healthcare policies.

The roles of doctors, nurses, and industrial hygienists in the healthcare management services in Korea: a comparison of the opinions of specialized health management institutions and entrusted enterprises

BACKGROUND: This study aimed to identify the difference of perception about the role of appointing health officers by comparing and analyzing the response of entrustment workplace (EW) and specialized health management institution (SI). This is considered an important aspect of an institutional assessment to improve the quality of health management services. METHODS: A survey questionnaire was mailed to 122 SIs and 319 EWs nationwide. The questionnaire survey was about the general characteristics of SIs and EWs and main occupations for each evaluation item. In total, 81 SIs (66.4%) and 30 EWs responded to the questionnaire. A logistic regression analysis was performed to compare the opinions of SI and EW. RESULTS: Based on the analysis, the items showing statistically significant differences were as follows. Doctors’ main tasks survey: “Guidance on their wearing personal protective equipment (PPE)” (OR: 4.58), “Guidance of improvement of work environment (WE)” (OR: 3.33), etc.; Nurses’ main tasks survey: “Guidance on their wearing PPE” (OR: 3.86), “Guidance for programs on health process in confined space (CS)” (OR: 0.36), “Guidance on the hearing conservation program (HCP)” (OR: 0.28), etc.; Industrial hygienist (IH)‘s main tasks survey: “Guidance of work through inspection (WTI)” (OR: 0.15), “Guidance on the improvement of WE” (OR: 0.32), “Management confirmation of substances used by process and Material Safety Data Sheet (MSDS)” (OR: 0.08), “Guidance on posting or keeping of MSDS and warning signs” (OR: 0.03), “Prevention of dust-induced medical problems” (OR: 0.28), “Guidance for programs of health process in CS” (OR: 0.39), etc. CONCLUSIONS: It is necessary to educate the EWs to recognize the need for physicians to perform tasks, such as wearing a PPE, and instruction to improve WE. As for nurses’ tasks, such as education about the CS and the noise work, educating the nurses of the SI is regarded necessary as the demand of the EWs is considered. With respect to the unique tasks of IH, such as WE management and instructions for wearing PPE, among several other tasks of IH, training should be provided for improved IH recognition.

Investigation of the Changes in Refractive Surgery Trends in Korea

PURPOSE: To evaluate changes in clinical practice in the field of refractive surgery in Korea over the past 10 years. METHODS: A survey consisting of 59 multiple-choice questions regarding the preferred types of refractive surgery, excimer laser machine, and presbyopia surgery was mailed to 742 members of the Korean Society of Cataract and Refractive Surgery in January 2016, and 50 members responded to the survey. These data were compared with the 2005 or 2007 survey results.

The Effect of Personality Type and Job Performance on Emotional Exhaustion and Job Satisfaction - Staff of the Center for Children's foodservice management - / 대한지역사회영양학회지

OBJECTIVES: This study examined the relationship between the personality traits and job performance of Centers for Children's Foodservice Management (CCFSM) staff on emotional exhaustion and job satisfaction. In addition, the characteristics of the center organization were examined to provide practical guidelines for the operation of the center. The aim was to determine management implications with an important meaning in human resource management to enhance the efficiency of the operation of Centers for Children's Foodservice Management (CCFSM). METHODS: Out of 207 centers, there were 1,057 employees at 173 centers who agreed to participate in the study, the questionnaire was mailed on February 17, 2017 and collected by mail on March 31, 2017. Finally, 81 centers (46.82%) participated in the survey and 493 questionnaires were used. RESULTS: Neuroticism among the five personality factors had a positive (+) influence on ‘cynicism’ and ‘exhaustion’ among the three subordinate factors of emotional exhaustion, negative (−) effects on the ‘job’ among the six subscales of job satisfaction. In addition, openness showed a negative (−) effect on ‘loss of professional confidence’ of emotional exhaustion and positive (+) relationship with the ‘job’ of job satisfaction. Agreeableness appeared to have a negative (−) effect on all factors of emotional exhaustion and a positive (+) influence on all factors of job satisfaction. As a result of analyzing the effects of job performance on emotional exhaustion and job satisfaction, the planning and operations management team showed a positive (+) influence on all factors of emotional exhaustion and negative (−) influence on all factors of job satisfaction. On the other hand, the nutrition management team showed a negative (−) influence on all emotional exhaustion factors and a positive (+) influence on the factors of job satisfaction. The hygiene management team showed a positive (+) relationship with ‘Emotional exhaustion’ among the subordinate factors of emotional exhaustion and a negative (−) influence on the ‘Educational opportunity’ of job satisfaction. CONCLUSIONS: The personality type and job performance of Centers for Children's foodservice management (ccfsm) staff significantly affected the emotional exhaustion and job satisfaction.

Consumo alimentar e estado nutricional de carteiros pedestres de Porto Alegre / Dietary intake and nutritional status of mail carriers Porto Alegre

Introdução: O aumento da prevalência de excesso de peso e o inadequado consumo alimentar têm sido uma preocupação frequente entre os trabalhadores brasileiros. Portanto, o objetivo do presente estudo foi avaliar o estado nutricional e o consumo alimentar de carteiros pedestres de Porto Alegre, Rio Grande do Sul. Métodos: Estudo de caráter transversal com trabalhadores dos Correios de Porto Alegre. O estado nutricional foi obtido a partir de dados de altura, peso e circunferências da cintura e do pescoço. Foi utilizado um questionário de frequência alimentar adaptado e dois recordatórios de 24 horas para avaliação do consumo alimentar. Resultados: Foram entrevistados 203 carteiros, dos quais 74,5% eram homens. A média de idade foi de 41,0 ± 11,28 anos. Observou-se que a maioria dos carteiros apresentou excesso de peso (63,6%), sendo 85 (41,9%) com sobrepeso e 44 (21,7%) com obesidade. Os alimentos consumidos pelo menos três vezes por semana pela maioria dos participantes foram carne vermelha, feijão, verduras, frutas e refrigerantes ou sucos artificiais. Por outro lado, os alimentos consumidos menos de uma vez por semana foram peixes e sucos de frutas naturais. Conclusão: Constatou-se uma alta taxa de excesso de peso entre os carteiros pedestres de Porto Alegre. Além disso, observou-se um elevado consumo de carne vermelha, refrigerantes e sucos artificiais, e dos nutrientes sódio e cobre, e baixo consumo de peixes, dos ácidos graxos ômega-3 e ômega-6, e dos minerais potássio e magnésio. Portanto, enfatiza-se a necessidade de promoção de atividades que visem a educação nutricional nessa população (AU)

Introduction: Increased prevalence of overweight and inadequate dietary intake have become a serious concern among Brazilian workers. Thus, the objective of the present study was to evaluate the nutritional status and the dietary intake of mail carriers in Porto Alegre, state of Rio Grande do Sul, Brazil. Methods: This was a cross-sectional study with Porto Alegre's mail carriers. Nutritional status was obtained using data on height, weight, and waist and neck circumferences. Dietary intake was evaluated by an adapted food frequency questionnaire and two 24-hour dietary recalls. Results: A total of 203 mail carriers were interviewed, of which 74.5% were men. Mean age was 41.0 ± 11.28 years. Most mail carriers showed excessive weight (63.6%) ­ 85 (41.9%) were overweight and 44 (21.7%) were obese. Foods consumed at least three times a week by most participants were red meat, beans, vegetables, fruits and soft drinks or artificial juices. Conversely, foods consumed less than once a week were fish and natural juices. Conclusions: There was a high rate of overweight among mail carriers in Porto Alegre. In addition, high consumption of red meat, soft drinks, artificial juices, and sodium and copper, and low consumption of fish, omega-3 and omega-6 fatty acids, and potassium and magnesium were observed. Therefore, there is a strong need to promote activities aimed at the nutritional education of this population (AU)

Intake of oral photoprotectors by postmen in Porto Alegre

Introduction: Postmen are daily exposed to high levels of solar radiation, and lack of protection can result in many health damages. The present study aimed to identify cutaneous phototypes and evaluate the intake of oral photoprotectors by postmen. Methods: Cross-sectional study, carried out from August 2011 to December 2012 in the city of Porto Alegre, state of Rio Grande do Sul, Brazil. Socioeconomic and behavioral data regarding daily solar exposure were collected through a questionnaire. To evaluate the intake of beta-carotene, lycopene and omega-3, two 24-hour dietary recalls were applied. Cutaneous phototypes were assessed by Fitzpatrick's classification. Results: A total of 181 postmen were analyzed, whose mean age was 40.2±11.4 years old, and 140 (77.3%) were male. The cutaneous phototypes II, III and IV were the most prevalent (n=138), totaling 76.3% of the sample. The median for the oral photoprotectors intake was 1.16 mg (0.46-2.29) of beta-carotene, 3.60 mg (1.01-6.31) of lycopene and 0.95 g (0.61-1.45) of n-3 fatty acids, all values significantly lower than the minimal doses to obtain photoprotective effect (p<0.001). The individuals in the group of phototypes V and VI showed lower adherence to the use of sunscreen and lower intake of beta-carotene, comparing to the other groups. Conclusions: The intake of oral photoprotectors is low in this population. Future studies may evaluate the real effect of oral photoprotectors, so that preventive measures using this approach can be included in photoprotection education actions for outdoor workers (AU)

Validity Test of K-SKAGOAO for Korean Nursing Groups and the Relationship of Nursing Group Power and Job Satisfaction, Organizational Commitment, Organizational Performance / 임상간호연구

PURPOSE: The purpose of this study was to test validity and reliability of the Korean-Sieloff King Assessment of Group Outcome Attainment within organization in Korea (K-SKAGOAO), and also to explore the relationship of Korean nursing group power and job satisfaction, organizational commitment, organizational performance. METHODS: Participants were 481 nurse managers, nurse unit managers or staff nurses with over 7 years experience. Data were collected by post mail and analyzed using descriptive statistics, ANOVA, Kruskal-Wallis test, Tukey test, and Spearman's correlation. RESULTS: Content Validity Index was over .82 and Cronbach's α coefficient for the K-SKAGOAO was .97. The mean score for Korean nursing group power was 136.77 among the total participants, 139.89 among nurse managers, 136.74 among nurse unit managers and 132.47 among staff nurses. These results showed high nursing group power in Korea nursing organization in hospitals. There was also a significant difference according to nurse position (p=.003). Korean nursing group power was positively related to job satisfaction, organizational commitment, and organizational performance. CONCLUSION: Findings show that the K-SKAGOAO has validity and reliability. Nursing groups can use the K-SKAGOAO to evaluate the nursing group power of each nursing organization and to develop strategies to improve nursing power and nursing outcomes.

An epidemic of thunderstorm asthma in Melbourne 2016: asthma, rhinitis, and other previous allergies

BACKGROUND: On 21st November 2016, Melbourne experienced an epidemic of ‘thunderstorm asthma.’ Although previously described in the literature, risk factors and natural history remain incompletely understood. OBJECTIVE: Our aim was to follow up those presenting to the 3 Emergency Departments (EDs) in our health service during the epidemic, and assess their history for previous asthma, rhinitis, and allergies. METHODS: ED notes of all respiratory presentations within 48 hours of the thunderstorm event were reviewed and patients with acute asthma included. A standardised questionnaire was devised encompassing asthma diagnosis, undiagnosed asthma symptoms and rhinitis severity. Patients were contacted by phone within 30 days of the event. RESULTS: Three hundred forty-four patients were identified overall; 263 patients were contactable and completed a phone or mail questionnaire. The mean age was 32.7 ± 19.2 years (range, 6 months–87 years; 25% < 18 years) with 58% male sex. A previous diagnosis of asthma was present in 42% (n = 111), and there was no previous asthma diagnosis in 58% (n = 152). Of those who had no asthma diagnosis 53% had probable undiagnosed asthma. Overall, rhinitis prevalence was 88%, of which 72% were moderate or severe (Allergic Rhinitis and its Impact on Asthma guidelines) and 51% (n = 133) reported a history of grass pollen allergy. CONCLUSION: Our data highlights the importance of atopy and rhinitis as risk factors for epidemic thunderstorm asthma. Better identification of undiagnosed asthma, and implementing treatment of asthma and rhinitis may be important.

Administration of the adrenaline auto-injector at the nursery/kindergarten/school in Western Japan

BACKGROUND: In view of the increasing prevalence of food allergies, there has been an associated increase in frequency of situations requiring an emergency response for anaphylaxis at the home, childcare facilities and educational institutions. OBJECTIVE: To clarify the situation of adrenaline auto-injector administration in nursery/kindergarten/school, we carried out a questionnaire survey on pediatric physicians in Western Japan. METHODS: In 2015, self-reported questionnaires were mailed to 421 physicians who are members of the West Japan Research Society Pediatric Clinical Allergy and Shikoku Research Society Pediatric Clinical Allergy. RESULTS: The response rate was 44% (185 physicians) where 160 physicians had a prescription registration for the adrenaline auto-injector. In the past year, 1,330 patients were prescribed the adrenaline auto-injector where 83 patients (6% of the prescribed patients) actually administered the adrenaline auto-injector, of which 14 patients (17% of the administered patients) self-administered the adrenaline auto-injector. “Guardians” at the nursery/kindergarten and elementary school were found to have administered the adrenaline auto-injector the most. Among 117 adrenaline auto-injector prescription-registered physicians, 79% had experienced nonadministration of adrenaline auto-injector at nursery/kindergarten/school when anaphylaxis has occurred. The most frequent reason cited for not administering the adrenaline auto-injector was “hesitation about the timing of administration.” CONCLUSION: If the adrenaline auto-injector was administered after the guardian arrived at the nursery/kindergarten/school, it may lead to delayed treatment of anaphylaxis in which symptoms develop in minutes. Education and cooperation among physicians and nursery/kindergarten/school staff will reduce the number of children suffering unfortunate outcomes due to anaphylaxis.

Practice status of specialized agencies for occupational health management of small- to medium-size enterprises and the factors improving their performance: a cross-sectional survey study

BACKGROUND: We examined the current status of specialized agencies for occupational health management (SAs) and their workforce. Furthermore, we aimed to clarify the current practice status of SA healthcare professionals and factors that influence their performance. METHODS: To examine the current SA workforce, we analyzed data from the 2014 Survey of Current Status of SA and their Workforce from the Ministry of Employment and Labor (MOEL). Furthermore, we mailed out an original questionnaire to SA professionals to determine their current health management status and factors that affect their performance. Data from the respondents (N = 384) were analyzed. RESULTS: In 2014, the workforce performing health management in SAs comprised 232 physicians, 507 nurses, and 312 occupational hygienists, with no significant regional differences in the distribution of physicians and nurses. According to the findings of the questionnaire, the average daily number of worker consultations by physicians and nurses was 22.8, while the average time taken for health management ranged from 74.3 to 104.3 min, depending on the size of the firm. Most of the respondents (41.5%) answered that they were following-up on more than 80% of individuals with illnesses. Among health management tasks, performance scores of “consultations for general diseases” and “consultations for lifestyle habits” were relatively high, whereas health promotion activities at workplaces were relatively low. There was a significant correlation between the utilization of general and special health examination results and task performance. CONCLUSION: Among health management tasks, follow-up management of individuals with illnesses and consultations for disease/lifestyle habits were relatively well performed, whereas health promotion activities at workplaces were not performed well. Among factors that positively influenced SA performance at workplaces, only the utilization of health examination results had significant effects. Therefore, to accomplish health management goals and perform effective health management at workplaces, there is a need to establish a comprehensive system of occupational health service outsourcing integrating health examinations and health management services. Furthermore, the current task system, which focuses on follow-up management, should be expanded to incorporate preventive and health promotion functions—the fundamental functions of occupational health services (OHS).

Surgical Outcomes Associated with Operable Gastric Cancer in a Tertiary Care Indian Hospital

PURPOSE: Data on operable gastric cancer from India is sparse. The purpose of this study was to investigate the clinical details, histopathological demographics, and 5-year overall survival (OS) and disease free survival (DFS) associated with operable, non-metastatic gastric cancer in a dedicated upper gastrointestinal (GI) surgical unit in India. MATERIALS AND METHODS: Data for patients diagnosed with operable gastric cancer between January 2006 and December 2014 were retrospectively analyzed. Data were collected from electronic hospital records in addition to mail and telephonic interviews when possible. RESULTS: A total of 427 patients were included. The tumor was located in the pyloro-antral region in 263 patients (61.7%). Subtotal gastrectomy was performed in 291 patients and total gastrectomy in 136 patients. Tumor stage classification revealed 43 patients (10.0%) with stage I, 40 patients (9.4%) with stage IIA, 59 patients (13.9%) with stage IIB, 76 patients (17.8%) with stage IIIA, 96 patients (22.5%) with stage IIIB, and 113 patients (26.4%) with stage IIIC disease. Follow-up data were available for 71.6% of the patients with a mean duration of 32.4 months. Five-year DFS and OS were 39% and 59%, respectively. CONCLUSIONS: Despite presenting at an advanced stage, the 5-year DFS and OS of patients with operable gastric cancer treated at a dedicated upper GI unit of a tertiary care center in India was good.