Evaluation on ophthalmic service ability of county hospitals based on improved DS evidence theory / 中华医院管理杂志

Objective:To evaluate the ophthalmic service ability of county hospitals in China based on the improved DS evidence theory.Methods:Convenient sampling method was used to select the data of ophthalmology department of 9 county hospitals in eastern, central and Western China in 2019. The improved DS evidence theory method based on Mahalanobis distance weight coefficient was applied to evaluate the medical service ability, and the evaluation results were compared with the classical evidence theory method.Results:The regional development of ophthalmic service capacity in counties of China was uneven, and there were regional differences in the evaluation results of some indicators. Hospitals in the eastern region were generally leading in the evaluation of a number of indicators related to the amount of medical services. The numbers of inpatient operations, outpatient operations, bed turnover times, bed utilization rate, number of inpatients, number of outpatients, number of patients in the eastern region were 3.25, 1.60, 1.81, 1.61, 2.64, 2.63 and 4.47 times of the numbers of hospitals in western region. Compared with the classical evidence theory method, the analysis results of the improved DS evidence theory method were consistent with the actual business development of each hospital, and the evaluation results were credible, which could more effectively reduce the uncertainty in the evaluation results.Conclusions:Ophthalmic service ability of county hospitals in China needs to be continuously improved. Improved DS evidence theory can be adopted to make continuous evaluation.

Aspects of work and sleep associated with work ability in regular aviation pilots / Aspectos do trabalho e do sono associados à capacidade para o trabalho entre pilotos

ABSTRACT OBJECTIVE: Analyze the association of work organization and sleep aspects with work ability in regular aviation pilots. METHODS: This is a cross-sectional epidemiological study with 1,234 regular aviation pilots who worked domestic and international flights, affiliated with the Brazilian Association of Civil Aviation Pilots. Data collection employed online questionnaire. We compared proportions using Pearson's Chi-squared or Fisher's exact hypothesis tests. Then, we conducted Poisson analysis, with robust variance, to test factors associated with moderate or low work ability. RESULTS: The prevalence of moderate or low work ability was 43.3%. We found that self-perception of insufficient sleep (PR = 1.29; 95%CI 1.06-1.57), increased perception for fatigue (PR = 1.51; 95%CI 1.24-1.84), more than 65 flight hours per month (PR = 1.22; 95%CI 1.01-1.46), less than 10 days of time off per month (PR = 1.27; 95%CI 1.04-1.55), and frequent operational delays (PR = 1.23; 95%CI 1.02-1.48) were factors associated with moderate or low work ability. CONCLUSIONS: Work organization was a determining factor for decreased work ability, especially concerning aspects related to rest and its influence on the sleep of pilots.

RESUMO OBJETIVO: Analisar a associação da organização do trabalho e dos aspectos do sono com a capacidade para o trabalho entre pilotos da aviação regular. MÉTODOS: Foi realizada uma pesquisa epidemiológica transversal, com 1.234 pilotos da aviação regular, que realizavam voos de rotas nacionais e internacionais, afiliados à Associação Brasileira de Pilotos da Aviação Civil. A coleta de dados foi feita através de questionário on-line. Para comparação entre as proporções foram realizados os testes de hipóteses qui-quadrado de Pearson ou Exato de Fisher. Posteriormente, foi efetuada a análise de Poisson, com variância robusta, para testar os fatores associados à capacidade moderada ou baixa para o trabalho. RESULTADOS: A prevalência de capacidade para o trabalho moderada ou baixa foi de 43,3%. Verificou-se que autopercepção de sono insuficiente (RP = 1,29; IC95% 1,06-1,57), maior percepção para fadiga (RP = 1,51; IC95% 1,24-1,84), jornada de voo maior que 65 horas por mês (RP = 1,22; IC95% 1,01-1,46), menos de 10 dias de folga por mês (RP = 1,27; IC95% 1,04-1,55) e atrasos operacionais frequentes (RP = 1,23; IC95% 1,02-1,48) foram fatores associados à capacidade moderada ou baixa para o trabalho. CONCLUSÕES: A organização do trabalho foi um fator determinante para a diminuição da capacidade para o trabalho, em especial quanto aos aspectos relacionados ao descanso e suas repercussões no sono de pilotos.

Factors that determine the Work Ability Index of street cleaners / 영남의대학술지

BACKGROUND: Korea has shown a rapid pace of aging and has become an aged society in a shorter period than Western countries. Therefore, it is important that middle-aged workers maintain their ability to work in the industrial field at the maximum level while maintaining their health. The purpose of this study was to analyze the factors affecting work ability and to use this data to maintain the working ability of middle-aged workers in the future.METHODS: From 2015 to 2017, we surveyed 371 street cleaners who visited a health center for health promotion in a metropolitan city. The relationship between the general characteristics of the survey subjects and the Work Ability Index (WAI) was confirmed by a univariate analysis. Statistically significant (p<0.2) factors were selected and a multiple linear regression analysis was conducted with WAI scores as a dependent variable.RESULTS: Age, body mass index, body fat percentage, the Alcohol Use Disorders Identification Test-Korea (AUDIT-K) scores, the Psychosocial Well-Being Index-Short Form (PWI-SF) scores, maximal oxygen consumption (VO(2max)), and hypertension showed statistically significant correlations with the WAI in the univariate analysis. In the multivariate analysis, the VO(2max), AUDIT-K scores, and PWI-SF scores were included in the regression equation. VO(2max) had the greatest effect on the standardization coefficient indicating the relative contribution of independent variables, followed by the AUDIT-K scores and the PWI-SF scores.CONCLUSION: Programs to increase workers’ physical work ability and alleviate psychosocial stress and drinking habits should be developed and implemented in the future.

Estressores afetando a capacidade para o trabalho em diferentes grupos etários na Enfermagem: seguimento de 2 anos / Stressors influence work ability in different age groups of nursing professionals: 2-year follow-up

Resumo Estressores do trabalho afetam a capacidade para o trabalho (CT) e o aumento da idade associa-se ao envelhecimento funcional. Foi avaliado se diferentes estressores afetam a CT de profissionais de enfermagem jovens e em envelhecimento. Uma coorte (2009-2011) de 304 trabalhadores de um hospital de São Paulo respondeu aos questionários Desequilíbrio Esforço-Recompensa (ERI), Escala Estresse no Trabalho (EET), Atividades que contribuem para dor/lesão (WRAPI) e Índice de Capacidade para o Trabalho (ICT). Mudanças na exposição aos estressores nos grupos etários (< 45 anos e ≥ 45anos) foram comparadas ao delta-ICT (diferença na pontuação inicial e final) pelo teste Mann-Whitney. Houve piora no delta-ICT (p = 0,609), sem diferença entre os dois grupos etários. Nos jovens a intensificação dos estressores ERI (p = 0,004), excesso de comprometimento (p = 0,002), apoio social (p = 0,014) e WRAPI (p = 0,004) associou-se à diminuição da CT e nos mais velhos apenas o ERI (p = 0,047). A CT dos jovens sofreu efeito da intensificação de vários estressores, enquanto a CT dos mais velhos recebeu influência apenas do desequilíbrio esforço-recompensa, indicando que ações de intervenção devem ser diferenciadas para os grupos etários.

Abstract Work stressors influence work ability – WA - and increasing age is associated with functional aging. We sought to establish whether work stressors differentially influence WA in young and aging nursing professionals. A cohort (2009-2011) composed of 304 workers at a hospital in Sao Paulo responded questionnaires Effort-Reward Imbalance (ERI), Job Stress Scale (JSS), Work-Related Activities That May Contribute To Job-Related Pain and/or Injury (WRAPI) and Work Ability Index (WAI). Changes in perceived exposure to stressors in each age group (< 45 and ≥ 45 years old) were compared to delta-WAI (difference between initial and final WAI score) by means of the Mann-Whitney test. There was a worsening in WAI (p = 0.609) without difference between the groups. WA impairment was associated with intensification of stressors ERI (p = 0.004), overcommitment (p = 0.002), social support (p = 0.014) and WRAPI (p = 0.004) among the younger workers, but with poorer ERI (p = 0.047) only among the older ones. While among the younger workers WA was influenced by the intensification of various stressors, in the case of the older ones it was influenced by effort-reward imbalance only, indicating that interventions should be differentiated according to age groups.

Research and practice on the evaluation system of public basic curriculum in medical colleges / 中华医学教育探索杂志

By analyzing the status and problems of academic evaluation level courses in public in-frastructure, we set up the academic level system of the process examination and ability evaluation of the public basic courses, from the four aspects, such as public basic curriculum, process examination and ability evaluation, the overall training objectives, teaching model, teaching and evaluation process, evaluation index classification and weight system of the academic level public basic curriculum. According to this system, effective measurement and verification have been carried out, and good results have been achieved. The system is conducive to students' correctly grasping the status of learning , and actively reflecting on the learning process, so that they can better grasp the learning methods. The system can serve as a useful refer-ence for the reform of similar institutions.

Distúrbio de voz e trabalho docente / Voice disorder and teaching work ability

RESUMO Objetivo: analisar a associação entre distúrbio de voz e capacidade para o trabalho em docentes da rede municipal de ensino de São Paulo. Métodos: professoras que buscaram atendimento fonoaudiológico, com queixa de alteração vocal; e professoras selecionadas sem queixa, expostas ao mesmo ambiente de trabalho, passaram por avaliação perceptivo-auditiva da voz; preenchimento dos protocolos Índice de Capacidade para o trabalho e Condição de Produção Vocal do Professor; e avaliação perceptivo-visual da laringe. Foram classificadas como Caso as que tinham alteração na avaliação perceptivo-auditiva e em pregas vocais (167) e Controle as sem alterações nas avaliações (105). Resultados: a capacidade para o trabalho esteve entre baixa e moderada entre os casos (67,4%) e entre boa e ótima (66,6%) nas professoras do controle (escore total). Houve associação estatística em duas dimensões do ICT, apontando que as docentes com distúrbio de voz apresentaram quase três vezes mais chance de perder capacidade para o trabalho e que quanto pior a perda da capacidade, mais forte é a associação com o distúrbio de voz. Conclusão: há associação entre o distúrbio de voz e as dimensões capacidade atual para o trabalho comparada com a melhor de toda vida, indicando que os sujeitos que apresentaram distúrbio de voz estavam em sua pior capacidade para trabalhar, e perda estimada para o trabalho por causa de doenças, indicando que quanto maior a perda da capacidade para o trabalho, mais forte é a relação com o distúrbio de voz, independente da idade.

ABSTRACT Purpose: to analyze the association between voice disorder and work ability in teachers of public schools of São Paulo. Methods: teachers who searched for speech therapy, with voice alteration complaint; and selected teachers with no complaint who were exposed to the work environment and submitted to the auditory voice perception; completing the Work Ability Index and the Conditions of Vocal Production of Teachers protocols; and perceptive visual larynx evaluation. Those with changes in perceptual evaluation and vocal folds were classified as Case (167) and those without changes in evaluations (105) were classified as Control. Results: the work ability was from low to moderate among the cases (67.4%) and between good and great (66.6%) in the control teachers (total score). There was a statistical association in two WAI dimensions, pointing out that teachers with voice disorders were nearly three times more likely to lose their work ability and the worst the loss of ability, the stronger is the association with the voice disorder. Conclusion: there is an association between the voice disorder and the dimensions for current work ability compared with the best of lifetime, indicating that subjects who had a voice disorder were at their worst conditions regarding their work ability, and estimated loss for work due to illnesses, indicating that the greater the loss of work ability, the stronger is the relationship with the voice disorder, regardless of age.

Work ability and health of security guards at a public University: a cross-sectional study / Capacidade para o trabalho e saúde dos vigilantes de uma Universidade pública / Capacidad para el trabajo y salud de los guardias de una Universidad pública: un estudio transversal

Abstract Objective: to evaluate the work ability and health status of security guards at a public University. Methods: a cross-sectional, descriptive, and analytical study was carried with 119 security guards. The following instruments were used: Work Ability Index (WAI), Patient Health Questionnaire (PHQ-9), International Physical Activity Questionnaire (IPAQ, short), Alcohol Use Disorders Identification Test (AUDIT), Medical Outcomes Study (MOS), and Demand-Control-Support (DCS). Descriptive statistics were used to describe the study samples and the Spearman's coefficient correlation was performed to assess the WAI. Significance level was set at 5%. Results: samples were composed by men; the mean age was 54.9 years (SD=5.7); 80% had partners, and 75% had basic education. The majority (95%) had only one job, the average length of service was 24.8 years (SD=11), ranging from 3 to 43 years. 88.9% worked ≤40 hours and 75% did not work at night shift or rotating shifts. The average score given to work ability was good (40.7 points), with significant correlation to social support at work (p-value=0.002), health conditions (p-value=0.094), and depression symptoms (p-value=0.054). Conclusion: this study showed that many characteristics might affect the work ability scores. Considering the results, we note that healthy life habits and a reorganization of work environments should be encouraged.

Resumo Objetivo: avaliar a capacidade para o trabalho e o estado de saúde dos vigilantes de uma Universidade pública. Métodos: foi desenvolvido um estudo transversal, descritivo e analítico com 119 vigilantes. Foram utilizados os seguintes instrumentos: Índice de Capacidade para o Trabalho (ICT), Questionário sobre a Saúde do Paciente (PHQ-9), Questionário Internacional de Atividade Física (IPAQ curto), Teste de Identificação dos Transtornos Devido ao Uso de Álcool (AUDIT), Escala de Apoio Social utilizada no Medical Outcomes Study (MOS) e Demanda-Controle-Apoio Social no Trabalho (DCS). Foi utilizada estatística descritiva para descrever a amostra do estudo e utilizado o coeficiente de correlação de Spearman para avaliar o ICT. O nível de significância adotado foi de 5%. Resultados: a amostra foi composta por homens: media de idade de 54,9 anos (DP=5,7); 80% casados e 75% tem ensino fundamental. A maioria (95%) tem apenas um emprego, a méd dia do tempo de servicçoe foi de 24,8 anos (DP=11), variando de 3 a 43 anos. 88,9% trabalhavam ≤ 40 horas e 75% não trabalhavam à noite ou em turnos alternantes. O valor médio da capacidade para o trabalho foi bom (40,7 pontos), com associação significativa com apoio social no trabalho (p= 0,002), condições de saúde (p=0,094) e sinais e sintomas de depressão (p=0.054). Conclusão: esse estudo mostrou que muitas características podem afetar a capacidade para o trabalho. Considerando os resultados, pode-se notar que hábitos de vida saudáveis e a reorganização do ambiente de trabalho devem ser estimulados.

Resumen Objetivo: evaluar la capacidad para el trabajo y el estado de salud de los guardias de seguridad de una Universidad Pública. Métodos: estudio transversal, descriptivo y analítico llevado a cabo con 119 guardias de seguridad. Se utilizaron los siguientes instrumentos: Índice de Capacidad para el Trabajo (ICT), Cuestionario de salud del paciente (PHQ-9), Cuestionario internacional de actividad física (IPAQ corto), Test de identificación de disturbios en el uso de alcohol (AUDIT), Estudio de resultados médicos (MOS), y Demanda-Control-Apoyo (DCS). Se utilizaron estadísticas descriptivas para describir las muestras en estudio y se utilizó el coeficiente de correlación de Spearman para evaluar el ICT. El nivel de significancia fue establecido al 5%. Resultados: las muestras estaban compuestas por hombres, de edad promedio 54.9 años (DE=5.7); el 80% tenia pareja y un 75% tenía educación básica. La mayoría (95%) solamente tenía un trabajo y el promedio de tiempo de servicio era de 24.8 años (DE=11) en un rango entre 3 y 43 años. El 88.9% trabajaban ≤40 horas y el 75% no trabajaban en horarios nocturnos o rotativos. El promedio de puntuación alcanzado en capacidad para el trabajo fue bueno (40.7 puntos), con una correlación significativa en relación al soporte social en el trabajo (valor de p=0.002), condiciones de salud (p=0.094) y síntomas de depresión (p=0.054). Conclusión: este estudio mostró que muchas características afectan la puntuación de capacidad para el trabajo. Considerando los resultados, notamos que se deben promover los hábitos de vida saludable y una reorganización de los ambientes de trabajo.

Establishment and practice of the evaluation system on research ability of staff of the maternal-child health / 中华医学科研管理杂志

Scientific research is important for the improvement of the health-care techniques,and is certainly important for the health of women and children of the whole society.With the development of medical science,research ability of maternal and child healthcare professionals is deemed essential.And the evaluation of their research ability,stimulation,and creativity have been important topics to address.Here we introduce an evaluation system for research capacity of maternal and child healthcare professionals established in our hospital,which is the fruit of constant exploration and practice for several years.It is proved to be practical,simple and feasible.The establishment methods,practices and experiences of the evaluation system are presented in this paper.

Responsiveness of 3 Scale for Swallowing Disorder on Elderly Dysphagic Patients / 中国康复理论与实践

@#ObjectiveTo determine the responsiveness of 3 assessment for swallowing disorder on elderly people. Methods40 elderly cases with were assessed with drinking test, classification of swallowing disorder, and swallowing ability evaluation before and 3 weeks after treatment. ResultsThe effect size was 1.04 for drinking test, 1.74 for classification of swallowing disorder and 2.06 for swallowing ability evaluation. The standardized response mean was 2.49 for drinking test, 2.35 for classification of swallowing disorder and 2.78 for swallowing ability evaluation. There was very significant difference before and after treatment in the score of all the scales (P<0.001). ConclusionDrinking test, classification of swallowing disorder, and swallowing ability evaluation are responsive for swallowing disorder in elderly people receiving rehabilitation.

Comparative Analysis of the Independent Medical Examination Reports and Legal Decisions in Pain Medicine

BACKGROUND: An independent medical examination (IME) is a critical process for awarding reparation for injury. However, conducting an IME in pain medicine is very difficult, not only because pain is a subjective symptom, but also because there are no proper objective methods to demonstrate it. This study was conducted to compare IME reports and the court decisions on the disability status of the patients. METHODS: We analyzed 79 IME reports and 25 corresponding court decisions on the disability status of patients. The diagnoses, causal relationships between the patients' status and the trauma, McBride's degree of disability, the American Medical Association's impairment ratings, the estimated annual cost for future treatment, and the necessity of care-giving were compared and analyzed. RESULTS: The diagnoses in the 79 cases were complex regional pain syndrome (CRPS) type I (58 cases), CRPS type II (7 cases), peripheral neuropathy (5 cases), myofascial pain syndrome (4 cases), herniated intervertebral disc (2 cases), and fibromyalgia (1 case). The types of accidents were road traffic accidents (50 cases), military injuries (14 cases), industrial accidents (11 cases), and others (4 cases). The IME reports and the court decisions stated considerably different McBride's degrees of disability (P = 0.014). However, there was no significant difference in the estimated cost for future treatment between the IME reports and the court decisions (P = 0.912). CONCLUSION: IME reports should be accurate, fair, and based on objective findings. Feedback on IMEs from the court decisions is helpful for reference use.