Percepção de danos físicos, psíquicos e sociais no trabalho de ser mãe universitária / Perception of physical, psychological, and social damages in the work of being college student mothers / Percepción de los daños físicos, sociales y psicológicos en el trabajo de ser madre universitaria

A vida universitária de mulheres mães apresenta questões que precisam ser mediadas quando comparadas com a mesma dinâmica em estudantes que não são mães. O referencial teórico da psicodinâmica do trabalho reconhece o estudar e o maternar como trabalho, pois demandam esforço cognitivo, físico e temporal com finalidade social. O objetivo deste artigo foi avaliar os danos advindos desses dois trabalhos, sobretudo, em suas dimensões física, psicológica e social, na vida de mães universitárias com filhos de até cinco anos de idade. Utilizou-se a metodologia quantitativa com ajuda da aplicação da Escala de Avaliação dos Danos Relacionados ao Trabalho (EADRT), e adaptada para o contexto estudantil e materno. A pesquisa foi respondida por 453 mães universitárias. Dessa forma, foi encontrada uma amostra heterogênea, cujas respostas apontaram para diferenças na percepção dos danos; correlações dos fatores; e associações com as variáveis sociodemográficas. Logo, discute-se a presença de danos físicos, sociais e psicológicos considerados graves para as duas atividades. No entanto, quando as mães universitárias residem com um companheiro ou têm maior renda, os danos sociais e psicológicos se mostraram menores. Com efeito, esta pesquisa ampliou o conhecimento sobre quem são as mães brasileiras na graduação e que tipo/grau de danos à saúde elas vivenciam, destacando que o acúmulo dos dois papéis acarreta níveis críticos que podem ser atenuados pelo apoio familiar e pela assistência às questões de vulnerabilidade econômica. Por fim, reforça-se a preocupação em analisar cientificamente essas realidades, servindo de embasamento para políticas públicas e estratégias futuras de intervenção.(AU)

The student life of college mothers shows complementary issues that need to be evaluated when compared with the same dynamic in students that are not mothers. The theoretical framework of the psychodynamics of work recognizes studying and mothering occupations as work activities, since they demand cognitive, physical, and temporal effort with a social purpose. The aim of this article was to assess the damage arising from these two workloads, especially, in their physical, psychological, and social dimensions, to the lives of women undergraduate students who have children up to five years old. We used a quantitative methodology with the application of the Work-Related Damage Assessment Scale (EADRT), adapted to the university and maternity context. The scale was answered by 453 college student mothers. Thus, we found a heterogeneous sample, whose answers pointed to variations in the perception of damage; correlations between factors; and connections with the socio demographic variables. Therefore, we discuss the presence of physical, social, and psychological damages considered severe for both activities. However, when the student mothers live with a partner or have a higher income, the social and psychological damage are lesser. In conclusion, this study expanded the knowledge about who are the Brazilian undergraduate student mothers and the type/degree of damages to their health they experienced, highlighting that the build-up of the two roles leads to critical levels that can be mitigated by family support and by assistance to issues concerning economic vulnerability. Finally, the importance to scientifically analyze these realities, serving as foundation for public policies and future intervention strategies, is reinforced.(AU)

La vida universitaria de madres tienen demandas diferentes que necesitan discusión en la comparación con la vida universitaria de mujeres que no son madres. El marco teórico de la psicodinámica de trabajo reconoce el papel de madre y de estudiante como trabajos, ya que para hacerlos se requiere esfuerzo cognitivo, físico y temporal, con finalidad social. El objetivo de este estudio es avaliar los daños que acompañan estos dos trabajos en sus dimensiones física, psicológica y social, en la vida de mujeres brasileñas estudiantes de grado que tienen hijos de hasta 5 años de edad. Se utilizó la metodología cuantitativa a partir de la aplicación de la Escala de Evaluación de Daños Relacionados al Trabajo (EADRT), adaptada al contexto estudiantil y de maternidad. La encuesta fue respondida por 453 madres universitarias. Como resultado, se encontró una muestra heterogénea, con diferencias entre la percepción de daños, correlaciones entre los factores y asociaciones entre los daños y variables sociodemográficas. Se discute la presencia de daños físicos, sociales y psicológicos considerados graves para los dos papeles. Sin embargo, cuando las madres universitarias viven con un compañero o tienen ingresos más grandes, los daños sociales y psicológicos son menores. Se concluye que este estudio permitió ampliar el conocimiento acerca de las madres brasileñas en el grado y qué tipo/nivel de los daños a la salud tienen, que destaca que la acumulación de los papeles genera niveles críticos que pueden ser mitigados por el apoyo familiar y asistencia en cuestiones de vulnerabilidad económica. Se destaca la preocupación por analizar científicamente las realidades de madres universitarias, sirviendo de base para políticas públicas y estrategias de intervenciones futuras.(AU)

Occupational lung diseases in South African miners at autopsy: 2020 surveillance report

The Pathology Division at the National Institute for Occupational Health (NIOH) provides autopsy services for deceased workers who worked in controlled mines or works under the provisions of the South African Occupational Diseases in Mines and Works Act, 1973 (Act No. 78 of 1973). This report describes the ages, commodities, employment durations, and occupational cardio-respiratory diseases in miners whose organs were submitted for autopsies in 2019 and 2020. Data were exported from the PATHAUT database into STATA for analysis. Differences in the proportions of disease (expressed per 1 000) were calculated using the Pearson's chi-square test; significance was set at p ≤ 0.05. There were 759 and 557 records of deceased miners and ex-miners in 2019 and 2020, respectively. Pulmonary tuberculosis decreased from 192/1 000 in 2019 to 153/1 000 autopsies in 2020, and silicosis decreased from 246/1 000 to 223/1 000. However, neither decrease was significant. There was a significant increase in the rate of asbestosis from 50/1 000 in 2019 to 79/1 000 in 2020. Pulmonary tuberculosis (TB), emphysema, and silicosis were the most frequent diseases, with high rates. There was a non-significant decrease in occupational respiratory disease rates in 2020 from 2019, but these remain higher than the rates seen in the early 1990s. The NIOH continues to conduct autopsy surveillance on miners to support compensation for families, and the development of policy and intervention programmes in the mining industry

Judicial Vulnerability on the Exercise of Orthodontics: Construction and Validation of a Questionnaire

Abstract Objective: To develop and validate a questionnaire to measure the vulnerability of orthodontists, measuring the risks of being involved in civil liability lawsuits. Material and Methods: In-depth interviews were performed with three groups: G1- law professionals, G2 - orthodontists, and G3 - orthodontic patients. From the analysis of the content of Bardin, domains for the construction of the first version of the 53-question questionnaire were identified. The questionnaire was submitted to experts for validation, inclusion and exclusion of questions, but maintaining the 53-question format. It was submitted to the test-retest phases and verification of internal consistency. Results: 247 professionals answered the final version of the questionnaire. The intraclass correlation coefficient was 88.8%. Cronbach's alpha was 0.946, with high internal consistency. The Kaiser-Meyer-Olkin and Bartlett's tests confirmed internal consistency showing the values of 0.909 and significance of <0.001, respectively. From the total score and factorial analysis, the sample was divided into three groups of judicial vulnerability. Conclusion: The results of this study demonstrated that the questionnaire is a valid tool to measure the risks of involvement in civil liability lawsuits by orthodontists. It presented a multidimensional character and might be applied as well as face to face or online, without prejudice to quality (AU).

Análisis comparativo de las pautas del consejo de organizaciones internacionales de ciencias médicas (CIOMS)2016. (Parte 3 de 3) / Comparative analysis of the standards of the council of international organizations of medical sciences (CIOMS)2016. (Part 3 of 3)

El este tercer trabajo se presenta el análisis comparativo de las últimas pautas de CIOMS 2016, realizado por estudiantes de la VI Cohorte de la Maestría en Bioética como parte de la evaluación de la asignatura Bioética e Investigación. En estas pautas se abordan de forma novedosa temas tan importantes como la investigación en grupos vulnerables, en situaciones de desastre y brotes de enfermedades de orden natural o creadas por el hombre e investigaciones con conglomerados, así como la compensación por daños, manejo de datos cuando se utiliza el entorno virtual y herramientas digitales y el conflicto de interés, lo cual proporcionará a los investigadores un aporte en su formación y una rápida adaptación a la nueva propuesta CIOMS(AU)

In this third work, the comparative analysis of the latest CIOMS 2016 guidelines, carried out by students of the VI Cohort of the Master in Bioethics, as part of the evaluation of the subject Bioethics and Research is presented. These guidelines deal in a novel way with important issues such as research in vulnerable groups in situations of disaster and outbreaks of natural or man-made diseases and investigations with clusters, as well as compensation for damages, data management when the virtual environment and digital tools and the conflict of interest are used, which will provide researchers with a contribution in their training and a rapid adaptation to the new CIOMS proposal(AU)

Interferência da Indústria do Tabaco no Brasil: a Necessidade do Ajuste de Contas / Tobacco Industry Interference in Brazil: the Necessity of Settling Accounts / Interferencia de la Industria Tabacalera en Brasil: la Necesidad del Ajuste de Cuentas

Introdução: No Brasil, cada vez mais são identificadas ações ilegais de publicidade, propaganda e patrocínio por parte da indústria do tabaco em eventos musicais e por meio das redes sociais, voltadas a atrair principalmente o público jovem para o uso do cigarro. Objetivo: Desenvolver uma metodologia que permita estabelecer um parâmetro de quantificação dos impactos negativos para o setor saúde desse descumprimento da lei. Método: Combinaram-se as informações nacionais existentes sobre i) a equivalência entre "custo direto médio da assistência médica" e "mortes por doenças atribuíveis ao tabagismo" e ii) a equivalência entre "a parcela do lucro revertido em ações de marketing" e "mortes de fumantes que contribuíram para a geração desse lucro por meio da compra de cigarros", de forma a se obter a relação "custo direto do tratamento" vs "parcela do lucro revertido em ações de marketing". As doenças selecionadas foram aquelas que apresentam os maiores custos diretos de tratamento atribuíveis ao fumo. Resultados: Para cada centavo investido em marketing pela indústria do tabaco, o Brasil tem um gasto com tratamento de doenças relacionadas ao tabaco 1,93 vezes superior ao dinheiro investido pela indústria. Conclusão: A mensuração da responsabilização dos violadores da legislação nacional para o controle do tabaco é fundamental para compensar parte dos custos associados ao tratamento de pacientes e aos programas de cessação ao fumo, favorecendo assim a redução do tabagismo no país.

Introduction: In Brazil, illegal actions of advertising, promotion, and sponsorship by part of the tobacco industry are increasingly identified in music events, and through social media, aimed mainly to attract young people to use cigarettes. Objective: To develop a methodology that allows the creation of a parameter of quantification of the negative impacts to the health sector of non-compliance with the law. Method: Combination of the current national information about i) the equivalence between "mean direct cost of medical care" and "deaths by diseases attributable to tobacco addiction" and ii) the equivalence between "the portion of the profit translated into marketing actions" and "deaths of smokers who contributed for the generation of this profit through purchase of cigarettes" in order to obtain the relation between "direct cost of the treatment" vs "portion of the profit translated into market actions". The diseases selected were those that presented the biggest direct cost of treatment attributable to tobacco. Results: For every cent invested in marketing strategies by the tobacco industry, Brazil spends 1.93 times more financial resources to treat tobacco-related diseases. Conclusion: The measurement of the liability for non-compliance of the tobacco national legislation is essential to offset part of the associated costs of the treatment of patients and programs of tobacco cessation to favor the reduction of smoking prevalence in Brazil.

Introducción: En Brasil, es cada vez más común identificar acciones ilegales de publicidad, promoción y patrocinio del tabaco por parte de la industria tabacalera en eventos musicales y a través de redes sociales, destinadas principalmente a atraer al público joven al consumo de cigarrillos. Objetivo: Desarrollar una metodología que permita establecer un parámetro para cuantificar los impactos negativos al setor de la salud de esa acción ilegal de la ley. Método: El artículo integra la información nacional existente sobre i) la equivalencia entre el "costo directo promedio de asistencia médica" y "muertes por enfermedades atribuibles al tabaquismo" y ii) la equivalencia entre "la parte del ingreso usado en acciones de marketing" y "las muertes de fumadores que han contribuido a la generación de estos ingresos a través de la compra de cigarrillos", para obtener la relación "costo directo del tratamiento" vs "parte de los ingresos usados en acciones de marketing". Las enfermedades seleccionadas fueron las que presentaron los costos más altos de tratamiento directo atribuibles al uso del tabaco. Resultados: Por cada centavo invertido en marketing por la industria tabacalera, Brasil tiene un gasto en tratamiento de enfermedades relacionadas con el tabaco 1,93 veces mayor que el monto invertido por la industria. Conclusión: Medir la responsabilidad de los infractores de la legislación nacional de control del tabaco es esencial para compensar parte de los costos asociados con el tratamiento de los pacientes y com los programas para dejar de fumar, favoreciendo así la reducción del consumo de tabaco en el país.

Gastric and rectal cancers in workers exposed to asbestos: a case series

A Survey Study on Rheumatologist Consultation Time in Korean Hospitals

OBJECTIVE: In Korea, short physician consultation time has been a cause of concern as it compromises the care provided. This study was aimed at finding the actual and optimal consultation time per patient for rheumatology outpatient clinic in Korea.METHODS: The surveys were prepared based on a study of the literature and consisted of multiple-choice questions as well as additional open questions. Surveys were conducted from November to February, 2018~2019. Rheumatologist members of the Korean College of Rheumatology were invited to complete the web-based survey as well as paper survey.RESULTS: The mean duration of consultation allocated to a new and an established patient was found to be 12.3 and 4.8 minutes, respectively, which corresponded to only 22%~35.3% of perceived optimal consultation time. On the other hand, the intrusion of physician autonomy for optimal patient care by the hospital executive was manifest such that only 4.7% responded discretion in allocating consultation time for patients and that 61.3% replied that they have been restrained from keeping the adequate outpatient clinic volumes. Sixty six percent of respondents replied that insufficient consultation time affects patient safety including errors in prescription.CONCLUSION: Rheumatology consultation time is very insufficient compared to optimal situation. A drastic change in health care policy promoting good quality of care, such as appropriate compensation which guarantees sufficient consultation time, as well as strong policy to control excessive profit-driven management policy of the hospitals is urgently needed.

Protección de la salud en el trabajo: de lo indemnizatorio mercantil al real cuidado de la salud / Protection of health at the workplace: from monetary compensation to true health care

Este artículo cuestiona los mecanismos de protección de la salud en el trabajo desarrollados internacionalmente hasta ahora por el campo de la seguridad y la salud en el trabajo. Su objetivo fue hacer un análisis de los enfoques de la salud ocupacional y el aseguramiento que han estructurado la praxis hegemónica de la protección de la salud en el trabajo y contrastarlos con el enfoque de la salud de los trabajadores proveniente del campo de la medicina social­ salud colectiva. La metodología usada para el desarrollo del artículo fue la de una investigación documental, conjugada con la experiencia en formación, investigación y organización en el campo de la salud de los trabajadores del autor del artículo. Las reflexiones epistémicas, ontológicas, metodológicas, políticas y prácticas, sobre la base de lo revisado documentalmente, permitieron sostener que a pesar de algunos beneficios de los mecanismos tradicionales de protección de la salud en el trabajo, los enfoques de la salud ocupacional y el aseguramiento no transforman las condiciones de trabajo que históricamente han generado efectos negativos sobre la salud y la vida de los trabajadores, mientras que el enfoque de salud del trabajador proporciona elementos que aportan a configurar una protección integral del cuidado de la salud en trabajo, con un sentido de autonomía y emancipación de los trabajadores y una apuesta real por la transformación tanto de las condiciones de trabajo, como de las del modo de producción(AU)

This paper questions the mechanisms of protection of health at the workplace currently applied globally in occupational safety and health. The author performed an analysis of occupational health and insurance approaches that have driven the hegemonic practice of occupational health protection, and contrasted them with an approach centered on workers' health coming from the field of social medicine/collective health. The methodology used for the development of the paper was that of a documentary investigation, combined with the author's experience in training, research and organization in occupational health. The epistemic, ontological, methodological, political and practical reflections, on the basis of the documentary review, allows the author to postulate that, despite some benefits of the traditional mechanisms of occupational health protection, these approaches do not transform the working conditions that have historically generated negative effects on the health and life of workers. In contrast, the workers' health-centered approach provides elements that contribute to configuring an integral protection of health care in the workplace, with a sense of autonomy and emancipation of workers and true commitment to the transformation of both working conditions and those of the means of production(AU)

Responsabilidad Médica en Chile: Fallos de la Corte Suprema de Justicia 2017 / Medical Malpractice in Chile: Rulings of the Supreme Court of Justice 2017

RESUMEN: El objetivo de este trabajo fue analizar los datos epidemiológicos y jurídicos de los casos por responsabilidad médica fallados por la Corte Suprema de Justicia chilena (CSJ) el año 2017, para relevar los escenarios de alto riesgo, aportando a su prevención. Se realizó un estudio retrospectivo, revisando los fallos de la CSJ en la base de datos electrónica del Poder Judicial chileno. Se seleccionaron y analizaron los fallos por responsabilidad médica. Se detectó un total de 61 casos por responsabilidad médica que alcanzaron la CSJ en 2017. Todos correspondieron a causas civiles. La duración promedio de los juicios fue 41,9 meses. La especialidad más demandada y condenada fue ginecología. La mayoría de las demandas y condenas afectó al Sistema Público de salud. Los casos que dan origen a las demandas son, en su mayoría, de atención de urgencias por sobre las programadas, y de tratamiento por sobre procedimientos quirúrgicos. El 54,8 % de los casos resultaron en la muerte del paciente. La mitad de los fallos condenatorios involucraba el fallecimiento del usuario afectado. Se deben investigar los factores de riesgo no sólo de la ocurrencia de mal-praxis, si no de la judicialización de los conflictos médico-paciente, especialmente en el área gineco-obstétrica, incluyendo los casos de instancias anteriores a la CSJ. Se debe investigar así mismo los factores de riesgo para la mayor propensión de los profesionales de sexo masculino de ser demandados y condenados por malpraxis médica.

ABSTRACT: The objective of the present study is to characterize the epidemiologic and juridical data for medical malpractice cases ruled by the Chilean Supreme Court (CSC) in 2017, to highlight the high risk scenarios, as a contribution to their prevention. A search of the CSC electronic database was conducted to identify and analyze CSC rulings for medical malpractice cases. In this study 61 malpractice cases ruled by CSC were identified. The CSC received only civil cases of medical malpractices during the studied period. The average duration of the trial was 41.9 months. Gynecologists faced suits and received sentences more frequently than any other type of specialist. The majority of prosecuted cases and convictions were associated with the public health system. A greater number of claims were related to emergency care than with scheduled procedures. Likewise, more claims were associated with non-surgical treatment than with surgical procedures. 54.8 % of all cases resulted in the patient's death. Half of the cases that lead to conviction, were related to the death of a patient. Risk factors should be investigated, not only of the occurrence of malpractice, but also of the judicial process of doctor-patient conflicts, especially in the obstetrics and gynecology area, including the analysis of cases of prior judicial instances. The risk factors for the higher propensity of male professionals to be prosecuted and convicted for medical malpractice should also be investigated.

Análise dos processos indenizatórios envolvendo a odontologia na Grande Vitória, Espírito Santo, Brasil / Analysis of the lawsutis involving Dentistry in metropolitan Vitória, Espírito Santo State, Brazil

A responsabilidade civil na atuação odontológica envolve a reparação de um dano e pode gerar, ao final do processo, a obrigação de indenizar o indivíduo lesado. O objetivo deste trabalho foi realizar o levantamento e a análise dos processos de responsabilidade civil envolvendo cirurgiões-dentistas e clínicas odontológicas na Região Metropolitana da Grande Vitória (RMGV), Espírito Santo, Brasil. Foram analisados processos instaurados entre 2009 e 2017, sendo verificados os valores de indenização, as especialidades odontológicas envolvidas, presença de laudo pericial e o acionamento de seguro de responsabilidade. Foi encontrado um total de 102 processos. As especialidades mais envolvidas foram Prótese Dentária, Ortodontia e Implantodontia. 84 processos foram instaurados nos Juizados Especiais Cíveis (JEC), enquanto 18 foram via justiça comum (JC). Nos processos do JEC, os valores de indenização solicitados variaram entre R$ 100,00 e R$ 35.000,00, sendo que 21 processos se apresentavam em andamento, 26 foram resolvidos por meio de acordo, 19 foram extintos sem resolução de mérito, em 11 houve sentença favorável ao paciente e sete foram extintos pelo autor. Nos processos da JC os valores de indenização solicitados variaram entre R$ 2.800,00 e R$ 120.237,00, sendo que 14 processos apresentavam-se em andamento, dois foram encerrados por acordo e em dois houve sentença favorável ao cirurgião-dentista. Houve presença de laudo pericial em quatro casos e nenhuma contratação de seguro de responsabilidade civil. Concluiu-se que no período estudado houve uma tendência ao crescimento na ocorrência dos processos na RMGV

Civil liability in the dental practice involves the obligation to repair an injury and can generate, in a lawsuit, the obligation to indemnify the patient. The aim of this study was to carry out a survey to analyze lawsuits involving dentists and dental offices in the Vitória Metropolitan Region (VMR), Espírito Santo state, Brazil. Lawsuits filed between 2009 and 2017 were analyzed and collected data as values, dental specialties involved, presence of expert witness report and the use of liability insurance. 102 lawsuits were found. The main dental specialties were Prosthodontics, Orthodontics and Dental Implants. 84 cases were filed in special civil courts (SCC), while 18 cases were filed through the ordinary courts (OC). In the SCC cases, the indemnity amounts requested ranged from R$ 100.00 to R$ 35,000.00, of which 21 were in progress, 26 were concluded through agreement, 19 were finished without merit resolution, in 11 cases the patient was the winner, and seven were extinguished by the author. In the cases of OC, the indemnity amounts requested ranged from R$ 2,800.00 to R$ 120,237.00, of which 14 were in progress, two were concluded through agreements and in two was a favorable decision to the dentist. There was expert witness report in four cases and no contracting of civil liability insurance. It was concluded that in the studied period there was a tendency to growth related to lawsuits involving Dentistry in the VMR.

A Qualitative Study on the Potential Utilization of a Mobile Phone for Obesity Management in Elementary-School Children : Parents Perspective / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS: The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS: The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS: The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.

High-Resolution Numerical Simulation of Respiration-Induced Dynamic B₀ Shift in the Head in High-Field MRI

PURPOSE: To demonstrate the high-resolution numerical simulation of the respiration-induced dynamic B0 shift in the head using generalized susceptibility voxel convolution (gSVC). MATERIALS AND METHODS: Previous dynamic B0 simulation research has been limited to low-resolution numerical models due to the large computational demands of conventional Fourier-based B0 calculation methods. Here, we show that a recently-proposed gSVC method can simulate dynamic B0 maps from a realistic breathing human body model with high spatiotemporal resolution in a time-efficient manner. For a human body model, we used the Extended Cardiac And Torso (XCAT) phantom originally developed for computed tomography. The spatial resolution (voxel size) was kept isotropic and varied from 1 to 10 mm. We calculated B0 maps in the brain of the model at 10 equally spaced points in a respiration cycle and analyzed the spatial gradients of each of them. The results were compared with experimental measurements in the literature. RESULTS: The simulation predicted a maximum temporal variation of the B0 shift in the brain of about 7 Hz at 7T. The magnitudes of the respiration-induced B0 gradient in the x (right/left), y (anterior/posterior), and z (head/feet) directions determined by volumetric linear fitting, were < 0.01 Hz/cm, 0.18 Hz/cm, and 0.26 Hz/cm, respectively. These compared favorably with previous reports. We found that simulation voxel sizes greater than 5 mm can produce unreliable results. CONCLUSION: We have presented an efficient simulation framework for respiration-induced B0 variation in the head. The method can be used to predict B0 shifts with high spatiotemporal resolution under different breathing conditions and aid in the design of dynamic B0 compensation strategies.

Effect of Hyaluronic Acid Injection for a Dysphagia Patient Who Has Unilateral Vocal Fold Paralysis due to a Lateral Medullary Infarction: A Case Report / 대한연하장애학회지

This paper reports a case of a female patient aged 48 years diagnosed with a right lateral medullary infarction and dysphagia after the onset period. In a video fluoroscopic swallowing study (VFSS), significant manifestations were not observed in the oral phase, but during swallowing aspiration, a larger amount of post-swallowing residue were observed on the test of swallowing of semisolid and liquid. After the VFSS, a laryngoscopy was performed, which indicated paralysis and para-median fixation in the right vocal fold. In this case, swallowing with rightward head rotation was adopted as a compensation technique to reduce the aspiration caused by the para-median fixation of the right vocal fold, but it was not enough to improve the dysphagia in this case. To medialize the right vocal fold, hyaluronic acid was injected with laryngoscopic guidance. In a VFSS conducted after the injection, aspiration was not observed on the test of swallowing a semisolid and liquid. The injection of hyaluronic acid is less invasive than surgical operations, does not require general anesthesia, and makes the recovery time shorter. Therefore, it is expected to be an alternative to the treatment of unilateral vocal fold paralysis (UVFP) accompanied with dysphagia.

Psychological Responses among Humidifier Disinfectant Disaster Victims and Their Families

To substantiate psychological symptoms following humidifier disinfectant (HD) disasters, counseling records of 26 victims and 92 family members of victims (45 were bereaved) were analyzed retrospectively. Among the victims, 34.6% had Clinical Global Impression-Severity scores of over 4, which meant they were moderately ill. While anxiety/fear and depression with respiratory symptoms were frequently observed in victims and family members, chronic psychological distress such as alcohol/smoking abuse and insomnia was relatively high in bereaved family members. In conclusion, it is important to provide mental health support for victims and their families, focusing on the characteristic symptoms of each group as well as monetary compensation.

Background and Activities of the Samsung Ombudsperson Commission in Korea / 예방의학회지

OBJECTIVES: The Samsung Ombudsperson Commission was launched as an independent third-party institution following an agreement among Samsung Electronics, Supporters for Health and Right of People in Semiconductor Industry (Banolim in Korean, an independent NGO), and the Family Compensation Committee, in accordance with the industry accident prevention measure required by the settlement committee to address the issues related to employees who allegedly died from leukemia and other diseases as a result of working at Samsung's semiconductor production facilities. METHODS: The Commission has carried out a comprehensive range of activities to review and evaluate the status of the company's occupational accidents management system, as well as occupational safety and health risk management within its facilities. RESULTS: Based on the results of this review, termed a comprehensive diagnosis, the Commission presented action plans for improvement to strengthen the company's existing safety and health management system and to effectively address uncertain risks in this area going forward. CONCLUSIONS: The Commission will monitor the execution of the suggested tasks and provide advice and guidance to ensure that Samsung's semiconductor and liquid crystal display production lines are safer.

Effects of a Self-Care Reinforcement Program for Socially Vulnerable Elderly Women with Metabolic Syndrome in Korea

PURPOSE: This study evaluates the efficacy of a Self-Care Reinforcement Program (SCRP) based on the Selection Optimization Compensation (SOC) model, in socially vulnerable elderly women with metabolic syndrome. METHODS: This study adopts a pretest-posttest nonequivalent control group design. The participants were 64 socially vulnerable elderly Korean women with metabolic syndrome (experimental group: 31, control group: 33). Participants' body composition analysis, nutrient intake, risk factors of metabolic syndrome, depressive symptoms, and social network were measured. Data were analyzed with an independent t-test; statistical significance levels were set at p<.05. The SCRP, including metabolic syndrome education, nutritional education, exercise, and social network, was performed three times a week for 8 weeks. RESULTS: There were statistically significant differences between the experimental and control groups in terms of systolic blood pressure, diastolic pressure, fasting blood sugar, triglycerides, sodium intake, depressive symptoms, and social networks. CONCLUSION: The SCRP is effective and can be recommended as a community health nursing intervention for socially vulnerable elderly women with metabolic syndrome.

Effects of Medicaid Case Manager's Communication Competence and Stress on Their Job Satisfaction

PURPOSE: This study was conducted to identify effects of Medicaid Case Manager's communication competence and stress on their job satisfaction. METHODS: The current work is descriptive research, and the participants were 154 medicaid case managers. Data were collected between May and July, 2017 through Embrain, a specialized research organization. The data were analyzed using independent t-test, ANOVA, and multiple regression. RESULTS: The mean communication competence of the medicaid case managers was 3.61, stress 1.76, and their job satisfaction 2.74. Age and average monthly compensation brought significant differences in their job satisfaction. Their communication competence was correlated with stress (r=−.35, p<.001), but not with their job satisfaction. The stress was the most influential factor in job satisfaction (β=−.45). CONCLUSION: The results of this work show that the medicaid case managers' communication competence was not an influence factor of their job satisfaction, which is different from implications from the previous studies and needs confirmation through future research. In addition the results of this study also suggest that stress management can be a useful approach to the improvement of medicaid case managers' job satisfaction.

Biases in the Assessment of Left Ventricular Function by Compressed Sensing Cardiovascular Cine MRI

PURPOSE: We investigate biases in the assessments of left ventricular function (LVF), by compressed sensing (CS)-cine magnetic resonance imaging (MRI). MATERIALS AND METHODS: Cardiovascular cine images with short axis view, were obtained for 8 volunteers without CS. LVFs were assessed with subsampled data, with compression factors (CF) of 2, 3, 4, and 8. A semi-automatic segmentation program was used, for the assessment. The assessments by 3 CS methods (ITSC, FOCUSS, and view sharing (VS)), were compared to those without CS. Bland-Altman analysis and paired t-test were used, for comparison. In addition, real-time CS-cine imaging was also performed, with CF of 2, 3, 4, and 8 for the same volunteers. Assessments of LVF were similarly made, for CS data. A fixed compensation technique is suggested, to reduce the bias. RESULTS: The assessment of LVF by CS-cine, includes bias and random noise. Bias appeared much larger than random noise. Median of end-diastolic volume (EDV) with CS-cine (ITSC or FOCUSS) appeared −1.4% to −7.1% smaller, compared to that of standard cine, depending on CF from (2 to 8). End-systolic volume (ESV) appeared +1.6% to +14.3% larger, stroke volume (SV), −2.4% to −16.4% smaller, and ejection fraction (EF), −1.1% to −9.2% smaller, with P < 0.05. Bias was reduced from −5.6% to −1.8% for EF, by compensation applied to real-time CS-cine (CF = 8). CONCLUSION: Loss of temporal resolution by adopting missing data from nearby cardiac frames, causes an underestimation for EDV, and an overestimation for ESV, resulting in underestimations for SV and EF. The bias is not random. Thus it should be removed or reduced for better diagnosis. A fixed compensation is suggested, to reduce bias in the assessment of LVF.

10-Year retrospective study for complaints about medical malpractice in emergency department

OBJECTIVE: Among emergency department patient complaints, complaints related to medical malpractice can often lead to lawsuits. This study examined the reasons for medical malpractice complaints and find ways to improve the medical process and patient satisfaction in an emergency department. METHODS: This study analyzed 269 official complaints of emergency department patients between January 1, 2007, and December 31, 2016. From these complaints, 100 complaints of medical malpractice were analyzed and the complaints of the non-medical process, such as unkindness, cost, facilities and the others, were excluded. The patients' age, sex, relationship between the patient and complainer, insurance state and visiting hour were analyzed. Details of the medical malpractice complaints were assessed and classified into four reasons: diagnosis, examination, treatment, and explanation. This study attempted to analyze the hospital's response to the complaints made during the medical process. RESULTS: Among the 100 medical malpractice complaints, 75 occurred at night duty; 40 were related to treatment, 32 to diagnosis, 22 to examination, and six to explanation. Among the treatment, wound problems were the most frequent reason for 23 cases. The hospital made financial compensation to 16 of its patients. CONCLUSION: The medical malpractice complaints occurred mainly at night. Treatment, especially wound problems, was the most frequent reason for the complaints. The rate of monetary compensation was higher than that of the other studies.