• Title/Summary/Keyword: Multiple Shock

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Automation of Tasks and Knowledge-Intensive Services: A Sectorial Approach to the Impact of Covid 19 in Argentina

  • Martinez, Ricardo Gabriel;Leone, Julian Gabriel;Repeti, Juan Manuel Rodriguez
    • Iberoamérica
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    • v.23 no.2
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    • pp.273-307
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    • 2021
  • The covid 19 pandemic led to an economic collapse and multiple impacts upon Argentina's labour dynamics. As well as in other parts of the region, falls in employment rates (both due to an increase in unemployment and significant withdrawals from the labour force) were combined with wage reductions for those who were able to keep their jobs. Thus, two important processes for the labour market complimented each other: a structural shock associated with a tasks automation as a reorganisation and substitution of factors, with a cyclical recession caused by the pandemic. The international experience shows the amplifying impact the latter has on the former, generating long-term consequences mainly in routine-intensive jobs. However, the knowledge-intensive services sector appears to be the most capable of cushioning the recessionary shock (both in terms of wages and labour absorption), even with nuances within the sector depending on the extent of the shutdown measures and its capability to switch to remote work. Finally, the task approach is decisive in capturing the ability to adapt both the cyclical and structural processes, absorbing a large part of the explanatory potential that sectoral classifications tend to bring about.

Profiles of Enterotoxin Genes and Antimicrobial Resistance in Staphylococcus pseudintermedius Strains Isolated from Livestock and Companion Animals

  • Lee, Gi Yong;Lee, Haeng Ho;Um, Hong Sik;Yang, Soo-Jin
    • Journal of Food Hygiene and Safety
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    • v.34 no.6
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    • pp.576-582
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    • 2019
  • Staphylococcus pseudintermedius is an opportunistic pathogen in dogs and is recognized as a zoonotic pathogen causing public health concern. Although canine-associated S. pseudintermedius has mainly been recognized for its antimicrobial resistance and ability to cause skin infections in dogs, information on antimicrobial resistance profiles and enterotoxigenicity of S. pseudintermedius in livestock is very limited. In this study, we investigated the prevalence of 18 different staphylococcal enterotoxin (SE) genes and toxic shock syndrome toxin gene (tst-1) in S. pseudintermedius strains isolated from dogs, pigs, and beef cattle. Moreover, antimicrobial resistance profiles of the strains were determined along with the presence of mecA and SCCmec types. Except for one bovine isolate, all S. pseudintermedius isolates from dogs and pigs were resistant to multiple drugs (≥ 4 different drugs). Four out of six canine isolates were methicillin resistant and carried SCCmec type V. In addition, 11 different SE genes (seb, sec, see, seg, sei, sej, sel, seo, sep, seq, and seu) and tst-1 were identified in S. pseudintermedius isolates from dogs, pigs, and beef cattle. Most S. pseudintermedius isolates (83%) harbored multiple SE genes, and sel (42%) and sep (42%) were most frequently detected in the isolates. Our results suggested that S. pseudintermedius isolates from livestock and companion animals may serve as a reservoir for SE genes and antimicrobial resistance.

The Correlation between Toxin Genotype and Antibiotic Resistance in Methicillin Resistant Staphylococcus aureus Isolated from Clinical Specimen of Intensive Care Unit (중환자실의 임상검체로부터 분리된 Methicillin 내성 Staphylococcus aureus의 독소유전자형과 항생제내성의 상관관계)

  • Park, Chul;Seong, Chi Nam
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.3
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    • pp.202-209
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    • 2016
  • This study is aimed to determine the correlation between the toxin gene types and antibiotic resistance from MRSA (methicillin-resistant Staphylococcus aureus). Fifty-two strains of MRSA, between January 2014, and December 2014, were isolated from clinical specimens obtained from 2,664 cases in the intensive care unit of a hospital in Suncheon, Jeonnam, Korea. Genes encoding mecA, enterotoxin (SE), toxic shock syndrome toxin-1 (TSST-1), exfoliative toxin (ET), and Panton-Valentine leukocidin (PVL) were detected by multiplex PCR-mediated amplification using specific primers. Toxin genes (seg and sei) were present in 40 strains (76.9%), followed by tst in 34 strains (65.4%). Other genes (eta, etb, sea, sed, see, seh, sej, and pvl) were not detected. Forty strains (76.9%) of MRSA had 2 or more toxin genes simultaneously; 5 coexistent toxin-genes (seb, sec, seg, sei, tst) were the most common in 28 strains (53.8%), and 6 strains (11.5%) had seg and sei genes. The coexistence of genes were 72.5~100%, showing a high correlation among genes (seb, sec, seg, sei and tst). As strains (seb, sec, tst) that had particular toxin genes (seb, sec, seg, sei, tst) in multiple showed 100% resistance to ciprofloxacin, clindamycin, erythromycin, we were able to find that seb, sec, and tst genes have a close relationship to the aforementioned antibiotics. It showed a higher resistance to ciprofloxacin, clindamycin, erythromycin, and tetracycline compared with strains that had toxin genes independent from multiple toxin genes.

Clinical Analysis of Death in Trauma Patients (외상으로 인한 사망 환자의 임상적 분석)

  • Kim, Whan Sik;Cho, Min Su;Bae, Keum Seok;Kang, Seong Joon;Lee, Kang Hyun;Hwang, Keum;Oh, Jin Rok;Park, Il Hwan
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.96-100
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    • 2007
  • Purpose: Trauma is the 5th most common leading cause of death in Korea, but there has been no appropriate management system for patients until now. We analyzed the main causes of death in trauma patients by comparing the characteristics of those patients with the characteristics of patients who survived. We feel this analysis should have a positive effect on the development of an appropriate trauma management system in Korea. Methods: We retrospectively reviewed trauma patients who had been admitted to the Department of General Surgery from February 2002 to February 2007. We compared several expected risk factors between the mortality and the survival group. Data on the transportation, arrival time at the emergency center, amount of transfusion, initial shock index, cause of death, and initial physical condition according to RTS (Revised trauma score), ISS (Injury severity score) and TRISS (Trauma and Injury Severity Score) were collected. Patients with ISS lower than 12 were excluded. Results: Three hundred sixty-six(366) patients with multiple injuries were included. There were 40 patients in the mortality group and 326 patients in the survival group. The mean arrival time (minutes) to emergency center was longer in the mortality group (137.6 vs 93.6 p 0.04). The total amount of transfusion (ml) was larger in the mortality group (7139 vs 2470 p 0.01). The initial shock index was higher in the mortality group (1.45 vs 1.17 p<0.01). The RTS, ISS, and TRISS were not statistically different between the groups. In the multivariate analysis, mean arrival time and initial shock index were important factors for survival. Conclusion: If the mortality rate of trauma patients is to be reduced, the arrival time at the emergency center should be minimized. Improvement of the emergency medical transfer service system is very important for achieving that.

Predictive Factors of Blood Transfusion Requirement in Blunt Trauma Patients Admitted to the Emergency Room (응급실에 내원한 둔상환자의 수혈 필요성 예측인자)

  • Oh, Ji Sun;Kim, Hyung Min;Choi, Se Min;Choi, Kyoung Ho;Hong, Tae Yong;Park, Kyu Nam;So, Byung Hak
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.218-226
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    • 2009
  • Purpose: In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician' and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room. Methods: In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis. Results: Of blunt trauma patients, 9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR) > 100 beats/min, respiratory rate (RR) > 20 breaths/min, Glasgow Coma Scale (GCS) < 14, Revised Trauma Score (RTS) < 11, white blood cell count (WBC) < 4000 or > 10000, and initial abnormal portable trauma series (Cspine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR > 100 beats/min (EXP 3.2), GCS < 14 (EXP 4.1), and abnormal trauma series (EXP 2.9), as independent predictors. Conclusion: In our study, systolic blood pressure (SBP) < 90 mmHg, old age > 65 years, hemoglobin < 13g/dL, mechanism of injury were poor predictors of early blood transfusion. Initial abnormal portable trauma series, HR > 100 beats/min, and GCS < 14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room.

Management of Traumatic Pancreas Injury in Multiple Trauma - Single Center Experience (다발성 외상 환자에서 췌장 손상 치료 경험)

  • Jang, Hyun-A;Shim, Hong-Jin;Cha, Sung-Whan;Lee, Jae-Gil
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.111-117
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    • 2011
  • Purposes: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. Methods: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. Results: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70 % of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury ($38.0{\pm}18.56$ vs. $34.5{\pm}33.68$ days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. Conclusion: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.

A Study on the Effects of Acculturative Stress Factors to Mental Health of Married Immigrant Women (여성결혼이민자의 문화적응스트레스가 정신건강에 미치는 영향에 관한 연구)

  • Lee, Eun-Hee;Chu, Youn-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1619-1624
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    • 2012
  • The purpose of this study is to examine the mental health of married immigrant women and the effect of cultural adaptation stress of married immigrant women on mental health. The subjects were 239 married immigrant women who live in Pusan city. Collected date were analyzed through frequency, percentage, and stepwise multiple regression analysis. The results are as follows. The 17.6% of the sample had the problem of mental health. The result of stepwise multiple regression analysis indicated that factors which predict the level of married immigrant women's mental health were cultural shock, fear, and guilty feeling. The findings give us significant practical implications for social work intervention.

Maxillary anterior implant restoration with appropriate anterior guidance using T-Scan in a patient with full fixed prostheses (전악 고정성 보철 수복 환자에서 T-Scan 분석을 이용해 전-측방유도를 부여한 상악 임플란트 보철 수복)

  • Nam, Rae-Kyeong;Pang, Eun-Kyoung;Cho, Young-Eun;Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.419-426
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    • 2017
  • In implant restorations, it is difficult for the patient to percept any symptoms. In addition, they are absent of shock absorbers, which can lead to mechanical failure if stress distribution is not considered. Since maxillary anterior multiple-implant restorations play a significant role in guiding the functional movement of the mandible by distributing lateral force, it is crucial to form appropriate occlusion. The use of the T-scan system is more advantageous in assessing 'dynamic occlusion', such as the change of occlusion over time, the amount of tooth contact during functional movement, and assessing the occlusion in the less-visible posterior teeth. The case is reported as it has satisfactory results in harmonious anterior guidance of a maxillary anterior multiple-implant restoration using T-scan analysis.

The length of hospital stay of the industrial workers with back injury (산업재해 요통근로자의 재원기간에 관한 연구)

  • Lee, Bok-im
    • Korean Journal of Occupational Health Nursing
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    • v.9 no.1
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    • pp.18-29
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    • 2000
  • Back injury is frequent in industry workers and is a common cause of productivity loss. It has been reported that the insured of industrial accident insurance tend to stay in hospital longer than that of other types of insurance. The purpose of this study was to identify factors affecting the length of hospital stay for the treatment of back injury in the workers under industrial accident insurance. The results of this study help insurers develop reasonable industrial accident insurance policy for back injury claims and prevention strategies of work-related back injury. A total of 2,949 patients whose industrial accident insurance claim has been approved for the treatment of work-related back injury from January to December 1999 were included in this study. Relationship between the length of hospital stay and characteristics of patient, work place, back injury, and hospital were assessed using ANOVA, t-test, simple linear regression and multiple resgression. The major findings of this study are as follows : 1. The average length of hospital stay(LOS) was 91.82 days, respectively. 2. Characteristics of Patient LOS of male patients was longer than that of female patients, there was positive correlation between age and LOS and between average wage and LOS. Working period was negatively correlated with LOS. Distance from resident to hospital was positively correlated with LOS and LOS was significantly different dependign on type of duty. 3. Characteristics of Work Place LOS was significantly different depending on types of industry and geographical region of work place. Size of work place was positively correlated with LOS. 4. Characteristics of Back Injury Occupational back pain required shorter LOS compared with back injury due to electric shock. Number of concomitant illnesses and severity of disability were positively correlated with LOS. 5. Characteristics of Hospital Patients treated in community hospitals required significantly longer LOS. Treatment in hospitals with rehabilitation program required decreased LOS. This was more prominent as number of physicians specialized in rehabilitation. 6. Multiple regression analysis revealed that distance form resident to hospital, geographical region of work place, size of work place, number of concomitant illnesses, severity of disability, and type of hospital were factors affecting LOS.

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Bivariate reliability models with multiple dynamic competing risks (다중 동적 Competing Risks 모형을 갖는 이변량 신뢰성 모형에 관한 연구)

  • Kim, Juyoung;Cha, Ji Hwan
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.3
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    • pp.711-724
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    • 2016
  • Under variable complex operating environment, various factors can affect the lifetimes of systems. In this research, we study bivariate reliability models having multiple dynamic competing risks. As competing risks, in addition to the natural failure, we consider the increased stress caused by the failure of one component, external shocks, and the level of stress of the working environment at the same time. Considering two reliability models which take into account all of these competing risks, we derive bivariate life distributions. Furthermore, we compare these two models and also compare the distributions of maximum and minimum statistics in the two models.