• Safety and Health at Work
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• 제8권2호
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• pp.162-168
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• 2017

Background: Pelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF. Methods: During the years 2003-2012, 282 injured individuals aged 20-55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment. Results: Almost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626-25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092-6.720) were identified as independent predictive factors of full RTW. Conclusion: PRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.

• Safety and Health at Work
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• 제1권2호
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• pp.149-157
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• 2010

Objectives: To quantify disability level in salespeople with concurrent low back pain (LBP) and to determine the relative associations between demographic, occupational, psychosocial and clinical factors and back disability. LBP is the most common cause of work-related disability in people under 45 years of age and the most expensive cause of work-related disability, in terms of workers' compensation and medical expenses. Evidence suggests high prevalence of LBP in salespeople. Methods: A cross-sectional survey was conducted in which 184 saleswomen with a current episode of self-reported LBP working in a large up-scale department store filled out a battery of 6 self-administered questionnaires and received a standardised physical examination. Results: Saleswomen with concurrent LBP had low disability levels. Factors significantly associated with disability were pain intensity, measured by a visual analogue scale, in the past week (p < 0.001), physical and mental health status (p < 0.001, p = 0.003, respectively), fear avoidance scores for both work and physical activities (p = 0.031, p = 0.014, respectively), past history of LBP (p = 0.019), and self-reported frequency of pushing or pulling objects placed in high positions during work (p = 0.047). A significant level (45%) of the variance in disability status was explained by these variables. Conclusion: In clinical management of LBP workers who required prolonged standing, such as salespeople, clinicians should look for modifiable risk factors associated with disability. Specific measures need to be taken to prevent disability due to LBP among salespeople.

• Safety and Health at Work
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• 제2권2호
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• pp.169-175
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• 2011

Objectives: The questionnaire of occupational stress index (OSI) has been popular in the workplace, and it has been tailored for bus drivers in Taiwan. Nevertheless, its outcomes for participants are based on self-evaluations, thus validation by their physiological stress biomarker is warranted and this is the main goal of this study. Methods: A cross-sectional study of sixty-three city bus drivers and fifty-four supporting staffs for comparison was conducted. Questionnaire surveys, 24-hour urine cortisol testing, and blood draws for dehydroepiandrosterone-sulfate (DHEA-S) testing were performed. The measured concentrations of these biological measures were logarithmically transformed before the statistical analysis where various scores of stressor factors, moderators, and stress effects of each OSI domain were analyzed by applying multiple linear regression models. Results: For drivers, the elevated 24-hour urine cortisol level was associated with a worker's relationship with their supervisor and any life change events in the most recent 3 months. The DHEA-S level was higher in drivers of younger age as well as drivers with more concerns relating to their salary and bonuses. Non-drivers showed no association between any stressor or satisfaction and urine cortisol and blood DHEA-S levels. Conclusion: Measurements of biomarkers may offer additional stress evaluations with OSI questionnaires for bus drivers. Increased DHEA-S and cortisol levels may result from stressors like income security. Prevention efforts towards occupational stress and life events and health promotional efforts for aged driver were important anti-stress remedies.

• The Korean Journal of Pain
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• 제35권3호
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• pp.311-318
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• 2022

Background: Ketamine is widely used in infants and young children for procedural sedation and anesthesia. The aim of this study was to evaluate the efficacy and safety of low dose oral ketamine to control pain and distress in children during intravenous (IV) cannulation. Methods: This is a prospective, randomized, double-blind study, including children aged between 3 and 6 years requiring a non-emergent IV-line placement. Children were randomly assigned to two groups, treated either with oral ketamine or a placebo. All patients were monitored for vital signs. Pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wong-Baker Faces Pain Rating Scale (WBFS) scales and sedation using a 5-point sedation score. The facility of IV-line placement was measured by a 3-point scale. Adverse effects were recorded after 1 and 24 hours. Results: A total of 79 and 81 children were entered in the ketamine and placebo groups, respectively. The heart and respiratory rates increased significantly in the placebo group. The median CHEOPS 4 (95% confidence interval [CI]: 3, 4, P < 0.001) and WBFS 6 (95% CI: 4, 6, P < 0.001) scores decreased statistically in the ketamine group. IV-line placement was 50% easier in the ketamine group (95% CI: 37%, 63%, P < 0.001). No serious adverse effects were observed in all cases. Conclusions: Low dose oral ketamine effectively decreased the pain and distress during IV cannulation in children without any significant adverse reactions.

• 보건의료산업학회지
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• 제2권1호
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• pp.1-27
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• 2008

The purpose of this study is to investigate the effects of customer orientation factors in relation to medical services on the values of the service and customer satisfaction and loyalty. Those factors include patient safety and, as found by previous studies, specialization, explanation of what to be medically examined and customer orientation itself. Based on these pervious studies, this study surveyed customers of 7 general hospitals located in Busan to empirically identify relations between customer orientation factors of medical services and the values of the services and customer satisfaction. Results of the study can be summarized as follows. First, this study is very meaningful in that it established a basic theory of patient safety as one of the above customer orientation factors, and tried to empirically demonstrated the theory by applying it to medical services. Second, another of the factors, specialization was found positively affecting the values of medical services, but not affecting customer satisfaction. Customers are likely to choose specialized medical institutions even at higher cost when they undergo an accident or disease. Nevertheless, in factors, whether medical service providers are specialized is not influencing customer satisfaction. This is because medical institutions are failing to properly make recognized their specialization to customers who want to receive specialized medical services. Third, another of customer orientation factors, that is, explanation of what to be medically examined was found not having positive effects on the values of medical services and customer satisfaction. This is probably because enough time was not given for the explanation or because the explanation itself was not provided enough. Fourth, medical service providers' customer orientation was found positively influencing the values of medical services and customer satisfaction. In other words, it seems that customer-centered attitudes and behaviors of medical service providers had positive effects on customers' perception of medical services. Fifth, another of the factors, that is, patient safety was found positively affecting the values of medical services and customer satisfaction. This is probably because medical services' accurate diagnoses and reliable services had positive effects on customers' perception of medical services. Sixth, customers' perceived values of medical services were found having positive effects on customer satisfaction and loyalty. This suggests that the values of medical services are an antecedent variable that directly influences customer satisfaction and loyalty. Seventh, customer satisfaction was found positively affecting customer loyalty. This suggests that customer satisfaction is an antecedent variable of customer loyalty. In conclusion, this study showed that in relation to medical services, customer orientation factors' significant influences on the values of the services and customer satisfaction requires continuous efforts for raising customers' perceived qualities of medical services.

• The Korean Journal of Pain
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• 제10권2호
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• pp.170-178
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• 1997

Background: The analgesic efficacy and safety of propacetamol, an injectable prodrug of acetoaminophen, in combination with intravenous morphine PCA were studied in 40 patients after gynecological surgery requiring lower abdominal incision. Methods: Using a double-blind, randomized, parallel-group design, the effects of four(every 6 hr) intravenous injections of 2 g propacetamol(=1 g acetoaminophen) were compared with four injections of placebo(PL) immediately after surgery. Efficacy of cumulative dose of morphine and number of boluses requested was assessed over 24 hours by automated recording on the PCA device. It was assessed on pain scores rated on a ten-point verbal scale along with vital signs, $K^+$, glucose, BUN, creatinine, PT and PTT were measured along with stress hormones(epinephrine, norepinephrine and cortisol). Results: There were no differences in demographic data between two groups. Propacetamol group demonstrated approximately 21% morphine sparing effect compared to placebo group($33.1{\pm}10.4$ mg vs $41.4{\pm}8.0$ mg). No significant differences noted in $K^+$, glucose, BUN, Creatinine, PT and PTT levels. There were significant increases in norepinephrine and cortisol in placebo group postoperatively, compared to preoperative values. At the same time, propacetamol group also showed significant changes in these hormones. Both group revealed high degree of patient satisfaction. Conclusion: Propacetamol showed significant morphine sparing effect to some degree. Side effects were much less in propacetamol group with subsequently high patient satisfaction. The secretion of stress hormone were not blocked by postoperative propacetamol injections. Authors concluded that propacetamol should be considered as an excellent adjuvant analgesics in postoperative pain control in opioid patient controlled analgesia.

• 한국산업보건학회지
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• 제32권1호
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• pp.1-9
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• 2022

Objectives: The purpose of this study is to evaluate exposure characteristics of lead using data from the domestic occupational exposure literature. Methods: Occupational airborne exposure data on lead reported in the domestic literature from 1981 to 2018 were collected and re-analyzed. The exposure levels in the data were expressed as an estimated arithmetic mean and a weighted arithmetic mean (WAM) of the number of samples. Lead exposure characteristics were analyzed by industry, process, and year. Results: From a total of 14 documents, 8,305 airborne lead measurements for 17 industries were identified, and the WAM concentration in eight industries exceeded the occupational exposure limit of 50 ㎍/m³. Three industries (battery manufacturing, lead smelting, and litharge manufacturing) accounted for 95% of the total data, and exposure trends could be confirmed over 10 years. Exposure levels continue to decrease in all three industries. Conclusions: Considering the distribution outlook of lead and lead compounds, the main management targets are lead storage battery manufacturing and secondary smelting for lead regeneration.

• Journal of Microbiology and Biotechnology
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• 제16권11호
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• pp.1699-1705
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• 2006

Recent studies have suggested that oral bacteriotherapy with probiotics might be useful for preventing and managing childhood atopic dermatitis (AD). The purpose of this investigation was to evaluate the efficacy and safety of oral treatment with probiotics for adolescent and adult AD patients as well as for childhood AD patients. Sixty-four patients with mild to moderate AD were recruited for treatment with a mixture of four probiotic strains (Lactobacillus rhamnosus, Lactobacillus plantarum, Lactobacillus casei, and Biftdobacterium lactis) twice daily for 8 weeks. The degree of pruritus was determined by a 10-point visual analog scale every other week, and the patients' global assessments of their clinical responses (i.e., better, unchanged, or worse) was done at the end of intervention. The clinical severity of the eczema was evaluated by eczema area and severity index (EASI) score every other week. As laboratory markers, total immunoglobulin E (IgE), eosinophil cationic protein (ECP) in the serum, and cytokine production [interleukin-4 (IL-4), interleukin-10 (IL-10), and $interferon-{\gamma}\;(IFN-{\gamma})$ by the peripheral blood mononuclear cells (PBMCs) were measured at the beginning and at the end of intervention. Of the 64 enrolled AD patients, only 50 patients finally completed the 8-week study. After 8-week treatment with probiotics, the EASI score was significantly improved (p<0.0001), 50% of the patients experienced improvement of their eczema, and significant improvement of the pruritus was also observed (p=0.0002). The effect was more pronounced for the patients with very high IgE levels (>1,000 ku/l) or for the patients with moderate disease severity. There was no significant difference in the therapeutic effects between the childhood AD and adolescent and adult AD patients. There were no significant changes of cytokines, as well as the total IgE and ECP levels, in the patients' serum. Treatment with the mixture of four probiotic strains was generally well tolerated. Our results suggest that the treatment with the mixture of four probiotic strains is beneficial for the management of the adolescent and adult AD patients, as well as for the childhood AD patients.

• 대한간호학회지
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• 제54권2호
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• pp.237-249
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• 2024

Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

• 대한방사선기술학회지:방사선기술과학
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• 제28권1호
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• pp.55-65
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• 2005

서울, 경기 지역의 중소 병 의원 회원들의 근무환경 실태를 파악하여, 국민보건증진과 무면허자의 방사선 검사업무 금지, 사기진작과 불만족해소, 직무만족도를 높여 복지와 권익을 향상, 정책 참여를 유도, 근무환경 개선에 목적이 있다. 2003년 7월부터 8월까지 271명을 대상으로 일반적 기본사항, 병실 수, 고용실태, 고용 및 업무범위, 이직빈도, 고용계약서 작성여부, 임금실태, 근무환경, 방사선사 호칭, 방사선안전관리, 품질관리, 방사선 차폐시설, 영상획득시스템, 필름시스템 종류, 장비보유현황, 방사선 피폭 방어기구, 협회와 관련된 항목을 설문 조사하였다. 근무환경, 불만족 문제점을 파악하여, 합리적이고 나은 근무환경을 제공하는 기초 자료로 활용하는데 이용하고, 근무환경 및 근무제도, 직제의 개선을 가져올 수 있도록 협회와 회원은 노력하여야한다. 주기적으로 설문조사를 실시하고 불만족을 해소하는 정책을 추진하도록 한다.