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Management of a traumatic anorectal full-thickness laceration: a case report

  • Fortuna, Laura;Bottari, Andrea;Somigli, Riccardo;Giannessi, Sandro
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.215-218
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    • 2022
  • The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

Influencing Factors of High PTSD Among Medical Staff During COVID-19: Evidences From Both Meta-analysis and Subgroup Analysis

  • Qi, Guojia;Yuan, Ping;Qi, Miao;Hu, Xiuli;Shi, Shangpeng;Shi, Xiuquan
    • Safety and Health at Work
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    • v.13 no.3
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    • pp.269-278
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    • 2022
  • Background: PTSD (Post-traumatic stress disorder, PTSD) had a great impact on health care workers during the COVID-19 (Corona Virus Disease 2019, COVID-19). Better knowledge of the prevalence of PTSD and its risk factors is a major public health problem. This study was conducted to assess the prevalence and important risk factors of PTSD among medical staff during the COVID-19. Methods: The databases were searched for studies published during the COVID-19, and a PRISMA (preferred reporting items for systematic review and meta-analysis) compliant systematic review (PROSPERO-CRD 42021278970) was carried out to identify articles from multiple databases reporting the prevalence of PTSD outcomes among medical staff. Proportion random effect analysis, I2 statistic, quality assessment, subgroup analysis, and sensitivity analysis were carried out. Results: A total of 28 cross-sectional studies and the PTSD results of doctors and nurses were summarized from 14 and 27 studies: the prevalences were 31% (95% CI [confidence interval, CI]: 21%-40%) and 38% (95% CI: 30%-45%) in doctors and nurses, respectively. The results also showed seven risks (p < 0.05): long working hours, isolation wards, COVID-19 symptoms, nurses, women, fear of infection, and pre-existing mental illness. Two factors were of borderline significance: higher professional titles and married. Conclusion: Health care workers have a higher prevalence of PTSD during COVID-19. Health departments should provide targeted preventive measures for medical staff away from PTSD.

Psychosocial Risks Assessment in Cryopreservation Laboratories

  • Fernandes, Ana;Figueiredo, Margarida;Ribeiro, Jorge;Neves, Jose;Vicente, Henrique
    • Safety and Health at Work
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    • v.11 no.4
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    • pp.431-442
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    • 2020
  • Background: Psychosocial risks are increasingly a type of risk analyzed in organizations beyond chemical, physical, and biological risks. To this type of risk, a greater attention has been given following the update of ISO 9001: 2015, more precisely the requirement 7.1.4 for the process operation environment. The update of this normative reference was intended to approximate OHSAS 18001: 2007 reference updated in 2018 with the publication of ISO 45001. Thus, the organizations are increasingly committed to achieving and demonstrating good occupational health and safety performance. Methods: The aim of this study was to characterize the psychosocial risks in a cryopreservation laboratory and to develop a predictive model for psychosocial risk management. The methodology followed to collect the information was the inquiry by questionnaire that was applied to a sample comprising 200 employees. Results: The results show that most of the respondents are aware of the psychosocial risks, identifying interpersonal relationships and emotional feelings as the main factors that lead to this type of risks. Furthermore, terms such as lack of resources, working hours, lab equipment, stress, and precariousness show strong correlation with psychosocial risks. The model presented in this study, based on artificial neural networks, exhibited good performance in the prediction of the psychosocial risks. Conclusion: This work presents the development of an intelligent system that allows identifying the weaknesses of the organization and contributing to the enhancement of the psychosocial risks management.

Artificial intelligence-based chatbot system for use in RCMS (RCMS에 활용하기 위한 인공지능 기반 챗봇 시스템)

  • Kim, Yongkuk;Kim, Sujin;Jung, Hoekyung
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.25 no.7
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    • pp.877-883
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    • 2021
  • Artificial intelligence technology is widely used in industrial and smart home fields such as manufacturing robots, artificial intelligence speakers, and robot vacuum cleaners. In this paper, we designed and implemented a 1:1 chatbot system based on artificial intelligence for use in RCMS (Real-time Cash Management System). The RCMS chatbot implemented in this paper was constructed with a total of 210 query scenarios in nine areas, including research expenses and system usage, based on 13,500 questions and answers from existing online bulletin boards. The chatbot is expected to solve the problem of insufficient number of counselors and to increase user satisfaction by responding to the researcher's inquiries after working hours, and the recommendation service for the cost of use, which had the most inquiries from researchers, reduces the number of consultations. It is expected to improve the quality of answers to other counseling inquiries.

Real-time TVOC Monitoring System and Measurement Analysis in Workplaces of Root Industry (뿌리산업 작업장내 총휘발성유기화합물류(TVOC) 실시간 노출감시체계 구축과 농도 분석)

  • Jong-Hyeok, Park;Beom-Su, Kim;Ji-Wook, Kang;Soo-Hee, Han;Kyung-Jun, Kim
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.4
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    • pp.425-434
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    • 2022
  • Objectives: This study analyzes TVOC concentrations in root industry workplaces in order to prevent probable occupational disease among workers. Root industry includes all the infrastructure of manufacturing, such as casting and molding. Methods: Real-time TVOC sensors were deployed in three root industry workplaces. We measured TVOC concentrations with these sensors and analyzed the results using a data-analysis tool developed with Python 3.9. Results: During the study period, the mean of the TVOC concentrations remained in an acceptable range, 0.30, 2.15, and 1.63 ppm across three workplaces. However, TVOC concentrations increased significantly at specific times, with respective maximum values of 4.98, 28.35, and 26.65 ppm for the three workplaces. Moreover, the analysis of hourly TVOC concentrations showed that during working hours or night shifts TVOC concentrations increased significantly to higher than twice the daily mean values. These results were scrutinized through classical decomposition results and autocorrelation indices, where seasonal graphs of the corresponding classical decomposition results showed that TVOC concentrations increased at a specific time. Trend graphs showed that TVOC concentrations vary by day. Conclusions: Deploying a real-time TVOC sensor should be considered to reflect irregularly high TVOC concentrations in workplaces in the root industry. It is expected that the real-time TVOC sensor with the presented data analysis methodology can eradicate probable occupational diseases caused by detrimental gases.

A study on retention intention of dental hygienists : focusing on the labor standards act (치과위생사의 재직의도에 관한 연구: 근로기준법을 중심으로)

  • Kim, Hui-Jeong;Moon, Sang-Eun;Kim, Yun-Jeong;Kim, Seon-Yeong;Cho, Hye-Eun;Kang, Hyun-Joo
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.3
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    • pp.199-207
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    • 2022
  • Objectives: The objectives of this study were to find the influential factors of dental hygienists' work environment and level of perception of rights on their retention intention, and to provide basic data for protecting their rights and interests and improving their employment rate. Methods: From June 6 to July 24, 2021, a questionnaire survey was conducted among 214 dental hygienists via an online link. After questionnaire collection, IBM SPSS program (ver. 21.0; IBM Corp., Armonk, NY, USA) was used to conduct frequency analysis, t-test, one-way ANOVA and multiple regression analysis. Results: The significant and positive influential factors of dental hygienists' retention intention were married individuals (p=0.022), fewer working hours (p<0.001, p=0.007), good work environment (p=0.002), higher wages (p<0.001, p<0.001), higher education (p=0.032), and perception of rights in a mid-level (p=0.038). Conclusions: It is necessary to consider wages and welfare equivalent to dental hygienists' work intensity and workload. By regularly educating dental hygienists to increase their perception of rights, expanding an opportunity of participation, and improving their work environment, it will be possible to increase their retention intention and efficiently establish manpower in dental clinics.

The effect of employment status and household equalization income on unmet dental and medical care needs : a study on the application of Korea Medical Panel Data 2018 (종사상 지위와 가구 균등화 소득이 치과 의료 미충족에 미치는 영향 : 2018 한국의료패널 자료를 활용한 분석)

  • Jin-Ha Lee;Gyung-Jae Oh
    • Journal of Korean society of Dental Hygiene
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    • v.23 no.2
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    • pp.125-132
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    • 2023
  • Objectives: This study used the 2018 Korea Health Panel Survey data to analyze factors affecting employment status and income relating to unmet dental and medical care needs. Additionally it investigated measures to reduce oral health inequality among various socioeconomic classes. Methods: Descriptive statistics for the subjects' unmet dental and medical care needs were calculated through chi-square test analysis, and multivariate logistic regression analysis was applied to identify factors affecting the unmet dental and medical care needs. The odds ratio and 95% confidence interval were calculated for each level. These data were analyzed using STATA 17.0 SE (64-bit) version, and the statistical significance level was set to p<0.05. Results: As a result of unmet dental and medical care needs according to general characteristics, the lower the education level (p<0.001), the higher the age (p<0.001) and the lower the household equalization income (p<0.024) and the smoker status (p<0.003) were, respectively. Factors that have a statistically significant impact on unmet dental and medical care needs were divorce, separation and bereavement (p<0.001) in individuals than in married persons, and being smokers than non-smokers (p<0.009). The frequency of unmet dental and medical care needs were found to be lower in the cases of a high school graduate than an elementary school graduate (p<0.018), and of higher household equalization income (p<0.001) than the lowest household equalization income, respectively. Conclusions: It was found that various factors such as age, education level, household equalization income, employment status, type of working hours type, and smoking status affect unmet dental and medical care needs.

Characteristics of Job Stress Factors in Delivery Workers (택배종사자의 직무스트레스 요인 특성에 관한 연구)

  • Sejung Lee;Sangeun Jin;Seong Rok Chang
    • Journal of the Korean Society of Safety
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    • v.38 no.4
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    • pp.32-38
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    • 2023
  • Job stress factors are factors that induce biological, psychological, and behavioral responses in individuals when they encounter mental and physical stimuli in the workplace. According to occupational safety and health standards, employers are responsible for the health consequences of job stress when workers engage in activities that result in high levels of physical fatigue and mental stress. Such activities include long working hours, shift work (including night shifts), driving vehicles, and operating precision machinery. Therefore, precautionary measures should be implemented. Following the COVID-19 epidemic, the logistics industry in Korea has experienced rapid growth owing to the shift from offline to online platforms facilitated by advanced digital infrastructure. Consequently, this study conducted a survey to analyze job stress factors among delivery workers. The survey utilized a Korean job stress factor assessment tool comprising 43 items and analyzed job stress factors considering the work characteristics of the courier business field obtained from responses provided by 421 courier workers nationwide. The survey analysis revealed that the physical environment, job demands, and job autonomy exhibited higher stress indices among Korean workers. Furthermore, the younger the age, the higher the stress on job demands, whereas the higher the age, the higher the stress on relationship conflict, job instability, and workplace culture. In addition, daytime delivery work was associated with higher stress levels in job demands and job instability compared with nighttime delivery work. These findings can serve as foundational data for reducing and preventing job stress among courier workers, whose workload has increased owing to the growth of the logistics industry.

Differences in Clinical Professors' Work-Life Balance by Position in Medical Schools (의과대학 임상교수 직급에 따른 일과 삶의 균형 차이 )

  • Yu Ra Kim;Hwan Ho Lee;So Jung Yune
    • Korean Medical Education Review
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    • v.25 no.1
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    • pp.45-54
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    • 2023
  • We investigated the work-life balance of clinical professors in charge of patient care, research, and education at medical schools and the demand for work-life balance support according to position (professor, associate professor, or assistant professor). In total, 163 clinical professors completed the consent form and participated in the study. They filled out an online survey consisting of questions about essential characteristics, a work-life balance test, stress, burnout, work-life satisfaction, and work-life balance support needs. We analyzed the results by analysis of variance and cross-tabulation using IBM SPSS ver. 23.0. Differences were found in work-life balance, stress, burnout, and satisfaction with life and work by position. The requirements for support for work-life balance also varied by professional status. Professors had a higher balance between life and work than associate professors or assistant professors. The specific requirements for work-life balance support were also slightly different for each position. Overall, there was a high demand for work process simplification and efficiency for work support, flexible working hours and sabbatical years for family and leisure, and career management consulting and training support for growth. Assistant professors and associate professors had a lower level of work-life balance than professors, as well as higher levels of stress and burnout. Professors' job satisfaction was also higher than that of the other groups. Based on the results of this study, we hope that a healthy work environment can be established through work-life balance support suitable for clinical professors' positions.

Effects of Anxiety and Infection Control Job Stress on Depression in Nurses (임상간호사의 불안과 감염관리 직무스트레스가 우울에 미치는 영향)

  • Ryu, Kyung Sun;Lee, Mi Hyang;Lim Hyo Nam;Lee, Kyung Hwa
    • Journal of Home Health Care Nursing
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    • v.30 no.1
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    • pp.5-14
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    • 2023
  • Purpose: This study aims to identify the degree of anxiety and depression related to infection control and job stress in clinical nurses during the COVID-19 pandemic. Furthermore, it seeks to identify the effects of depression. Finally, it intends to develop intervention measures to prevent depression in clinical nurses during epidemics of new infectious diseases and prepare basic data for developing educational programs. Methods: Data were collected using a self-report questionnaire survey administered to 208 nurses. The data were analyzed using the IBM SPSS (Version 26.0) statistics program. Results: The correlation analysis between participant depression, anxiety, and infection control job stress found that depression had a positive correlation with anxiety (r=.63, p<.001) and infection control work stress (r=.26, p<.001). Anxiety (β=0.60, p<.001) was found to significantly affect participant depression with an explanatory power of 40.2%, confirming that higher anxiety levels induce increased depression. Conclusion: Based on the above results, anxiety is confirmed to be a factor that affects depression. Accordingly, education is required to strengthen individuals' physical and mental capabilities and promote a safe working environment, including providing sufficient personal protective devices and other appropriate gear to defend clinical nurses against outbreaks of emerging infectious diseases at medical institutions and through healthcare policies. Other considerations should include sufficient rest hours and paying additional benefits for nurses caring for patients with severe confirmed COVID-19.