Purpose: The purpose of this study was to describe the current status of work-related back pain among nurses in the U.S. Method: Literature review and website searching were conducted. Key words as 'nurse and back pain (or back injury)' were used in searching the Medline, NIOSHTIC-2and reference list of selected studies. Total studies were selected of which subjects were nurses working in the U.S., and published since 1970. Results: Though there was variation in the measurement among studies, the prevalence rate of back pain among nurses in the U.S. could be estimated about 50%. Risk factors were confirmed as the frequency of patient lifting, ward, nursing shortage, overtime, work shift, stress on physical demand, but age and work experiences showed the inconsistent relation. It has been well known that educational approach is not enough to prevent back pain. Intervention studies to apply the ergonomic approach using mechanical devices reported the effects, but the devices were less diverse than European countries or Canada. The study for lifting team was rare. Federal government developed only the guideline for nursing home that had no legal obligation. As a professional nursing organization, ANA has been trying to educate and advocate for "No lift policy" since 2003. Meanwhile, two trade unions of nurses made efforts to establish the law strengthening the responsibility of health care facilities. Conclusion: The research and policy development will be needed to prepare to rapid increase of back pain among Korean nurses.
Objective: The human body is often modelled as a spring-mass system. Lower extremity stiffness has been considered to be one of key factor in the performance enhancement of running, jumping, and hopping involved sports activities. There are several different classification of lower extremity stiffness consisting of vertical stiffness, leg stiffness, joint stiffness, as well as muscle and tendon stiffness. The primary purpose of this paper was to review the literature and describe different stiffness models and discuss applications of stiffness models while engaging in sports activities. In addition, this paper provided a current update of the lower extremity literature as it investigates the relationships between lower extremity stiffness and both functional performance and injury. Summary: Because various methods for measuring lower extremity stiffness are existing, measurements should always be accompanied by a detailed description including type of stiffness, testing method and calculation method. Moreover, investigator should be cautious when comparing lower extremity stiffness from different methods. Some evidence highlights that optimal degree of lower extremity stiffness is required for successful athletic performance. However, the actual magnitude of stiffness required to optimize performance is relatively unexplored. Direct relationship between lower extremity stiffness and lower extremity injuries has not clearly been established yet. Overall, high stiffness is potentially associate risk factors of lower extremity injuries although some of the evidence is controversial. Prospective injures studies are necessary to confirm this relationship. Moreover, further biomechanical and physiological investigation is needed to identify the optimal regulation of the lower limb stiffness behavior and its impact on athletic performance and lower limb injuries.
Background: Melanoma, the most life-threatening type of skin cancer, is a malignant tumor initiating in melanocytes that rapidly metastasizes and causes death. Materials and Methods: In this retrospective study, samples were selected from patients' information files in our Cancer Institute in Tehran with a designed checklist. A total of 322 files were found from 2003 until 2012. Then the raw data were transferred to Statistical Package for Social Sciences (SPSS) software version 16 and additional analysis was performed by Students t-test. The important variables were considered according to the available information from history of pathology including age, gender, occupation, stage and location of tumor. Results: Our data showed that incidence of melanoma has been different in the studied 10-year period according to age. Also, incidence of melanoma was higher in men than women. It was more common in lower limbs. More commonly housewives among women and farmers among men were affected by melanoma. Conclusions: Taken together the descriptive data clarified general aspects of this disease for further screening and interventions.
Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.
Jee Hyun Kim;Jae Il Shin; Ji Hong Kim;Keum Hwa Lee
Childhood Kidney Diseases
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제28권1호
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pp.44-50
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2024
Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.
Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
Journal of Chest Surgery
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제50권2호
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pp.86-93
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2017
Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.
The gait instability in the elderly has been associated with age-related deterioration in physical strength and reducing the potential for elderly falls requires regular exercise. In 2005, National Center for Injury Prevention and Control(NCIPC) reported that most elderly falls occur during activities in daily living(ADL). To better reveal biomechanic mechanisms underlying age-related degeneration in gait stability, and to enhance the assessment of falls risk, an accurate quantification of a person's balance maintenance during locomotion is needed. Instantaneous orientation of the line connecting COP and COM can characterize whole body position with respect to the supporting foot during gait and the angle between this line and the vertical line passing through the COP known as a good assessment to detect the elderly gait instability. Therefore the purpose of this study was to investigate a 6-month walking exercise effects in reducing elderly fall risk factors by using COP-COM inclination angles. Twenty-two community-dwelling elderly participated this study. The participants performed a walking exercise(3 times/week, 1 hour/visit) for 6 months. Laboratory kinematics during walking was assessed at months 0, 3 and 6. Significant increased in gait velocity was found among periods(p=.011, $1.25{\pm}.03$, $1.32{\pm}.03$, and $1.39{\pm}.04\;m/s$ in 0-, 3-, and 6-month, respectively). Also, significant differences in anterior and posteriror inclination angles were found among the periods(p<.05; posterior inclination angles: $12.8{\pm}2.2$, $11.0{\pm}2.9$, & $10.9{\pm}1.9$; anterior inclination angles: $13.7{\pm}1.7$, $14.6{\pm}3.2$, & $1.46{\pm}.21$ in 0month, 3month, & 6month, respectively). These findings provide evidence of significant reduced fall risk factors of community-living older adults associated with a systematic walking program.
Purpose: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. Methods: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. Results: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance ($ISI{\geq}15$), fatigue (FSS $score{\geq}4$), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS $score{\geq}4$). Conclusion: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.
Kim, Jaekwang;Yoon, Hyejin;Basak, Jacob;Kim, Jungsu
Molecules and Cells
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제37권11호
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pp.767-776
/
2014
Alzheimer's disease (AD) is clinically characterized with progressive memory loss and cognitive decline. Synaptic dysfunction is an early pathological feature that occurs prior to neurodegeneration and memory dysfunction. Mounting evidence suggests that aggregation of amyloid-${\alpha}$ ($A{\alpha}$) and hyperphosphorylated tau leads to synaptic deficits and neurodegeneration, thereby to memory loss. Among the established genetic risk factors for AD, the ${\varepsilon}4$ allele of apolipoprotein E (APOE) is the strongest genetic risk factor. We and others previously demonstrated that apoE regulates $A{\alpha}$ aggregation and clearance in an isoform-dependent manner. While the effect of apoE on $A{\alpha}$ may explain how apoE isoforms differentially affect AD pathogenesis, there are also other underexplored pathogenic mechanisms. They include differential effects of apoE on cerebral energy metabolism, neuroinflammation, neurovascular function, neurogenesis, and synaptic plasticity. ApoE is a major carrier of cholesterols that are required for neuronal activity and injury repair in the brain. Although there are a few conflicting findings and the underlying mechanism is still unclear, several lines of studies demonstrated that apoE4 leads to synaptic deficits and impairment in long-term potentiation, memory and cognition. In this review, we summarize current understanding of apoE function in the brain, with a particular emphasis on its role in synaptic plasticity and the underlying cellular and molecular mechanisms, involving low-density lipoprotein receptor-related protein 1 (LRP1), syndecan, and LRP8/ApoER2.
The foreign trends of noncompliance occurring frequently in food contact materials during the period of 2011-2019 was investigated by analyzing the food safety risk information DB in the National Food Safety Information Service (NFSI). A total of 2,042 cases of noncompliance of food utensils, containers, and packages were classified into 5 violation categories; administrative procedures, manufacturing and processing standards, residues and migration standards, labeling and advertising, and quality standards. This was again subcategorized according to non-compliance causative factors. The non-compliances in residues and migration standards comprised the largest proportion (76.4%) of the violative categories. The number of noncompliance information collected in 2011 was 88 cases and increased to 373 cases in 2019. A 72.8% of the non-compliance case was identified to be products of 4 countries (China 64.2%, Germany 4.0%, Japan 3.2%, and Taiwan 3.1%), those produce large quantities of containers and packaging products. During the period of 2011-2019, the number of illegal use of hazardous materials and illegal recycling of waste synthetic resins has decreased to less than one a year since 2014. On the other hand, after 2016, inconsistency of heat-resisting temperature labeling (Taiwan), non-compliance in paper container's strength standards, violation of printing standards, and the risk of consumer injury while using the products were newly reported due to the strengthening of consumer safety protection regulations. Migration of hazardous substances in synthetic polymer products such as heavy metals, melamine and formaldehyde in melamine tableware, primary aromatic amines which are colorant components in kitchenware such as ladles and spatulas, and phthalate plasticizers have been continuously reported with high frequency.
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