Implementation Of Preventive Measures Research Articles

Prioritization of Evaluation Items for Industrial Accident Prevention Factors Using the Fuzzy TOPSIS Technique

With the rapid progress of industrialization, serious accidents have frequently occurred at industrial sites. Despite the existence of several laws and regulations for preventing industrial accidents, including the Occupational Safety and Health Act, social criticism has been raised regarding their inefficiency. To address this issue, the Serious Accident Punishment Act was implemented. The Ministry of Employment and Labor and the Korea Safety and Health Agency have prepared and implemented various industrial accident prevention measures and programs; however, the number of industrial accidents has not decreased. Therefore, new evaluation criteria must be introduced when establishing policies or systems to prevent industrial accidents. This study introduces evaluation items used in Europe and the United States as industrial accident prevention items for assessing industrial accident prevention projects and proposes a plan to select priorities for these items by applying the fuzzy TOPSIS technique. Prioritization was determined by calculating four evaluation criteria and ten industrial accident prevention items using a 7-point linguistic scale. Our results allow for the simultaneous consideration of several industrial accident prevention items. Thus, various aspects of industrial accident prevention activities can be comprehensively evaluated, enhancing the effectiveness and execution of safety and health management, thereby helping to reduce industrial accidents.

Prevention of sexual exploitation of children in sport clubs and social work in Switzerland

Abstract The Convention on the Rights of the Child, ratified in 1989, provides a clear normative basis for the protection of children from violence, abuse and exploitation. Despite efforts to protect children, many children and young people are victims of sexual violence. In the extracurricular sector, clubs offer great potential for preventing sexual exploitation. However, obstacles such as the taboo nature of the topic and the clubs’ limited resources make it difficult to develop and independently implement specific prevention offers. The aim of the project was to record the activities and competencies of sports clubs, youth associations and other youth organizations in the area of prevention of sexual assault among children and adolescents in the leisure sector and to determine the need for prevention services in the canton of Zurich in Switzerland. In addition, information was obtained on the impact of existing prevention services as well as information on their further development in terms of content and organization. Together, 979 participants from sports clubs, youth associations and youth organizations (e.g. board members, coaches, leaders) as well as the parents of children who are members of these clubs were surveyed. An impact model was developed for systematic modeling, as proposed by “Health Promotion Switzerland”. The prevention of sexualized violence is seen as a very relevant topic by sports clubs, youth associations, open child and youth work and parents. However, the current implementation of prevention measures also shows that there are still barriers to implementation and room for improvement in prevention work. Participants from all areas would particularly like support with advice on how to deal with suspected cases/incidents, the provision of information materials and the creation of a protection concept. Specific ideas for the further development of prevention work were also generated and will be discussed. Key messages • The prevention of sexualized violence is seen as a very relevant topic by sports clubs, youth associations, open child and youth work and parents. • The study reveals that prevention measures are only partially implemented and identifies barriers and facilitators for improvement.

Information to the Population About COVID-19 in the First Year of the Pandemic: Case Study on the Portal of the Health Department of Campina Grande, Paraíba, Brazil

Objective: To analyze the risk communication about the COVID-19 pandemic carried out on the website of the Health Department of Campina Grande, Paraíba, Brazil. Theoretical Framework: Risk communication in public health emergencies, according to the WHO guideline for policy and practice of this health communication in crises. Method: Qualitative study, focused on the content analysis of the publications made on the website of the Health Department of Campina Grande, Paraíba, from March 2020 to December 2021. Results and Discussion: The Health Department of Campina Grande, Paraíba, effectively used its website to disseminate information about the COVID-19 pandemic, such as social isolation measures and partial lockdown in areas with a high incidence of cases; sanitary barriers to monitor symptoms and control circulation; the installation of a field hospital, expansion of testing in Basic Health Units and distribution of masks and hygiene kits in vulnerable areas. The most frequent words on the portal in 2022 were “pandemic”, “mask” and “coronavirus”, in daily updates, guidelines on prevention measures, service protocols, decrees and restrictions, education and awareness and vaccination campaign at the end of the year. Research Implications: There was publication of accurate and accessible information, publication of administrative acts, positive culture in public health and, therefore, these actions demonstrate a significant effort by the Campina Grande Health Department to use digital communication to face the COVID-19 pandemic in accordance with the UN guideline. However, it was observed that in terms of clarity, some messages used technical terms that may have made it difficult for less educated audiences to understand. The portal did not provide accessible versions for people with visual impairments. Originality/Value: This study contributes to demonstrating that during the pandemic, the Campina Grande Health Department portal was an essential tool for residents of Campina Grande-PB in a practical and accessible way, with constant updates, disseminating information on the progress of the disease, vaccination campaigns and preventive measures, such as the use of masks and social distancing, with potential contribution to the implementation of preventive measures and adherence to vaccination. It is suggested that there could be greater accessibility for people with less education and sensory disabilities.

Malignancy risk factors based on endometrial polyp

AimsThis study aims to examine cases identified with endometrial polyp and carcinoma originating from polyps in patients presenting with gynaecological problems, and to highlight the significance of risk factors contributing to malignancy.Materials and methodsThe study comprised 203 patients who visited our clinic between January 2019 and 2024 with various gynaecological problems and were identified with endometrial polyps after a clinical, radiographic, and laboratory assessment. We retrospectively analysed data from 191 benign endometrial polyps and hyperplasia without atypia and 12 patients with endometrial polyps and underlying endometrial hyperplasia with atypia and/or endometrial carcinoma, diagnosed histopathologically after hysteroscopic resection, retrieved from our hospital's electronic archive system.Two hundred three participants were tested in the study, with 191 classifieds with benign tumours and 12 diagnosed with malignant tumours and atypical endometrial hyperplasia (premalignant). Cases were chosen according on consistent criteria for age, BMI, gravida, parity, abortion, educational level, smoking habits, operation history, and co-morbidities. After determining the sample size for the malignant group, patients from the control group were selected to be included in the study. Initially, patients with similar age and BMI distributions were included into the study. Next, the cases were analysed for similarities in gravida, parity, and abortion parameters, and those that matched were chosen. Following this step, the educational status was compared for resemblance, and examples with matching educational status were chosen. Consequently, the study covered a total of 34 patients, with 12 identified with malignant tumours and atypical endometrial hyperplasia (premalignant) and 22 with benign tumours.Two groups of cases were diagnosed with endometrial polyp, and risk factors that may cause the development of endometrial polyp and underlying carcinoma: age, gravida, parity, abortion, education level, smoking, previous operation history, comorbidity, gynaecological complaints, fasting blood sugar, CRP values, haemoglobin, and haematocrit were evaluated in terms of endometrial polyp sizes, endometrial thickness level, and endometrial polyp localization. By examining the pathological risk factors of these cases, particularly during the premenopausal period, the goal is to predict endometrial cancer, the most prevalent gynaecological cancer in women, along with its antecedents, and implement preventive measures proactively.ResultsAge, BMI, gravida, parity, number of abortions, educational status, smoking status, operation history, co-morbidity, and complaint variables did not exhibit a statistically significant difference between the groups (p > 0.05). It was revealed that the FBG level, CRP level, Polyp length and Endometrial thickness level of the malignant group were statistically significantly higher than the benign group (p < 0.01) (p < 0.05). Upon analysing the FBG distribution among groups, it is noted that the ODDS ratio is 10.20 for FBG values of 122.5 and above (95% CI: 1.97 – 52.78). Upon analysing the CRP distribution by groups, it is noted that the ODDS ratio is 231 for CRP values of 9.7 and above (95% CI: 13.15 – 4058.67). Upon analysing the distribution of Polyp length based on groups, it was determined that the ODDS ratio is 13.5 for Polyp lengths of 2.25 and above (95% CI: 2.47 – 73.71). Upon analysing the distribution of EM thickness based on groups, it is shown that the ODDS ratio is 5.25 for EM thicknesses of 11 and above (95% CI: 1.09 – 25.21).ConclusionEndometrial polyps are common benign growths that are typically not seen as cancer precursors but may be linked to cancer in people with advanced age. It is vital to remember that in cases of endometrial polyps, variables such as increasing polyp length, endometrial thickness, fasting glucose level, and elevated CRP levels are significant risk factors for the development of cancer associated with polyps.

Data-driven Machine Learning Models for Risk Stratification and Prediction of Emergence Delirium in Pediatric Patients Underwent Tonsillectomy/Adenotonsillectomy.

In the pediatric surgical population, Emergence Delirium (ED) poses a significant challenge. This study aims to develop and validate machine learning (ML) models to identify key features associated with ED and predict its occurrence in children undergoing tonsillectomy or adenotonsillectomy. The analysis involved data cleaning, exploratory data analysis (EDA), supervised predictive modeling, and unsupervised learning on a medical dataset (n = 423). After preliminary data cleaning, EDA encompassed plotting histograms, boxplots, pairplots, and correlation heatmaps to understand variable distributions and relationships. Four predictive models were trained including logistic regression (LR), random forest (RF), Support Vector Machine (SVM), and Gradient Boosting (XGBoost). The models were evaluated and compared using Receiver Operating Characteristic (ROC) Area Under the Curve (AUC), precision, recall, and feature importance. The RF model showed better performance and was used for the test (AUC-ROC 0.96, precision 1.00, and recall 0.92 on the validation set). K-means clustering was applied to find groups within the data. Elbow method and silhouette scores were used to determine the optimal number of clusters. The formed clusters were analyzed by aggregating features to understand the characteristics of each cluster. EDA revealed significant positive correlations between age, weight, American Society of Anesthesiologists (ASA) health score, and surgery duration with the risk of developing ED. Among the ML models, RF achieved the highest performance. Key predictive variables, based on the model's feature importance, included delirium screening scales, extubation time, and time to regain consciousness. Unsupervised K-means clustering identified 2-3 optimal clusters, which represented distinct patient subgroups: younger, healthier, low-risk individuals (cluster 0), and older patients with increasing chronic disease burden, higher delirium screening scores, and consequently higher post-operative delirium risk (clusters 1 and 2). ML techniques are valuable tools for extracting insights and making accurate predictions from healthcare data. High-performing algorithm-based models can be implemented for clinical decision support systems, facilitating early identification and intervention for ED in pediatric patients. By investigating various variables, it is possible to assess risk and implement preventive measures effectively. Furthermore, unsupervised clustering reveals distinct patient subgroups, enabling personalized perioperative management strategies and enhancing overall patient care.

The Incidence and Characteristics of Oral Candidiasis in Patients Hospitalized for SARS-CoV-2 Infection During the Circulation of Alpha, Beta, and Delta Variants

Background: Oral candidiasis has been documented in patients with SARS-CoV-2 infection, with varying prevalence rates across geographic regions and patient demographics. This study aimed to ascertain the incidence, characteristics, and risk factors associated with the development of oral candidiasis in patients hospitalized for SARS-CoV-2 infection in a tertiary infectious diseases hospital in Romania. Methods: A retrospective analysis was conducted on adult patients hospitalized between March 2020 and December 2022 with moderate or severe forms of SARS-CoV-2 infection, for whom a culture of lingual scrapings for Candida spp. was performed. Results: A total of 294 patients were deemed eligible for inclusion in the analysis, with an incidence rate of oral candidiasis of 17.0%. The incidence of oral candidiasis was 4.2 times higher in patients with severe forms of SARS-CoV-2 infection compared to those with moderate forms. Patients with a diagnosis of COVID-19 and oral candidiasis were more likely to receive antibiotics (98.0% vs. 86.1%, p = 0.017) and corticosteroids (100% vs. 83.6%, p = 0.003) than those without oral candidiasis. These findings were associated with a 19% higher relative risk of developing oral candidiasis for patients who received corticosteroid therapy compared to those who did not, and a 13% higher relative risk for those who were administered antibiotics compared to those who were not. The presence of respiratory insufficiency increased the odds of oral candidiasis association 4.7-fold (88.0% vs. 61.1%, p &lt; 0.001). Conclusions: Although the data have been analyzed retrospectively, we have shown that individuals with severe forms of COVID-19 exhibited an elevated risk of developing oral candidiasis. The administration of antibiotics and corticosteroids was identified as a positive predictor for the development of oral candidiasis. The data presented here suggest that a key aspect of the therapeutic management of patients with SARS-CoV-2 infection should include the implementation of preventive measures to minimize the risk of secondary fungal infections.

Routine activities and consumer fraud victimization: findings from a social survey in Chiba Prefecture, Japan

AbstractRecently, Japan has been grappling with various forms of consumer fraud. Consumer fraud victimization causes not only monetary losses but also nonmonetary costs such as emotional stress and psychological trauma. Therefore, it is necessary to investigate the factors associated with the risk of consumer fraud victimization in order to identify vulnerable groups and implement suitable prevention measures. Consequently, this study aims to analyze the sociodemographic and routine activity factors associated with consumer fraud victimization risk in Japan. Drawing on data from a social survey of residents in Chiba Prefecture, Japan, this study employs a series of logistic regression models. This study demonstrates that while using social networking services is unrelated to respondents’ likelihood of experiencing consumer fraud victimization, the frequency of contacting individuals whom respondents have only met online was statistically linked to increased consumer fraud risk. Additionally, only 10.7 to 31.9% of respondents were aware of the available support services for victims of consumer fraud and related issues. This study proposes that social networking providers could aid in preventing consumer fraud by displaying warning messages when users send messages, alerting them to possible threats.

Playing-related musculoskeletal disorders among Chinese conservatoire piano students: prevalence, risk factors and preventive interventions.

Both professional musicians and conservatoire students are at significant risk of developing playing-related musculoskeletal disorders (PRMDs) during their career life. With the growing number of students pursuing a conservatory degree and graduating from music conservatory in China, the aims of this study were: (1) to identify the nature of PRMD and explore the prevalence of PRMD in Chinese conservatoire students; (2) to determine the relevant risk factors with the presence of PRMD among Chinese conservatoire students; and (3) to suggest preventive interventions for young pianists at their early career stage. A self-reported online survey study was conducted among 363 Chinese conservatoire students who majored in piano performance. Of all respondents, 82.6% reported having had at least one PRMD. The wrist was proved to be the most affected body site, followed by the shoulder, finger and arm. Respondents who experienced PRMD reported "pain," "fatigue," and "stiffness" as the most frequent symptoms. The main risk factors associated with PRMD included gender, years of playing experiences, practice hours, warm-up habits before practice, and break-taking during practice. Female students, those with longer year of playing experience, those who practice longer hours, those who do not warm up before practice, and those who do not take breaks during practice were found to have more PRMD symptoms and higher level of severity. This study highlights the need to increase awareness of PRMD among conservatoire students and to understand the occurrence of PRMD; it is helpful for young pianists to prevent severe musculoskeletal disorders and implement preventive measures at early career stages. Further studies are suggested to follow up on music students who have had at least one PRMD at different stages of professional musical training.

Prioritising preventive measures for unintentional sport and recreation-related deaths in Québec, Canada, based on a 14-year review

ObjectivesThis study analysed sport and recreation-related fatalities in Québec, Canada, from January 2006 to December 2019, focusing on the six activities with the highest mortality frequencies. It aimed to identify...

Developing a rapid predictive model for falls in older hospitalized patients.

This study was aimed to identify the independent risk factors for falls n hospitalized older patients and develop a corresponding predictive model. A retrospective observational study design was adopted, comprising 440 older patients with falls history and 510 older patients without falls history during hospitalization. Data collected included demographic information, vital signs, comorbidities, psychiatric disorder, function absent, current medication, other clinical indicators. Mobility disability, high-risk medications use, frequency of hospitalizations, psychiatric disorder, visual impairment are independent risk factors for falls in older patients. The A-M2-HPV scoring system was developed. The AUC value of the nomogram was 0.884, indicating the model has excellent discriminative ability. The AUC value of the A-M2-HPV score was 0.788, demonstrating better discrimination and stratification capabilities. The A-M2-HPV scoring system provides a valuable tool to assess the risk of falls in hospitalized older patients and to aid in the implementation of preventive measures.

Variation in Urology Care after Urinary Stone Surgery among Veterans at High-risk for Recurrence

ObjectiveTo determine rates of urology follow-up and implementation of stone prevention measures after stone surgery and to assess variation in care delivery within a large, integrated healthcare system. Materials and MethodsWe used nationwide data from the United States Veterans Health Administration to identify patients who had stone surgery between 2016 and 2018 and who were at higher risk for recurrence. Our cohort included 13,444 Veterans across 90 facilities. We examined the proportion of patients who had a post-operative urology visit or who received a prevention measure (24-hour urine test, serum parathyroid hormone measurement, or prescription of a stone-related medication) within 6 months of stone surgery. We calculated the median odds ratio to quantify facility-level variation in urology care after stone surgery, adjusting for patient- and facility-level characteristics. ResultsWithin 6 months of stone surgery, 94.2% Veterans had a urology visit, yet only 8.8% completed 24-hour urine testing, 8.4% had a parathyroid hormone measurement, and 31.0% were prescribed a stone-related medication. Implementation of prevention measures varied widely across facilities with the median odds ratio ranging between 1.18 for medication prescriptions and 1.77 for 24-hour urine testing. ConclusionsWhile most patients have a urology visit after stone surgery, stone prevention measures were implemented infrequently and inconsistently for patients at higher risk for recurrence, indicating an opportunity for quality improvement.

The effect of surgical smoke on operating room workers, attitudes towards risks, and the implementation of preventive measures

Amaç: Bu araştırma, cerrahi dumanın ameliyathane sahipleri üzerinde mevcutlukları, risklere karşı tutumlarını ve para harcamanlarını planlama amacıyla tanımlama olarak yapılmıştır. Gereç ve Yöntem: Kesitsel kalitede bu çalışma, Türkiye'de bir hastanenin ameliyathane ünitesinde Nisan-Mayıs 2022′de kayıtlı süre boyunca devam etmektedir. Araştırmanın boyutları, dahil edilme kriterlerini karşılayan 73 ameliyathane çalışanından oluşuyordu. Araştırmanın verileri Kişisel Bilgi Formu, AORN (Peri-Operatif Kayıtlı Hemşireler Derneği) rehberleri ve ilgili kaynaklarla kırsal Cerrahi Dumanın Ameliyathane Çalışanları Üzerindeki Etkileri, Risklere Yönelik Tutumlar ve Önleyici Tedbirlerin Uygulanması Anketi ile toplanmıştır. Bulgular: Ameliyathane çalışanlarının %91,8′i (n=67) son beş yıl içerisinde cerrahi dumanla ilgili herhangi bir eğitime katılmadığını belirtti. Bunların %75,3′ü cerrahi dumana maruz kaldıklarını bildirdi. Ameliyathane çalışanlarının yaklaşık %50,7′si (n=37) lazer dumanı tahliyesi için herhangi bir cihazın kullanılmadığını belirtirken, %39,7′si (n=29) tahliye dumanı için kullanılan cihazlar hakkında bilgisinin olmadığını belirtti. Ameliyathane çalışanlarının %65,8′inin (n=48) iş yerlerinde cerrahi dumanla ilgili herhangi bir protokolden haber yoktu. Cerrahi dumana maruz kalmanın sağlık üzerindeki etkilerine, maruziyete dayanıklına süt verdiklerini bildirdiler: sızıntı (%65,8), göz tahrişi (%65,8), gözlerde sulanma (%63,0), göz kuruluğu (%65,8)), uyku bozuklukları (%49,3) %), solunum problemleri (%37,0) ve baş ağrısı (%35,6). Araştırmada ameliyathane çalışanlarının elde edebilecekleri cerrahi dumandan korunmak için kişisel koruyucu önlemlerin alınması. Cerrahi maske (%100), aspirasyon sondası (%60,3), önlük (%41,1) ve gözlük (%35,6) belirlendi. Sağlık çalışanlarının cerrahi dumanın potansiyel tehlikelerine karşı tutumları değerlendirildi. Diğer sağlık çalışanlarının ameliyathane çalışanlarına göre daha fazla kaygı yaşadıkları belirlendi. Sonuç: Araştırmanın düzenine göre ameliyathane çalışanlarının sağlıklı duman tehlikelerine yönelik ilerlemeye yönelik tutumlarını geliştirecek yöntemlerin benimsenmesinin esasları. Ayrıca vakum dumanıyla ilgili tamamlayıcıları önlemek için politikalar ve kılavuzlar iletilmeli ve yöneticilerden uygun ekipman ve destek eğitimi.

Impact of patient death on physicians’ mental health

IntroductionPhysicians often encounter stressful situations that can impact their mental well-being. The death of a patient represents one of the most difficult situations in routine medical practice. Literature notably lacks comprehensive studies into physicians’ personal experiences with patients’ deaths. However, it does underscore heightened levels of sorrow, guilt, and stress stemming from the passing of terminally ill patients. As a majority of studies in this realm adopt qualitative methodologies, there is merit in supplementing existing research with a quantitative approach that employs validated psychometric scales. Furthermore, the study of phenomena associated with stress, particularly the perceived professional support by physicians in stressful events, can contribute to the implementation of preventive measures to help physicians cope. ObjectiveOur study aims to measure the traumatic impact on resident and intern physicians at national university hospitals following the death of patients, as well as to assess the perceived level of professional support among these physicians. Materials and methodsWe conducted a nationwide cross-sectional, descriptive, and analytical study. Participants included interns and residents from various specialties (medical, surgical and laboratory) at national university hospitals in Morocco. Assessing the traumatic impact of patients’ death on doctors was conducted using two psychometric scales: the Peri-Traumatic Distress Inventory (PDI) and the Revised Impact of Event Scale (IES-R). Additionally, we used the Perceived Professional Social Support Scale (QSSP-P) to evaluate how supportive the professional environment was towards these doctors. All scales utilized in the study are validated in the French language. ResultsThe study included 96 participants, with 67.7% being female. The average age was 26.8 years, ranging from 23 to 39 years. The majority of participants managed more than nine patients simultaneously (58.3%) while 41.7% were scheduled for more than six 24h shifts per month. During their training, over 64.6% of interns and residents faced more than ten patients’ death incidents, and 68.8% considered their first patient death as the most traumatizing. Half of the physicians evaluated the patients’ care as moderately appropriate, with 46.9% believing that the incident could have been prevented. Notably, 70.8% of interns and residents involved in patient care experienced self-blame and attributed a share of responsibility to themselves for the patient's demise. The majority of participants, 82.3%, exhibited peri-traumatic distress with a PDI score exceeding 15. Among the studied factors, only the perceived responsibility and a management system centered on a single physician (rather than a team) demonstrated a noteworthy correlation with PDI scores. The mean score on the IES-R scale was 25.6, with almost half of the sample (54.2%) reporting moderate to severe PTSD symptoms. The severity of these symptoms was significantly correlated with higher age, high number of patient's deaths experienced and the physician's perceived sense of responsibility. Participants in our study were more satisfied with support from colleagues compared to support functions (paramedical staff, administrative officials) or superiors. Moreover, only colleagues’ support was statistically significantly associated with low scores on the traumatic impact scales. ConclusionPhysicians maintain a unique relationship and therapeutic alliance with their patients. Therefore, the death of a patient can have a significant psychological impact on the physician. This study allowed us to objectively measure this psychological impact and evaluate professional support. The results of these studies encourage further exploration of the issue and the implementation of measures to reduce this psychological impact.

Occurrence and circumstances of child sexual assault in Maputo, Mozambique

BackgroundChild Sexual Abuse (CSA) is a significant public health issue, with its health and social consequences well documented. While CSA has been extensively studied in high-income countries, its incidence and circumstances of occurrence in low-income countries, especially in Africa, remains under-represented in the scholarly literature. MethodsThis study aimed to investigate the occurrence and circumstances of CSA among victims assisted at the Forensic Service of the Hospital Central de Maputo in Mozambique. A cross-sectional, quantitative study was conducted using secondary data from 2015 to 2020, extracted from the medico-legal reports of all victims under 18 years old. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 28.0. Results2610 cases of CSA were reported for the period 2015 to 2020, of which 2588 were included for analysis. Of the cases analysed, the majority of victims were girls (93.7 %), predominantly aged 12–17 years (48.6 %). The reported types of penetration revealed that vaginal penetration was the most frequent (86 %), followed by anal (11 %) and oral (2 %). Most assaults occurred either at the victims' or perpetrators’ homes (54.8 %), primarily during the week (71.1 %), and typically in the afternoon (36.5 %) or evening (41.9 %). The assaults were predominantly perpetrated by a single individual (88.7 %), who was most often identified as an acquaintance (72.9 %). Additionally, 54.1 % of the children experienced concomitant physical violence, and approximately 74.9 % of the perpetrators did not use condoms during the assault. ConclusionsThe findings of this study underscore the urgent need to implement prevention measures specifically targeting adolescent girls and younger boys, aiming to promote early reporting and prevent mental, physical, and sexual and reproductive health complications. Raising awareness about all forms of child abuse, including sexual abuse, and enhancing reporting and diagnostic systems in Mozambique is crucial.

Prevalence of Painful Temporomandibular Disorder Symptoms Among Professional and Student Musicians: An Online Survey.

Within the fields of medicine and music, increasing attention is given to evidence indicating music performance being an occupational risk factor for temporo-mandibular disorders (TMD). Assessment of self-reported painful TMD symptoms among student and professional musicians. Using Survey Monkey software, the German version of the 'TMD-Pain-Screener' was distributed electronically to professional and student musicians in Europe. Supplementary questions addressed age, gender, daily playtime, instrument type and type of professional practice. Results are presented as median [interquartile range]. The TMD-pain-screener was completed by 492 participants. Among them, 96 (19.5%) reported painful TMD (Pain_pos) and 396 did not experience pain (80.5%, Pain_neg). Pain_pos participants were significantly younger (Pain_pos: 34 years [26; 46], Pain_neg: 44 years [30; 56], p = 0.0003), had less work experience (Pain_pos: 15.5 years [6; 25], Pain_neg: 20 years [10; 32], p = 0.009), had fewer performances/year (Pain_pos: 20/year [10; 45], Pain_neg: 30/year [12; 53.5], p = 0.03) and were predominantly female (OR = 3.22 [1.87, 5.74], p < 0.0001). Comparisons among music performance types revealed no statistical significance in the overall test (p = 0.13), although 'keyboard' (OR = 2.99 [0.58, 30.12]), 'upper string' (OR = 2.31 [0.43, 23.63]) and 'singer' (OR = 2.14 [0.44, 20.75]) stood out compared to the reference group 'lower string' (OR 1.00). Organ players formed the largest group and showed a comparatively low prevalence of Pain_pos (16%), compared to other keyboard instruments (Pain_pos 30.2%). Prevalence of TMD pain was highest among young inexperienced female musicians. Playing keyboard instruments (other than organ) or upper strings instruments were frequently associated with painful TMD screening. An improved understanding of causes, implementation of preventive measures, professional guidance and a biopsychosocial health care perspective may decrease this occupational risk while maintaining the health benefits of music.

Cardio-oncology: chances and challenges.

Cardio-oncology is an emerging field that aims to ensure optimal cancer treatment while minimising cardiovascular toxicity. The management of cardiovascular toxicity is critical because it can lead to premature discontinuation of treatment, increasing the risk of cancer recurrence and mortality. The 2022 European Society of Cardiology guidelines were a milestone in advocating a patient-centred, multidisciplinary approach. Key components include risk stratification and a standardised criterion for adverse events, incorporating definitions from the International Cardio-Oncology Society. Effective risk stratification, supported by imaging and biomarkers, helps to anticipate cardiovascular problems and implement preventive measures. Future research should focus on understanding mechanisms, developing preventive strategies and implementing personalised medicine. Education and reducing disparities in care are essential to advance cardio-oncology and improve patient outcomes.

Socioecological Resilience: Quantitative Assessment of the Impact of an Invasive Species Assemblage on a Lake Ecosystem

An invasive assemblage refers to a group of invasive species that coexist and interact within an ecosystem, significantly altering its dynamics, biodiversity, functions, and ecosystem services. Their presence in lakes can severely affect these ecosystems. The objective of this article is to present an assessment using indexes of socioecological resilience to the impact of an assemblage of two invasive species (P. clarkii and E. crassipes) in a lake ecosystem, the Fúquene Lagoon in Colombia. Socioecological resilience indexes (rating scale: 0.0–100%) are developed based on community perception within the area of influence of the lake ecosystem under study. Indexes are developed for each dimension of analysis (ecological, social, and economic) and include a global resilience index. Community perception is obtained through a survey according to the dimensions of analysis. The results of the comprehensive assessment using the developed indexes suggest significant vulnerability of the ecological (index = 37.7%) and social (index = 40.9%) resilience of the lake ecosystem to the invasive species assemblage. The low-risk perception and limited implementation of preventive measures accentuate this fragility. Although the economic dimension shows greater robustness (index = 56.9%), it is imperative to strengthen the adaptive capacity of the socioecological system to mitigate the adverse impacts of biological invasions and ensure the sustainability of the ecosystem (global resilience index = 45%). Assessing lake ecosystems’ recovery from invasive species requires a multidimensional approach, focusing on ecological, economic, and social factors to develop integrated management strategies for resilience and sustainability.

Different Etiological Entities of Liver Cancer Across Populations: Implications From Age-Period-Cohort Analysis on Incidence Trends.

The incidence of liver cancer has shown different temporal trends across populations, while the underlying reasons remain unclear. We examined temporal trends in the incidence of liver cancer in Hong Kong, Sweden, and the United States since the 1970s through 2021 using joinpoint regression and age-period-cohort analysis. The age-standardized incidence rate of liver cancer in Hong Kong steadily decreased (average annual percentage change [AAPC] -2.2%, 95% confidence interval [CI] -2.8% to -1.7% in men; AAPC -2.1%, 95% CI -3.1% to -1.1% in women) in 1983-2020. The rate in Sweden increased on average by 0.8% (95% CI 0.2%-1.4%) per year in men and was stable in women (AAPC 0.2%, 95% CI -0.9%-1.4%) in 1970-2021. The rate in the United States increased by 2.1% (95% CI 1.5%-2.8%) per year in men and by 2.1% (95% CI 1.6%-2.5%) in women in 1975-2020, but decreasing trends were noted in 2015-2020 (AAPC -6.6%, 95% CI -8.3% to -4.9% in men; AAPC -4.2%, 95% CI -7.5% to -0.8% in women). Stratified analysis by histological type showed such decrease in recent years was limited to hepatocellular carcinoma, rather than intrahepatic cholangiocarcinoma. We observed distinct changes in trends across age groups and different trends across birth cohorts. The incidence of liver cancer has decreased in Hong Kong but increased in Sweden and in the United States since the 1980s, despite the decreasing incidence in the United States since 2015. Such disparities may be explained by different etiology and implementation of preventive measures across populations.

B - 30 Influence of Military Blast Exposure on Subjective Post-Concussion Symptom Reporting

Abstract Objective Repeated subconcussive blast exposure associated with explosive breaching, mortars, and shoulder-fired artillery weapons is commonly seen in the military/veteran population and has been found to contribute to adverse neurological outcomes; however, the extent is not fully understood. The aim of this study was to assess the effects of blast exposure during military or other training exercises on neurobehavioral symptom endorsement. Method Cross-sectional data from 48 nonclinical post-deployment Operation Enduring Freedom/Operation Iraqi Freedom veterans prospectively-recruited for a study examining posttraumatic stress and cognitive correlates at an urban VA Medical Center were examined (M age = 36.02; SD = 6.12; M years of education = 14.94; SD = 1.84). The sample was 96% male, 41% White, 39% Black, 4% Asian, and 16% Other. The Neurobehavioral Symptom Inventory (NSI) was used to assess self-reported vestibular, somatosensory, cognitive, and affective post-concussion symptoms, and the Boston Assessment of Traumatic Brain Injury-Lifetime semi-structured clinical interview assessed military-related blast exposure. Results There was a significant difference in neurobehavioral symptoms based on blast exposure, F(4,43) = 3.49, p = 0.015; Wilk’s Λ = 0.755, partial η2 = 0.25. Follow-up analyses showed that veterans with history of blast exposure endorsed significantly higher levels of somatosensory (F(1,47) = 7.69, p = 0.008, η2 = 0.143); affective (F(1,47) = 12.66, p &amp;lt; 0.001, η2 = 0.216); cognitive (F(1,47) = 5.97, p = 0.018, η2 = 0.115); and vestibular (F(1,47) = 7.21, p = 0.010, η2 = 0.136) post-concussive symptoms on the NSI compared to those without history of military blast exposure. Conclusion Veterans with blast exposure during military service reported significantly greater levels of post-concussion symptoms. This demonstrates the need to assess history of blast exposure, implement prevention measures through safeguards and decreased exposure when possible, and establish treatment modalities to improve outcomes.

OCCUPATIONAL SAFETY IN CIVIL CONSTRUCTION OF THE STATE OF RORAIMA

This research highlights the safety of work in civil construction in the state of Roraima, with the objective of analyzing the safety practices adopted in the sector, identifying the main risks faced and assessing the effectiveness of implemented preventive measures. The methodology was based on the analysis of regulatory standards, local case studies and workers’ perception. The results showed that Roraima’s climate and geographical particularities impose additional security challenges, highlighting the importance of adapted practices and effective risk management. The conclusion points to the need to strengthen security culture in companies, with emphasis on workers’ education and training, as a way to reduce accidents and improve working conditions.