BACKGROUND: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.METHODS: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.RESULTS: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72).CONCLUSION: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.
Caregivers ; Child ; Cross-Sectional Studies ; Emergencies ; Hospitalization ; Humans ; Korea ; Logistic Models ; Lower Extremity ; Odds Ratio ; Play and Playthings ; Risk Factors ; Social Control, Formal ; Wounds and Injuries

One person dies every six seconds from a smoking-related disease and this problem is likely to worsen. While many people try to quit smoking on their own or with using medicinal products, many of them fail. There is an ongoing debate within the public health community about e-cigarettes on whether they have a potential role in smoking cessation, whether their use can reduce harm for individual users, whether the widespread use of these devices has the potential to reduce or increase population-level harm, and how best to regulate e-cigarette use to minimize both individual and population-level harm. Although the long-term effects of e-cigarette use among smokers and non-smokers are not known, nicotine aerosol produced from a solution, rather than from burning tobacco, releases fewer harmful substances than cigarette smoke does. Some experts advocate wider availability and softer regulations regarding e-cigarette use and perceive them as having the potential to help smokers quit or switch to a harm-reducing means of consuming nicotine. Based on scientific evidence on e-cigarettes, this article explores its pros and cons to public health in order to guide practice, policy, and regulation through reviews of debate articles. ‘Quit or die’ is no longer the only option for those who cannot quit. Safer nicotine products offer another way. There is substantial international and independent evidence that these products are safer than cigarettes.
Burns ; Electronic Cigarettes ; Harm Reduction ; Humans ; Nicotine ; Public Health ; Smoke ; Smoking ; Smoking Cessation ; Social Control, Formal ; Tobacco ; Tobacco Products

Treatment of burning mouth syndrome (BMS) is challenging because there is no consensus regarding pharmalogical or nonpharmalogical therapies. The use of anticonvulsants is controversial. We present nine patients BMS who respond to pregabalin. They were diagnosed secondary BMS except two. Etiologic regulations were made firstly in patients with secondary BMS but symptoms did not decrease. We preferred pregabalin in all patients and got good results. Furthermore the addition of pregabalin to the treatment of two patients who did not respond adequately to duloxetine provided good results. We are only aware that pregabalin may reduce symptoms as a result of case reports. We believe that the diagnosis of pathologic etiology with appropriate diagnostic tests will result in better outcomes in treatment.
Anticonvulsants ; Burning Mouth Syndrome ; Burns ; Consensus ; Diagnosis ; Diagnostic Tests, Routine ; Duloxetine Hydrochloride ; Humans ; Pregabalin ; Social Control, Formal

PURPOSE: Residents' duty-hour regulations and the evolution of minimally invasive surgical techniques require more effective and efficient surgical skill teaching models. We used frozen-thawed human tissue remnants harvested during abdominoplasty or abdominal tissue-based breast reconstruction to allow for a medium-sized group workshop program, simulating a realistic surgical environment and visual/haptic feedback. METHODS: Full-thickness abdominal tissue (skin and subcutaneous fat) were donated from patients who underwent autologous breast reconstruction and gave consent to use their tissue for comprehensive research and medical educational purposes. Anonymized tissue was frozen-preserved and then thawed the day of the surgical skills workshop. A total of 53 residents completed 50-minute hands-on training in 3-to-5 person modules in four sessions of the workshop program. RESULTS: Thawed tissue regained almost normal texture and consistency. Structural integrity was also histologically confirmed. All participants were generally satisfied with the program, especially regarding the suture material provided. CONCLUSION: Frozen-thawed tissue remnants from abdominoplasty or autologous breast reconstruction could be preserved and used as a suture education material in medium-group workshops for surgery residents or medical students given anonymity and with proper consent guaranteed. This approach provided an excellent model maintaining relatively real anatomic structure and consistency with minimal cost.
Abdominoplasty ; Anonyms and Pseudonyms ; Education ; Female ; Humans ; Internship and Residency ; Mammaplasty ; Social Control, Formal ; Students, Medical ; Sutures ; Training Support

OBJECTIVE: The act on decisions on life-sustaining treatment, the well-dying law (WDL), has been implemented in Korea since February of 2018 so that a patient may die with dignity in his or her death bed. On the other hand, there has been an increase in in-hospital cardiac arrest patients, resulting in poor outcomes due to strict regulations of withdrawal of life support. This study examined the survival of in-hospital cardiac arrest patients before and after implementation of the WDL. METHODS: The in-hospital cardiac arrest data registry from the authors' in-hospital cardiac arrest committee and electronic medical records were reviewed retrospectively. The baseline characteristics, cardiac arrest variables, and cardiac arrest outcomes were compared before and after implementation of the WDL. Multivariate logistic regression was conducted to analyze the association of the implementation of the WDL and return of spontaneous circulation (ROSC) of in-hospital cardiac arrest patients. RESULTS: This study analyzed 183 patients before and 346 patients after the implementation of the WDL. The ROSC (115 [62.8%] vs. 158 [45.7%]), 24-hour survival (53 [29.0%] vs. 60 [17.3%]), and survival discharge (25 [13.7%] vs. 29 [8.4%]) were higher in the before period than in the after period. Multivariate logistic regression analysis showed that the WDL was associated with a lower ROSC (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.37–0.85; P<0.01) and lower survival at 24 hours (OR, 0.53; 95% CI, 0.31–0.93; P=0.03), but not a lower survival discharge (OR, 0.84; 95% CI, 0.39–1.83; P=0.67). CONCLUSION: The implementation of the WDL has been associated with a lower ROSC and lower survival at 24 hours in in-hospital cardiac arrest patients.
Cardiopulmonary Resuscitation ; Electronic Health Records ; Hand ; Heart Arrest ; Humans ; Jurisprudence ; Korea ; Logistic Models ; Resuscitation ; Retrospective Studies ; Social Control, Formal

BACKGROUND: Although the importance of pharmaceutical care service has been growing to meet the needs of customers with the improvement of clinical and humanistic outcomes, there was not a systematic strategy to promote research in Korea. The aim of this study was to suggest the core agendas for pharmaceutical care services research and development (R&D) considering priorities. METHODS: Based on desk researches, we developed R&D agendas for the needs of improving pharmaceutical care services in the area of institution, community, and public health. To determine the priority of agendas in developing pharmaceutical care service, analytic hierarchy process (AHP) analysis was performed by the 14 experts. Criteria and subcriteria were assessed for significance by pairwise comparisons. Then, agendas were evaluated for importance according to each subcriteria, and rank ordered considering the weight calculated by multiplying the importance scores of the criteria and the subcriteria. RESULTS: We derived 25 agendas including 13 for institutional pharmaceutical care service, 8 for community pharmaceutical care service, and 4 for public-health related pharmaceutical care service. AHP model was constructed based on 4 criteria and 8 subcriteria by a hierarchical structure. From the AHP survey, the ‘Development of pharmaceutical care service for metabolic and chronic disease’ agenda accounted for the highest priority. CONCLUSION: We have developed the R&D agendas of the pharmaceutical care service which should be promoted. The results should be utilized by the government to nationally support the development of the standards and relevant regulations related to pharmaceutical care services in Korea.
Korea ; Pharmaceutical Services ; Public Health ; Social Control, Formal

BACKGROUND AND OBJECTIVES: Although poor hearing outcomes have been associated with acute noise-induced hearing loss (ANIHL), only limited studies exist on this issue. This study evaluated the prognosis of ANIHL in comparison to idiopathic sudden sensorineural hearing loss (ISSNHL) and investigated the types of noise causing these disorders. SUBJECTS AND METHOD: Patients with sudden sensorineural hearing loss due to noise exposure were included in the ANIHL group if the threshold shift was more than 30 dB in three or more consecutive frequencies within the study period (from January 2010 to December 2016). The ANIHL group included 19 patients. As a matched-control group, treated patients with ISSNHL (n=95) were selected as a way of controlling the known prognostic factors that were evenly distributed between groups. Selected prognostic variables used for matching included age, sex, the degree of initial hearing loss, the number of days before the start of treatment, and treatment method. RESULTS: The overall hearing recovery rate of ANIHL was 11% and that of the control group was 80% (p<0.001). Noise exposure in military service (37%) and leisure activities (37%) was the most prominent cause of ANIHL. CONCLUSION: The hearing outcome of ANIHL was worse than that of ISSNHL. It is thus necessary to establish national guidelines for environmental noise regulations and to raise awareness of hazardous noise exposure.
Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Hearing ; Humans ; Leisure Activities ; Methods ; Military Personnel ; Noise ; Prognosis ; Social Control, Formal

BACKGROUND: Increasing workplace health-care perception has become a major issue in the world. Most of the health-related problems are faced because of the lack of health management instruments. The level of health care can be improved through workplace health well-being regulations. The aim of the present study is to formulate a conceptual model of physical checkup. METHODS: This study applied conceptual theories and figures and used secondary data from articles and relevant websites for evaluating the validity of the study. RESULTS: Annual health checkup increases health-care awareness perception of states, organizations, employees, and their families and manages the annual health record of employees, organizations, and states. CONCLUSIONS: Health care and awareness perception of states, organizations, employees, and families improves with annual health checkup, and annual health checkup also prevents unhealthy acts.
Delivery of Health Care ; Health Status ; Humans ; Social Control, Formal

BACKGROUND: Painters in the automotive sector are routinely exposed to volatile organic solvents, and the levels vary depending on the occupational health and safety controls enforced at the companies. This study investigates the levels of exposure to organic vapors and the existence of controls in the formal economy sector in southern Colombia. METHODS: This is an exploratory study of an observational and descriptive character. An analysis of solvents is conducted via the personal sampling of painters and the analysis of samples using the National Institute for Occupational Safety and Health 1501 method. The amount of solvents analyzed varied according to the budget allocated by the companies. The person in charge of the occupational safety and health management system was interviewed to learn about the exposure controls implemented at the companies. RESULTS: A medium exposure risk for toluene was found in one company. Another presented medium risk for carbon tetrachloride, xylene, ethylbenzene, and n-butanol. The others showed low risk of exposure and that the controls implemented were not sufficient or efficient. CONCLUSION: These results shed light on the working conditions of these tradespeople. The permissible limits established by Colombian regulations for the evaluated chemical contaminants were not exceeded. However, there were contaminants that exceeded the limits of action. The analysis of findings made it possible to propose improvements in occupational safety and health management systems to allow the optimization of working conditions for painters, prevent the occurrence of occupational diseases, and reduce costs to the country's health system.
1-Butanol ; Carbon Tetrachloride ; Colombia ; Humans ; Methods ; National Institute for Occupational Safety and Health (U.S.) ; Occupational Diseases ; Occupational Health ; Social Control, Formal ; Solvents ; Toluene ; Xylenes

BACKGROUND: The oil and gas industry is one of the riskiest industries for confined space injuries. This study aimed to understand an overall picture of the causal factors of confined space accidents through analyzing accident reports and the use of a qualitative approach. METHODS: Twenty-one fatal occupational accidents were analyzed according to the Human Factors Analysis and Classification System approach. Furthermore, thirty-three semistructured interviews were conducted with employees in different roles to capture their experiences regarding the contributory factors. The content analyses of the interview transcripts were conducted using MAXQDA software. RESULTS: Based on accident reports, the largest proportions of causal factors (77%) were attributed to the organizational and supervisory levels, with the predominant influence of the organizational process. We identified 25 contributory factors in confined space accidents that were causal factors outside of the original Human Factors Analysis and Classification System framework. Therefore, modifications were made to deal with factors outside the organization and newly explored causal factors at the organizational level. External Influences as the fifth level considered contributory factors beyond the organization including Laws, Regulations and Standards, Government Policies, Political Influences, and Economic Status categories. Moreover, Contracting/Contract Management and Emergency Management were two extra categories identified at the organizational level. CONCLUSIONS: Preventing confined space accidents requires addressing issues from the organizational to operator level and external influences beyond the organization. The recommended modifications provide a basis for accident investigation and risk analysis, which may be applicable across a broad range of industries and accident types.
Accidents, Occupational ; Classification ; Confined Spaces ; Emergencies ; Humans ; Jurisprudence ; Oil and Gas Industry ; Social Control, Formal