Superior Vena Cava Syndrome (SVCS) in Thoracic Malignancies

The superior vena cava syndrome (SVCS) comprises various symptoms due to occlusion of the SVC, which can be easily obstructed by pathological conditions (eg, lung cancer, due to the low internal venous pressure within rigid structures of the thorax [trachea, right bronchus, aorta]). The resulting increased venous pressure in the upper body may cause edema of the head, neck, and upper extremities, often associated with cyanosis, plethora, and distended subcutaneous vessels. Despite the often striking clinical presentation, SVCS itself is usually not a life-threatening condition. Currently, randomized controlled trials on many clinically important aspects of SVCS are lacking. This review gives an interdisciplinary overview of the pathophysiology, etiology, clinical manifestations, diagnosis, and treatment of malignant SVCS.

Predictors of sickness absence in patients with a new episode of low back pain in primary care

This study examines predictors of sickness absence in patients presenting to a health practitioner with acute/ subacute low back pain (LBP). Aims of this study were to identify baseline-variables that detect patients with a new LBP episode at risk of sickness absence and to identify prognostic models for sickness absence at different time points after initial presentation. Prospective cohort study investigating 310 patients presenting to a health practitioner with a new episode of LBP at baseline, three-, six-, twelve-week and six-month follow-up, addressing work-related, psychological and biomedical factors. Multivariate logistic regression analysis was performed to identify baseline-predictors of sickness absence at different time points. Prognostic models comprised 'job control', 'depression' and 'functional limitation' as predictive baseline-factors of sickness absence at three and six-week follow-up with 'job control' being the best single predictor (OR 0.47; 95%CI 0.26-0.87). The six-week model explained 47% of variance of sickness absence at six-week follow-up (p<0.001). The prediction of sickness absence beyond six-weeks is limited, and health practitioners should re-assess patients at six weeks, especially if they have previously been identified as at risk of sickness absence. This would allow timely intervention with measures designed to reduce the likelihood of prolonged sickness absence.

Changes in Psychological Characteristics of Working Adults in Different Stages of Economic Transition in Lithuania

Global economic changes have psychological consequences and Mr. Lepeska set out to assess these changes in working adults in Lithuania between 1993 and 1997. He surveyed two groups of working adults, with a total of 200 people, randomly selected and representing different organisations and professions. In both groups around 30% of participants were managers, with the remainder working in non-managerial positions. The participants were surveyed twice, once in 1993 and the second time in 1997,using various psychodiagnostic tools to measure their psychological characteristics. The results showed that strategies for coping with stress have changed, with problem solving strategies being used more often, and avoidance behaviour or seeking social support less. Men tended to have rejected these strategy more radically than women. Attitudes towards work had become more positive, with managers' attitudes having changed more significantly than those of employees from lower levels of organisations. Younger people were more positive towards work-related changes, while situational anxiety tended to increase with age, although overall it remained low. Mr. Lepeska found that while there were some indications of an increasing individualist in relation to peers, the traditional collective orientation of Lithuanian adults had if anything increased. People have become more accepting of an unequal distribution of power, making it difficult to increase the participation of subordinates in decision making. He also noted a tendency for Lithuanians to see their organisations as traditional families, expecting them to take care of them physically and economically in return for loyalty. The strong feminine orientation with its stress on interpersonal relations and overall quality of life has also strengthened, but the ability of Lithuanians to take initiative and control their environment was relatively low. Mr. Lepeska concludes that organisations should seek to recruit people who are able to adjust more easily to changes and consider measuring dominance, individualism, and attitudes to work-related change and situational anxiety in the process of professional selection. There should also be more emphasis on team building and on training managers to maintain closer relationships with their subordinates so as to increase the latter's participation in decision making. Good interpersonal relations can be a strong work motivator, as may be special attention to the security needs of older employees.

Survey of safety climate in public hospitals in Costa Rica in 1997

In response to growing concern for occupational health and safety in the public hospital system in Costa Rica, a research program was initiated in 1995 to evaluate and improve the safety climate in the national healthcare system through regional training programs, and to develop the capacity of the occupational health commissions in these settings to improve the identification and mitigation of workplace risks. A cross-sectional survey of 1000 hospital-based healthcare workers was conducted in 1997 to collect baseline data that will be used to develop appropriate worker training programs in occupational health. The objectives of this survey were to: (1) describe the safety climate within the national hospital system, (2) identify factors associated with safety climate focusing on individual and organizational variables, and (3) to evaluate the relationship between safety climate and workplace injuries and safety practices of employees. Individual factors evaluated included the demographic variables of age, gender, education and profession. Organizational factors evaluated included training, psychosocial work environment, job-task demands, availability of protective equipment and administrative controls. Work-related injuries and safety practices of employees included the type and frequency of injuries experienced and reported, and compliance with established safety practices. Multivariate regression analyses demonstrated that training and administrative controls were the two most significant predictors of safety climate. None of the demographic variables were significant predictors of safety climate. Safety climate was inversely and significantly associated with workplace injuries and positively and significantly associated with safety practices. These results suggest that training and administrative controls should be included in future training efforts and that improving safety climate will decrease workplace injuries and increase safety practices. ^

Quality of life after pulmonary embolism: Prospective validation of the German version of the PEmb-QoL questionnaire.

BACKGROUND The Pulmonary Embolism Quality of Life questionnaire (PEmb-QoL) is a 40-item questionnaire to measure health-related quality of life in patients with pulmonary embolism. It covers six 6 dimensions: frequency of complaints, limitations in activities of daily living, work-related problems, social limitations, intensity of complaints, and emotional complaints. Originally developed in Dutch and English, we prospectively validated a German version of the PEmb-QoL. METHODS A forward-backward translation of the English version of the PEmb-QoL into German was performed. German-speaking consecutive adult patients aged ≥18 years with an acute, objectively confirmed pulmonary embolism discharged from a Swiss university hospital (01/2011-06/2013) were recruited telephonically. Established psychometric tests and criteria were used to evaluate the acceptability, reliability, and validity of the German PEmb-QoL questionnaire. To assess the underlying dimensions, an exploratory factor analysis was performed. RESULTS Overall, 102 patients were enrolled in the study. The German version of the PEmb-QoL showed a good internal consistency (Cronbach's alpha ranging from 0.72 to 0.96), item-total (0.53-0.95) and inter-item correlations (>0.4), and test-retest reliability (intra-class correlation coefficients 0.59-0.89) for the dimension scores. A moderate correlation of the PEmb-QoL with SF-36 dimension and summary scores (0.21-0.83) indicated convergent validity, while low correlations of PEmb-QoL dimensions with clinical characteristics (-0.16-0.37) supported discriminant validity. The exploratory factor analysis suggested four underlying dimensions: limitations in daily activities, symptoms, work-related problems, and emotional complaints. CONCLUSION The German version of the PEmb-QoL questionnaire is a valid and reliable disease-specific measure for quality of life in patients with pulmonary embolism.

Project development for older adults : Orientation's contribution

This paper systematizes the work developed during the first year of the initiation scholarship for the research project entitled 'Orientation within the new Active Aging Model: educational, work-related, personal and social choices (1)'. This project articulates the Active Aging Model and the Theoretical Operative Model in Orientation, in order to learn how new projects are developed by older adults who used to be part of the formal system of labor and by those who were out of it, and to design programmatic proposals for educational, work-related, personal and social Orientation choices for such population. The sample is made up by seventy people between 64 and 74 years of age, residing in La Plata. The first conclusions evidence the importance that older adults place on project development at this stage of their life cycle, giving special importance to educational, personal and social projects; as well as on the identification of economic factors, health state, family needs for care and social support, among other things, as conditioning the fulfillment of such projects. The differences found in terms of the labor system they used to belong to can be especially observed in the type of project developed.

Estrategias orientadoras ante la inequidad psicosocial

El presente artículo corresponde a una primera etapa del proyecto de investigación denominado: "Investigación evaluativa sobre estrategias de orientación vocacional ocupacional integral para contribuir a revertir la inequidad psicosocial" , que se está llevando a cabo en la actualidad. Se hará una síntesis de las primeras estrategias metodológicas, que incluyen la modalidad de investigación-acción. En esta primera etapa, se analizan los primeros resultados de: a) Los talleres de Información Orientada, y b) La escala de afrontamiento para adolescentes. Cada una de estas intervenciones, que apuntan a diferentes objetivos, van brindando insumos para un primer nivel de análisis. Dicha intervención permite conocer qué recursos les brinda la institución escuela a estos jóvenes para la elección de un proyecto educativo, laboral, personal y social. Se comprueba la importancia de: tener un espacio de información y reflexión compartida; analizar las distorsiones en la información; y profundizar los interrogantes que produce todo cambio. Asimismo, comprobar cómo pueden afrontar dichos jóvenes, pertenecientes a escuelas medias denominadas "vulnerables", diversas situaciones de la vida diaria. En este trabajo, se realiza un análisis comparativo con otra institución educativa de prestigio en la región, cuya población se encuentra en una mejor situación socioeconómica

Elaboración de proyectos en adultos mayoresz : Aportes de la orientación

El presente trabajo sistematiza la labor desarrollada durante el primer año de la beca de iniciación del proyecto de investigación 'La Orientación en el nuevo modelo de envejecimiento activo: elecciones educativas, laborales, personales, sociales (1)'. Dicho proyecto articula el Modelo de Envejecimiento Activo y el Modelo Teórico Operativo en Orientación, con el propósito de conocer cómo elaboran los nuevos proyectos los adultos mayores que pertenecieron al sistema formal de trabajo y aquellos que permanecieron fuera de él, y diseñar propuestas programáticas de Orientación y elección educativa, laboral, personal y social destinadas a esta población. La muestra está conformada por sesenta personas de entre 64 y 74 años de edad, residentes en la Ciudad de La Plata. Las primeras conclusiones dan cuenta de la importancia que atribuyen los adultos mayores a la elaboración de proyectos en esta etapa del ciclo vital, prevaleciendo los proyectos educativos, personales y sociales; así como la identificación de factores económicos, condiciones de salud, demanda de cuidados de otros familiares y apoyo social, entre otros, como condicionantes para la concreción de dichos proyectos. Las diferencias encontradas con respecto al sistema de trabajo al que han pertenecido se observan principalmente en el tipo de proyecto elaborado

Project development for older adults : Orientation's contribution

This paper systematizes the work developed during the first year of the initiation scholarship for the research project entitled 'Orientation within the new Active Aging Model: educational, work-related, personal and social choices (1)'. This project articulates the Active Aging Model and the Theoretical Operative Model in Orientation, in order to learn how new projects are developed by older adults who used to be part of the formal system of labor and by those who were out of it, and to design programmatic proposals for educational, work-related, personal and social Orientation choices for such population. The sample is made up by seventy people between 64 and 74 years of age, residing in La Plata. The first conclusions evidence the importance that older adults place on project development at this stage of their life cycle, giving special importance to educational, personal and social projects; as well as on the identification of economic factors, health state, family needs for care and social support, among other things, as conditioning the fulfillment of such projects. The differences found in terms of the labor system they used to belong to can be especially observed in the type of project developed.

Estrategias orientadoras ante la inequidad psicosocial

El presente artículo corresponde a una primera etapa del proyecto de investigación denominado: "Investigación evaluativa sobre estrategias de orientación vocacional ocupacional integral para contribuir a revertir la inequidad psicosocial" , que se está llevando a cabo en la actualidad. Se hará una síntesis de las primeras estrategias metodológicas, que incluyen la modalidad de investigación-acción. En esta primera etapa, se analizan los primeros resultados de: a) Los talleres de Información Orientada, y b) La escala de afrontamiento para adolescentes. Cada una de estas intervenciones, que apuntan a diferentes objetivos, van brindando insumos para un primer nivel de análisis. Dicha intervención permite conocer qué recursos les brinda la institución escuela a estos jóvenes para la elección de un proyecto educativo, laboral, personal y social. Se comprueba la importancia de: tener un espacio de información y reflexión compartida; analizar las distorsiones en la información; y profundizar los interrogantes que produce todo cambio. Asimismo, comprobar cómo pueden afrontar dichos jóvenes, pertenecientes a escuelas medias denominadas "vulnerables", diversas situaciones de la vida diaria. En este trabajo, se realiza un análisis comparativo con otra institución educativa de prestigio en la región, cuya población se encuentra en una mejor situación socioeconómica

Elaboración de proyectos en adultos mayoresz : Aportes de la orientación

El presente trabajo sistematiza la labor desarrollada durante el primer año de la beca de iniciación del proyecto de investigación 'La Orientación en el nuevo modelo de envejecimiento activo: elecciones educativas, laborales, personales, sociales (1)'. Dicho proyecto articula el Modelo de Envejecimiento Activo y el Modelo Teórico Operativo en Orientación, con el propósito de conocer cómo elaboran los nuevos proyectos los adultos mayores que pertenecieron al sistema formal de trabajo y aquellos que permanecieron fuera de él, y diseñar propuestas programáticas de Orientación y elección educativa, laboral, personal y social destinadas a esta población. La muestra está conformada por sesenta personas de entre 64 y 74 años de edad, residentes en la Ciudad de La Plata. Las primeras conclusiones dan cuenta de la importancia que atribuyen los adultos mayores a la elaboración de proyectos en esta etapa del ciclo vital, prevaleciendo los proyectos educativos, personales y sociales; así como la identificación de factores económicos, condiciones de salud, demanda de cuidados de otros familiares y apoyo social, entre otros, como condicionantes para la concreción de dichos proyectos. Las diferencias encontradas con respecto al sistema de trabajo al que han pertenecido se observan principalmente en el tipo de proyecto elaborado

Project development for older adults : Orientation's contribution

This paper systematizes the work developed during the first year of the initiation scholarship for the research project entitled 'Orientation within the new Active Aging Model: educational, work-related, personal and social choices (1)'. This project articulates the Active Aging Model and the Theoretical Operative Model in Orientation, in order to learn how new projects are developed by older adults who used to be part of the formal system of labor and by those who were out of it, and to design programmatic proposals for educational, work-related, personal and social Orientation choices for such population. The sample is made up by seventy people between 64 and 74 years of age, residing in La Plata. The first conclusions evidence the importance that older adults place on project development at this stage of their life cycle, giving special importance to educational, personal and social projects; as well as on the identification of economic factors, health state, family needs for care and social support, among other things, as conditioning the fulfillment of such projects. The differences found in terms of the labor system they used to belong to can be especially observed in the type of project developed.

Estrategias orientadoras ante la inequidad psicosocial

El presente artículo corresponde a una primera etapa del proyecto de investigación denominado: "Investigación evaluativa sobre estrategias de orientación vocacional ocupacional integral para contribuir a revertir la inequidad psicosocial" , que se está llevando a cabo en la actualidad. Se hará una síntesis de las primeras estrategias metodológicas, que incluyen la modalidad de investigación-acción. En esta primera etapa, se analizan los primeros resultados de: a) Los talleres de Información Orientada, y b) La escala de afrontamiento para adolescentes. Cada una de estas intervenciones, que apuntan a diferentes objetivos, van brindando insumos para un primer nivel de análisis. Dicha intervención permite conocer qué recursos les brinda la institución escuela a estos jóvenes para la elección de un proyecto educativo, laboral, personal y social. Se comprueba la importancia de: tener un espacio de información y reflexión compartida; analizar las distorsiones en la información; y profundizar los interrogantes que produce todo cambio. Asimismo, comprobar cómo pueden afrontar dichos jóvenes, pertenecientes a escuelas medias denominadas "vulnerables", diversas situaciones de la vida diaria. En este trabajo, se realiza un análisis comparativo con otra institución educativa de prestigio en la región, cuya población se encuentra en una mejor situación socioeconómica

Elaboración de proyectos en adultos mayoresz : Aportes de la orientación

El presente trabajo sistematiza la labor desarrollada durante el primer año de la beca de iniciación del proyecto de investigación 'La Orientación en el nuevo modelo de envejecimiento activo: elecciones educativas, laborales, personales, sociales (1)'. Dicho proyecto articula el Modelo de Envejecimiento Activo y el Modelo Teórico Operativo en Orientación, con el propósito de conocer cómo elaboran los nuevos proyectos los adultos mayores que pertenecieron al sistema formal de trabajo y aquellos que permanecieron fuera de él, y diseñar propuestas programáticas de Orientación y elección educativa, laboral, personal y social destinadas a esta población. La muestra está conformada por sesenta personas de entre 64 y 74 años de edad, residentes en la Ciudad de La Plata. Las primeras conclusiones dan cuenta de la importancia que atribuyen los adultos mayores a la elaboración de proyectos en esta etapa del ciclo vital, prevaleciendo los proyectos educativos, personales y sociales; así como la identificación de factores económicos, condiciones de salud, demanda de cuidados de otros familiares y apoyo social, entre otros, como condicionantes para la concreción de dichos proyectos. Las diferencias encontradas con respecto al sistema de trabajo al que han pertenecido se observan principalmente en el tipo de proyecto elaborado

Avaliação da incidência de acidentes ocupacionais com potencial perigo biológico e implementação de medidas comportamentais corretivas em profissionais da veterinária

Nos dias de hoje, continua a assistir-se a elevados níveis de sinistralidade, no eventual reflexo de deficientes ou inexistentes estruturas de prevenção de riscos profissionais em muitos locais de trabalho. A necessidade de segurança, higiene, prevenção e formação no trabalho é, simultaneamente, uma reflexão sobre nós mesmos e as nossas atitudes, intervenientes prioritários, cada vez mais dependentes e exigentes com o trabalho e com tudo o que ele implica. Todavia, nos locais de trabalho são frequentemente criadas situações de perigo para a saúde e para a integridade física dos trabalhadores. A nível mundial, fontes ligadas à OMS (Organização Mundial da Saúde) e à OIT (Organização Internacional do Trabalho) referem que as condições de trabalho de cerca de 2/3 da população ativa estão abaixo dos padrões mínimos de qualidade, ou seja representam um risco real para a saúde e integridade física dos indivíduos. As estatísticas mundiais apontam para a existência de cerca de 157 milhões de novos casos de doenças profissionais por ano e de 120 milhões de acidentes de trabalho, dos quais 220 mil acidentes são fatais.