Special care dentistry: Midazolam conscious sedation for patients with neurological diseases

Aim Midazolam is used very often to control the anxiety of patients for dental treatment especially in patients with special needs. The objective of this study was to evaluate the efficiency of Midazolam in patients with neurological diseases referred for dental treatment. Study design Descriptive study Methods Forty consecutive patients with neurological disorders (encephalopathy, autism, and epilepsy) were referred to dental treatment, and 45 sedations were performed; all were sedated with Midazolam (intramuscular 0.2-0.3 mg/kg or intravenous 0.1mg/kg) and all were anesthetised with lidocaine 2% (0.5-2 mL). During the dental procedure, their behavior was analysed and classified into 3 categories: A (indifferent), 8 (reacted but allowed treatment), and C (did not allow treatment). Data were tabbed and statistically analysed. Results The final patients` classification was: A 22 (49%), 8 18 (40%) and C 5 (11%); the patients with encephalopathy had the best results of sedation according to the proposed classification (p<0.05). Conclusion Midazolam demonstrated to be effective in 89% of this sample for dental procedures in patients with neurological and behavioral disturbances, but it was less effective for patients with autism (p<0.05).

Guidelines of Special Care Dentistry in Patients with Chromosomal and Genetic syndromes

Chromosomal and genetic syndromes are frequently associated with dental and cranio-facial alterations. The aim of our study is to identify and describe the dental and craniofacial alterations typical of six genetic and chromosomal syndromes examined. Materials and Methods- A dental visit was performed to 195 patients referred from Sant’Orsola Hospital of Bologna, University of Bologna, to Service of Special Need Dentistry, Dental Clinic, Department of Biomedical and Neuromotor Science, University of Bologna. The patients recruited were 137 females and 58 males, in an age range of 3-49 years (mean age of 13.8±7.4). The total sample consisted of subjects affected with Down Syndrome (n=133), Familiar Hypophosphatemic Ricket (n=10), Muscular Dystrophies (n=12), Noonan Syndrome (n=13), Turner Syndrome (n=17), Williams Syndrome(n=10). A questionnaire regarding detailed medical and dental history, oral health and dietary habits, was filled by parents/caregivers, or patients themselves when possible. The intra-oral and extra-oral examination valued the presence of facial asymmetries, oral habits, dental and skeletal malocclusions, dental formula, dental anomalies, Plaque Index (Silness&LÖe Index), caries prevalence (dmft/DMFT index), gingivitis and periodontal disease, and mucosal lesions. Radiographic examinations (Intraoral radiographies, Orthopanoramic, Skull teleradiography) were executed according to patient’s age and treatment planning. A review of literature about each syndrome and its dental and cranio-facial characteristics and about caries, hygiene status and malocclusion prevalence on syndromic and non-syndromic population was performed. Results - The data of all the patients were collected in the “Data Collection Tables” created for each syndrome. General anamnesis information, oral hygiene habits and dmft/DMFT, PI, malocclusion prevalence were calculated and compared to syndromic and non-syndromic population results found in literature. Discussions and conclusions - Guidelines of Special Care dentistry were indicated for each syndrome, in relation to each syndrome features and individual patient characteristics.

Performance assessment of an architecture with adaptative interfaces for people with special needs

People in industrial societies carry more and more portable electronic devices (e.g., smartphone or console) with some kind of wireles connectivity support. Interaction with auto-discovered target devices present in the environment (e.g., the air conditioning of a hotel) is not so easy since devices may provide inaccessible user interfaces (e.g., in a foreign language that the user cannot understand). Scalability for multiple concurrent users and response times are still problems in this domain. In this paper, we assess an interoperable architecture, which enables interaction between people with some kind of special need and their environment. The assessment, based on performance patterns and antipatterns, tries to detect performance issues and also tries to enhance the architecture design for improving system performance. As a result of the assessment, the initial design changed substantially. We refactorized the design according to the Fast Path pattern and The Ramp antipattern. Moreover, resources were correctly allocated. Finally, the required response time was fulfilled in all system scenarios. For a specific scenario, response time was reduced from 60 seconds to less than 6 seconds.

Sopeutumattomien oppilaiden tunne- ja itsesäätelytaitojen kehittyminen: Oppilaiden ja opettajien arvioita ja kokemuksia Aggression portaat -interventiosta

Tässä tutkimuksessa tarkastellaan sopeutumattomien erityisoppilaiden tunne- ja itsesäätelytaitojen kehittymistä Aggression portaat -interventio-ohjelman avulla kolmen vuoden tutkimusjakson aikana. Käsite sopeutumaton oppilas ei ole yksiselitteisesti määriteltävissä, mutta tässä tutkimuksessa sillä tarkoitetaan yleisopetussuunnitelman mukaan opiskelevaa oppilasta, joka käyttäytymiseen ja tunne-elämään liittyvien haasteidensa vuoksi on saanut siirron erityisopetuksen oppilaaksi ja saa enintään 10 oppilaan opetusryhmässä erityistä pedagogista tukea. Tutkimuksen yksi keskeinen tehtävä oli tutkia, onko tunne- ja itsesäätelytaitojen opettamisesta hyötyä sopeutumattomien oppilaiden tunteiden hallinnan ja käyttäytymisen itsesäätelyn kannalta. Tutkimuksen teoreettisena viitekehyksenä on Rose-Krasnorin (1997) malli yksilön sosioemotionaalisesta kompetenssista täydennettynä muiden tutkijoiden näkemyksillä. Sosioemotionaalinen kompetenssi on yläkäsite, johon kuuluvat alakäsitteinä tunne- ja itsesäätelytaidot, sosiokognitiiviset taidot ja sosiaaliset taidot. Lisäksi sosioemotionaaliseen kompetenssiin vaikuttavat kiintymyssuhteet ja osallisuus sekä tavoitteet vuorovaikutuksessa ja konteksti. Tässä tutkimuksessa keskitytään tunne- ja itsesäätelytaitoihin. Interventioryhmän (N=36) muodostivat Varsinais-Suomen alueella opiskelevat sopeutumattomien oppilaiden erityiskoulun 8-13-vuotiaat oppilaat, joille opetettiin tunne- ja itsesäätelytaitoja Aggression portaat -opetusmateriaaliin (Cacciatore 2007) pohjautuvan intervention avulla. Kontrolliryhmän (N=26) oppilaat olivat interventioryhmän oppilaiden ikäisiä ja he opiskelivat Varsinais-Suomen alueen kouluissa pienluokissa myös käyttäytymiseen ja tunne-elämään liittyvien haasteidensa vuoksi. Kontrolliryhmän oppilaat eivät saaneet tutkimusjakson aikana interventio-ohjelman mukaista opetusta. Interventioryhmän oppilaat kävivät erityiskoulua, jossa kaikilla oppilailla oli sopeutumisongelmia ja kontrolliryhmän oppilaat opiskelivat yleisopetuksen koulujen yhteydessä olevilla sopeutumattomien oppilaiden pienluokilla. Tutkimusaineisto on kerätty vuosina 2010-2012. Tutkimusmetodeina olivat sekä oppilaille että opettajille laaditut Webropol-alustaiset kyselyt ja oppilaiden kirjoittamat väkivalta-aiheiset tekstit. Tutkimus- ja kontrolliryhmän oppilaille pidettiin ”Tunteiden hallinta ja käyttäytyminen”- kyselyn avulla alkumittaus syksyllä 2009 ja mittaus toistettiin keväällä 2010, 2011 ja 2012. Kyselyiden avulla selvitettiin, miten oppilaiden tunteiden kokeminen ja ilmaiseminen sekä tunteiden hallinta ja käyttäytymisen itsesäätely muuttuivat tutkimusjakson aikana. Kyselyssä kartoitettiin myös oppilaiden kokemuksia kiusaamisena ilmenevästä väkivallasta. Aineistolähtöisen sisällönanalyysin avulla selvitettiin oppilaiden kirjoitelmista heidän ajatuksiaan ja näkemyksiään väkivallasta ja ehdotuksia keinoista väkivallan vähentämiseksi. Keväällä 2012 interventioryhmän oppilaille ja opettajille laadittujen erillisten kyselyiden avulla selvitettiin sekä oppilaiden että opettajien arvioita ja kokemuksia oppilaiden tunne- ja itsesäätelytaitojen muutoksesta interventio-ohjelman avulla. Lisäksi oppilaat ja opettajat arvioivat pidettyjen tunnetaitotuntien hyödyllisyyttä oppilaille. Interventioryhmän opettajat arvioivat myös Aggression portaat -interventiomateriaalin käyttökelpoisuutta. Vuoden 2014 Perusopetuksen opetussuunnitelman perusteissa esitetyt velvoitteet opettaa kouluissa oppilaille tunne- ja vuorovaikutustaitoja edellyttävät tietoa konkreettisista käytänteistä ja tutkimusperustaisista interventio-ohjelmista. Tämän tutkimuksen tulokset osoittavat, että interventioryhmän muodostaneet sopeutumattomat oppilaat hyötyivät Aggression portaat -interventiosta. Heidän tunne- ja itsesäätelytaidoissaan tapahtui myönteistä kehitystä etenkin myönteisten tunnekokemusten lisääntymisen ja toisiin kohdistuneen fyysisen väkivallan vähenemisen osalta. Myös suhtautuminen väkivaltapelien ikärajoihin oli merkittävästi myönteisempää kuin kontrolliryhmän oppilailla, joilla kielteinen asenne lisääntyi selvästi tutkimusjakson aikana. Lisäksi interventioryhmän oppilailla oli keinoja itsensä rentouttamiseksi, päinvastoin kuin kontrolliryhmän oppilailla, joilla keinottomuuden kokemus jopa lisääntyi. Interventioryhmän oppilaat suhtautuivat hyvin kielteisesti toisen yllyttämiseen väkivaltaiseen tekoon ja kirjoittivat enemmän ajatuksiaan väkivallasta tuoden esille runsaasti ehdotuksia keinoista väkivallan vähentämiseksi. Myös oppilaat ja opettajat kokivat interventio-ohjelman oppilaiden kehityksen kannalta hyödylliseksi ja opettajat myös interventiomateriaalin käyttökelpoiseksi.

Formação de profissionais em psicologia para atenção às pessoas com deficiência: análise de ementários dos cursos públicos de graduação no país

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Inclusão social pela educação: uma necessidade especial para profissionais da área

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Self assembled monolayers for engineering of structured inorganic materials in the micrometer and submicrometer range

Deutsch:In der vorliegenden Arbeit konnten neue Methoden zur Synthese anorganischer Materialien mit neuartiger Architektur im Mikrometer und Nanometer Maßstab beschrieben werden. Die zentrale Rolle der Formgebung basiert dabei auf der templatinduzierten Abscheidung der anorganischen Materialien auf selbstorganisierten Monoschichten. Als Substrate eignen sich goldbedampfte Glasträger und Goldkolloide, die eine Mittelstellung in der Welt der Atome bzw. Moleküle und der makroskopischen Welt der ausgedehnten Festkörper einnehmen. Auf diesen Substraten lassen sich Thiole zu einer monomolekularen Schicht adsorbieren und damit die Oberflächeneigenschaften des Substrates ändern. Ein besonderer Schwerpunkt bei dieser Arbeit stellt die Synthese speziell auf die Bedürfnisse der jeweiligen Anwendung ausgerichteten Thiole dar.Im ersten Teil der Arbeit wurden goldbedampfte Glasoberflächen als Template verwendet. Die Abscheidung von Calciumcarbonat wurde in Abhängigkeit der Schichtdicke der adsorbierten Monolage untersucht. Aragonit, eine der drei Hauptphasen des Calciumcarbonat Systems, wurde auf polyaromatischen Amid - Oberflächen mit Schichtdicken von 5 - 400 nm Dicke unter milden Bedingung abgeschieden. Die einstellbaren Parameter waren dabei die Kettenlänge des Polymers, der w-Substituent, die Bindung an die Goldoberfläche über Verwendung verschiedener Aminothiole und die Kristallisationstemperatur. Die Schichtdickeneinstellung der Polymerfilme erfolgte hierbei über einen automatisierten Synthesezyklus.Titanoxid Filme konnten auf Oberflächen strukturiert werden. Dabei kam ein speziell synthetisiertes Thiol zum Einsatz, das die Funktionalität einer Styroleinheit an der Oberflächen Grenze als auch eine Möglichkeit zur späteren Entfernung von der Oberfläche in sich vereinte. Die PDMS Stempeltechnik erzeugte dabei Mikrostrukturen auf der Goldoberfläche im Bereich von 5 bis 10 µm, die ihrerseits über die Polymerisation und Abscheidung des Polymers in den Titanoxid Film überführt werden konnten. Drei dimensionale Strukturen wurden über Goldkolloid Template erhalten. Tetraethylenglykol konnte mit einer Thiolgruppe im Austausch zu einer Hydroxylgruppe monofunktionalisiert werden. Das erhaltene Molekül wurde auf kolloidalem Gold selbstorganisiert; es entstand dabei ein wasserlösliches Goldkolloid. Die Darstellung erfolgte dabei in einer Einphasenreaktion. Die so erhaltenen Goldkolloide wurden als Krstallisationstemplate für die drei dimensionale Abscheidung von Calciumcarbonat verwendet. Es zeigte sich, dass Glykol die Kristallisation bzw. den Habitus des krsitalls bei niedrigem pH Wert modifiziert. Bei erhöhtem pH Wert (pH = 12) jedoch agieren die Glykol belegten Goldkolloide als Template und führen zu sphärisch Aggregaten. Werden Goldkolloide langkettigen Dithiolen ausgesetzt, so führt dies zu einer Aggregation und Ausfällung der Kolloide aufgrund der Vernetzung mehrer Goldkolloide mit den Thiolgruppen der Alkyldithiole. Zur Vermeidung konnte in dieser Arbeit ein halbseitig geschütztes Dithiol synthetisiert werden, mit dessen Hilfe die Aggregation unterbunden werden konnte. Das nachfolgende Entschützten der Thiolfunktion führte zu Goldkolloiden, deren Oberfläche Thiol funktionalisiert werden konnte. Die thiolaktiven Goldkolloide fungierten als template für die Abscheidung von Bleisulfid aus organisch/wässriger Lösung. Die Funktionsweise der Schutzgruppe und die Entschützung konnte mittels Plasmonenresonanz Spektroskopie verdeutlicht werden. Titanoxid / Gold / Polystyrol Komposite in Röhrenform konnten synthetisiert werden. Dazu wurde ein menschliches Haar als biologisches Templat für die Formgebung gewählt.. Durch Bedampfung des Haares mit Gold, Assemblierung eines Stryrolmonomers, welches zusätzlich eine Thiolfunktionalität trug, Polymerisation auf der Oberfläche, Abscheidung des Titanoxid Films und anschließendem Auflösen des biologischen Templates konnte eine Röhrenstruktur im Mikrometer Bereich dargestellt werden. Goldkolloide fungierten in dieser Arbeit nicht nur als Kristallisationstemplate und Formgeber, auch sie selbst wurden dahingehend modifiziert, dass sie drahtförmige Agglormerate im Nanometerbereich ausbilden. Dazu wurden Template aus Siliziumdioxid benutzt. Zum einen konnten Nanoröhren aus amorphen SiO2 in einer Sol Gel Methode dargestellt werden, zum anderen bediente sich diese Arbeit biologischer Siliziumoxid Hohlnadeln aus marinen Schwämmen isoliert. Goldkolloide wurden in die Hohlstrukturen eingebettet und die Struktur durch Ausbildung von Kolloid - Thiol Netzwerken mittels Dithiol Zugabe gefestigt. Die Gold-Nanodrähte im Bereich von 100 bis 500 nm wurden durch Auflösen des SiO2 - Templates freigelegt.

Three Dichotomies in Lawyers’ Ethics (With Particular Attention to the Corporation as Client)

Three usually unexpressed, and too often unnoticed, conceptual dichotomies underlie our perception and understanding of lawyers’ ethics. First, the existence of a special body of professional ethics and professional regulation presupposes some special need or risk. Criminal and civil law are apparently insufficient. Ordinary day-to-day morality and ordinary ethics, likewise, are not considered to be enough. What is the risk entailed by the notion of a profession that is special; who needs protection, and from what? Two quite different possible answers to this question provide the first of the three dichotomies examined in this article: one can understand the risk as primarily to a vulnerable client from a powerful professional; or, to the contrary, from a powerful client-lawyer combination toward vulnerable others. Second, what is the foundational orientation of lawyers? Are lawyers serving primarily their particular clients, and those clients’ preferences, choices and autonomy? Or is the primary allegiance of lawyers to some community or collective goal or interest distinct from the particular goals or interests of the client? The third dichotomy concerns not the substance of the risk, or the primary orientation, but the appropriate means of responding to that risk or that fundamental obligation. Should professional ethics be implemented primarily through rules? Or, should we rely on character and the discretion of lawyers to make a thought out, all things considered, decision? Each of these three presents a fundamental difference in how we perceive and address issues of lawyers’ ethics. Each affects our understanding and analysis on multiple levels, from (1) determining the appropriate or requisite conduct in a particular situation, to (2) framing a specific rule or approach for a particular category of situations, to (3) more general or abstract theory or policy. A person’s inclinations in regard to the dichotomies affects the conclusions that person will reach on each of those levels of analysis, yet those inclinations and assumptions are frequently unexamined and unarticulated. One’s position on each of the dichotomies tends to structure the approach and outcome without the issues and choice having been explicitly addressed or possibly even noticed. This article is an effort to ameliorate that problem. Part I addresses the question of what is the risk in the work of lawyers, or the function of lawyers, for which professional ethics is the answer. The concluding section focuses on the particular problem of the corporation as client. Part II then asks the related and possibly consequent question of what is the foundational orientation or allegiance of the lawyer? Is it to the individual client? Or is it to some larger community interest? Again, the concluding section focuses on the corporation. Part III turns to the means or method for addressing the obligations and possible problems of the professional ethics of lawyers. Should lawyers’ ethics guide and confine the conduct of lawyers primarily through rules? Or should it function primarily through reliance on the knowledge, judgment and character of lawyers? If the latter were the guide, ethical decisions would be made on a situation by situation basis under the discretion of each lawyer. Toward the end of each discussion possibilities for bridging the dichotomy are considered (and with such bridges each dichotomy may come to look more like a spectrum or continuum.). At several points after its introduction in Parts I and II, the special problem of the corporation as client is revisited and possible solutions suggested. Illustrating the usefulness of keeping the dichotomies in view, Part IV applies them to several exemplary situations of ethical difficulty in actual lawyer practice. For readers finding it difficult to envision the consequences of these distinctions, turning ahead to Part IV may be useful in making the discussion more concrete. Some commonalities across the dichotomies and connections among them are then developed in the concluding section, Part V.

Three Dichotomies in Lawyers’ Ethics (With Particular Attention to the Corporation as Client)

Three usually unexpressed, and too often unnoticed, conceptual dichotomies underlie our perception and understanding of lawyers’ ethics. First, the existence of a special body of professional ethics and professional regulation presupposes some special need or risk. Criminal and civil law are apparently insufficient. Ordinary day-to-day morality and ordinary ethics, likewise, are not considered to be enough. What is the risk entailed by the notion of a profession that is special; who needs protection, and from what? Two quite different possible answers to this question provide the first of the three dichotomies examined in this article: one can understand the risk as primarily to a vulnerable client from a powerful professional; or, to the contrary, from a powerful client-lawyer combination toward vulnerable others. Second, what is the foundational orientation of lawyers? Are lawyers serving primarily their particular clients, and those clients’ preferences, choices and autonomy? Or is the primary allegiance of lawyers to some community or collective goal or interest distinct from the particular goals or interests of the client? The third dichotomy concerns not the substance of therisk, or the primary orientation, but the appropriate means of responding to that risk or that fundamental obligation. Should professional ethics be implemented primarily through rules? Or, should we rely on character and the discretion of lawyers to make a thought out, all things considered, decision? Each of these three presents a fundamental difference in how we perceive and address issues of lawyers’ ethics. Each affects our understanding and analysis on multiple levels, from (1) determining the appropriate or requisite conduct in aparticular situation, to (2) framing a specific rule or approach for a particular category of situations, to (3) more general or abstract theory or policy. A person’s inclinations in regard to the dichotomies affects the conclusions that person will reach on each of those levels of analysis, yet those inclinations and assumptions are frequently unexamined and unarticulated. One’s position on each of the dichotomies tends to structure the approach and outcome without the issues and choice having been explicitly addressed or possibly even noticed. This article is an effort to ameliorate that problem. Part I addresses the question of what is the risk in the work of lawyers, or the function of lawyers, for which professional ethics is the answer. The concluding section focuses on the particular problem of the corporation as client. Part II then asks the related and possibly consequent question of what is the foundational orientation or allegiance of the lawyer? Is it to the individual client? Or is it to some larger community interest? Again, the concluding section focuses on thecorporation. Part III turns to the means or method for addressing the obligations and possible problems of the professional ethics of lawyers. Should lawyers’ ethics guide and confine the conduct of lawyers primarily through rules? Or should it function primarily through reliance on the knowledge, judgment and character of lawyers? If the latter were the guide, ethical decisions would be made on a situation by situation basis under the discretion of each lawyer. Toward the end of each discussion possibilities for bridging the dichotomy are considered (and with such bridges each dichotomy may come to look more like a spectrum or continuum.). At several points after its introduction in Parts I and II, the special problem of the corporation as client is revisited and possible solutions suggested. Illustrating the usefulness of keeping the dichotomies in view, Part IV applies them to several exemplary situations of ethical difficulty in actual lawyer practice. For readers finding it difficult to envision the consequences of these distinctions, turning ahead to Part IV may be useful in making the discussion more concrete. Some commonalities across the dichotomies and connections among them are then developed in the concluding section, Part V.

Relatório de estágio em gestão de unidade de saúde na UCC Montemor

O presente relatório enquadra-se na disciplina de Estagio Curricular do 1.º Curso de Mestrado em Enfermagem de Especialização em Gestão de Unidades de Saúde, lecionado na Escola Superior de Saúde do Instituto Politécnico de Portalegre, com a orientação da Prof. Coordenadora Graça Gama. O estagio, decorreu de 14 Fevereiro de 2011 até 24 Junho de 2011 sob o tema “A melhoria contínua da Qualidade dos cuidados, no âmbito da organização e do funcionamento na Unidade de Cuidados na Comunidade Monte Mor” de Montemor-o-Novo. Esta é uma pequena unidade funcional do ACES vocacionada para actuar na comunidade e capaz de mobilizar competências instaladas noutras unidades com objectivos precisos para prestar cuidados de saúde a indivíduos, famílias e grupos com necessidades especiais de cuidados, através de intervenções específicas nos domicílios e na comunidade, ao nível da prevenção, promoção e protecção da saúde. Este estagio teve por base a garantir da qualidade nos Cuidados de Saúde Primários em que foi necessário conhecer as principais componentes do conceito de qualidade, elaborar um documento denominado Regulamento Interno [RI], integrado no programa de garantia da qualidade, planear em conjunto com a equipa multidisciplinar a sua execução e definir o modelo a aplicar. O relatório tem inicio com um enquadramento conceptual adequado ao tema, a caracterização do local onde se realizou o estagio, assim como as atividades desenvolvidas, o resultado obtido ao longo dos cinco meses de duração do mesmo. No final, encontramos a reflexão que faz a avaliação geral do estagio. Em jeito de consideração final, temos a conclusão em que se realça as ideias gerais do estagio e reforçase a opinião sobre o decorrer do mesmo.

Single access laparoscopic cholecystectomy: technique without the need for special materials and with better ergonomics

The authors describe a surgical technique which allows, without increasing costs, to perform laparoscopic cholecystectomy with a single incision, without using specific materials and with better surgical ergonomics. The technique consists of a longitudinal umbilical incision, navel detachment, use of a permanent 10mm trocar and two clamps directly and bilaterally through the aponeurosis without the use of 5mm trocars, transcutaneous gallbladder repair with straight needle cotton suture, ligation with unabsorbable suture and umbilical incision for the specimen extraction. The presented technique enables the procedure with conventional and permanent materials, improving surgical ergonomics, with safety and aesthetic advantages.

Conceptual Rapprochement and the Analysis of the Historical, Normative and Jurisprudential Treatment of the Rural Workers, as Regards the Need for Special Protection

This article aims to present an approach to the issue of farm or rural zone workers, including a labour law study of agrarian legal decisions, so as to demonstrate their importance in respect to social, economic and cultural rights in Colombia. The study will serve to illustrate through the history, the applicable law and the jurisprudence, the different ways in which farmers have been treated from the time of the origin until the arrival of modern systems of industrialization. It calls into question the effectiveness of existing laws and the role of the courts, in spite of globalization, to maintain the minimum rights and guarantees of farm workers who are considered to be a vulnerable population. In conclusion, this study seeks to illustrate the current role of the Labor law and the National Health Service in the area of demonstrating of the existence or absence of mechanisms to protect workers in rural areas and the need to create some mechanisms that involve social justice given its prime importance in the Constitution of 1991.