Journal of UOEH
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In this study, the nature of safety climates at construction work sites and workers' safety attitudes was ascertained, and the effect of safety climates on workers' safety attitudes and work site safety was examined. A self-rating questionnaire prepared for this study was delivered to 300 employees who were working at construction sites and 300 foremen of affiliated companies. Eight factors were extracted for the safety climate of work sites. ⋯ The scores of negative safety attitudes in companies with fewer labor accidents were smaller than those in companies with more accidents. Negative safety attitudes were affected by safety climate more than positive ones, and this tendency was more remarkable for foremen than employees. These results suggest the importance of promoting safety climates for raising workers' safety attitudes and work site safety by diminishing negative safety attitudes.
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Patients on chronic hemodialysis are at high risk for endocarditis due to prosthetic access devices. Right-sided endocarditis without any predisposing factors is rare in dialysis patients. A 76-year-old female, who had chronic renal failure had been treated by hemodialysis and had a permanent pacemaker implanted, was admitted to our hospital with a high fever and lumbago after abscess formation at an autogenous arteriovenous fistula for hemodialysis. ⋯ Chest X-ray and perfusion lung scintigraphy showed pulmonary infarction, perhaps due to vegetation-derived emboli. Computed tomography also showed pyogenic spondylitis in L4 and L5. Repeated vascular punctures even of autogenous grafts expose dialysis patients to bacteremia and imply a higher risk of infectious endocarditis.
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Securing the airway is the most important part of anesthesia safety. In clinical practice there is always the risk of encountering laryngospasm, which is defined as the occlusion of the glottis by the action of the intrinsic laryngeal muscles. ⋯ In this paper, we have reviewed laryngospasm, according to the induction of anesthesia and emergence from it, methods for securing the airway using a tracheal tube or a laryngeal mask airway, and the timing of tracheal extubation. In addition, we have summarized a prompt diagnosis and adequate prevention and management of laryngospasm associated with anesthesia.
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Basic life support(BLS) does not require any special instruments or drugs, and its skills can be understood and performed easily by the lay person. The main goal of cardiopulmonary resuscitation(CPR) for the victims of cardiac pulmonary arrest(CPA) is not only restoration of cardiopulmonary function but also return to their previous life. An early bystander CPR plays a pivotal role to achieve this target. ⋯ When there are no signs of breathing or pulse, BLS consisting of artificial respiration and/or chest compression must be started immediately and continued until EMS staffs arrive. In this article, the details of the revised guidelines for BLS by the American Heart Association are described. Current CPR education for pre- or early post-graduate medical students in our institution is reported.
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We developed a lung sound auscultation simulator "Mr. Lung" in 2001. To improve the auscultation skills of lung sounds, we utilized this new device in our educational training facility. ⋯ Self-assessment scores were significantly higher after the class than before. The ratio of correct lung sound answers was surprisingly low among medical students. We believe repetitive auscultation of the simulator to be extremely helpful for medical education.