• 제목/요약/키워드: public health approach

검색결과 635건 처리시간 0.038초

Mini-Array of Multiple Tumor-associated Antigens (TAAs) in the Immunodiagnosis of Esophageal Cancer

  • Qin, Jie-Jie;Wang, Xiao-Rui;Wang, Peng;Ren, Peng-Fei;Shi, Jian-Xiang;Zhang, Hong-Fei;Xia, Jun-Fen;Wang, Kai-Juan;Song, Chun-Hua;Dai, Li-Ping;Zhang, Jian-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2635-2640
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    • 2014
  • Sera of cancer patients may contain antibodies that react with a unique group of autologous cellular antigens called tumor-associated antigens (TAAs). The present study aimed to determine whether a mini-array of multiple TAAs would enhance antibody detection and be a useful approach in esophageal cancer detection and diagnosis. Our mini-array of multiple TAAs consisted of eleven antigens, p53, pl6, Impl, CyclinB1, C-myc, RalA, p62, Survivin, Koc, CyclinD1 and CyclinE full-length recombinant proteins. Enzyme-linked immunosorbent assays (ELISA) were used to detect autoantibodies against eleven selected TAAs in 174 sera from patients with esophageal cancer, as well as 242 sera from normal individuals. In addition, positive results of ELISA were confirmed by Western blotting. In a parallel screening trial, with the successive addition of antigen to a final total of eleven TAAs, there was a stepwise increase in positive antibody reactions. The eleven TAAs were the best parallel combination, and the sensitivity and specificity in diagnosing esophageal cancer was 75.3% and 81.0%, respectively. The positive and negative predictive values were 74.0% and 82.0%, respectively, indicating that the parallel assay of eleven TAAs raised the diagnostic precision significantly. In addition, the levels of antibodies to seven antigens, comprising p53, Impl, C-myc, RalA, p62, Survivin, and CyclinD1, were significantly different in various stages of esophageal cancer, which showed that autoantibodies may be involved in the pathogenesis and progression of esophageal cancer. All in all, this study further supports our previous hypothesis that a combination of antibodies might acquire higher sensitivity for the diagnosis of certain types of cancer. A customized mini-array of multiple carefully-selected TAAs is able to enhance autoantibody detection in the immunodiagnosis of esophageal cancer and autoantibodies to TAAs might be reference indicators of clinical stage.

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest-Posttest Study

  • Ketelaar, Sarah M.;Nieuwenhuijsen, Karen;Bolier, Linda;Smeets, Odile;Sluiter, Judith K.
    • Safety and Health at Work
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    • 제5권4호
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    • pp.216-221
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    • 2014
  • Background: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. Methods: We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. Results: One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

시간활동 접근법에 의한 면 보건요원의 업무량 분석 (Measuring Myun Health Worker's Performance by Time-Activity Approach)

  • 김한중;김문식
    • Journal of Preventive Medicine and Public Health
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    • 제10권1호
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    • pp.34-43
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    • 1977
  • This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.

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Exploring Reproductive Health Education Needs in Infertile Women in Iran: A Qualitative Study

  • Khakbazan, Zohreh;Maasoumi, Raziyeh;Rakhshaee, Zahra;Nedjat, Saharnaz
    • Journal of Preventive Medicine and Public Health
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    • 제53권5호
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    • pp.353-361
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    • 2020
  • Objectives: An inadequate understanding of infertility can affect individuals' self-efficacy and ability to perform self-care; thus, reproductive health education is an important part of infertility treatment. The present qualitative study aimed to explore the experiences and educational needs of infertile women with regard to reproductive health. Methods: In this qualitative study, we utilized a content analysis approach. Purposive sampling was performed to ensure maximum diversity. In total, 23 individual interviews were conducted with 20 Iranian women with infertility and 3 key informants between July 2018 and February 2019 in northern Iran. Data were collected through in-depth, semi-structured interviews. Data analysis was performed using a conventional content analysis approach. Results: Reproductive health education needs were identified by analyzing interview data from 4 main categories: familiarity with the fertility process and preparation for pregnancy, recognition of infertility and expectations around seeking treatment, recognition of preventive actions associated with reproductive health, and correction of false beliefs. Recognizing the causes of infertility and understanding the different approaches to infertility treatment are among the most important educational needs of infertile women. The potential for neglect of health-related issues due to concerns about fertility and the maternal experience necessitates education about preventive measures for cervical cancer, breast cancer, and sexually transmitted infections. Correcting misconceptions, including those related to contraceptives and traditional medicine, can also help promote reproductive health. Conclusions: In infertile women, the educational needs associated with reproductive health are multifaceted. Satisfying these needs can help achieve optimal treatment results and promote reproductive health.

예방의학 발전을 위한 전공의 수련 교육개선 (Reformation of Residency Trainingship for the Future of Preventive Medicine in Korea)

  • 김창윤
    • Journal of Preventive Medicine and Public Health
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    • 제39권2호
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    • pp.110-114
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    • 2006
  • From the start of the residency trainingship in 1963, the residency training programs have been contributed much on the establishment and development of preventive medicine in Korea. But these programs are now have several problems to update the changes in health service needs of the population that were caused by a rapid epidemiologic transition from the acute infectious diseases to chronic diseases in last a few decades. Strengthening in medical practice, not just in knowledge is urgently required. Must have more concentrate on preventive service for the individual, as in clinical preventive medicine. Training residents by the systematic and well scheduled programs, not just 'teacher' assistant' in the academic facilities. Trying the change in the system of Specilty of Preventive Medicine to the well established several subspecialty, so more specific competency can be gained through the training. These approach and reformation may not only contribute for the better future of the preventive medicine, but also improve in disease prevention and health promotion, which required by the society in Korea.

Re-Examination of Opisthorchis viverrini in Nakhon Ratchasima Province, Northeastern Thailand, Indicates Continued Needs for Health Intervention

  • Kaewpitoon, Soraya J;Rujirakul, Ratana;Loyd, Ryan A;Panpimanmas, Sukij;Matrakool, Likit;Tongtawee, Taweesak;Kompor, Porntip;Norkaew, Jun;Chavengkun, Wasugree;Kujapan, Jirawoot;Polphimai, Sukanya;Phatisena, Tanida;Eaksunti, Thawatchai;Polsripradist, Poowadol;Padchasuwan, Natnapa;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.231-234
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    • 2016
  • Opisthorchis viverrini infection is associated with cholangiocarcinoma particularly in the cases of chronic or re-infection. This presents a serious health problem in northeastern and northern Thailand. A community base approach is required for surveillance. Therefore, in a pilot project, re-examination of O. viverrini infection was conducted in the 3 districts of Nakhon Ratchasima province, Thailand, during June and October 2015. A total of 355 participants from a 194,152 population, was selected through multi-stage sampling. O. viverrini infection was determined using modified Kato Katz thick smear technique. Participants were 229 males and 126 females, and aged ${\geq}30$ years old. Prevalence of O. viverrini infection was 2.25% (8/355 participants). O. viverrini infection was slightly higher in females (3.17%), and age group between 41-50 years (4.49%). Mueang Yang district had a highest of O. viverrini infection rate (2.82%), and followed by Bua Yai (2.48%), and Chum Phuang (1.84%), respectively. O. viverrini infection rate was increased from year 2012 to 2015 particularly in Bua Yai and Mueang Yang. These re-examinion results indicate that opisthorchiasis is still problem in community of Nakhon Ratchasima province, therefore, the provincial-wide scale is need required. Furthermore health education is need intervened in the infected group, and screening of cholangiocarcinoma is urgently concerned.

일개 대학 간호학과생의 보건소 실습평가와 경험에 관한 연구 (Evaluation of Community Health Nursing Practice and Nursing Student's Clinical Experience at Public Health Centers)

  • 박정모;이숙정
    • 지역사회간호학회지
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    • 제13권1호
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    • pp.161-170
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    • 2002
  • Purpose: To evaluate community health nursing practice by nursing students for basic data to improve nursing practice education, and to determine the clinical practice experiences of nursing students at public health centers. Method: According to methodological triangulation, all data was collected from March 2001 to June 2001 through prepared questionnaires with 62 Participants, and in depth interviews with 2 Participants, and content analysis with 8 Participants. Results: 1. Clinical practice content was needed to make up professionally. 2. Clinical practice instructor was satisfied with teaching by community health nursing professor, but not by public health center nurse. 3. Clinical environment was perceived as good. 4. Clinical practice time was perceived suitable, but practice evaluation was given a low grade. 5. Experience of nursing students was grouped into 9 categories and 20 themes. 9 Categories are as follows: change of public health center image, difficulty in the personal relationship, positive personal relationships, doubt about the attitude, doubt about the task, tension, worth, ambivalance of the conference, feeling about the end stage of the clinical practice. Twenty themes are stereotypic of the public health care center: recognition, difficulty between tasks and interrelationships with the clients, decrease of self esteem due to deficiency of trust with the students, exchange of feelings in the relationships, the situation of clients was not considered, feelings were disregarded, not systematic, regarding students as supplementory manpower, independent work but not enough contents, anxiety & fear, self-trust, be skilled in the practice, pragmatic knowledge formation, understanding of the old person, self-study of oneself. live up to the expectation, consider as the job, dissolve the stress and impose burden, feeling the lack regarding active approach in the practice. Conclusion: The students have perceived the need of community health nursing through the clinical practice. Clinical practice of community health nursing requires content supplement, correction of instruction by public center nurses, environmental alteration, evaluation criteria set up. Experience of clinical practice in the public health center was as follows: Getting rid of the stereotype about public health center, nursing students comprehended variety and were worth while to do clinical practice in spite of tension& anxiety and fear. And they thought to be a community nurse someday.

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농촌형 노인 주간보호시설 모형개발 (Development of a Model of a Day Care Center for Rural Elderly People)

  • 강경숙
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.551-565
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    • 2004
  • Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

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지역사회 간호 서비스 전달 체계 모형 개발 -가정방문서비스를 중심으로- (Development of Community Health Nursing Service Model: - Based on the Visiting Nurses Project in Seoul, Kyonggi, and Kang-won Area-)

  • 김성실
    • 지역사회간호학회지
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    • 제12권2호
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    • pp.361-374
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    • 2001
  • This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

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Cancer Registration in India - Current Scenario and Future Perspectives

  • Chatterjee, Sharmila;Chattopadhyay, Amit;Senapati, Surendra Nath;Samanta, Dipti Rani;Elliott, Leslie;Loomis, Dana;Mery, Lesly;Panigrahi, Pinaki
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.3687-3696
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    • 2016
  • Cancer registration, an important component of cancer surveillance, is essential to a unified, scientific and public health approach to cancer prevention and control. India has one of the highest cancer incidence and mortality rates in the world. A good surveillance system in the form of cancer registries is important for planning and evaluating cancer-control activities. Cancer registration in India was initiated in 1964 and expanded since 1982, through initiation of the National Cancer Registry Program (NCRP) by the Indian Council of Medical Research. NCRP currently has twenty-six population based registries and seven hospital based registries. Yet, Indian cancer registries, mostly in urban areas, cover less than 15% of the population. Other potential concerns about some Indian registries include accuracy and detail of information on cancer diagnosis, and timeliness in updating the registry databases. It is also important that necessary data collection related quality assurance measures be undertaken rigorously by the registries to ensure reliable and valid information availability. This paper reviews the current status of cancer registration in India and discusses some of the important pitfalls and issues related to cancer registration. Cancer registration in India should be complemented with a nationwide effort to foster systematic investigations of cancer patterns and trends by states, regions and sub populations and allow a continuous cycle of measurement, communication and action.