• Journal of Preventive Medicine and Public Health
• /
• 제51권4호
• /
• pp.181-187
• /
• 2018

Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

• 한국환경보건학회지
• /
• 제42권3호
• /
• pp.205-212
• /
• 2016

Objectives: The objective of this study was to evaluate the distribution of blood lead concentrations of residents in the areas surrounding an industrial complex. Methods: During the three-month period from August to October 2012, informed consent was obtained from a total of 417 residents in Gwangyang and Yeosu. We collected blood samples from all subjects, and their demographic characteristics were acquired using a questionnaire. The blood samples were analyzed using an atomic absorption spectrometer and data analysis was conducted using IBM SPSS version 21.0. Results: The geometric mean concentration of blood lead in all subjects was $1.85{\mu}g/dL$. The highest (p<0.01) blood lead concentrations were in the current drinking group ($2.24{\mu}g/dL$). Blood lead concentrations in the smoking group ($0.59{\mu}g/dL$) were significantly (p<0.05) higher than those in the non-smoking group ($0.24{\mu}g/dL$). Risk assessment was performe using the Korean National Environmental Health Survey (KNEHS) as a reference. The hazard indices of blood lead in males and females were 0.65 and 0.52, respectively Conclusion: We provided baseline data for reference values of toxicity and heavy lead concentrations. Our results might be useful for further evaluation of risks due to exposure to heavy metals via oral, air, and percutaneous routes.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권8호
• /
• pp.4013-4016
• /
• 2012

Purpose: Breast cancer is the commonest malignancy of females throughout the world with one million new cases each year. In Pakistan, the burden of breast cancer disease is high with late stage presentation being a common feature, more than half being stage III or stage IV. The objective of this study was to study various aspects, patterns and risk factors in breast cancer patients of Balochistan. Method: Present study was performed on 134 patients of breast cancer who were registered in CENAR. The patients were interviewed by providing a questionnaire. Informed consent was taken from all the patients who took part in this study after explanation of the study aims. Body mass index (BMI) was calculated andbiopsy reports were obtained from patients files. All the cases were classified with respect to age, gender, ethnic group (Baloch, Pashtoon, Punjabi, Afghani, Hazara) BMI, cancer type, cancer grade, hormonal status, side of the cancer, fertility and marital status. Results: Out of 134 patients, the most common ethnic group was Pashtoon with a total of 42 and the common age group was 41-50 years with a total of 51. Invasive ductal carcinoma (IDC) was the most common type, accounting for in 128 patients (95.5%) followed by invasive lobular carcinoma (ILC). Conclusion: Pashtoon was the most common ethnic group, IDC was common type and most of the patients had an ER/PR positive hormonal status.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권1호
• /
• pp.139-144
• /
• 2015

Background: The work force in industries are at risk of developing unduly high rates of health and behaviour related problems including abuse of alcohol, betel nut and cigarette (alcohol, betel nut and cigarette consumption). This study describes the relationships between alcohol, betel nut and cigarette consumption and health promoting behaviour among industrial workers. Materials and Methods: A cross sectional survey was conducted on workers in various industries of Ghaziabad city with concerned authority permission. A sample size of 732 workers was calculated based on pilot study. Through Simple random sampling 732 workers in 20 to 50 years age group with informed consent were interviewed through structured, pretested, validated questionnaire in vernacular language by one calibrated investigator. Data on socio demography, alcohol, betel nut and cigarette consumption pattern and health behaviour were collected. The association between health promoting behaviour and alcohol, betel nut and cigarette consumption was analysed by Logistic regression and Chi-square test through SPSS 16 at p<0.05 and 95%CI as significant. Results: Total prevalence of alcohol, betel nut and cigarette consumption in study population was 88%. The prevalence of individual alcohol, betel nut and cigarette consumption were 82%, 68% and 79% respectively. Combined alcohol, betel nut and cigarette prevalence in study population was 58%. Alcohol and cigarette users were significantly higher (p<0.001) in 30 to 40 years age group with lower level of education having poor attitude towards health promoting behaviour, poor oral hygiene practices and rare indulgence in regular physical exercise. Conclusions: This study stimulate further research on exploring methods to prevent initiation of health risk behaviour and promote healthy behaviour with cessation help for the current alcohol, betel nut and cigarette users.

• Journal of Korean Neurosurgical Society
• /
• 제29권12호
• /
• pp.1620-1627
• /
• 2000

Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권14호
• /
• pp.5781-5785
• /
• 2014

Background: As in other developing countries, cervical cancer is the most frequent gynecologic malignancy in Indonesia. Persistent high risk genotypes of human papillomavirus (HPV) that infect the cervical tissue have been established as the etiology of cervical cancer. This study aimed to explore the profile of cervical cancer patients and the infected HPV genotypes at Dr. Hasan Sadikin General Hospital-Bandung. Materials and Methods: During the year 2010, 554 cervical cancer patients were registered. In a subset of the patients during July - November 2010, 40 randomized fresh biopsies were tested for HPV genotype after obtained informed consent. The distribution of HPV genotypes and the association to risk factors were analysed. Results: The result showed that 62.5% of the tested biopsies were infected by multiple HPV infections, with HPV-16 found in most of the cervical cancer patients (90%). Marriage at age younger than 16 years old was statistically significant in relation to multiple HPV infection (p=0.003), but not parity more than three times (p=0.59). Conclusions: Although high paritiy in our study was not associated with multiple HPV infection, good family planning programs and reproductive health education need to be emphasized in Indonesia as high parity and marriage at young age might increase the chance of cervical cancer development.

• Tuberculosis and Respiratory Diseases
• /
• 제71권1호
• /
• pp.37-45
• /
• 2011

Background: Pulmonary emphysema (PE) is major cause of obstructive pulmonary function impairment (OPFI), which is diagnosed by spirometry. PE by high resolution CT is known to be correlated with OPFI. Recently, low dose CT (LDCT) has been increasingly used for screening interstitial lung diseases including PE. The aim of this study was to evaluate OPFI risks of subjects with PE detected by LDCT compared with those detected by simple digital radiography (SDR). Methods: LDCT and spirometry were administered to 266 inorganic dust exposed retired workers, from May 30, 2007 to August 31, 2008. This study was approved by our institutional review board and informed consent was obtained. OPFI risk was defined as less than 0.7 of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), and relative risk (RR) of OPFI of PE was calculated by multiple logistic regression analysis. Results: Of the 266 subjects, PE was found in 28 subjects (10.5%) by LDCT and in 11 subjects (4.1%) by SDR; agreement was relatively low (kappa value=0.32, p<0.001). FEV1 and FEV1/FVC were significantly different between PE and no PE groups determined by either SDR or LDCT. The differences between groups were larger when the groups were divided by the findings of SDR. When PE was present in either LDCT or SDR assays, the RRs of OPFI were 2.34 and 8.65, respectively. Conclusion: LDCT showed significantly higher sensitivity than SDR for detecting PE, especially low grade PE, in which pulmonary function is not affected. As a result, the OPFI risks in the PE group by LDCT was lower than that in the PE group by SDR.

• International Journal of Oral Biology
• /
• 제46권1호
• /
• pp.60-65
• /
• 2021

Dental health care workers (DHCW) are at a risk of occupational exposure to Helicobacter pylori from the aerosolized oral biofilms and saliva of patients. We designed this study to investigate the prevalence of H. pylori in the oral biofilms of a group of dental and non-dental undergraduates from Sri Lanka. After obtaining informed consent, oral biofilms were collected from 38 dental undergraduates (19 males and 19 females) undergoing clinical training and 33 non-dental undergraduates (14 males and 19 females). The participants were in the age range of 22-27 years and had healthy periodontium. Total DNA from the oral biofilms were extracted, and H. pylori DNA was detected using polymerase chain reaction (PCR) amplification of 16S rRNA gene of H. pylori using JW22-JW23 primers, and the results were confirmed using PCR amplification of H. pylori-urease specific HPU1-HPU2 primers. Out of 71 participants, 11 (28.95%) dental and 3 (9.09%) non-dental undergraduates had H. pylori in their oral biofilms indicating an overall prevalence rate of 19.72% (14/71). Thus, the prevalence of H. pylori in oral biofilms was significantly higher in dental undergraduates than in non-dental undergraduates (p < 0.05). An odds ratio of 4.07 indicated that dental undergraduates were four times more likely to harbor H. pylori in their oral biofilms than non-dental undergraduates. Foregoing data support the fact that there may be greater occupational risk of exposure to H. pylori for dental undergraduates during clinical training than that for non-dental undergraduates, warranting meticulous infection control practices during clinical dentistry.

• 한국운동역학회지
• /
• 제24권1호
• /
• pp.59-66
• /
• 2014

The purpose of this study was to investigate the effects of knee joint muscle fatigue and overweight on shock absorption during single-leg landing of adult women. Written informed consent forms, which were approved by the human subject research and review committee at Dong-A University, were provided to all subjects. The subjects who participated in this study were divided into 2 groups: a normal weight group and an overweight group, consisting of 15 young women each. Both the normal weight group and the overweight group showed that use soft landing and ankle dominant strategy. The peak vertical ground reaction force, the knee joint absorption power, and eccentric work done, as the increase of knee joint muscle fatigue level, showed a decrease. And the hip joint absorption power and eccentric work done, as the increase of weight, was less than the overweight group showed the normal weight group. In conclusion, the accumulation of the knee joint muscle fatigue and the increase of body weight may lead to an increased risk of injury during landing.

• 대한물리의학회지
• /
• 제5권4호
• /
• pp.543-549
• /
• 2010

Purpose : The study was designed to investigate the changes of plantar foot pressure by different loads during walking in flatfoot. Methods : Fifteen subjects with flatfoot were recruited along with their written informed consent. They were asked to walk on plate at a self-selected and comfortable speed with loads of 0, 5, 10, and 15kg. Three walking trials were obtained and then averaged for data analysis. Foot pressure were measured from RS-Scan system (RS-Scan system, RS scan Ltd., German) and contact area, maximum force were analyzed. Results : There were significant increases on midfoot and decreases on forefoot in contact area. And there were significant increases in maximum force of foot pressure of 2nd metatarsal bone and midfoot. Conclusion : These findings revealed that flatfoot increases risk factors of metatarsal bone with different loads. Therefore, patients of flatfoot must be careful during walking with loads or activities of daily living.