• 제목/요약/키워드: risk-targeted

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Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases

  • Meng, Lu;Wolff, Marilyn B.;Mattick, Kelly A.;DeJoy, David M.;Wilson, Mark G.;Smith, Matthew Lee
    • Safety and Health at Work
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    • 제8권2호
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    • pp.117-129
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    • 2017
  • Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

산업장 건강증진 프로그램 개발에 관한 연구 -건강행위의 변화의도 예측요인 및 대상의 유형 분류를 중심으로- (Planning Health Promotion Program in Workplace)

  • 전경자;김화중
    • 지역사회간호학회지
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    • 제5권1호
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    • pp.5-29
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    • 1994
  • In recent years, interests in health promotion have been stimulated by the epidemiological transition from infectious to chronic diseases as lead ing causes of death, the aging of the population, rapidly escalating health care costs, and epidemiologic findings linking individual risk to morbidity and mortality. It is not surprising that the workplace has been targeted as a promising setting for health promotion. In Korea, national attention to the opportunities for workplace health promotion began in the first 1990s. But there is no in depth study to identify the relating factors to the health promotion program in the workplace. The objective of this study is behavioral and physical characteristics to find that in crease the person's risk for a range of health problems and to analysis other characteristics to influence the degree of his/her intention to change health behavior. In addition, this study is purposed to present the process of planning health promotion program in the workplace. To accomplish these objectives, one workplaces was selected. And 363 employees in those workplaces were served as subjects for the study. Major findings in this study are as follows. (1) They have many risk factors such as smoking, drinking, lack of sleep, law rate of regular exercise, irregular eating, stress. (2) Some of the health risk factors such as smoking, drinking, and stress have the negative correlation to the intention to change. (3) Among cognitive and socio-environmental factors, significant predictors to the intention are attitude and social support. (4) In the cluster analysis to segment the target population in to homogeneous unit, three clusters of lifestyle are specified. (5) Smoking cessation and exercise program are planned for the risk group to change their behavior.

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한국 성인의 식습관-암과 관련된 영양 지식, 믿음, 태도에 관한 연구 (Diet-Cancer Related Nutrition Knowledge, Beliefs, and Attitudes of Korean Adults)

  • 진영희
    • 한국식생활문화학회지
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    • 제15권2호
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    • pp.111-121
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    • 2000
  • This study was to investigate the nutrition and cancer prevention knowledge, beliefs, attitudes, and self-reported dietary changes. Data were collected from 903 parents whose children were attending an elementary school, a middle school, a high school, or a junior college in Kimcheon. Thirty-seven percent of the subjects reported that they had made dietary changes for their health. Respondents reported eating more vegetables(33.1%), fruit(24.1%), whole grains(19.9%), and lower-fat meats(14.5%) and less alcohol(17.2%), high-fat meat(16.4%), fats(13.8%), smoked foods(13.8%), snacks/cake/sweets(11.7%), salty foods(9.6%), and refined grain products(6.1%). Those who did not make any dietary changes most often said the reason was that they thought their diets were already healthful and therefore there was no reason to make a change. Eighty-nine percent of the subjects agreed that diet and disease were related and 89.5% knew that diet and cancer were related, yet 8% believed there was nothing a person could do to reduce the risk of getting cancer. In response to open-ended questions about foods that either increase or decrease cancer risk, vegetables, fruit, traditional fermented foods, etceteras, and whole grains were thought to decrease risk, and burned foods, salty foods, additives, high-fat meats/fats, and alcohol were thought to increase cancer risk. In this study, education levels to be the major demographic variable and residential district had an impact on cancer prevention knowledge and attitudes. People at lower educational levels and rural residents should be targeted for education about cancer risk reduction.

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기계적 혈전제거술을 시행한 허혈성 뇌졸중 환자의 뇌재관류 손상 위험요인과 임상결과 (Risk Factors and Clinical Outcomes of Brain Reperfusion Injury after Mechanical Thrombectomy for Ischemic Stroke)

  • 문지현;최혜란
    • Journal of Korean Biological Nursing Science
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    • 제23권3호
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    • pp.217-226
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    • 2021
  • Purpose: The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. Methods: A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and logistic regression with IBM SPSS/WIN 24.0. Results: Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome (𝛘2=6.01, p=.014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR]=1.14, 95% Confidence interval [CI]=1.06-1.23), aphasia (OR=6.16, CI=1.62-23.40), anosognosia (OR=4.84, CI=1.13-20.79), presence of both aphasia and anosognosia (OR=7.33, CI=1.20-44.60), and time required to achieve targeted blood pressure (OR=1.00, CI=1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation (𝛘2=6.32, p=.012), intensive care unit length of stay (Z=-2.08, p=.038), National Institute of Health Stroke scale score at discharge (Z=-3.14, p=.002), and modified Rankin Scale score at discharge (Z=-2.93, p=.003). Conclusion: This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.

Screening for Patients with Non-small Cell Lung Cancer Who Could Survive Long Term Chemotherapy

  • Wu, Xue-Yan;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.647-652
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    • 2015
  • Background: Lung cancer was one of the most common cancers in both men and women all over the world. In this study, we aimed to clarify who could survive after long term chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods: We enrolled 186 patients with stage IV NSCLC after long term chemotherapy from Jun 2006 to Nov 2014 diagnosed in Jiangsu Cancer Hospital. Multiple variables like age, gender, smoking, histology of adenocarcinoma and squamous-cell cancer, number of metastatic sites, metastatic sites (e.g. lung, brain, bone, liver and pleura), hemoglobin, lymphocyte rate (LYR), Change of LYR during multiple therapies, hypertension, diabetes, chronic bronchitis, treatments (e.g.radiotherapy and targeted therapy) were selected. For consideration of factors influencing survival and response for patients with advanced NSCLC, logistic regression analysis and Cox regression analysis were used in an attempt to develop a screening module for patients with elevated survival after long term chemotherapy become possible. Results: Of the total of 186 patients enrolled, 69 survived less than 1 year (short-term group), 45 one to two years, and 72 longer than 3 years (long-term group). For logistic regression analysis, the short-term group was taken as control group and the long-term group as the case group. We found that age, histology of adenocarcinoma, metastatic site (e.g. lung and liver), treatments (e.g. targeted therapy and radiotherapy), LYR, a decreasing tendency of LYR and chronic bronchitis were individually associated with overall survival by Cox regression analysis. A multivariable Cox regression model showed that metastatic site (e.g. lung and liver), histology of adenocarcinoma, treatments (e.g. targeted therapy and radiotherapy) and chronic bronchitis were associated with overall survival. Thus metastatic site (e.g. lung and liver) and chronic bronchitis may be important risk factors for patients with advanced NSCLC. Gender, metastatic site (e.g. lung and liver), LYR and the decreasing tendency of LYR were significantly associated with long-term survival in the individual-variable logistic regression model (P<0.05). On multivariate logistic regression analysis, gender, metastatic site (e.g. lung and liver) and the decreasing tendency of LYR associated with long-term survival. Conclusions: In conclusion, female patients with stage IV adenocarcinoma of NSCLC who had decreasing tendency of LYR during the course therapy and had accepted multiple therapies e.g. more than third-line chemotherapy, radiotherapy and/or targeted therapy might be expected to live longer.

초음파검사로 진단된 갑상선결절의 융복합 위험요인 (Convergence Risk Factors for Thyroid Nodules Diagnosed Ultrasound)

  • 이혜남;박연화
    • 디지털융복합연구
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    • 제14권1호
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    • pp.305-310
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    • 2016
  • 최근 초음파검사의 접근이 일반화되면서 한국에서는 갑상선암발생율의 연간변화율이 24.5%로 상승하였다. 이에 고식적 갑상선암의 위험요인인 전리방사선과 요오드식이 이외의 갑상선암의 위험요인을 파악하고자 하였다. 2011년 1월부터 2013년 3월까지 종합검진센타에서 초음파검사 후 미세침흡인검사로 진단된 양성결절 260명과 악성 결절 151명의 여자를 대상으로 나이, 혈액학적 수치, 비만지수, 허리둘레, 폐경여부, 유방결절 유무, 자근근종 유무, 지방간 유무를 비교하였다. 연구 결과 갑상선암 그룹에서 비만인 경우, 유방의 결절과 자궁근종이 있는 경우가 많았으며 갑상선자극호르몬 수치가 양성결절그룹보다 높게 나타났다. 향후 갑상선 및 갑상선암에 영향을 끼치는 요인들을 정립시키기 위한 연구가 지속적으로 필요할 것이다.

영산강 유역 간흡충 고위험군의 감염실태 및 관련요인에 관한 연구 (Prevalence and Related Factors for Clornorchiasis in a High Risk Population in the Yeongsan River Area)

  • 정희영;김은숙;김혜원;김미리;박은숙;정인숙;서옥경;김향자;홍영옥;김필숙;김현자
    • 한국농촌간호학회지
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    • 제4권1호
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    • pp.22-30
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    • 2009
  • Purpose: The purpose of this study was to explore the prevalence of Clornorchiasis and related factors, targeting inhabitants living in a 5 Km area of the Yeongsan River and to identify knowledge related to Clornorchiasis and intended behavioral changes related to risk of infection. Method: The data were collected from December 16, 2008 to January 10, 2009. A total of 553 questionnaires were distributed, 28 were deleted as answers were not complete, resulting in 525 copies being used for data analysis, which was done using frequency, percentage, $x^2$-test, and t-test with the SPSS 12.0 program. Results: Clornorchiasis was found in 25 persons of the 525 (4.8%). As for knowledge on Clornorchiasis, the Clornorchiasis group had a higher mean score of 10.08 $({\pm}4.96)$, of a possible 17, than the negative group score of 9.42 $({\pm}4.81)$, but, the difference was not statistically significant. The intended behavioral change related to risk of infection, according to presence of infection or not, was statistically significant. Conclusion: Effective management of Clornorchiasis demands management targeted at the inhabitants living in all of the risk areas without any distinction according to sex, areas, live food diet or not, nor liquor consumption or not.

Disaster Health Literacy of Middle-aged Women

  • Seifi, Bahar;Ghanizadeh, Ghader;Seyedin, Hesam
    • Journal of Menopausal Medicine
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    • 제24권3호
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    • pp.150-154
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    • 2018
  • As disasters have been increasing in recent years, disaster health literacy is gaining more important for a population such as middle-age women. This is because they face developmental crises (menopause) and situational crisis (disaster). Due to the growing elderly population, it is imperative to seriously consider the issue of aging women's healthcare, and their educational needs relative to emergencies and disasters. The purpose of study was to clarify the importance of disaster health literacy for middle-age women. This study is a review of the literature using PubMed, ScienceDirect, Web of Science, Google Scholar, SCOPUS, OVID, ProQuest, Springer, and Wiley. Data was collected with keywords related to the research topic ("Women's health" OR "Geriatric health") AND ("Health literacy" OR "Disaster health literacy" OR "Disaster prevention literacy" OR "Risk knowledge" OR "Knowledge management") AND ("Disasters" OR "Risk" OR "Crises") in combination with the Boolean-operators OR and AND. We reviewed full text English-language articles published November 2011 November 2017. Additional references were identified from reference lists in targeted publications, review articles and books. This review demonstrated that disaster health literacy is critical for elderly women, because they may suffer from physical and psychological problems triggered by developmental crises such as menopause and situational crises such as disasters. Disaster literacy could enable them to improve resiliency and reduce disaster risk. Education has vital role in health promotion of middle-age women. Policymakers and health managers should be aware of the challenges of elderly women as a vulnerable group in disasters and develop plans to incorporate disaster health literacy for preparedness and prevention in educating this group.

국가별 건강보험체계에 따른 국가건강검진제도 비교 연구 (Comparative Study on the National Health Screening Programs according to the Health Insurance System)

  • 이예지;김은영;이동현
    • 보건행정학회지
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    • 제31권3호
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    • pp.272-279
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    • 2021
  • Background: Korea's health screening program has been faced the need for changes as the population and diseases structure are changing. In addition to Korea, many countries operate state-led health check-up programs to improve the health level of the people, and the operating methods of the program appear in various forms according to each country's health insurance system. This study examines other state-led health screening programs and proposes a direction for the development of Korea's health screening program. Methods: The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The operating method of the health screening programs and the financial resources were compared according to the health insurance system. Five countries were selected as Korea, the United States, the United Kingdom, Japan, and Taiwan. Results: The analyzed countries mainly operate the health screening program as a management method for chronic diseases, but there were differences in the operating method, financing, and targeted subjects and examination items. In most countries, a risk assessment was performed prior to the examination (screening), and the subjects who needed the examination were first selected, and a follow-up management service was provided in accordance with the risk each individual exposed. Conclusion: Rather than applying the same screening method to populations with different risk levels, a health screening program will be constructed in consideration of the individual's health level and exposure risk, and the healthcare delivery system will be reorganized so that screening and treatment services can be linked.

Relationship of Blood Metabolites with Reproductive Parameters during Various Seasons in Murrah Buffaloes

  • Khan, H.M.;Mohanty, T.K.;Bhakat, M.;Raina, V.S.;Gupta, A.K.
    • Asian-Australasian Journal of Animal Sciences
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    • 제24권9호
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    • pp.1192-1198
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    • 2011
  • Peri-partum metabolic profile was evaluated in winter and summer calving, with 15 Murrah buffaloes in each seasonal group. In summer calvers, significantly lower values were observed for blood plasma urea nitrogen (BUN) at day 30 pre-partum (p<0.05), on calving day (p<0.05) and at all other stages (p<0.01); plasma non-esterified fatty acids (NEFA) values were significantly lower on day 30 pre-partum (p<0.01) and on day 60 post-partum (p<0.05). This was associated with significant reduction in days to first service (DFS) and service per conception (SPC) and an overall better reproductive performance in terms of service period, risk to first service on days 60, 90 and >90, and pregnancy risk to first service up to days 60 and 90. This may be attributed to better pre-partum nutritional status. Cervical and uterine involution were completed in fewer days, involutional changes took place at a faster pace and there were a lower number of abnormal involutional changes in winter compared to summer season. This may be attributed to better post-partum nutrition and less environmental stress. However, validation requires further targeted cohort investigation with a large sample size.