• Title/Summary/Keyword: Noncommunicable disease

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Noncommunicable Diseases: Current Status of Major Modifiable Risk Factors in Korea

  • Kim, Hyeon Chang;Oh, Sun Min
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.4
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    • pp.165-172
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    • 2013
  • A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.

Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma

  • Rolfes, Mary Claire;Juhn, Young Jun;Wi, Chung-Il;Sheen, Youn Ho
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.113-135
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    • 2017
  • Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.

Burden of Noncommunicable Diseases and National Strategies to Control Them in Korea

  • Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.4
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    • pp.155-164
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    • 2013
  • Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.

Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome

  • Lee, Hye Ah;Park, Hyesook
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.4
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    • pp.173-182
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    • 2013
  • Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

Comparison of the Performance of Log-logistic Regression and Artificial Neural Networks for Predicting Breast Cancer Relapse

  • Faradmal, Javad;Soltanian, Ali Reza;Roshanaei, Ghodratollah;Khodabakhshi, Reza;Kasaeian, Amir
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5883-5888
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    • 2014
  • Background: Breast cancer is the most common cancers in female populations. The exact cause is not known, but is most likely to be a combination of genetic and environmental factors. Log-logistic model (LLM) is applied as a statistical method for predicting survival and it influencing factors. In recent decades, artificial neural network (ANN) models have been increasingly applied to predict survival data. The present research was conducted to compare log-logistic regression and artificial neural network models in prediction of breast cancer (BC) survival. Materials and Methods: A historical cohort study was established with 104 patients suffering from BC from 1997 to 2005. To compare the ANN and LLM in our setting, we used the estimated areas under the receiver-operating characteristic (ROC) curve (AUC) and integrated AUC (iAUC). The data were analyzed using R statistical software. Results: The AUC for the first, second and third years after diagnosis are 0.918, 0.780 and 0.800 in ANN, and 0.834, 0.733 and 0.616 in LLM, respectively. The mean AUC for ANN was statistically higher than that of the LLM (0.845 vs. 0.744). Hence, this study showed a significant difference between the performance in terms of prediction by ANN and LLM. Conclusions: This study demonstrated that the ability of prediction with ANN was higher than with the LLM model. Thus, the use of ANN method for prediction of survival in field of breast cancer is suggested.

Evaluation of Related Risk Factors in Number of Musculoskeletal Disorders Among Carpet Weavers in Iran

  • Karimi, Nasim;Moghimbeigi, Abbas;Motamedzade, Majid;Roshanaei, Ghodratollah
    • Safety and Health at Work
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    • v.7 no.4
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    • pp.322-325
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    • 2016
  • Background: Musculoskeletal disorders (MSDs) are a common problem among carpet weavers. This study was undertaken to introduce affecting personal and occupational factors in developing the number of MSDs among carpet weavers. Methods: A cross-sectional study was performed among 862 weavers in seven towns with regard to workhouse location in urban or rural regions. Data were collected by using questionnaires that contain personal, workplace, and information tools and the modified Nordic MSDs questionnaire. Statistical analysis was performed by applying Poisson and negative binomial mixed models using a full Bayesian hierarchical approach. The deviance information criterion was used for comparison between models and model selection. Results: The majority of weavers (72%) were female and carpet weaving was the main job of 85.2% of workers. The negative binomial mixed model with lowest deviance information criterion was selected as the best model. The criteria showed the convergence of chains. Based on 95% Bayesian credible interval, the main job and weaving type variables statistically affected the number of MSDs, but variables age, sex, weaving comb, work experience, and carpet weaving looms were not significant. Conclusion: According to the results of this study, it can be concluded that occupational factors are associated with the number of MSDs developing among carpet weavers. Thus, using standard tools and decreasing hours of work per day can reduce frequency of MSDs among carpet weavers.

Factors influencing health behavior of residents in Lao People's Democratic Republic: Focusing on mediating effect of health locus of control (라오스 주민의 건강행위에 영향을 미치는 요인: 건강통제위 매개효과를 중심으로)

  • Lee, Mee Sun;Lee, Gun Jeong
    • Journal of Korean Public Health Nursing
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    • v.35 no.2
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    • pp.268-282
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    • 2021
  • Purpose: This study sought to investigate health behavior (HB) and its affecting factors based on Anderson's behavioral model in Lao People's Democratic Republic (PDR). Also, it attempted to identify the mediation of the health locus of control (HLC) between HB and the affecting factors. Methods: Secondary data from 694 people without noncommunicable diseases (NCDs) from a survey conducted by the Ewha Womans and the Laos University were used. The measurements included predisposing, enabling, and needs factors, HLC, HB (current non-smoking, low-risk drinking, physical activity, fruit and vegetable consumption, medical checkup). The mediating effect was analyzed using Baron and Kenny's method and the Sobel test. Results: Predisposing (gender, educational level, ethnic), enabling (social support, item ownership in household) and the needs factors (body mass index) were affecting HB. Internal HLC had a positive influence on HB. The stronger the others and chance HLC, the lower the HB. Chance HLC mediated the relationship between the educational level and HB. Conclusion: There is a need to recognize the importance of chance HLC as a mediator between the educational level and HB. Through this result, high-quality nursing education for the prevention of NCDs should be developed considering the impact of chance HLC.

Survival Analysis of Gastric Cancer Patients with Incomplete Data

  • Moghimbeigi, Abbas;Tapak, Lily;Roshanaei, Ghodaratolla;Mahjub, Hossein
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.259-265
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    • 2014
  • Purpose: Survival analysis of gastric cancer patients requires knowledge about factors that affect survival time. This paper attempted to analyze the survival of patients with incomplete registered data by using imputation methods. Materials and Methods: Three missing data imputation methods, including regression, expectation maximization algorithm, and multiple imputation (MI) using Monte Carlo Markov Chain methods, were applied to the data of cancer patients referred to the cancer institute at Imam Khomeini Hospital in Tehran in 2003 to 2008. The data included demographic variables, survival times, and censored variable of 471 patients with gastric cancer. After using imputation methods to account for missing covariate data, the data were analyzed using a Cox regression model and the results were compared. Results: The mean patient survival time after diagnosis was $49.1{\pm}4.4$ months. In the complete case analysis, which used information from 100 of the 471 patients, very wide and uninformative confidence intervals were obtained for the chemotherapy and surgery hazard ratios (HRs). However, after imputation, the maximum confidence interval widths for the chemotherapy and surgery HRs were 8.470 and 0.806, respectively. The minimum width corresponded with MI. Furthermore, the minimum Bayesian and Akaike information criteria values correlated with MI (-821.236 and -827.866, respectively). Conclusions: Missing value imputation increased the estimate precision and accuracy. In addition, MI yielded better results when compared with the expectation maximization algorithm and regression simple imputation methods.

Development of a Family Nursing Model for Prevention of Cancer and Other Noncommunicable Diseases through an Appreciative Inquiry

  • Jongudomkarn, Darunee;Macduff, Colin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10367-10374
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    • 2015
  • Background: Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. Aim: The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. Materials and Methods: An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Results: Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. Conclusions: The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.

Performances of Prognostic Models in Stratifying Patients with Advanced Gastric Cancer Receiving First-line Chemotherapy: a Validation Study in a Chinese Cohort

  • Xu, Hui;Zhang, Xiaopeng;Wu, Zhijun;Feng, Ying;Zhang, Cheng;Xie, Minmin;Yang, Yahui;Zhang, Yi;Feng, Chong;Ma, Tai
    • Journal of Gastric Cancer
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    • v.21 no.3
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    • pp.268-278
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    • 2021
  • Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease. The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59-0.72), 0.60 (0.54-0.65), and 0.63 (0.56-0.69), respectively. Conclusions: Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.