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Impact of public releasing of hospitals' performance on acute myocardial infarction outcomes (병원의 급성심근경색증 진료 결과 공개의 효과)

  • Eun, Sang Jun;Kim, Yoon;Lee, Eun Jung;Jang, Won Mo
    • Quality Improvement in Health Care
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    • v.17 no.1
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    • pp.69-78
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    • 2011
  • Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

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Perception of Breast Health amongst Malaysian Female Adolescents

  • Che, Chong Chin;Coomarasamy, Jeya Devi;Suppayah, Balakrishnan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7175-7180
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    • 2014
  • Background: Breast cancer is the most common cancer among women in Malaysia, about one in 19 women being at risk. This study aimed to investigate knowledge and practice of breast self-examination (BSE), as well as knowledge of risk factors for breast cancer amongst female adolescents in Malaysia. Subsequently, relationships between demographic characteristics and knowledge level of BSE, risk factors for breast cancer and BSE practice were assessed. Materials and Methods: A descriptive, cross sectional survey was conducted using a sample of 500 Malaysian adolescents from the age of 15 to 19 years. A self-administered questionnaire was used to gather socio-demographic characteristics, knowledge of BSE, knowledge of risk factors for breast cancer and BSE practices. Results: The findings of this study indicated that female adolescents in Malaysia demonstrated an inadequate knowledge level of BSE and risk factors for breast cancer. Only 27.8% of female adolescents performed BSE regularly. BSE practice, knowledge of BSE and knowledge of risk factors for breast cancer showed significant positive relationships. Conclusions: The study highlighted the importance of planning and implementing breast health education programs for female students in secondary schools in Malaysia. It will also provide the health care providers an avenue to stress on the importance of imparting breast health education to adolescents.

Non-chemical Risk Assessment for Lifting and Low Back Pain Based on Bayesian Threshold Models

  • Pandalai, Sudha P.;Wheeler, Matthew W.;Lu, Ming-Lun
    • Safety and Health at Work
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    • v.8 no.2
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    • pp.206-211
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    • 2017
  • Background: Self-reported low back pain (LBP) has been evaluated in relation to material handling lifting tasks, but little research has focused on relating quantifiable stressors to LBP at the individual level. The National Institute for Occupational Safety and Health (NIOSH) Composite Lifting Index (CLI) has been used to quantify stressors for lifting tasks. A chemical exposure can be readily used as an exposure metric or stressor for chemical risk assessment (RA). Defining and quantifying lifting nonchemical stressors and related adverse responses is more difficult. Stressor-response models appropriate for CLI and LBP associations do not easily fit in common chemical RA modeling techniques (e.g., Benchmark Dose methods), so different approaches were tried. Methods: This work used prospective data from 138 manufacturing workers to consider the linkage of the occupational stressor of material lifting to LBP. The final model used a Bayesian random threshold approach to estimate the probability of an increase in LBP as a threshold step function. Results: Using maximal and mean CLI values, a significant increase in the probability of LBP for values above 1.5 was found. Conclusion: A risk of LBP associated with CLI values > 1.5 existed in this worker population. The relevance for other populations requires further study.

Prevalence Rates and Risk Factors of Non-Insulin-Dependent Diabetes Mellitus in Minorities in the United States

  • Sohn, Ae-Ree
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.97-114
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    • 2000
  • Minority populations in the United States have a higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and more persons die of the disease than white persons. This study was to review and compare risk factors and prevalence rates of NIDDM in African Americans, Hispanic s, Korean Americans and Native Americans in the United States. The risk factors of NIDDM, including family history of diabetes, obesity, physical inactivity, diet and age, were reviewed in the minority populations. Risk factors such as obesity, physical inactivity and family history of diabetes occurred to a greater extent in some minority populations than in the white population. Diabetes should be treated as a public health problem for minority populations. Due to the increase of older populations and the increased prevalence of obesity and sedentariness, NIDDM in minorities is nearing epidemic proportions. Good diet and regular exercise can reduce the incidence of NIDDM but an understanding of the cultural aspects of diabetes is imperative in order to provide adequate community health education programs because those programs involve diet and behavior changes, characteristics that are often culturally determined. In summary, it is important to plan a community health education program targeted on NIDDM in a culturally adapted manner that will be received with both comprehension and acceptability. In particular, the program for high-risk populations should be stressed so to prevent diabetes. Preventive approaches to diabetes should be considered because they can be both therapeutic and cost effective.

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Cardiovascular Disease Risk according to Socioeconomic Factors among Low-income Midlife Women (사회경제적 요인에 따른 지역사회 저소득층 중년여성의 심혈관질환 위험요인 차이)

  • Ham, Ok-Kyung;Kim, Bong-Jung;Lee, Young-Ah
    • Journal of Korean Public Health Nursing
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    • v.22 no.1
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    • pp.27-38
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    • 2008
  • Purpose: To determine the degree of cardiovascular disease risk according to socioeconomic factors among midlife women in the community and thereby provide baseline data for the development of health promotion programs. Method: A total of 200 women participated in health screenings and a health survey. The survey was performed in November and December, 2006. The survey instruments included socioeconomic factors, health behavior (smoking and exercise), and family history. Biophysical measurement included BMI and blood pressure. Blood samples were drawn for glucose and total cholesterol tests. Results: The mean age was 52.5 years, 34.0% had received education less than 6 years, 70.0% earned a monthly income of less than \1,500,000, and 61.5% were homemakers. Cardiovascular disease risk was significantly different by age (BMI, systolic BP, and exercise), education (systolic BP), monthly income (T. cholesterol), marital status (smoking), and occupation (exercise). Most women had 2 or 3 cardiovascular disease risks. Older age, lower education, and lower income were significantly associated with increased cardiovascular disease risk. Conclusion: Efforts should be made to decrease the number and severity of cardiovascular disease risk factors for midlife women in the community by developing health promotion programs targeting to modify their cardiovascular disease risk factors.

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Factors Associated with Unplanned Hospital Readmission (서울시 소재 한 대학병원 퇴원환자의 재입원 관련요인)

  • Lee, Eun-Whan;Yu, Seung-Hum;Lee, Hae-Jong;Kim, Suk-Il
    • Korea Journal of Hospital Management
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    • v.15 no.4
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    • pp.125-142
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    • 2010
  • Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

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The Relationship between Metabolic Syndrome and Korean Cardiocerebrovascular Risk Assessment: for Male Researchers in a Workplace (대사증후군과 뇌심혈관질환 발병위험도 평가와의 연관성: 일개 사업장 남성 근로자를 대상으로)

  • Yoon, Jong-Wan;Yi, Kyung-Jin;Lee, Sang-Yun;Oh, Jang-Gyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.5
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    • pp.397-403
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    • 2007
  • Objectives: The prevalence of metabolic syndrome has recently increased, Payments from the Korea Labor Welfare Corporation for compensation for mortality in workers caused by cardiovascular and cerebrovascular diseases have also increased in Korea in recent years. The association of metabolic syndrome and cardiocerebrovascular disease has been investigated by several researchers in recent studies, This study was conducted in an attempt to characterize the relationship between metabolic syndrome and Korean cardiocerebrovascular disease risk assessment, and to provide basic data to group health practices for the prevention of cardiocerebrovascular disease. Methods: Health examinations were previously conducted for 1526 male researchers at a private laboratory. The prevalence by age and the odds ratio of metabolic syndrome scores into the "cardiocerebrovascular risk group" (sum of low, intermediate, and high risk groups) of the Korean cardiocerebrovascular disease risk assessment were assessed, in an effort to elucidate the associations between metabolic syndrome and cardiocere brovascular disease risk assessment. Results: The prevalence of metabolic syndrome and inclusion in the cardiocerebrovascular risk group was 11,7% and 22.1% respectively. The severity of metabolic syndrome and cardiocerebrovascular risk assessment showed that individuals in their 40's and 50's were at higher risk than those in their 30's (p<0,001). The age-adjusted odds ratio of metabolic syndrome to cardiocere brovascular risk group inclusion was 5.6. Conclusions: An active prevention program for cardiocerebrovascular disease needs to begin in the 40's, as the prevalence of metabolic syndrome and the risk group of cardiocerebrovascular risk assessment peak in the 40's age group. The odds ratio between metabolic syndrome and the cardiocerebrovascular risk group was high, which indicates that metabolic syndrome scores should be utilized as guidelines during the consultation and behavioral modification program for the workplace prevention of cardiocerebrovascular diseases in group health practices.

Comparative Study on the Institutional Framework of Risk Assessment between German, UK and Korea, Japan in Asian Countries (독일, 영국과 한국, 일본 등 아시아 국가 간의 위험성평가 제도 비교연구)

  • Shin, In Jae
    • Journal of the Korean Society of Safety
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    • v.28 no.1
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    • pp.151-157
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    • 2013
  • This paper is a comparative study on risk assessment policy between Asian countries such as Japan, Korea, Singapore and EU countries, German, UK. Risk assessment is a tool adopted currently in many countries in order to reduce occupational risk in workplace because it help employers to identify their hazard arousing in their working conditions then to settle the issues. This paper compares institutional framework posed in EU and Asian countries. As a result of comparative study, EU countries have more concrete legal system for risk assessment than Asian countries. But Asian countries are now interested in risk assessment such as Japan, Korea and Singapore. The author also suggests successful ways to settle down the risk assessment policy in a country. These findings help to understand occupational health and safety policy on risk assessment in Asian countries.

The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women (여자노인의 영양상태 평가 및 건강관리를 위한 Nutritional Risk Index (NRI) 비교 분석)

  • Yang, Eun-Ju
    • Journal of Nutrition and Health
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    • v.42 no.3
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    • pp.234-245
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    • 2009
  • Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

Awareness of Ovarian Cancer Risk Factors among Women in Malaysia: A Preliminary Study

  • Keng, Soon Lean;Wahab, Syakirah Bainun Abdul;Chiu, Lim Bee;Yusuf, Azlina
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.537-540
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    • 2015
  • Background: Ovarian cancer is recognized as the fourth leading cancer in Malaysia. However, women do not always seek help in a timely manner and gaps in awareness may influence screening uptake and presentation. The purpose of this study was to determine levels of awareness of ovarian cancer risk factors in female population in Penang, Malaysia. Materials and Methods: A cross-sectional study was conducted in Penang, Malaysia from January until February 2014. Eighty-seven women were selected by convenient sampling. Awareness of risk factors of ovarian cancer was assessed using a self-administered questionnaire. Data were analyzed using statistical package for the social sciences (SPSS) version 20.0 for descriptive statistics and Pearson chi-square test for the association between socio-demographic data and awareness. A p value ${\leq}0.05$ was considered statistically significant. Results: In all, 74.7% of participants answered correctly for the risk factor of increasing age, although 94.3% were unaware of increased risk of tall women. A majority, 71.3%, had a low level of awareness of ovarian cancer risk factors. There was a significant association between age and knowledge (p=0.047). Additionally, there was a significant association between higher education level and level of awareness of ovarian cancer risk factors (p=0.039). Conclusions: This study revealed that awareness of ovarian cancer risk factors among Malaysian women is low. The results show a need for improved public understanding about ovarian cancer risks and provision of important information for health professionals about initiatives needed for future awareness, prevention and screening programs.