Periodic Health Assessments Research Articles

Knowledge and Attitude of Patients Attending Primary Health Care (PHC) or Family Medicine Clinics About Periodic Health Assessment.

Background This study assesses the awareness and perceptions of periodic health assessments (PHA) among patients at primary health care (PHC) and family medicine clinics. Despite PHC's importance in preventive health, previous research indicates a significant gap in the public's knowledge and routine practice of PHA, potentially affected by various demographic factors. Materials & methods A cross-sectional approach was employed in Riyadh, Saudi Arabia, with data gathered via self-administered questionnaires from 382 participants. The survey focused on socio-demographic information, knowledge about PHA, and attitudes towards it. Statistical analysis explored the influence of demographic and clinical factors on individuals' knowledge and attitudes. Results Findings showed that 300 (78.5%) participants had engaged in routine medical examinations, displaying substantial knowledge of PHA. Nevertheless, issues like healthcare accessibility and provider availability were identified as the major barriers, affecting 125 (32.7%) and 84 (22%) participants, respectively. The overall attitude towards PHA was positive, especially among individuals with chronic conditions, emphasizing its perceived benefits in health management. Conclusion The research underscores a generally positive attitude and fair knowledge level regarding PHA among the studied population, alongside significant barriers to participation. Targeted interventions that address these barriers and capitalize on the positive attitudes may enhance PHA uptake, promoting better health outcomes. This study contributes to the understanding of public engagement with PHA, offering insights for improving health promotion and disease prevention strategies.

Smart cement‐sensor composite: The evolution of nanomaterial in developing sensor for structural integrity

AbstractThe integration of self‐sensing ability and different functional properties of nanomaterials into construction materials leads to smart and multifunctional cementitious sensor composites. Significant evolution of the Structural Health Monitoring (SHM) has helped to elevate the life span and mitigate damages of the structure. Developing smart cementitious sensor composite with electrical properties as a parent element and embedding it in the structural components have proved to be advantageous in terms of evaluating the damages, monitoring the periodic health and life assessment of the structures. In this review, the copious development processes and various methods of designing smart‐sensing cementitious composites have been scrutinized. This work recapitulates the principle of self‐sensing technique, typical functional fillers, trends of percolation threshold, dispersing material, dispersion technology, and also describes the required sensing ability of the sensors using the conduction theory. Subsequently application of smart cement‐sensors in structural components for SHM is discussed. In addition, this review article provides comprehensive information on the effects of nano materials and their dispersion in the development for smart and multifaceted cementitious sensor composites with enhanced sensitivity parameters and economic benefits that are suitable for future prospects.

The Association of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, and Sun-Protective Behaviors in a Navy Population.

U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention perceptions, benefits, threats, barriers, and sun-protective behavior self-efficacy) and sun-protective behaviors (e.g., wearing long sleeve shirts and using sunscreen and not deliberately exposing skin for a tan) in a Navy population. A cross-sectional, descriptive, correlational design was utilized, and the study approval was obtained by the Naval Medical Center Portsmouth Institutional Review Board. Two-hundred twenty-nine active duty Navy service members aged 18-30 years who presented to primary care for their periodic health assessment completed the Brief Skin Cancer Risk Assessment and the Skin Cancer Survey. Descriptive statistics were utilized to assess service members' perceptions and knowledge regarding skin cancer prevention along with sociodemographic characteristics. The Spearman rank-order correlation and the Mann-Whitney U test were used to assess associations. P-values <.05 were used to determine statistical significance. Skin cancer prevention knowledge was significantly related to sun-protective behavior self-efficacy (r = 0.218, P = .001), benefits (r = 0.271, P ≤ .001), sun protection behaviors (r = 0.152, P = .024), skin cancer risk (r = 0.256, P = .001), current frequency of high-risk sun behavior (r = 0.183, P = .006), past frequency of high-risk sun behavior (r = 0.219, P = .001), sun exposure (U = 4,813.50, P = .005), tanning bed use (U = 3,154.50, P = .031), and training (U = 4,099.50, P = .005). Integrating skin cancer education into primary care visits (i.e., periodic health assessments) may improve Navy service members' modifiable sun-protective attitudes and behaviors and may contribute to lowering future skin cancer rates.

Comparative analysis of the health status of military police officers and firefighters: a cross-sectional study in the State of Paraná, Brazil

ObjectivesTo evaluate the health-condition of military police officers and firefighters. To identify risk factors for not being medically ready for duty.DesignCross-sectional study.SettingData were extracted from medical records during annual periodic...

An exploration of women's sexual and reproductive health following traumatic brain injury.

To develop a gendered understanding of sexual and reproductive health for Australian women following traumatic brain injury. The intersection of socialised normative expectations of sexuality and sexual health, and being a woman with a disability, can lead to inequity and a misconception that a woman with a disability is asexual. An equal weighting concurrent mixed methods design. Twenty women participated in conversational interviews and 49 women completed an online survey. Equal priority was given to both qualitative and quantitative data which were collected concurrently. A separate analysis of data was performed and was later merged. This paper follows the Good Reporting of a Mixed Methods Study guidelines for reporting mixed methods research. Women reported changes in menstruation, reproduction, and sexual activity. Results identified that following traumatic brain injury, routine reproductive, and sexual health screening were neglected. Women revealed a personal reticence to discuss sexual health in a holistic sense and appeared more comfortable discussing reproductive health rather than sex for pleasure. Additionally, they perceived there was a reticence by clinicians to discuss sexual health as part of their rehabilitation. Shifting the focus to be on women's health through periodic comprehensive health assessments is essential to the delivery of holistic health care. These results can inform the provision of sexual health, sexual safety, and sexual assertiveness education and training for women and girls within a rehabilitation framework and would be a way of addressing what women in this study identified as an unmet need. Reproductive and sexual health are important elements of routine comprehensive health screening for women. Nurses are well positioned to begin discussions regarding sexual agency, sexual, and reproductive health to ensure person-centred care.

Probabilistic forecasting informed failure prognostics framework for improved RUL prediction under uncertainty: A transformer case study

The energy transition towards resilient and sustainable power plants requires moving from periodic health assessment to condition-based lifetime planning, which in turn, creates new challenges and opportunities for health estimation and prediction. Probabilistic forecasting models are being widely employed to predict the likely evolution of power grid parameters, such as weather prediction models and probabilistic load forecasting models, that precisely impact on the health state of power and energy components. These models synthesize forecasting knowledge and associated uncertainty information, and their integration within asset management practice would improve lifetime estimation under uncertainty through uncertainty-aware probabilistic predictions. Accordingly, this paper presents a probabilistic prognostics method for lifetime planning under uncertainty integrating data-driven probabilistic forecasting models with expert-knowledge based Bayesian filtering methods. The proposed concepts are applied and validated with power transformers operated in two different power generation systems and obtained results confirm that the proposed probabilistic transformer lifetime estimate aids in the decision-making process with informative lifetime distributions and associated confidence intervals.

Use of electronic cigarettes among U.S. Military service members – prevalence and associated risk factors

Background Decreased physical fitness, loss of vision and hearing, and increased risk of chronic diseases are significant primary and secondary implications associated with the health of U.S. Military Service members who use tobacco, including electronic cigarettes. Despite the medical and non-medical costs to the U.S. Department of Defense and potential adverse health effects to Service members, electronic cigarette use is on the rise. Methods U.S. Military Service members who completed their Periodic Health Assessment, a standardized, electronic, logic-based tool, from July 2018 to July 2019 were eligible. This exploratory study examines the prevalence and significant risk factors associated with self-reported use of electronic cigarettes, as well as determines if tobacco use varies by sex and Service branch, through use of Chi-square analysis and logistic regression. Results U.S. Military Service members 17–70 years old were included in this study (N = 1.12 M), with 80% of study participants being male and 20% female. Exposure to secondhand smoke (OR: 2.12, 95% CI: 2.15–2.22) and screening positive for hazardous drinking (OR: 2.70, 95% CI: 2.64–2.76) were found to show the greatest increase in odds of using electronic cigarettes, with similar findings after stratification by sex and Service branch. Stratification by Service branch revealed further differences in the association between electronic cigarette use and various demographic, military, lifestyle, and health characteristics. Conclusion Electronic cigarette use is increasing across the United States. U.S. Service members have unique risk factors and patterns of tobacco use. Despite tobacco use having potential adverse effects on military readiness, its use remains prevalent in this population. Our findings identify opportunities for the U.S. Department of Defense to review tobacco policy and availability and accessibility of cessation services to promote quitting tobacco, especially electronic cigarettes.

Role of Family Physician in Periodic Health Assessment Screening: A Review

A family physician is considered the first line of healthcare with patients. In the public sector, a medical officer is a generalist with no postgraduate training. The periodic health assessment has its roots at least as far back as the industrial revolution, employers paid for annual medical fitness examinations and tests to assess the state of their workers with intention of keeping their workforce healthy and safe. The technique is now included into the work of primary care physicians and is still practiced across multiple countries but it may be named with a different name such as Periodic health examination (PHE). The PHE allows for the implementation of evidence-based preventative measures, the education of patients on lifestyle issues, the updating of vaccines, and, most importantly, the detection of risk factors and diagnoses by updating the patient's cumulative profile. In low-risk individuals, however, treatment may not be essential every year. There’s serious question about the value of Periodic health assessment/examination. In this article we’ll be reviewing the PHE, its value and the role of family physician in it.

With Equal-Access, Service Members with Lymphoma Have Better Outcomes Than Their Civilian Counterparts

Introduction: The Military Health System (MHS) is a single-payer, equal-access healthcare system that provides healthcare to 1.4 million active-duty service members (ADSMs) from diverse socioeconomic backgrounds. ADSMs with cancer receive prompt care without copayments, deductibles, prior authorizations, or other insurance barriers. Lymphoma is the most common hematologic malignancy diagnosed in ADSMs. We sought to compare overall survival (OS) of ADSMs with lymphoma with matched civilian lymphoma patients. We also sought to identify variables among ADSMs that predicted OS.Methods: The Department of Defense Automated Central Tumor Registry (ACTUR) was retrospectively accessed to identify ADSMs with Hodgkin Lymphoma (HL), diffuse large B-cell lymphoma (DLBCL), and indolent lymphomas over a 20-year span from 1997-2017. A comparator arm was created from the National Cancer Institute's Surveillance, Epidemiology and End-Result (SEER)-18 database and was matched in a 4:1 ratio by age, sex, race, ethnicity, year of diagnosis, and stage. OS was assessed with Cox proportional hazards models. Kaplan Meier curves were constructed and compared using log rank tests. Among ADSMs, univariate and multivariable analyses were performed to assess OS based on race, ethnicity, sex, age at diagnosis, stage, year of diagnosis, rank, branch of service, and geographic region at diagnosis. All data analyses were conducted using STATA/SE 15.1 for Windows; the alpha level for statistical significance was set to 0.05.Results: There were 1,170 ADSMs with HL, 443 with DLBCL, and 284 with indolent lymphomas identified from ACTUR. Most ADSMs were between ages 20-40, white/non-Hispanic, enlisted, and in the Army. All three groups of ADSMs had superior OS when compared with their matched civilian counterparts. There were 49%, 48%, and 35% reductions in the risk of death among ADSMs with DLBCL, indolent lymphoma and Hodgkin lymphoma, respectively (DLBCL hazard ratio [HR] 0.51, 95% CI 0.40-0.65, p<0.0001; indolent HR 0.52, 95% CI 0.33-0.81, p <0.002; HL HR 0.65, 95% CI 0.52-0.82, p <0.002). Among the ADSMs, variables that reached statistical significance in the univariate and/or the multivariable analyses for OS include increasing age (DLBCL, indolent), advanced stage (DLBCL, HL), and geographic residence at diagnosis (DLBCL, HL). Notably, there were no statistically significant differences in OS based on race, ethnicity, sex, rank, or branch of service.Discussion: ADSMs with lymphoma treated within the MHS have significantly better survival than their matched civilian counterparts. Further, disparities based on race/ethnicity and sex are not present in the MHS, despite being pervasive in the civilian sector. It is possible that better access to care within the equal-access MHS might explain our results. Alternatively, regular fitness tests and periodic health assessments may render ADSMs are more fit and less comorbid than their civilian counterparts, translating to a better chance of long-term survival. Although this study is limited by its retrospective design and possible coding inaccuracies, the finding of advanced age and stage impacting OS serves as a good internal control and confirms the quality of ACTUR data. Findings from this study reflect favorably on ADSMs with cancer. The absence of racial/ethnic or gender disparities reflects favorably on cancer care received within the equal-access MHS. [Display omitted] DisclosuresThornton: Undisclosed Companies: Current equity holder in publicly-traded company.

Monoclonal Gammopathy of Ocular Significance (MGOS) - a Series of Corneal Manifestations and Treatment Outcomes

IntroductionMonoclonal gammopathy of ocular significance (MGOS) is a rare subset of monoclonal gammopathy of clinical significance (MGCS) occurring secondary to plasma cell dyscrasia resulting in ocular manifestations. Given the rarity of these conditions, optimal management strategies are not defined; the approach is dependent upon the underlying cause of the monoclonal gammopathy and whether or not the patient's vision is affected. We report our review of 23 cases with MGOS, more specifically on paraproteinemic keratopathy (PPK) the most common form, to obtain a better understanding of the patient characteristics, diagnosis and treatments.MethodsWe report an international retrospective series of patients with MGOS. Data was collected on patients with MGOS:there were no other inclusion criteria besides monoclonal gammopathy with an ophthalmologic manifestation; however, this report focuses only on patients with PPK. Efficacy outcomes were the hematologic and the ocular responses in patients with PPK. Hematologic responses were reported according to the IMWG response criteria. The ophthalmologic response to treatment was assessed by each contributing physician and reported as either complete, partial or no sight recovery.ResultsWe identified 23 patients with PPK in the setting of monoclonal gammopathy of unknown significance (MGUS), smoldering multiple myeloma (SMM), or multiple myeloma (MM) diagnosed between 2006 and 2019 in 7 countries. Table 1 summarizes the patients' characteristics. The ocular diagnosis was typically made at the same time or after the hematologic diagnosis. Eleven of 23 patients presented decreased vision. Four were treated by penetrating keratoplasty with or without systemic therapy, including chemotherapy with new generation anti-MM agents with or without autologous stem cell transplantation (ASCT). All patients with MM and 40% of those with other diagnoses such as SMM or MGUS received systemic therapy. In most cases, neither ocular nor hematologic treatment, even when ASCT was performed, afforded a durable improvement in the visual acuity despite initial responses. MGOS typically relapsed within one year of the initial response (Table 2).ConclusionTo date, this is the largest retrospective study focusing on MGOS patients with monoclonal immunoglobulin deposits accumulating in the cornea and resulting in visual impairment. Further studies will be required to determine the optimal strategy to treat and prevent the relapse of ocular symptoms in patients with PPK and specifically to address the timing of keratoplasty and systemic chemotherapy and the role of maintenance therapy. Patients with corneal manifestation of unknown origin should undergo a hematologic check-up and patients with paraproteinemia should have a periodic ocular health assessment. [Display omitted] DisclosuresGarderet: Takeda: Consultancy; Sanofi: Consultancy; Amgen: Consultancy; Janssen: Consultancy; Celgene: Consultancy. Munder: Janssen: Consultancy, Honoraria; BMS: Consultancy, Honoraria; Abbvie: Consultancy; Takeda: Consultancy, Honoraria; Amgen: Honoraria; Sanofi: Consultancy; GSK: Consultancy; Incyte: Research Funding. Gozzetti: AbbVie: Honoraria; Janssen: Honoraria. Rosinol: Janssen, Celgene, Amgen and Takeda: Honoraria. Jurczyszyn: Janssen-Cilag, Amgen: Honoraria, Speakers Bureau.

Preventive screening in women who have sex with women.

> A 30-year-old woman who is new to your practice presents for a periodic health assessment. While taking the sexual history, she indicates that she has only been in relationships with other women. She questions the need for cervical cancer screening based on the advice that she had been given by

Deteriorating Habitats and Conservation Strategies to Repopulate the Endangered Indus River Dolphin (Platanista gangetica minor); a Lesson Learned From the Conservation Practices of the Yangtze Finless Porpoise (Neophocaena asiaeorientalis)

The Indus River dolphin (IRD;Platanista gangetica minor) is an endangered and blind freshwater cetacean, endemic to the Indus River system of Pakistan and India. This review article provides detailed information about the major challenges IRDs are facing, and their possible consequences on the population dynamics of the IRD. Furthermore, we have suggested future conservation strategies for the IRD based on the lesson learned from the conservation of the Yangtze finless porpoise (YFP;Neophocaena asiaeorientalis), a Critically Endangered freshwater cetacean. The major challenges for IRDs are habitat degradation, habitat fragmentation, and several types of industrial and agricultural pollutants. Worsening climatic changes, illegal fishing, and overfishing are additional threats. The construction of several barrages has fragmented the population into several short segments, some of which are too small for the IRDs to survive. In some segments, the population status of the IRD is unknown. In the remaining populations, genetic inbreeding, water shortage, canal entrapment, and altered ecological environment are potent negative factors for the survival of the IRD. Conservation strategies including fishing bans, translocation, and future research (tagging, periodic health assessments, necropsy and virtopsy, understanding the reproductive biology, and genomics) are possible recommendations. Very serious conservation efforts are needed to save the IRD from decline keeping in view the water shortage, pollution, lack of health assessment studies, and habitat degradation and fragmentation.

Functional and joint evaluation in a prospective cohort of patients with severe haemophilia.

Arthropathy is the main morbidity of haemophilia. Periodic joint health assessment enables a better understanding of the limitations of these patients. To evaluate the functional and joint performance in patients with haemophilia at one-year follow-up, as well as its association with prophylactic treatment and attendance at scheduled consultations at a haemophilia treatment centre. This prospective cohort study included patients with severe haemophilia aged 7years or more and treated at Fundação Hemocentro de Brasília, Brazil, from January 2014 to December 2018. The Hemophilia Joint Health Score and Functional Independence Score in Hemophilia were assessed at the first consultation and after a one-year follow-up. The study included 69 patients. The mean age at study recruitment was 22.5±4.5years, 62.3% of patients aged 18years or older, and 29 patients were receiving primary prophylaxis (38.0%). There was a positive correlation between HJHS and age and a negative correlation between FISH and age. The worsening HJHS was associated with non-primary prophylaxis and non-attendance at scheduled multidisciplinary consultations. The worsening FISH was associated with non-primary prophylaxis. The correlation between FISH and treatment adherence was significant for the delta. The older the patient with haemophilia, the higher the probability of a worsening of the HJHS. In the presence of more arthropathies, the older the patient, the worse the FISH. Patients receiving primary prophylaxis show better results in the HJHS and FISH when compared to patients receiving secondary prophylaxis and/or on-demand treatment.

Factors contributing to functional dependence among older adults in Ile–Ife, Nigeria

Old age presents myriads of challenges particularly in the dimension of dependence in the performance of activities of daily living and those contributing to maintenance of health. This study therefore, assessed factors contributing to functional dependence among older adults attending care in a Nigerian Teaching Hospital.A cross-sectional correlational design was employed to study 400 respondents 60 years and above attending care in the hospital. Data regarding the respondents’ sociodemographic attributes, their degree of dependence in instrumental activities of daily living (IADLs) as well as health maintenance practices were collected with a validated interviewer-administered questionnaire and were analysed descriptively and inferentially using Stata 12 statistical package.Results revealed that almost a quarter (24.5%) of the respondents were dependent (moderate) on others in all the dimensions of IADLs measured, while majority (83.0%) had moderate health maintenance practices. Furthermore, respondents age (Β = −0.124, p < 0.001), health maintenance practice (Β = 0.180, p < 0.001) sex (Β = 1.181, p < 0.001), Income level (Β = 0.551, p < 0.001), level of education (Β = 0.723, p < 0.001) significantly predicted functional dependence among the older adults.In conclusion, this study showed that functional dependence is prevalent among the residents in this setting. Therefore, there is a need for nurses to carry out a periodic health assessment among the older adults and also educate the general geriatric cohort on the need to scale up the performance of health maintenance practices which will in turn increase their functional capacity and promote better quality of life.

Mental health problems in health-care workers working in COVID-19 quarantine centers

Background: The coronavirus disease-19 (COVID-19) pandemic in India has put health-care workers (HCWs) under intense pressure and has led to immense psychological stress due to factors including a high risk of infection, inadequate protection from contamination, overwork, cutting-off with families, and exhaustion. The unprecedented stressful conditions are causing mental health problems such as stress, anxiety, depression, disturbed sleep, irritability, fear, and panic. The present study was carried out to investigate the mental health problems among HCWs working in close proximity with COVID-19 patients in quarantine centers and to explore the relevant influencing factors for the development of psychological interventions for them. Subject and Methods: HCWs working in COVID-19 quarantine centers in Ajmer were interviewed for exploring mental health problems in a cross-sectional study carried out at JLN Medical College, Ajmer, India. Depressive symptoms, anxiety, and stress among HCWs were assessed using the Depression Anxiety Stress Scale and Perceived Stress Scale (PSS). Relevant data were analyzed, and comparisons between different groups were performed using the two independent sample t-tests. All statistical analyses were performed using the SPSS software version 22.0 for Windows. Results: 53.57% (n = 30) of participants were suffering from depressive symptoms, 64.28% (n = 36) were suffering from anxiety symptoms, and 78.6% (n = 47) were suffering from stress. HCWs living in joint families were more affected by depression (P = 0.02). Both anxiety and stress were more commonly reported by HCWs of age <30, females, nurses and those living in joint families, but difference was statistically insignificant. Conclusion: The present study demonstrated that a considerable number of HCWs were suffering from mental health problems such as depression, anxiety, and stress. It is important to have periodic mental health assessment of HCWs dealing with COVID-19 patients.

A Burden and Prevalence Analysis of Chronic Pain by Distinct Case Definitions among Active Duty U.S. Military Service Members, 2018

Background: Chronic pain is a growing problem in the military, and the methods by which we have to perform epidemiologic surveillance are insufficient. It represents both a public health and military readiness concern, as those who suffer from it experience adverse impacts on work productivity, physiological health, and quality of life. Objectives: This study was designed to assess the prevalence of chronic pain among active component military service members utilizing 2 distinct, published case definitions. It sought to describe the demographics and military characteristics of those receiving chronic pain diagnoses. The study also aimed to provide improved granularity regarding military chronic pain patients’ pain severity and its impacts on their job performance. Study Design: Cross-sectional analysis for 2018. Setting: This analysis utilized data available from the Defense Medical Surveillance System, a database containing longitudinal data on service members. Methods: Patients: The surveillance population consisted of all active component service members from the U.S. Army, Navy, Air Force, and Marines of all grades serving at any point during the surveillance period of January 1, 2018 through December 31, 2018. Measurement: Diagnoses were ascertained from the administrative records of all medical encounters of individuals who received care through the Military Health System or civilian referrals. Data from patients’ Periodic Health Assessment (PHA) encounters were also utilized to derive more granular data regarding their experiences of pain. Results: Case Definition 1, more specific for identifying chronic pain, identified a more severe subset of chronic pain patients when compared against Case Definition 2, a more comprehensive method for identifying potential chronic pain patients. Case Definition 1 found a higher prevalence of impactful pain (CD1: 36.7% vs. CD2: 23.5%), and Case Definition 1 patients are more likely to be on limited duty and require treatment related to their pain. Several demographic groups were also found to be at increased risk of chronic pain diagnosis, including women, black non-Hispanic, Army, older age, and enlisted. Limitations: First, in utilizing administrative data, this allows for the possibility of misclassification bias. Second, some deployment data still used ICD-9 coding even in 2018, resulting in a minor underestimation by approximately 30 patients and approximately 60 encounters. Third, the prevalence estimates for the demographics were not adjusted for potential confounders. Conclusions: Chronic pain has been difficult to define via administrative and screening data, and as such its burden and prevalence estimates can vary considerably depending on which case definition is used. This is of particular importance in the U.S. military, as these estimates can significantly impact our calculations for force readiness and the protection of our national security. To our knowledge, this study is the first of its kind to examine chronic pain across the entirety of the U.S. armed forces and to utilize granular, annually collected PHA data in this way. The results of this exploratory analysis could be used as a template to better characterize the burden of chronic pain from a populationbased perspective and monitor the effectiveness of pain management strategies. Key words: Chronic pain, military, case definition, surveillance, epidemiology

Ten-year Cardiovascular Disease Risk Amongst Workers in a Tertiary Healthcare Institution in Kuala Lumpur

&#x0D; Strategising, which is an effective workplace intervention to curb cardiovascular disease (CVD), requires understanding of the CVD risk related to a specific working population. The Framingham Risk Score (FRS) is widely used in predicting the ten-year CVD risk of various working populations. This study aimed to use FRS to determine the ten-year CVD risk amongst workers in a tertiary healthcare setting and its associated factors. A cross-sectional study was conducted on workers who participated in the special health check programme at the staff clinic of a tertiary healthcare institution in Kuala Lumpur, Malaysia. A set of data sheets was used to retrieve the workers’ sociodemographic and CVD risk information. The prevalence of high, moderate and low ten-year CVD risk was 12.8%, 20.0% and 67.2%, respectively. Workers in the high-risk group were older [mean age: 54.81 (standard deviation, 5.72) years], male (44%), smokers (72.7%) and having hyperglycaemia (46.7%) and hypertriglyceridemia [median triglycerides: 1.75 (interquartile range, 1.45) mmol/L]. Diastolic blood pressure (aOR 1.07, 95% CI: 1.01,1.14), hyperglycaemia (aOR 8.80, 95% CI: 1.92,40.36) and hypertriglyceridemia (aOR 4.45, 95% CI: 1.78,11.09) were significantly associated with high ten-year CVD risk. Diastolic blood pressure (aOR 1.08, 95% CI: 1.03,1.13) and hypertriglyceridemia (aOR 2.51, 95% CI: 1.12-5.61) were significantly associated with moderate ten-year CVD risk. The prevalence of high and moderate ten-year CVD risk was relatively high. Amongst the workers in the high-risk group, they were older, male, smokers and with high fasting blood sugar and triglyceride. Understanding the ten-year CVD risk and its associated factors could be used to plan periodic workplace health assessment and monitor to prevent CVD.

EFFECT OF QUALITY OF WORKING LIFE ON PSYCHOLOGICAL WELL-BEING AND MARITAL SATISFACTION AMONG MARRIED RESIDENT FEMALES AT FACULTY OF MEDICINE – ZAGAZIG UNIVERSITY

AbstractWorking women are exposed to many stressors especially in the medical field which affect their well being and marital satisfaction. Individual perception of high Work Life Balance (WLB) and sense of well being has become vital for any organization in order to ensure enhanced performance efficiency. Aim of work: To assess the effect of quality of working life on psychological wellbeing and marital satisfaction among married resident females and to assess the effect of psychological wellbeing on marital satisfaction. Materials and methods: A cross- sectional study was conducted on 100 married resident females in different clinical departments at Zagazig University hospitals. Standardized scales were used to gather information including the Quality of Work Life (QOWL) scale, Ryff s Psychological Well-Being (PWB) scale and Enrich Marital Satisfaction (EMS) scale along with semi-structured questionnaire for socio-demographic data. Results: This study showed that the majority of our sample (70.0%) had low QOWL, 86.0% with low psychological well being and 75.0% with poor marital satisfaction and there were statistical significant direct correlation between QOWL and psychological wellbeing & marital satisfaction; also between psychological well being and marital satisfaction. Conclusion and recommendations: the results of thisstudy attract the attention to the high work-stress situation among medical staff and the reciprocal effects of job satisfaction, psychological well being and marital satisfaction. These results should be considered by health policy decision makers when providing facilities such as educational programs for empowering couples, encourage periodic medical and health assessments of medical staff, and providing psychological and family consulting services at the workplace.

Prevalence of Anaemia and Iron Deficiency among Primary Schoolchildren in Malaysia.

The present study aimed to report the prevalence of anaemia and iron deficiency (ID) and to explore the associations among socio-demographic characteristics, nutritional status and inflammation status in the occurrence of anaemia and ID in a nationally representative sample of Malaysian primary schoolchildren. Using data from the South East Asian Nutrition Surveys (SEANUTS), 544 Malaysian children aged 7 to 12 years were included in this secondary analysis. Blood samples were drawn for haemoglobin and serum ferritin analysis while C-reactive protein (CRP) and α-1-acid glycoprotein (AGP) were measured to detect inflammation. Prevalence of anaemia and ID were 4.0% and 5.2%, respectively. There were significantly more anaemic indigenous bumiputra children (9.9%) than Chinese children (0.6%). Correction for inflammation did not change the prevalence of ID. More overweight/obese children than thin/normal weight children were found to have elevated acute phase protein (APP). Children with elevated inflammatory markers had significantly higher ferritin level than children without inflammation. Periodic health assessments of anaemia and ID at the population level to monitor and clarify the epidemiology of health problems are required to inform public health policies and strategies.

IMPROVEMENT OF RADIATION SAFETY STANDARDS. PART 1. APPROPRIATENNES OF THE LIMITAION OF THE MEDICAL EXPOSURE OF HEALTHY INDIVIDUALS

Dose limits are commonly not applied for the radiation protection from medical exposure in the international practice; the principles of justification and optimization are used instead. However, the Russian Norms of the Radiation Safety NRB 99/2009 provide for the limitation (non-exceedance) of the doses for the healthy individuals undergoing X-ray examinations related to the employment-related, legal or screening purposes by 1 mSv per year. The aim of the study was to assess the feasibility of limiting the doses for the healthy individuals undergoing diagnostic medical X-ray examinations in the context of the revision of the Norms of the Radiation Safety. The study included the analysis of the existing Russian legislative documents regulating the medical exposure related to the employment-related, legal and screening purposes; evaluation of the imaging modalities commonly used for these purposes and conservative estimation of the effective doses per employment-related medical examination or a periodic health assessment. The results of the study indicate that a limit of 1 mSv per year is systematically exceeded for the healthy individuals undergoing X-ray examinations related to the employment-related, legal or screening purposes. Implementation of the modern screening methods (low-dose computer tomography, breast tomosynthesis) would lead to the significant increase of the effective dose per periodic health assessment up to 3-8 mSv per year. Hence, it is proposed to use the principle of the optimization with the establishment of the diagnostic reference levels for the screening X-ray examinations for the radiation protection of healthy individuals from medical exposure.