Preventive Care System Research Articles

The link between unhealthy lifestyle behaviors and emotional and behavioral problems in children and adolescents: a latent class analysis

ABSTRACT Unhealthy lifestyle behaviors (ULBs) in children and adolescents are relatively common. Previous studies have shown an association between a single ULBs and emotional and behavioral problems (EBPs); however, few studies have explored the connection between multiple behavioral patterns and EBPs in children and adolescents. Hence, we aimed to investigate the link between ULBs clusters and EBPs among Chinese children and adolescents. From April to May 2019, we used cluster sampling to investigate children and adolescents in grades 1–12 from 14 schools located across six streets of Bao’an District in the city of Shenzhen. We measured emotional and behavioral problems using the Strengths and Difficulties Questionnaire (SDQ). ULBs included the consumption of sugar-sweetened beverages, takeaway and fast food consumption, lack of sleep, low outdoor activity, and excessive screen time. We performed clustering of ULBs using the regression hybrid modeling method of latent class analysis (LCA). We analyzed the association between ULBs and EBPs using logistic regression. In total, 30188 children and adolescents remained for analysis, with an average age of 12.44 ± 3.47 years. The LCA revealed four distinct patterns of ULBs: (1) lowest risk; (2) high-risk unhealthy lifestyle behaviors; (3) high-risk dietary unhealthy lifestyle behaviors; and (4) highest risk. Compared to ULBs with the lowest risk, high-risk ULBs, high-risk dietary ULBs, and highest risk ULBs were positively correlated with EBPs, with an adjusted odds ratio (aOR) (95% confidence interval [CI]) of 1.27, 1.34 and 2.05, respectively. Children and adolescents who reported engaging in multiple ULBs were also more likely to have poorer EBPs status. This implies that school administrations should pay more attention to the management of dietary and lifestyle behaviors to prevent EBPs in children and adolescents. Our findings highlight the need to focus on multiple clusters of ULBs among adolescents in a preventive care system and to validate EBP that may occur in children who are exposed to ULBs.

Comments on the section “Cardiovascular risk estimation” in the 2021 European Society of Cardiology guidelines on cardiovascular disease prevention in clinical practice

The article discusses a new approach to assessing cardiovascular risk in clinical practice, presented in the European guidelines 2021. Two novel risk charts (SCORE2 and SCORE2-OP) have been proposed that have undergone significant revision and require significant changes in primary care practice. It has been suggested that in modern conditions their practical introduction is premature, since the healthcare system is not ready for renewal. Therefore, time is needed to adapt it to the practical healthcare conditions and to revise the medical screening protocols, which will require financial costs. The implementation of these recommendations should be taken responsibly so as not to harm the existing system of preventive care.

Dynamics of morbidity and mortality of the population of the North Caucasus Federal District from major chronic non-communicable diseases and the system of preventive care

<h3></h3> Аналитический обзор проведен на основании официальных данных Росстата в разрезе субъектов Российской Федерации (РФ) от 2019 г. Проанализированы следующие показатели: смертность в трудоспособном возрасте, в том числе по основным классам причин; финансирование здравоохранения; объемы оказания бесплатной и высокотехнологической медицинской помощи; обеспеченность медицинским персоналом лечебно-профилактических учреждений (ЛПУ) и организация профилактики хронических неинфекционных заболеваний (ХНИЗ). Смертность в трудоспособном возрасте на Северном Кавказе оказалась самой низкой, что является в первую очередь отражением относительно низкой частоты заболеваемости ХНИЗ и их осложнений. Смертность среди мужчин на Северном Кавказе в 1,5—2 раза, а среди женщин — в 2—2,5 раза меньше по сравнению с другими округами РФ. Среди причин смерти в Северо-Кавказском федеральном округе (СКФО) первое место занимают болезни системы кровообращения, так как каждый второй фатальный инцидент связан с осложнениями сердечно-сосудистых событий (инфарктом миокарда и мозговым инсультом). Второе место занимают новообразования, частота которых оказались в 3 раза меньше, чем частота болезней системы кровообращения (БСК). В СКФО показатели по основным классам причин смерти являются более низкими по сравнению со средними параметрами РФ. Самая высокая смертность от БСК зарегистрирована в Ставропольском крае и Северной Осетии, тогда как в Ингушетии, Дагестане и Чечне данный показатель в 3 раза меньше. Фактические объемы бесплатной медицинской помощи, предоставляемые населению в рамках территориальных программ государственных гарантий в 2018 г. в СКФО, оказались на 17% меньше по сравнению с установленным нормативом, а по сравнению со средними показателями РФ — на 32,6%. По количеству центров здоровья для взрослых СКФО занимает последнее место среди всех федеральных субъектов РФ. Несмотря на то что численность взрослого населения в Северо-Кавказском (9866,8 тыс.) и Дальневосточном федеральных округах (8188,6 тыс.) в целом сопоставима, количество центров здоровья различается в 2 раза: 19 и 35 соответственно. При этом число лиц, обучившихся основам здорового образа жизни в этих федеральных округах, оказалось сопоставимым.

Организация системы профилактической помощи детям с близорукостью в Чувашской Республике. Проект «Здоровое зрение»

Организация системы профилактической помощи детям с близорукостью в Чувашской Республике. Проект «Здоровое зрение»

Health protection of employees against SARS-CoV-2 coronavirus infection causing the COVID-19 disease - the current state of knowledge and recommendations

The COVID-19 pandemic, despite the restrictions and preventive measures applied, has rapidly spread and reached Poland. The adaptation to the dynamically changing epidemiological situation requires a prompt implementation of effective preventive measures. The aim of the publication is to provide current knowledge to all persons involved in the preventive care system, i.e., employees, employers and professionals of occupational medicine, about the epidemiological situation related to SARS‑CoV- 2, as well as recommendations and possible solutions. In order to analyze these issues, a review of literature was conducted based on medical research databases: PubMed, SCOPUS, and the Web of Science Core Collection. The literature was supplemented with studies found on websites of the Ministry of Health and the World Health Organization. Data on the cases of and deaths due to COVID-19 come from reports provided by the Ministry of Health, data published on the websites of the European Center for Disease Prevention and Control, and ourworldindata.org. By the time of submitting the publication, 34 154 cases and 1444 deaths due to coronavirus had been recorded in Poland. Data from published studies suggest that the virus is mainly transmitted via droplets or through contact with contaminated objects and surfaces. Therefore, in the absence of an effective vaccine, preventive actions are based mainly on strategies that minimize the risk of pathogen transmission. In addition to discussing the current epidemiological situation, diagnostic procedures, risk groups and COVID-19 characteristics, the paper presents recommendations and proposed solutions for employers and employees regarding the prevention of SARS‑CoV- 2, along with currently applicable laws and recommendations on employee prophylactic examinations during the pandemic. Subsequently, COVID-19 was discussed in the aspect of an occupational disease and other health threats related to the pandemics. The epidemiological situation regarding coronavirus indicates the need to take immediate and effective actions to minimize infection transmission among employees, and to develop procedures for a quick and effective ability to locate the COVID-19 outbreaks in workplaces. Med Pr. 2021;72(1):69-87.

CONCEPTUAL DIRECTIONS IN ORGANIZATION OF MEDICAL ASSISTANCE FOR CHILDREN IN THE CONDITIONS OF EDUCATION

The aim of this work is: to define the Conceptual model of medical provision of children in educational institutions in modern conditions. Materials and methods: analysis of data from a longitudinal study of children's health; questionnaire of parents, teachers, heads of educational institutions on the volume of medical support for students; questioning students' lifestyle and social determinants of health. Results: According to the study has determined the medical and social determinants which negative affect on health status of school age childrens; detected the most appropriate types of of school health services which based on the parents, medical and teachers opinion. The important also is monitoring of health status of children for develop of prevent measure for improove health status and forming of healthy lifestyle behavioral. Problematic issues to be addressed include: improving the legal framework on the competences and volumes of health care for pupils in educational institutions; material equipment; setting up a system for monitoring and analyzing the health status of students and educational groups, identifying health risk factors; establishing a continuous multimodal health-oriented system of student-oriented youth behavior. Conclusions: The health status of students and the level of health-oriented behavior, the reform of the medical sector require introduction of an effective system of medical support for students of organized groups, improving the system of preventive care for students, parents, which is presented in the Conceptual model.

A Study on Intelligent Dialogue Agent for Older Adults’ Preventive Care – Towards Development of a Comprehensive Preventive Care System –

A Study on Intelligent Dialogue Agent for Older Adults’ Preventive Care – Towards Development of a Comprehensive Preventive Care System –

A Socio-Temporal Perspective on Pilot Implementation: Bootstrapping Preventive Care

Systems for preventive care seek to provide healthcare services to citizens at risk of developing disease. In doing so they wrestle with identifying the citizens at risk of developing lifestyle-related disease and with reshaping the existing healthcare infrastructure into effective health offers for these citizens. In this study we analyze how a system for preventive care was enacted through a pilot implementation. The temporariness of the pilot implementation was, we argue, central to its contribution toward bootstrapping the system. By being temporary the pilot implementation became a means of acquiring clinical evidence for the cost-effectiveness of the system prior to committing to its long-term and large-scale use. The temporariness also legitimized temporary solutions to issues that otherwise made it difficult to bring actors, practices, and technologies into alignment. Once aligned, even if merely temporarily, the resurfacing of these issues after the pilot implementation will be shaped by the experiences from the pilot implementation. In this way pilot implementations have a generative role in infrastructure evolution; they are not merely tests but help bootstrap systems by making alignment manifest and benefits salient. We discuss this generative side of learning in pilot implementations and the extent to which they can enact a system by bootstrapping it.

The organizational forms of preventive activities in population

The concept of health progression through treatment of patient received no justification as significant deterioration of population health in last years is an obvious evidence. The practical medicine is to be focused on both ill and healthy people. The characteristics of modern structure of morbidity and mortality in Russia force to admit priority of caring health of healthy people. In the post-Soviet period the existed then system of preventive care of schoolchildren, representatives of main professions and groups of population factually was destroyed. This kind of activities is to be restored in medical sanitary units. However, the analysis of practice of clinical examination revealed the presence of a number of organizational and methodological costs that decreases efficiency of applied resources does not allow to fully achieve established goals. The article presents analysis of dispensarization of population in the Russian Federation and evaluation of efficiency of functioning of the Health Centers. The experience of youth-friendly clinics is evaluated. The organizational structure of preventive work at the level of primary medical sanitary care and its interaction with specialized services in health care.

Identification of Chinese Medicine Constitution in Public Health Services.

Public health is the science and art of preventing disease, prolonging life and prompting physical and mental health through evaluation, policy development and sanitary measures. The development of public health has become an important part of health care reform in China, and it requires the participation of Chinese medicine (CM) in the practice of public health. This study analyzed the problems of CM services in public health, suggested that the identification of CM constitution could propose an application paradigm of CM services in public health, and described from aspects of theory, technology and application. The identification of CM constitution gained national approval and support of government and industry. With the application and popularization of this technology, it will promote the establishment of characteristic CM preventive care system and the development of public health.

Users’ adherence to care in day services specializing in preventive care

Background: In 2006, a new allowance category was added to the Long-term Care Insurance System for preventive care, and the provision of day services to provide such care was initiated in Japan. In order to maintain and improve day service users’ remaining motor function, it is necessary to enhance their adherence to care. However, to the present, the rates of the continuous use of day services specializing in preventive care have rarely been reported.

An empirical study on evaluating basic characteristics and adaptability to users of a preventive care system with learning communication robots

In many countries, and particularly in Japan, rising medical costs and shortfalls in the number of healthcare personnel are becoming serious national problems. This paper proposes a Preventive Care system with learning Communication robots (PrevCareCom), aiming to provide a preventive care approach wherein the elderly can engage in exercise over the long term without getting bored while communicating with robots through match-up games. In the PrevCareCom, the preventive care exercises are based on a simple, traditional Japanese match-up game, and several kinds of robots are used as opponents. The proposed system encourages a sense of familiarity with the robots (agents) for elderly users based on the concept of human–agent interaction. Reinforcement learning methods are also used to adapt system parameters such as exercise intensity and robot behavioral policy to the athletic performance of each user. Several experiments were carried out with the cooperation of local governments and health and welfare facilities to investigate characteristics of the PrevCareCom and to evaluate how well it adapts to its users in terms of familiarity, quality and quantity of exercise. The results of experiments showed that the users’ interest in the proposed system and sense of familiarity with the robots were encouraged by playing the game and interacting with the robots. Questionnaire results also showed that the PrevCareCom could provide appropriate exercise loads for the users’ care prevention.

Analysis of multicultural meta‐ethical clinical perceptions concerning life and death of patients

PurposeThe prime objective of this article is related to dignified human beings as patients in clinical interventions. The main attention of such a perception focuses on observance of humaneness in relationships among physicians, patients, family members, and community at large. This paper aims to address these issues.Design/methodology/approachThe paper examines in depth, analytical deliberations concerning traditional and modern values of medical care and healthcare knowledge and practices.FindingsTherefore, we need to attest that we live in a global village in which multicultural people must live side‐by‐side, if they desire to peacefully coexist. We must assume that human values are based upon general agreements about ethical issues. Such agreements rely on a framework of equitable treatments of all mankind. Medical ethics is about committed codes and oaths of professional medical authorities to protect natural rights, human rights, and civil rights of patients in clinical interventions. It strives to achieve professional objectives to facilitate patients to be recovered from pain and suffering and regain their health in order to live the good life.Practical implicationsThis paper is devoted to define the notions relevant to the philosophies of quality of life, ethical, and moral problems concerning clinical medicine, and preventive care systems. It analyzes certain ethical and moral distinctions between medical care and healthcare services, and indicates that cautions should be observed in discussing these notions within the context of preventive care and clinical care systems.Originality/valueThis paper explores the following questions: What is the meaning of a psychosomatic normal life? How life should be respected? What are the meta‐medical practices? What should be the logical and philosophical foundations for medical care and healthcare ethics? How should clinicians and practitioners respect not only cost‐benefit analysis but also consider cost‐effectiveness analysis in providing and promoting medical care and healthcare services for patients?

Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening

Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals. This statement provides an algorithm as a strategy to support health care professionals in developing a pattern and practice for addressing developmental concerns in children from birth through 3 years of age. The authors recommend that developmental surveillance be incorporated at every well-child preventive care visit. Any concerns raised during surveillance should be promptly addressed with standardized developmental screening tests. In addition, screening tests should be administered regularly at the 9-, 18-, and 30-month visits. (Because the 30-month visit is not yet a part of the preventive care system and is often not reimbursable by third-party payers at this time, developmental screening can be performed at 24 months of age. In addition, because the frequency of regular pediatric visits decreases after 24 months of age, a pediatrician who expects that his or her patients will have difficulty attending a 30-month visit should conduct screening during the 24-month visit.) The early identification of developmental problems should lead to further developmental and medical evaluation, diagnosis, and treatment, including early developmental intervention. Children diagnosed with developmental disorders should be identified as children with special health care needs, and chronic-condition management should be initiated. Identification of a developmental disorder and its underlying etiology may also drive a range of treatment planning, from medical treatment of the child to family planning for his or her parents.

介護保険 ２００５ 東京―介護保険法改正にあたって―１．介護保険改正の流れ

The Japanese long term care insurance has started since 2000. After 5 years' experience, it is scheduled to change in 2006, the most important point is preventive care which means to stop the deterioration of ADL or cognitive function. Prevention is thought to be best way to cut the cost of care services. The preventive care system will start in April, 2006, over 1 million people with supportive care needs will receive muscle training or oral care and nutritional support from care workers in the community. New comprehensive community centers will open and these should which make assessments for preventive care, and provide consultations for care givers and families, and comprehensive care management in the community, and protect the dignity of the elderly will newly start. To improve quality of care services is important, and each prefecture has to evaluate all services and to publish the data with internet, so that everybody can see it and select the most appropriate care or company. Also, the government will start a new system of community based services including group homes, small and multifunctional care services, and day care services for people with dementia. These services should have one room available for each individual.

Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review.

Many computer software developers and vendors claim that their systems can directly improve clinical decisions. As for other health care interventions, such claims should be based on careful trials that assess their effects on clinical performance and, preferably, patient outcomes. To systematically review controlled clinical trials assessing the effects of computer-based clinical decision support systems (CDSSs) on physician performance and patient outcomes. We updated earlier reviews covering 1974 to 1992 by searching the MEDLINE, EMBASE, INSPEC, SCISEARCH, and the Cochrane Library bibliographic databases from 1992 to March 1998. Reference lists and conference proceedings were reviewed and evaluators of CDSSs were contacted. Studies were included if they involved the use of a CDSS in a clinical setting by a health care practitioner and assessed the effects of the system prospectively with a concurrent control. The validity of each relevant study (scored from 0-10) was evaluated in duplicate. Data on setting, subjects, computer systems, and outcomes were abstracted and a power analysis was done on studies with negative findings. A total of 68 controlled trials met our criteria, 40 of which were published since 1992. Quality scores ranged from 2 to 10, with more recent trials rating higher (mean, 7.7) than earlier studies (mean, 6.4) (P<.001). Effects on physician performance were assessed in 65 studies and 43 found a benefit (66%). These included 9 of 15 studies on drug dosing systems, 1 of 5 studies on diagnostic aids, 14 of 19 preventive care systems, and 19 of 26 studies evaluating CDSSs for other medical care. Six of 14 studies assessing patient outcomes found a benefit. Of the remaining 8 studies, only 3 had a power of greater than 80% to detect a clinically important effect. Published studies of CDSSs are increasing rapidly, and their quality is improving. The CDSSs can enhance clinical performance for drug dosing, preventive care, and other aspects of medical care, but not convincingly for diagnosis. The effects of CDSSs on patient outcomes have been insufficiently studied.

The role of the physician as an information source on mammography.

The value of mammography for asymptomatic women younger than 50 years of age has been under debate, and it had been suggested that each woman should decide for herself whether to start having mammograms in her 40s. This decision-making process requires women to have knowledge of screening guidelines. This study reported key determining informational factors that led women age 40 and older to obtain a mammogram. To examine the relationship between sources of information and utilization of mammography, the authors conducted a communitywide telephone survey, in English and Spanish, of a stratified random sample of 999 white, black, and Hispanic women in Dade County, Florida. The survey was designed to measure knowledge, attitudes, practices, and beliefs about breast cancer, its prevention, and its early detection. Data for 784 women 40 years and older are analyzed and reported here. The most commonly cited source of information was the media (90.2%). In a logistic regression, having had a checkup in the past year was the strongest predictor of having had a recent mammogram as opposed to a distant one (OR 4.17; 95% CI 2.92-5.95). Women who named their physician as an important source of information about health and prevention were also more likely to have had a recent examination (OR 1.85; 95% CI 1.27-2.69). This analysis of the relationship between the source of information and utilization of mammography suggests that physicians, as sources of information, serve to motivate women to obtain a mammogram. This is true even after taking into account the patient's age and utilization of the healthcare system for preventive care in general. For this reason, it is imperative that clinicians be aware of national guidelines for breast cancer screening; of the risks and benefits of screening measures; and of the implications of a positive and negative test result. In addition, clinicians must realize the importance of follow-up to remind the patient to obtain a mammogram or other screening test and should develop strategies to provide this service.

An office system for organizing preventive services: a report by the American Cancer Society Advisory Group on Preventive Health Care Reminder Systems

Despite increasing recognition of the importance of preventive services, such services are not provided in primary care practice as often as recommended. One of the most important reasons is the lack of a systematic, organized approach within practices. The American Cancer Society Ad Hoc Advisory Group on Preventive Health Care Reminder Systems reviewed evidence-based reports and expert opinion to summarize current knowledge about office systems for clinical preventive services. This article describes the process of developing an office system for preventive care, beginning with writing a practice policy, auditing charts for baseline performance, developing and implementing a plan for efficient delivery of preventive care, involving office staff, and monitoring progress. Strategies for dissemination of this approach to a wide range of primary care practices may involve professional medical organizations and managed care companies.