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Ο καρκίνος «θερίζει» τους διασώστες των Δίδυμων Πύργων
Δευτέρα, 07.28.2014, 11:44pm

 

 

For What Illnesses Is a Disease Management Program Most Effective?
Κύριακη, 02.01.2015, 03:00am
Objective: We examined the impact of a disease management (DM) program offered at the University of Minnesota for those with various chronic diseases.Methods: Differences-in-differences regression equations were estimated to determine the effect of DM participation by chronic condition on expenditures, absenteeism, hospitalizations, and avoidable hospitalizations.Results: Disease management reduced health care expenditures for individuals with asthma, cardiovascular disease, congestive heart failure, depression, musculoskeletal problems, low back pain, and migraines. Disease management reduced hospitalizations for those same conditions except for congestive heart failure and reduced avoidable hospitalizations for individuals with asthma, depression, and low back pain. Disease management did not have any effect for individuals with diabetes, arthritis, or osteoporosis, nor did DM have any effect on absenteeism.Conclusions: Employers should focus on those conditions that generate savings when purchasing DM programs.Clinical Significance: This study suggests that the University of Minnesota's DM program reduces hospitalizations for individuals with asthma, cardiovascular disease, depression, musculoskeletal problems, low back pain, and migraines. The program also reduced avoidable hospitalizations for individuals with asthma, depression, and low back pain.
Bias From Using Occupational Smoking Prevalence to Adjust Occupational Incidence Cohort Lung Cancer Mortality Rates
Κύριακη, 02.01.2015, 03:00am
Objective: To describe how smoking correction factors based on comparing worker smoking prevalence with population smoking prevalence are biased if applied to an occupational incidence cohort.Methods: Relative rates of smoking for shorter-tenure workers derived from occupational cohort lung cancer studies were applied to incidence and prevalence population tenure distributions to calculate relative smoking estimates.Results: High smoking rates in short-tenure workers have little effect on prevalent worker rates (relative smoking estimates, 1.04 and 1.02) and much larger effect in occupational incidence populations (relative smoking estimates, 1.58 and 1.21), which have a much higher proportion of short tenure-workers.Conclusions: Smoking correction estimates derived from surveys of smoking habits in prevalent workers may introduce bias when applied to incidence workers because of very different proportions of short-tenure workers (length-time biased sampling).
Effectiveness and Acceptance of a Health Care–Based Mandatory Vaccination Program
Πέπμτη, 01.01.2015, 03:00am
Objective: To decrease the risk of transmission of hospital-associated transmission of influenza and pertussis through mandatory vaccination of staff.Methods: A mandatory influenza and toxoid-diphtheria toxoid-acellular pertussis program was implemented systemwide. A structured vaccine exemption program was implemented for those requesting a medical and/or religious/moral/ethical exemption.Results: Systemwide influenza vaccination rates increased from 67% historically, 76.2% in the 2012 to 2013 influenza season, to 94.7% in 2013 to 2014 with an overall compliance rate of 97.8%. Toxoid-diphtheria toxoid-acellular pertussis vaccination rates systemwide reached 94.9%, with an overall compliance rate of 98%. Higher rates were experienced at individual hospital facilities compared with the corporate location.Conclusions: Successful vaccination campaign outcomes can be achieved through diligent enforcement of mandatory vaccination, masking, and other infection prevention procedures.
The Reliability and Validity of the Caregiver Work Limitations Questionnaire
Πέπμτη, 01.01.2015, 03:00am
Objective: To test a new Caregiver Work Limitations Questionnaire (WLQ). On the basis of the original WLQ, this new survey instrument assesses the effect of caregiving for ill and/or disabled persons on the caregiver's work performance.Method: A questionnaire was administered anonymously to employees of a large business services company. Scale reliability and validity were tested with psychometric methods.Results: Of 4128 survey participants, 18.3% currently were caregivers, 10.2% were past caregivers, and 71.5% were not caregivers. Current caregivers were limited in their ability to perform basic job tasks between mean 10.3% and 16.8% of the time. Confirmatory factor analysis yielded a scale structure similar to the WLQ's. Scales reliabilities (the Cronbach's α) ranged from 0.91 to 0.95.Conclusions: The Caregiver WLQ is a new tool for understanding the workplace effect of caregiving.
Implementation of a Worksite Wellness Program Targeting Small Businesses: The Pinnacol Assurance Health Risk Management Study
Πέπμτη, 01.01.2015, 03:00am
Objective: To assess small business adoption and need for a worksite wellness program in a longitudinal study of health risks, productivity, workers' compensation rates, and claims costs.Methods: Health risk assessment data from 6507 employees in 260 companies were examined. Employer and employee data are reported as frequencies, with means and standard deviations reported when applicable.Results: Of the 260 companies enrolled in the health risk management program, 71% continued more than 1 year, with 97% reporting that worker wellness improves worker safety. Of 6507 participating employees, 34.3% were overweight and 25.6% obese. Approximately one in five participants reported depression. Potentially modifiable conditions affecting 15% or more of enrollees include chronic fatigue, sleeping problems, headaches, arthritis, hypercholesterolemia, and hypertension.Conclusions: Small businesses are a suitable target for the introduction of health promotion programs.
HRCT/CT and Associated Spirometric Effects of Low Libby Amphibole Asbestos Exposure
Πέπμτη, 01.01.2015, 03:00am
Objective: Evaluate the relationship between cumulative fiber exposure and high-resolution or conventional chest computed tomography (HRCT/CT) changes and spirometry of workers with Libby amphibole asbestos exposure.Methods: Of the original 1980 cohort (n = 513), 431 were living and asked to participate. Images were evaluated for localized pleural thickening (LPT), diffuse pleural thickening (DPT), and parenchymal changes.Results: A total of 306 participants provided either HRCT/CT scans (n = 191) or chest radiographs (n = 115). Of the 191 with HRCT/CT, 52.9% had pleural changes and 13.1% had parenchymal changes. Those with LPT only, LPT and/or DPT, or DPT and/or parenchymal changes had mean 6.1, 8.0, and 18.0 loss in percent predicted forced vital capacity, respectively.Conclusions: Exposure to vermiculite containing amphibole fibers is associated with pleural and parenchymal HRCT/CT changes at low cumulative fiber exposure; these changes are associated with spirometric decrements.
Biomonitoring in California Firefighters: Metals and Perfluorinated Chemicals
Πέπμτη, 01.01.2015, 03:00am
Objective: To assess California firefighters' blood concentrations of selected chemicals and compare with a representative US population.Methods: We report laboratory methods and analytic results for cadmium, lead, mercury, and manganese in whole blood and 12 serum perfluorinated chemicals in a sample of 101 Southern California firefighters.Results: Firefighters' blood metal concentrations were all similar to or lower than the National Health and Nutrition Examination Survey (NHANES) values, except for six participants whose mercury concentrations (range: 9.79 to 13.42 μg/L) were close to or higher than the NHANES reporting threshold of 10 μg/L. Perfluorodecanoic acid concentrations were elevated compared with NHANES and other firefighter studies.Conclusions: Perfluorodecanoic acid concentrations were three times higher in this firefighter group than in NHANES adult males. Firefighters may have unidentified sources of occupational exposure to perfluorinated chemicals.
Prostate-Specific Antigen and Perfluoroalkyl Acids in the C8 Health Study Population
Πέπμτη, 01.01.2015, 03:00am
Purpose: To inform questions raised by inconsistent findings regarding an association between perfluoroalkyl acids (PFAAs) and prostate cancer by assessing the relationship of PFAAs in human serum to prostate-specific antigen (PSA).Materials and Methods: Using 2005 to 2006 survey data from a large survey population, we compared serum PFAA concentrations in adult males with PSA concentrations adjusted for risk factors including age, body mass index, smoking status, and socioeconomic status.Results: Perfluoroalkyl acids are not consistently associated with PSA concentration in general, or with PSA more than 4.0.Discussion: These findings do not provide evidence that PFAA exposure is associated with PSA.
Improving Sleep: Outcomes From a Worksite Healthy Sleep Program
Πέπμτη, 01.01.2015, 03:00am
Objective: Unhealthy and inadequate sleep is a common and significant problem impacting absenteeism, presenteeism, health, and productivity. This study aimed at analyzing the effect of a worksite-based healthy sleep program.Methods: Retrospective analysis of 53 adult members of a worksite wellness center who participated in an 8-week healthy sleep program and completed pre- and postintervention health behavior questionnaires.Results: Following the intervention participants felt significantly more rested, more confident in their ability to deal with sleep problems, and more knowledgeable about sleep. In addition, they reported a reduction in their stress level, improved quality of life, and increase energy level.Conclusions: These results support the effectiveness of worksite programs designed to promote healthy sleep. Future randomized studies are needed to further investigate the effectiveness and optimal delivery of healthy sleep promotion.
Success Overlooked—Navistar, 1999 to 2009: The Huge Impact an Employer's Approach to Wellness Can Have on Health Care Costs and Sustained Value
Πέπμτη, 01.01.2015, 03:00am
No abstract available
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