Study on interventional preventive service in venereal clinic * / 重庆医学

Objective To study and evaluate the effect of developing the preventive service in venereal clinic .Methods The questionnaire survey on the selected outpatients was performed by the trained medical personnel in the venereal disease clinic of 5 medical institutions in Chongqing .The intervention services were carried out by providing healthy advices and tailor-made preven-tive packs .The healthy knowledge publicity were posted in the waiting area of the venereal clinic .The questionnaire investigation in the re-visiting patients was performed again to understand the awareness of prevention venereal disease knowledge and the condom use .Results 96 .4% of outpatients in this study accepted the AIDS-related knowledge at the first visit .84 .1% of them acquired the knowledge by consulting their doctor ,60 .9% of the patients insisted on using condom in sexual activity after accepting the interven-tion knowledge ,which was much higher than 17 .4% before intervention .Conclusion The STD clinic attenders satisfy the interven-tional preventive service in the venereal clinic ,the improvement of the venereal disease related knowledge and the adverse behaviors is obvious .

Obesity management and scientific evidence

Obesity is now recognized as a critical target for public health intervention in many parts of the world, affecting virtually all age and socio-economic groups within both developed and developing countries. This study's objective is to provide an overview of the full range of methods and models available for weight loss, including some methods used by overweight and obese people without medical supervision. Many diverse approaches for achieving weight loss and weight maintenance have been evaluated. According to some evidence-based guidelines, in order to achieve the best treatment outcomes, it is recommended that a combination of dietary therapy with low-calorie diet, increased physical activity, and behavioral therapy be incorporated. Advances in treatment and innovative policy initiatives focusing on prevention could reverse the global problem of obesity and overweight. The most effective forms of treatment require collaboration among health care providers in primary care settings, including nurses, dietitians, psychologists, physicians, and psychiatrists. Effective strategies for weight loss require management strategies that combine dietary therapy and physical activity by using behavioral interventions. Thus, in the near future, the Korean government must develop evidence-based (clinical or community) guidelines for obesity management. Also, due to the lack of high quality primary studies on obesity management in Korea, future randomized clinical or community trials are recommended in this area.

Stress management and mind-body medicine: focusing on relaxation and meditation

Stress management is important and various stress management methods are required in the area of clinical preventive services. Although defining stress is somewhat complicated, stress can usually be divided into two concepts, stressors and the stress reaction. Stressors are stimuli that arouse the stress reaction. Examples are disasters, life events requiring changes, and everyday hassles. The stress reaction is often called the 'fight or flight reaction' and is mediated by the sympathetic nervous system and various hormones, including cortisol and catecholamine. Stress is closely related with health behaviors and several chronic diseases. Stress is measured using biological tests or self report, including questionnaires and interviews. Psychosocial Wellbeing Index-Short Form, Brief Ecounter PsychoSocial Instrument-Korean version, Global Assessment of Recent Stress Scale, and Symptom Checklist-90-Revised are examples of questionnaires that are widely used in Korea. Stress coping methods are categorized into stimuli-oriented methods, cognitive-behavioral methods, and mind-body interventions. Relaxation and meditation are widely used mind-body medical interventions. Relaxation Response and Mindfulness-Based Stress Reduction are two of the most widely used meditative programs in the Western mainstream medical system. Abdominal breathing, Progressive Muscular Relaxation, relaxing imagery, Autogenic Training, and biofeedback are other well-known techniques for relaxation and stress management. Relaxation and meditation are effective in improving health behaviors and quality of life, and complement the treatment methods of various chronic diseases, including cardiovascular disorders and cancer. Relaxation and meditation also seem to be effective methods for use in clinical preventive services. Program development, standardization, and further study are necessary for more widespread use of mind-body interventions in the area of clinical preventive services.

Health Promotion Services and Chronic Disease Management and Preventive services

The goal is to improve the national health level in our country. To achieve this how to manage the chronic diseases cost-effectively is very important. Population-based comprehensive Chronic Care Model approach should be arranged in the national health insurance framework. It is necessary that private health promotion services are launched in the market, but we should focus on which way of delivering preventive services can benefit in the future.

Effects of Having Regular Source of Care on Preventive Services and Disease Control

BACKGROUND: Regular source of care has been demonstrated to be positively correlated with an individual's access to the health care system, improvement of patient's satisfaction with medical care and clinical preventive services, and control of chronic disease. But in Korea, no studies exist on the maintenance rate of regular source of care, the associated factors of maintenance and the effects on preventive services and disease control. METHODS: We analyzed 25,478 subjects aged 19 and over from the 2001 Korean National Health and Nutrition Examination Survey. RESULTS: Among all, 29.9% had a regular source of care. Those who had regular source of care 59.6% were primary clinic, 35.9% were hospitals. The maintenance rate of regular source of care was higher in those of age over 50, higher education level, non-manual and other works, married state, and poorly perceived health status. Having a regular source of care had positive effects on preventive services, such as stomach, breast, cervix cancer exam, and blood pressure checkup. But having a regular source of care had no significant effect on predictive factors of smoking cessation and control of hypertension and diabetes. CONCLUSION: The maintenance rate of a regular source of care was low, about 30% of the subjects. Age, education level, occupation, marital state, perceived health status were related with the maintenance. Health policy to promote having a regular source of care is needed, considering the positive effect on preventive services. Hereafter, studies to assess clinical and health scientific significance of having a regular source of care are needed.

Effects of Having Regular Source of Care on Preventive Services and Disease Control

BACKGROUND: Regular source of care has been demonstrated to be positively correlated with an individual's access to the health care system, improvement of patient's satisfaction with medical care and clinical preventive services, and control of chronic disease. But in Korea, no studies exist on the maintenance rate of regular source of care, the associated factors of maintenance and the effects on preventive services and disease control. METHODS: We analyzed 25,478 subjects aged 19 and over from the 2001 Korean National Health and Nutrition Examination Survey. RESULTS: Among all, 29.9% had a regular source of care. Those who had regular source of care 59.6% were primary clinic, 35.9% were hospitals. The maintenance rate of regular source of care was higher in those of age over 50, higher education level, non-manual and other works, married state, and poorly perceived health status. Having a regular source of care had positive effects on preventive services, such as stomach, breast, cervix cancer exam, and blood pressure checkup. But having a regular source of care had no significant effect on predictive factors of smoking cessation and control of hypertension and diabetes. CONCLUSION: The maintenance rate of a regular source of care was low, about 30% of the subjects. Age, education level, occupation, marital state, perceived health status were related with the maintenance. Health policy to promote having a regular source of care is needed, considering the positive effect on preventive services. Hereafter, studies to assess clinical and health scientific significance of having a regular source of care are needed.

The Delivery of Diabetic Care and Preventive Services among Diabetic Patients in Family Practice

BACKGROUND: The delivery of proper diabetes care and preventive services is essential for diabetic patients in family practice. However, there are few studies on preventive service practice. This study aimed to survey the delivery of preventive services among diabetic patients in an outpatient department of family medicine in a general hospital. METHODS: We reviewed all of the electronic medical records and charts of patients with a recent diagnosis code of type II diabetes mellitus in an outpatient department of family medicine at Asan Medical Center from January 1, 2001, to December 31, 2002, encompassing documentation of laboratory tests, treatment, and cancer screening. RESULTS: This study included 124 patients with diabetes. Blood pressure measurement, fundus examination, and nutritional counseling were performed in 96.7%, 80.6%, and 50% of subjects, respectively. Lipid profiles and urine microalbumin were checked in 91.1% and 58.2%, respectively. Anti-platelet and anti-smoking agents were prescribed in 17.7% and 13.2%, respectively. In males, the rate of cancer screening for stomach and colon were 55.9 and 53.2%, respectively. In females, the rate of cancer screening for stomach, colon, breast, and cervix were 45.5, 51.6, 43.2, and 38.6%, respectively. CONCLUSION: Diabetic care related services were delivered more often than those of preventive services, such as cancer screening and prescription of anti-smoking or anti-platelet agents. Efforts to improve the delivery of preventive services are needed among diabetic patients in family practice.