The impact of hypertension follow-up management on the choices of signing up family doctor contract services: does socioeconomic status matter?

BACKGROUND: This study aimed to explore the association between hypertension follow-up management and family doctor contract services, as well as to examine whether socioeconomic status (SES) had an interaction effect on this relationship among older adults in China. METHODS: We used data from the sixth National Health Service Survey of Shandong Province, China, including 3,112 older adults (age ≥ 60 years) with hypertension in 2018. Logistic regression models and a margins plot were used to analyze the role of SES in the relationship between hypertension follow-up management and family doctor contract services. RESULTS: The regular hypertension follow-up management rate and family doctor contracting rate were 81.8% and 70.9%, respectively, among older adults with hypertension. We found that participants with regular hypertension follow-up management were more likely to sign family doctor contract services (OR=1.28, 95%CI: 1.04, 1.58, P=0.018). The interaction effect occurred in the groups who lived in rural areas (OR=1.55, 95%CI: 1.02, 2.35), with high education level (OR=0.53, 95%CI: 0.32, 0.88) and had high incomes (OR=0.53, 95%CI: 0.35, 0.81). CONCLUSIONS: Our findings suggested that regular hypertension follow-up management was associated with family doctor contract services and SES influenced this relationship. Primary health care should improve the contracting rate of family doctors by strengthening follow-up management of chronic diseases. Family doctors should focus on improving services quality and enriching the content of service packages especially for older adults with higher income and education level.

Prenatal transposition of great arteries diagnosis and management: a Chinese single-center study.

Objective: This study aimed to assess the diagnostic value of prenatal echocardiography for identifying transposition of the great arteries (TGA) during pregnancy and evaluating the associated outcomes. Methods: We conducted a retrospective analysis of 121 prenatally diagnosed patients with TGA at our hospital between January 2012 and September 2022. This analysis included prenatal ultrasound, prenatal screening, clinical management and follow-up procedures. Results: Among the 103 fetuses considered in the study, 90 (87.4%) were diagnosed with complete transposition of the great arteries (D-TGA), while 13 (12.6%) exhibited corrected transposition of the great arteries (CC-TGA). Diagnoses were distributed across the trimester, with 8 D-TGA and 2 CC-TGA patients identified in the first trimester, 68 D-TGA patients and 9 CC-TGA patients in the second trimester, and 14 D-TGA and 2 CC-TGA patients referred for diagnosis in the third trimester. Induction of labour was pursued for 76 D-TGA patients (84.4%) and 11 CC-TGA patients (84.6%), and 14 D-TGA patients (15.6%) and 2 CC-TGA patients (15.4%) continued pregnancy until delivery. Among the D-TGA patients, 9 fetuses (10.0%) underwent surgery, two of which were inadvertent fatality, while the remaining seven experienced positive outcomes. Additionally, seven TGA patients received palliative care, leading to four fatalities among D-TGA patients (5.2%), whereas 1 D-TGA patients and 2 CC-TGA patients survived. Conclusion: This study underscores the feasibility of achieving an accurate prenatal diagnosis of TGA during early pregnancy. The utility of prenatal ultrasound in the development of personalized perinatal plans and the application of multidisciplinary treatment during delivery are conducive.

The importance of intensive follow-up and achieving optimal chronic antithrombotic treatment in hospitalized medical patients with anemia: A prospective cohort study.

BACKGROUND: Anemia is a global health concern, particularly among the elderly on chronic antithrombotic treatment. Close monitoring of hemoglobin (Hb) levels and achievement of an optimized treatment significantly enhance patients' quality of life. This study aimed to examine the impact of antithrombotic treatment on Hb levels and readmissions in hospitalized patients with anemia. METHODS: This is a prospective cohort study of patients admitted to the Department of Internal Medicine of the University Hospital of Heraklion, Greece, from November 2021 to October 2022 with the diagnosis of anemia while receiving antithrombotic treatment. Data regarding demographics, past medical history, and laboratory and endoscopy findings were recorded. For those receiving inappropriate therapy according to international guidelines, antithrombotic treatment was optimized. Subsequent follow-ups occurred at one and six months post-discharge. Six- and twelve-month anemia-caused readmissions, as well as annual mortality, were evaluated. RESULTS: In total, 104 patients were assessed. Among them, 34.6% were on antiplatelets, 56.7% were on anticoagulants, and 8.7% were on combination treatment. The mean age was 80 ± 8.2 years, and 54.8% were males. On admission, mean Hb levels were 6.86 ± 1.23 g/dL, while 56 (53.8%) patients had severe anemia. Gastroscopy and colonoscopy were performed in 75.0% and 41.4% of patients, respectively, confirming gastrointestinal bleeding in most of the cases. Treatment optimization was carried out for 56 patients. Follow-up revealed elevated Hb levels after one and six months post-discharge, while anemia-related readmissions stayed below 10%. CONCLUSIONS: Most hospitalized anemic patients on antithrombotic treatment had endoscopic findings favoring gastrointestinal bleeding. Half received inappropriate antithrombotic therapy. Treatment optimization and regular follow-up improved Hb levels and reduced readmissions.

Innovative Teaching of "Doctor-patient" Friendly Model for Diabetes from the Perspective of Deep Blended Learning / 中国医学伦理学

The teaching of diabetes has always been the focus and difficulty of clinical internal science teaching. How to skillfully integrate theoretical knowledge into clinical practice and help students deeply master medical knowledge and clinical skills is a topic that clinical teaching teachers are considering. Under the background of analyzing the concept and connotation of deep blended learning, this paper constructed the diabetes "doctor-patient" friendly model teaching process in the perspective of deep blended learning from the three stages of "learning situation analysis and independent learning" in the early stage, "ability improvement and in-depth research" in the middle stage, and "reflection and ability expansion" in the later stage. This paper expounded the positive role of the "doctor-patient" friendly model of diabetes in clinical teaching from three main aspects: improving the integration effect of theory and practice, fully meeting students’ learning needs, and increasing the connection between doctors, patients, and students.

Follow-up management service and health outcomes of hypertensive patients in China: A cross-sectional analysis from the national health service survey in Jiangsu province.

Background: Hypertension is a major cause of early mortality worldwide. Health follow-up management services can encourage patients with hypertension to improve their health behavior and outcomes. However, a lack of studies on the relationship between specific factors of follow-up management and both subjective and objective health outcome among hypertensive patients exists. The current study investigated the relationship between service content, frequency, mode, and institutions of follow-up management and health outcomes among Chinese hypertensives. Methods: Data were obtained from the sixth National Health Service Survey (NHSS) of Jiangsu Province, which was conducted in 2018. Descriptive statistics were used to analyze the sample characteristics and the utilization of follow-up management services. Both multiple linear regression and logistic regression were used to estimate the association of follow-up management service and other factors with hypertensives' subjective and objective health outcomes. Result: Some respondents (19.30%) reported hypertension, and 75.36% of these patients obtained follow-up management services. Hypertensive patients' subjective health outcome self-reported health status and objective health outcome blood pressure (BP) control were found to be significantly associated with follow-up management services. The outcomes were both significantly improved by a high frequency of management services, a high level of follow-up providers, the mode of visiting healthcare facilities and/or calling, and receiving instructions on medication use. However, inquiring about patients' symptoms was negatively associated with self-reported health status and BP control. In addition, BP measurement was significantly and positively associated with hypertensive patients' self-reported health status; the patients receiving lifestyle guidance were more likely to have their BP levels under control. Conclusions: Hypertension management strategies should further focus on the frequency of healthcare follow-up management via categorization of the follow-up services and appropriate adjustment of service delivery modes to optimize health follow-up management for hypertensives further improve their outcomes. Meanwhile, complementary policies are also needed to address other socioeconomic factors that can promote good health conditions for hypertension patients.

WeChat-based remote follow-up management alleviates the home care burden and anxiety of parents of premature infants: Randomized controlled study.

OBJECTIVE: The purpose of this study was to explore the effect of WeChat-based remote follow-up management on reducing the home care burden and anxiety of parents of premature infants. METHODS: A randomized controlled study was conducted in our hospital, with 150 premature infants enrolled in this study, each with 75 cases in the intervention group and the control group. WeChat-based remote follow-up management was performed in the intervention group after discharge, while traditional outpatient follow-up management was performed in the control group. Zarit Burden Interview (ZBI) scale as the primary outcome was used to compare the parental care burden between the two groups. RESULTS: At the 1-month follow-up, the ZBI (37.1 ± 8.3 vs. 54.2 ± 10.5 [mean ± SD], mean difference: 17.1, the 95% confidence interval for the mean difference: [14.07, 20.13], P = 0.016), Family Caregiver Task Inventory (FCTI) scale (23.1 ± 5.2 vs. 33.4 ± 6.7 [mean ± SD], mean difference: 10.3, the 95% confidence interval for the mean difference: [8.38, 12.22], P = 0.023), Self-Rating Anxiety Scale (SAS) (49.6 ± 8.5 vs. 60.2 ± 10.8 [mean ± SD], mean difference: 10.6, the 95% confidence interval for the mean difference: [7.49,13.71], P = 0.021) and Self-Rating Depression Scale (SDS) (48.2 ± 9.5 vs. 58.8 ± 11.2 [mean ± SD], mean difference: 10.6, the 95% confidence interval for the mean difference: [7.28, 13.92], P = 0.019) scores of the intervention group were lower than those of the control group, and the lower scores indicate better outcomes. CONCLUSION: WeChat-based remote follow-up management of premature infants after discharge can effectively improve parents' ability to care and their psychological state and reduce burden of care.

Gestión de seguimiento a pacientes rurales con parasitosis intestinales: apoyo desde el laboratorio clínico / Follow-up management of rural patients with intestinal parasites: support from the clinical laboratory

Se realizó una investigación operativa, de alcance longitudinal, en el periodo comprendido entre abril y noviembre de 2019, con el objetivo determinar indicadores y propuestas de mejora para la gestión de seguimiento a pacientes rurales con parasitosis intestinales, diagnosticados en el laboratorio clínico del Centro de Salud Tipo C Quero (CSQ). El universo del estudio estuvo conformado por 15.842 usuarios potenciales del CSQ. El tipo de muestreo fue por conveniencia; la población consistió en 217 pacientes que acudieron al laboratorio institucional durante el periodo de estudio para realizarse el examen coproparasitario. La muestra estuvo conformada por 184 pacientes con diagnóstico de parasitosis intestinal. Para determinar la gestión de cuidados de los pacientes rurales diagnosticados con parasitosis intestinales, se tuvieron en cuenta 8 variables y 8 indicadores para el período de estudio, las cuales se obtuvieron mediante el seguimiento a los procesos del laboratorio clínico, una vez completado el periodo de la investigación. Un total de 217 pacientes del Centro de Salud Tipo C Quero acudieron al laboratorio institucional durante el periodo de estudio para realizarse el examen coproparasitario, de los cuales 169 (77,89%) mostraron un resultado positivo al examen directo, y 15 (6,91%) fueron diagnosticados mediante la técnica de sedimentación por centrifugación, para un total de 184 pacientes con parasitosis intestinales, es decir el 84,8% de la población de estudio, aiendo Endolimax nana, con 22,94% la especie más frecuente, seguida de Entamoeba coli con el 20,78%, Blastocystis spp. 16,06%. Del grupo de 184 pacientes con diagnóstico de parasitosis intestinal que conformaron la muestra del estudio, 31 y 8 (16,85 y 4,35%) mostraron resultado positivo para coparasitación con 2 y 3 especies diferentes, respectivamente. La implementación de indicadores de gestión de cuidados de los pacientes diagnosticados con parasitosis intestinales puede contribuir a la planeación de estrategias para la prevención e identificación factores de riesgo, en dicha población, así como dirigir campañas de educación sanitaria y promover la conciencia sobre la salud y la higiene como medidas que deben ser consideradas e implementadas para disminuir las prevalencias(AU)

An operative investigation, of longitudinal scope, was carried out in the period between April and November 2019, with the objective of determining indicators and improvement proposals for the follow-up management of rural patients with intestinal parasites, diagnosed in the clinical laboratory of the Center for Health Type C Quero (CSQ). The universe of the study was made up of 15,842 potential users of the CSQ. The type of sampling was for convenience; The population consisted of 217 patients who attended the institutional laboratory during the study period to undergo coproparasitic examination. The sample consisted of 184 patients diagnosed with intestinal parasitosis. To determine the care management of rural patients diagnosed with intestinal parasites, 8 variables and 8 indicators were taken into account for the study period, which were obtained by monitoring the clinical laboratory processes, once the period of study was completed. the investigation. A total of 217 patients from the Quero Type C Health Center attended the institutional laboratory during the study period to undergo coproparasitic examination, of which 169 (77.89%) showed a positive result on direct examination, and 15 (6. 91%) were diagnosed by the centrifugation sedimentation technique, for a total of 184 patients with intestinal parasites, that is, 84.8% of the study population. Being Endolimax nana, with 22.94% the most frequent species, followed by of Entamoeba coli with 20.78%, Blastocystis spp. 16.06%. Of the group of 184 patients diagnosed with intestinal parasitosis that made up the study sample, 31 and 8 (16.85 and 4.35%) showed positive results for co-parasitic infection with 2 and 3 different species, respectively. The implementation of care management indicators for patients diagnosed with intestinal parasites can contribute to the planning of strategies for the prevention and identification of risk factors in said population, as well as directing health education campaigns and promoting awareness about health and hygiene as measures that must be considered and implemented to reduce prevalence(AU)

Risk Factors and Clinical Outcomes of 54 Cases of Rectal Neuroendocrine Tumors with Incomplete Resection: A Retrospective Single-Center Study.

OBJECTIVE: The present study aimed to analyze the risk factors and clinical outcomes of the incomplete endoscopic resection of rectal neuroendocrine tumors (rNETs). METHODS: This study retrospectively analyzed the cases of 428 patients with rNETs who had undergone endoscopic treatment in the Department of Gastroenterology at the PLA General Hospital, China, between January 2010 and September 2019. RESULTS: Of the 428 patients with rNETs, 266 were men (62.1%) and 162 were women (37.9%). Of these, 54 had been pathologically diagnosed with positive incisal margins without lymphatic vessel invasion, and the incomplete resection (R1) rate was 12.6%. Among the R1 patients, 28 had received endoscopic submucosal dissection, 22 had received endoscopic mucosal resection, two had received snare resection, and two had undergone removal with forceps. In addition, there were 31 cases of grade G1 R1 resection (11.2%; 31/277), 13 cases of grade G2 R1 resection (23.2%; 13/56), and 10 cases whose grading was not described. The univariate analysis showed the pathological grade was statistically correlated with R1 resection (P < 0.05), and the grade G2 R1 resection rate was higher than that of grade G1. The multivariate logistic regression analysis showed that grade G2 was an independent risk factor leading to R1 resection (P = 0.02). All patients with R1 resection were followed up for 10-110 months, with an average of 38 months. No salvage treatment was performed. The endoscopic monitoring showed there were no recurrences during the follow-up period. CONCLUSION: Endoscopic resection is a good option for rNETs, with a high complete resection rate and good prognosis, with rare recurrence even if endoscopic resection is not complete.

Telemedicine for Follow-up Management of Patients After Liver Transplantation: Cohort Study.

BACKGROUND: Technical capabilities for performing liver transplantation have developed rapidly; however, the lack of available livers has prompted the utilization of edge donor grafts, including those donated after circulatory death, older donors, and hepatic steatosis, thereby rendering it difficult to define optimal clinical outcomes. OBJECTIVE: We aimed to investigate the efficacy of telemedicine for follow-up management after liver transplantation. METHODS: To determine the efficacy of telemedicine for follow-up after liver transplantation, we performed a clinical observation cohort study to evaluate the rate of recovery, readmission rate within 30 days after discharge, mortality, and morbidity. Patients (n=110) who underwent liver transplantation (with livers from organ donation after citizen's death) were randomly assigned to receive either telemedicine-based follow-up management for 2 weeks in addition to the usual care or usual care follow-up only. Patients in the telemedicine group were given a robot free-of-charge for 2 weeks of follow-up. Using the robot, patients interacted daily, for approximately 20 minutes, with transplant specialists who assessed respiratory rate, electrocardiogram, blood pressure, oxygen saturation, and blood glucose level; asked patients about immunosuppressant medication use, diet, sleep, gastrointestinal function, exercise, and T-tube drainage; and recommended rehabilitation exercises. RESULTS: No differences were detected between patients in the telemedicine group (n=52) and those in the usual care group (n=50) regarding age (P=.17), the model for end-stage liver disease score (MELD, P=.14), operation time (P=.51), blood loss (P=.07), and transfusion volume (P=.13). The length and expenses of the initial hospitalization (P=.03 and P=.049) were lower in the telemedicine group than they were in the usual care follow-up group. The number of patients with MELD score ≥30 before liver transplantation was greater in the usual care follow-up group than that in the telemedicine group. Furthermore, the readmission rate within 30 days after discharge was markedly lower in the telemedicine group than in the usual care follow-up group (P=.02). The postoperative survival rates at 12 months in the telemedicine group and the usual care follow-up group were 94.2% and 90.0% (P=.65), respectively. Warning signs of complications were detected early and treated in time in the telemedicine group. Furthermore, no significant difference was detected in the long-term visit cumulative survival rate between the two groups (P=.50). CONCLUSIONS: Rapid recovery and markedly lower readmission rates within 30 days after discharge were evident for telemedicine follow-up management of patients post-liver transplantation, which might be due to high-efficiency in perioperative and follow-up management. Moreover, telemedicine follow-up management promotes the self-management and medication adherence, which improves patients' health-related quality of life and facilitates achieving optimal clinical outcomes in post-liver transplantation.

Development of a Chatbot Program for Follow-Up Management of Workers' General Health Examinations in Korea: A Pilot Study.

(1) Background: Follow-up management of workers' general health examination (WGHE) is important, but it is not currently well done. Chatbot, a type of digital healthcare tool, is used in various medical fields but has never been developed for follow-up management of WGHE in Korea. (2) Methods: The database containing results and explanations related to WGHE was constructed. Then, the channel, which connects users with the database was created. A user survey regarding effectiveness was administered to 23 healthcare providers. Additionally, interviews on applicability for occupational health services were conducted with six nurses in the agency of occupational health management. (3) Results: Chatbot was implemented on a small scale on the Amazon cloud service (AWS) EC2 using KaKaoTalk and Web Chat as user channels. Regarding the effectiveness, 21 (91.30%) rated the need for chatbots as very high; however, 11 (47.83%) rated the usability as not high. Of the 23 participants, 14 (60.87%) expressed overall satisfaction. Nurses appreciated the chatbot program as a method for resolving accessibility and as an aid for explaining examination results and follow-up management. (4) Conclusions: The effectiveness of WGHE and the applicability in the occupational health service of the chatbot program for follow-up management can be confirmed.

Application of REDCap system in clinical study follow-up process management / 中华医学科研管理杂志

Objective:To summarize the experiences of clinical study project management in Peking University Clinical Research Institute, REDCap (Research Electronic Data Capture) data management system was proposed to improve the follow-up process management.Methods:Current clinical study follow-up process management situation were analyzed and methods for utilizing REDCap in follow-up management was proposed.Results:Using REDCap through " direct management" and " system management" data management can improve the follow-up quality and standard level of management in clinical study, at the same time, secured better protection of participants′ privacy and rights during the process.Conclusions:REDCap plays crucial roles in securing follow-up data quality from the source, timely tracking and standardization of follow-up management, it can be adopted more widely in assisting clinical study follow-up management.

Challenges and suggestions for follow-up management of investigator initiated clinical trials under the normalization of COVID-19 / 中华医学科研管理杂志

Objective:Proposed suggestions to improve the quality of investigator-initiated trials follow-up management under the normalization of COVID-19.Methods:Analyzed current status and challenges of follow-up management in China investigator initiated trial through a combination of literature review and previous work reflection, in the context of normalization of COVID-19.Results:Follow-up management of investigator initiated trial had shown variations in follow-up contents, methods, personnel and auxiliary tools. The insufficient research funding and lacking of professional clinical research team support have led to the challenges of low follow-up visits, insufficient follow-up personnel, lack of electronic follow-up platforms, and unknown follow-up time windows for investigator-initiated trials, which became more prominent in the context of COVID-19.Conclusions:In order to improve the quality of follow-up management during the normalization of COVID-19, appropriate amendment of the investigator-initiated trials follow up should be carefully considered. For instance, taking into account of the characteristics of the research disease, the main research endpoints, the content of the key indicators of the research key follow-up, follow-up methods, follow-up frequency, and follow-up tools to make sure the scientific validity and feasibility, as well as the mandate of clinical research related laws, regulations and ethical requirement. The possible amendments may include follow content, method, mode, frequency, time window. At the same time, re-consent or sufficient disclosure of information should be carried out with compliance of the updated protocols to assure the quality of clinical research follow up.

Key points of serious adverse eventand protection of patients in ophthalmic clinical trials during novel coronavirus pneumonia outbreak / 中华实验眼科杂志

The prevention and control of novel coronavirus pneumonia is the most priority recently, and various measures during the prevention and control period will have varying degrees of impact on the implement of clinical trials. However, various examinations in ophthalmological clinical trials need close contact between operators and patients, which put us at risk of cross-infection. This paper indicated some suggestions based on the criteria of clinical trials under major public health emergencies, the management of clinical trials during epidemic period including the follow-up of subjects, the treatment of epidemic serious adverse event (SAE) and the management requirements of co-sponsors, as well as the requirements and management principles for environment, subjects, examiners and inspection equipment in the process of ophthalmic clinical trials. It may be helpful to the ophthalmic clinical trial researchers and subjects during the period of novel coronavirus infection.

The Effect of Special Medical Examination for Night Shift Workers and Follow-Up Management Against Hypertension.

BACKGROUND: Special health examination is a screening program introduced in 1973 in Korea to examine health problems of workers who are regularly exposed to 177 hazardous substances and physical environments specified by the Occupational Safety and Health Act. Shiftwork was added as a risk factor in 2013. The purpose of this study was to analyze changes of hypertension status after a special medical examination and subsequent follow-up management. METHODS: We used the data based on the special medical examination outcomes for night shift workers, performed at seven different health examination centers under the Korea Medical Institute (KMI) between 2014 and 2016. Workers who received special medical examinations for two consecutive years (2014⁻2015 and 2015⁻2016) were selected. A final study population of 2070 was evaluated. RESULTS: Compared with the first-year examination, 1503 subjects (72.6%) received hypertension medication or showed improvement in blood pressure in their second-year examination. Older age (≥40s), women, larger workplaces (≥300 full-time workers), long-term workers (≥12 years), improvement in smoking habits, improvements for diabetes or dyslipidemia, normal or reduced BMI, and normal waist circumference were associated with proper management of hypertension. CONCLUSIONS: An appropriate follow-up management program should be developed to provide health management for night shift workers that need to focus on the factors identified in this study.

Research on strategies for academic clinical research investigators strengthening follow-up management / 中华医学科研管理杂志

Objective According to the study of academic clinical research managed by Peking University Clinical Research Institute,identified problems that existed during the follow up in clinical research.Strategies and methods were proposed after analyzed the related problems,to enhance the quality of follow-up in clinical research.Methods Analysis of common follow-up management problems found in project management and on-site monitoring.Results Strategies and suggestions were proposed,table tools and management software were recommended to investigators for strengthening follow-up management.Conclusions Investigators should follow the scientific validity,research strategy and methodologies during the implementation of clinical research,to make sure compliance to increase the follow-up rates and guarantee the data quality.

Effect of team follow-up on continuous management of cancer pain patients / 中国实用护理杂志

Objective To explore the effect of continuous management of cancer pain patients by group follow-up model. Methods A total of 86 cases of cancer pain patients discharged from oncology department from March to May 2016 were selected and grouped according to the number of inpatients. The control group(44 cases)was treated with conventional intervention, and the experimental group(42 cases) was followed by team follow-up. The cancer pain control effect and quality of life were evaluated in the two groups after 1 month. Results The average degree of pain degree within 24 h in the past pain after intervention respectively was (2.90 ± 0.85) (2.56 ± 0.79) points in the experimental group and (4.17 ± 0.92) (4.00 ± 1.18) points in the control group, there was statistically significant difference between the two groups (t=6.618, 6.492, P < 0.01). The quality of life in physical function, cognitive function, social function, general health level was(66.83 ± 20.02),(69.33 ± 15.45),(61.17 ± 16.50),(63.83 ± 17.93)points in the experimental group,(27.83 ± 11.97),(36.17 ± 16.24),(26.14 ± 17.29),(28.23 ± 17.43)points in the control group, there were significant differences(t =4.224-9.727,P<0.05 or 0.01). There was no significant difference in role function and emotion function between the two groups (P>0.05). Conclusions The continuous management of team follow-up can help the patients with cancer pain continue to receive standard treatment and care after discharge, which will help improve the patient's pain control level and improve the quality of life.

Effect of Follow-up Management on Cerebro-cardiovascular Disease Risk for Small Sized Company Workers / 계명의대학술지

To explore the effect of follow-up management after health examination for the cerebro-cardiovascular disease risk, a survey applied with the KOSHA cerebro-cardiovascular disease risk assessment tool was conducted with 500 workers in small scale enterprise less than 50 employees. They were provided two types of health services; post-examination management and health consultation, and finally compared the cerebro-cardiovascular disease risk changes between 2014 and 2015. In normal group in 2014, only 18.7% of workers who received the follow-up management had elevated risks, while 23.8% of workers who received the health consultation had elevated risks in 2015. In risk group in 2014, only 2.8% of workers who got follow-up management had elevated risks, while 7.7% of workers who got only health consultation had elevated risks in 2015. After adjustment for gender, age, exercise, body mass index, nationality and type of industry, negative correlation was found in association to the follow-up management (odds ratio = 0.87). This study shows that workers with cerebro-cardiovascular disease or who are at high cerebro-cardiovascular risk in small scale enterprise should receive early detection and management using counselling and regular follow-up after periodic health examination. Also the health counselling including preventive education for cerebro-cardiovascular disease is needed for all workers to improve their self-management for health.

Loss to follow-up in anti-HCV-positive patients in a Brazilian regional outpatient clinic

Loss to follow-up (LF), which refers to patients who started care but voluntary stopped it, is a problem for patients with chronic disease. We aimed to estimate the rate of LF among patients seropositive for hepatitis C virus (HCV) and identify possible demographic and lifestyle risk factors associated with LF. From January 2009 through December 2012, 1010 anti-HCV-positive patients were included in the study. Among participants, 223 (22.1%) met the case definition for LF (more than 1-year elapsed since the last clinical appointment). Among 787 patients who remained in follow-up, 372 (47.2%) were discharged after undetectable HCV RNA, 88 (11.1%) were transferred (and remained on regular follow-up at the destination), and 25 (3.1%) died. According to univariate analysis, male gender, absence of a life partner, black race, psychiatric illness, previous alcohol abuse, previous or current recreational drug use, and previous or current smoking were significantly associated with LF. In multivariate analysis, absence of a life partner (adjusted odds ratio (AOR)=1.44; 95% confidence interval (95%CI)=1.03–2.02), black race (AOR=1.81, 95%CI=1.12–2.89), psychiatric illness (AOR=1.77, 95%CI=1.14–2.73), and the presence of at least one lifestyle risk factor (pertaining to substance abuse) (AOR=1.95, 95%CI=1.29–2.94) were independently associated with LF. Our study provides an estimate of the incidence of LF among anti-HCV-positive patients and identifies risk factors associated with this outcome. In addition, these results can help clinicians recognize patients at risk for LF, who require additional support for the continuity of care.

Analysis on application effect of the wechat public platform in follow-up management of patients with moderate or severe craniocerebral injury / 中国实用护理杂志

Objective To explore the application effect of the wechat public platform in follow-up management of patients with moderate or severe craniocerebral injury.Methods 98 patients admitted in the craniocerebral department of our hospital from February to November 2014 were selected and divided into two groups by random number table method,with 48 cases in the control group and 50 cases in the observation group;the traditional follow-up management mode using telephone was adopted to patients in the control group,while the follow-up management mode using the wechat public platform was adopted to those in the observation group,with a follow-up period of 3 months;for patients in both groups,their activities of daily living (ADL) and exercise of self-care agency (ESCA) abilities before and after intervention,occurrence of adverse events and complications within the follow-up period,and their degree of satisfaction towards the follow-up management were collected.Results After intervention,ADL score,total scores of ESCA and total scores of satisfaction towards the follow-up management among patients in the observation group were 87.34±15.26,24.36±17.24 and 86.07±14.82,which were significantly higher than that among patients in the control group were 66.72±14.62,99.37±15.29 and 61.14±13.19 (t=7.941,7.982,6.962,all P ＜0.01);within intervention,the observation group had significantly lower total occurrence rate of adverse events and complications which was16.00％ (8/50) compared to the control group 39.58％ (19/48) (x2=6.824,P ＜ 0.01).Conclusions By establishing the follow-up management mode for patients with craniocrerbral injury through the wechat public platform,effect of the follow-up management can be effectively promoted,prognosis of patients can be improved and patients' degree of satisfaction can be enhanced;it is worth of being further promoted clinically.