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1.
J Oral Rehabil ; 51(5): 840-850, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38186265

RESUMO

BACKGROUND: Aboriginal older adults residing in remote areas have poor oral function due to inadequate access to healthcare services. Lay health advisor (LHA) strategies can fill capacity shortages of healthcare professionals in rural communities and increase population acceptance of health care or healthy behaviours. OBJECTIVE(S): To evaluate the effectiveness the LHA program on oral function and oral health-related quality of life (OHRQoL) among older adults in aboriginal community. METHODS: Participants were randomly assigned to an experimental group (EG; n = 122) and a control group (CG; n = 118). All participants performed oral exercises, and the EG received additional one-on-one 30-min lessons by an LHA over 4 weeks. Data were collected through face-to-face interview and oral examination. The generalized estimating equation model was used to analyse changes in outcomes over time. RESULTS: The EG exhibited significantly greater improvement in swallowing (ß = .63) at the 6-month follow-up and in masticatory performance (ß = .52) and pronunciation of the syllable/pa/ (ß = 2.65) at the 2-week follow-up than the CG did. The EG had a significantly lower plaque control record (ß = -.14) and plaque index (ß = -.30) at the 3-month follow-up than the CG did. Moreover, the OHRQoL was significantly increased at 6-months follow-up in the EG (p = .010). CONCLUSION: The LHA program had positive effects on chewing, swallowing and plaque control in aboriginal older adults. LHA group also experienced positive long-term effect on OHRQoL after intervention.


Assuntos
Promoção da Saúde , Qualidade de Vida , Humanos , Idoso , Assistência Odontológica , Índice de Placa Dentária , Saúde Bucal
2.
J Clin Periodontol ; 49(10): 988-998, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35713224

RESUMO

AIM: To evaluate the effects of an at-home artificial intelligence (AI)-assisted dental monitoring application on treatment outcomes in patients with periodontitis. MATERIALS AND METHODS: Participants with periodontitis were recruited and randomly assigned to an AI (n = 16), AI and human counselling (AIHC; n = 17), or control (CG; n = 20) group. All participants received non-surgical periodontal treatment. We employed an AI-assisted tool called DENTAL MONITORING® (DM) intervention, a new technological AI monitoring product that utilizes smartphone cameras for intra-oral scanning and assessment. Patients in the AI and AIHC groups received additional (a) DM or (b) DM, respectively, with real-person counselling over 3 months. Periodontal parameters were collected at baseline and follow-ups. A mixed-design model analysed the follow-up effects over time. RESULTS: The AI and AIHC groups, respectively, exhibited greater improvement in probing pocket depth (PPD) (mean diff = -0.9 ± 0.4 and -1.4 ± 0.3, effect size [ES] = 0.76 and 1.98), clinical attachment level (mean diff = -0.8 ± 0.3 and -1.4 ± 0.3, ES = 0.84 and 1.77), and plaque index (mean diff = -0.5 ± 0.2 and - 0.7 ± 0.2, ES = 0.93 and 1.81) at 3-month follow-up than the CG did. The AIHC group had a greater reduction in PPD (ES = 0.46) and clinical attachment level (ES = 0.64) at the 3-month follow-up compared with the AI group. CONCLUSIONS: Using AI monitoring at home had a positive effect on treatment outcomes for patients with periodontitis. Patients who received AI-assisted health counselling exhibited better treatment outcomes than did patients who received AI monitoring alone.


Assuntos
Periodontite Crônica , Periodontite , Inteligência Artificial , Periodontite Crônica/terapia , Raspagem Dentária , Seguimentos , Humanos , Perda da Inserção Periodontal/tratamento farmacológico , Índice Periodontal , Bolsa Periodontal/tratamento farmacológico , Periodontite/tratamento farmacológico
3.
BMC Oral Health ; 21(1): 573, 2021 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749720

RESUMO

BACKGROUND: We evaluated the effects of health-promoting school (HPS) strategy on plaque control and behavior change in high-caries schoolchildren in Taitung, Taiwan. METHODS: A quasi-experimental design was adopted; six intervention schools (intervention group [IG]) and six comparison schools (comparison group [CG]) were selected from elementary schools with higher-than-average caries rates (> 68%). The IG was selected using cluster sampling, and the CG was selected to match the IG. In total, the IG and CG groups included 166 and 174 children each. The selected schools implemented the HPS framework for 3 months in the 2019 academic year. An oral examination of dental plaque was administered, and a self-administered questionnaire regarding knowledge, attitude, self-efficacy, and behaviors was distributed at baseline and at 2-week follow-up. A linear and logistic regression model using generalized estimating equations (GEEs) was used to analyze the differences between baseline and the follow-up data. RESULTS: Compared with the CG, the IG had a greater reduction in plaque index among second graders (ß = - 0.36) and plaque control record scores among second, fourth, and sixth graders (ß = - 27.48, - 26.04, and - 18.38, respectively). The IG also exhibited a greater increase at follow-up with respect to oral health-related knowledge among second graders and fourth graders (ß = 1.46 and ß = 0.92, respectively), attitude toward oral hygiene behaviors among sixth graders (ß = 1.78), and self-efficacy regarding flossing for sixth graders (ß = 1.43). Sixth graders in the IG were significantly more likely to brush before sleeping (adjusted odds ratio [aOR] = 2.99) and use fluoride toothpaste (aOR = 5.88) than those in the CG. CONCLUSIONS: The HPS strategy was effective in reducing dental plaque and promoting preventing behaviors in rural high-caries schoolchildren.


Assuntos
Cárie Dentária , Placa Dentária , Criança , Suscetibilidade à Cárie Dentária , Placa Dentária/prevenção & controle , Humanos , Projetos de Pesquisa , Instituições Acadêmicas , Taiwan
4.
Caries Res ; 49(2): 147-56, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25634314

RESUMO

Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.


Assuntos
Agentes Comunitários de Saúde/educação , Currículo , Cárie Dentária/prevenção & controle , Emigrantes e Imigrantes , Disparidades em Assistência à Saúde , Adulto , Atitude Frente a Saúde , Cariostáticos/uso terapêutico , Criança , Comunicação , Assistência à Saúde Culturalmente Competente , Assistência Odontológica para Crianças , Dispositivos para o Cuidado Bucal Domiciliar , Feminino , Fluoretos/uso terapêutico , Comportamentos Relacionados com a Saúde , Educação em Saúde Bucal , Conhecimentos, Atitudes e Prática em Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Área Carente de Assistência Médica , Higiene Bucal , Avaliação de Programas e Projetos de Saúde , Autoeficácia , Ensino/métodos , Escovação Dentária/métodos , Cremes Dentais/uso terapêutico , Adulto Jovem
5.
BMC Public Health ; 14: 755, 2014 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-25065303

RESUMO

BACKGROUND: Current smokers exhibit a higher rate of betel-quid chewing than non-smokers. However, little is known regarding the extent to which betel-quid chewing may affect attempts to quit smoking and smoking cessation. The aim of the present study is to examine the association between betel-quid chewing and patterns of quitting smoking. Specifically, we explore whether betel-quid chewing is associated with (1) current smokers who have never attempted to quit versus those who have attempted to quit and have failed, those who are in the process of quitting, and successful cessation smokers, and (2) current smokers who have attempted to quit and have failed versus those who have successfully quit smoking. METHODS: A telephone survey of 7,215 workers was conducted and obtained an 88.6% response rate. In the survey, the respondents' smoking and betel-quid chewing statuses were recorded and a list of covariates was assessed. RESULTS: After controlling for the effect of the covariates, betel-quid chewing was found to be more highly associated with current smokers who have never attempted to quit, compared to current smokers who are in the process of quitting (OR = 12.72; 95% CI = 1.05-154.26), successful cessation smokers (OR = 3.62; 95% CI = 2.32-5.65), and smokers who have attempted to quit and have failed (OR = 1.37; 95% CI = 1.06-1.77), respectively. In addition, betel-quid chewing is more highly associated with a failure to quit smoking than with successfully quitting smoking (OR = 3.46; 95% CI = 2.17-5.51). CONCLUSION: The findings support four plausible reasons why betel-quid chewing may dissuade smokers from quitting. These reasons highlight additional avenues for potentially reducing the smoking population in workplaces, such as considering work contexts and social norms, and product sales in smoking-cessation campaigns.


Assuntos
Mastigação , Ocupações , Piper betle , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/terapia , Adulto , Feminino , Humanos , Masculino , Fumar/epidemiologia , Taiwan/epidemiologia , Local de Trabalho
6.
BMC Oral Health ; 14: 3, 2014 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-24423385

RESUMO

BACKGROUND: With the growing number of transnational marriages in Taiwan, oral health disparities have become a public health issue. This study assessed immigrant-native differences in oral health behaviors of urban mothers and their children. METHODS: We used the baseline data of an oral health promotion program to examine the immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors. A cross-sectional study was conducted to collect data from mothers in urban area, Taiwan. A total of 150 immigrant and 440 native mothers completed the self-report questionnaires. Logistic regression models analyzed the racial differences in oral health behaviors. RESULTS: Approximately 37% of immigrant mothers used dental floss, 25% used fluoride toothpaste, and only 13.5% of them regularly visited a dentist. Less that 40% of immigrant mothers brush their children's teeth before aged one year, 45% replaced child's toothbrush within 3 months, and only half of the mothers regularly took their child to the dentist. Immigrant mothers had lower level of caries-related knowledge and attitudes than native mothers (p < .001). Compared to native group, the immigrant mothers were less likely to use of dental floss ([Adjusted odds ratio (aOR) =0.35], fluoride toothpaste (aOR = 0.29), visit a dentist in the past 2 years (aOR = 0.26), and take their children to regular dental check-up (aOR = 0.38); whereas, they were more likely to not consume sweeten beverages (aOR = 3.13). CONCLUSIONS: The level of caries-related knowledge, attitudes and oral health behaviors were found lower in immigrant mothers than native ones. The findings suggested cross-cultural caries prevention programs aimed at reducing immigrant-native disparities in child oral health care must be developed for these immigrant minorities.


Assuntos
Atitude Frente a Saúde , Cárie Dentária/psicologia , Emigrantes e Imigrantes/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Saúde Bucal , Adulto , Fatores Etários , Bebidas , Cariostáticos/uso terapêutico , Criança , Pré-Escolar , Estudos Transversais , Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/etiologia , Dispositivos para o Cuidado Bucal Domiciliar/estatística & dados numéricos , Sacarose Alimentar/administração & dosagem , Escolaridade , Emprego , Comportamento Alimentar , Feminino , Fluoretos/uso terapêutico , Humanos , Renda , Relações Mãe-Filho , Taiwan , Escovação Dentária/estatística & dados numéricos , Cremes Dentais/uso terapêutico , Saúde da População Urbana
7.
BMC Public Health ; 12: 40, 2012 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-22251625

RESUMO

BACKGROUND: Exposure to household Secondhand Smoke (SHS) poses a major health threat to children after an indoor smoking ban was imposed in Taiwan. This study aimed to assess the household SHS exposure in elementary school children in southern Taiwan and the factors associated with their avoidance of SHS exposure before and after the implementation of Taiwan's new Tobacco Hazards Prevention Act in 2009. METHODS: In this cross-sectional school-based study, data on household SHS exposure, avoidance of SHS and related variables was obtained from the 2008 and 2009 Control of School-aged Children Smoking Study Survey. A random sample of 52 elementary schools was included. A total of 4450 3-6 graders (aged 8-13) completed the questionnaire. Regression models analyzed factors of children's self-confidence to avoid household SHS exposure. RESULTS: Over 50% of children were found to have lived with a family member who smoked in front of them after the new law enacted, and 35% of them were exposed to household SHS more than 4 days a week. Having a positive attitude toward smoking (ß = -0.05 to -0.06) and high household SHS exposure (ß = -0.34 to -0.47) were significantly associated with a lower avoidance of SHS exposure. Comparing to girls, boys had lower scores in their knowledge of tobacco hazards; and this factor was significantly related to their SHS avoidance (ß = 0.13-0.14). CONCLUSIONS: The intervention program should enhance school children do actively avoid exposure to SHS in home settings, and more importantly, provide tobacco hazard knowledge to male students to avoid exposure to household SHS for themselves. The results also provide further evidence that Tobacco Hazards Prevention Act should perhaps be extended to the family environment in order to protect children from the hazards of household SHS exposure.


Assuntos
Características da Família , Autoeficácia , Estudantes/psicologia , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Análise de Regressão , Taiwan
8.
Healthcare (Basel) ; 10(4)2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35455815

RESUMO

Many studies have investigated health-care workers' confidence in handling workplace violence with the aim of preventing negative outcomes and fear of such events. The aim of this cross-sectional study was to identify the predictors of physicians' confidence in handling workplace violence. A self-administered questionnaire was used to collect data on various factors related to workplace violence against physicians in four regional teaching hospitals in northern Taiwan. Of the 180 respondents, 78 (43.3%) had experienced workplace violence in the 3 months preceding the study; they were assigned to the "victim group". The others (102 respondents) were assigned to the "nonvictim group". According to multiple linear regression analysis, the factors significantly associated with physicians' confidence in handling workplace violence in the victim group were perceived organizational support and workplace violence-related training courses. In the nonvictim group, affiliated department and perceived safety climate were key factors. Organizational factors are key predictors of physicians' confidence in handling workplace violence. Therefore, hospital managers should strive to bolster physicians' confidence in handling workplace violence. For victims of workplace violence, team-based trainings may improve their interpersonal skills and perceived support from colleagues, both of which can prevent workplace violence events and the repetition of such events.

9.
Saf Health Work ; 13(4): 394-400, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36579017

RESUMO

Background: Impacts of exposure are generally monitored and recorded after injuries or illness occur. Yet, absence of conventional after-the-effect impacts (i.e., lagging indicators), tend to focus on physical health and injuries, and fail to inform if workers are not exposed to safety and health hazards. In contrast to lagging indicators, leading indicators are proactive, preventive, and predictive indexes that offer insights how effective safety and health. The present study is to validate an extended Voluntary Protection Programs (VPP) that consists of six leading indicators. Methods: Questionnaires were distributed to 13 organizations (response rate = 93.1%, 1,439 responses) in Taiwan. Cronbach α, multiple linear regression and canonical correlation were used to test the reliability of the extended Voluntary Protection Programs (VPP) which consists of six leading indicators (safe climate, transformational leadership, organizational justice, organizational support, hazard prevention and control, and training). Criteria-related validation strategy was applied to examine relationships of six leading indicators with six criteria (perceived health, burnout, depression, job satisfaction, job performance, and life satisfaction). Results: The results showed that the Cronbach's α of six leading indicators ranged from 0.87 to 0.92. The canonical correlation analysis indicated a positive correlation between the six leading indicators and criteria (1st canonical function: correlation = 0.647, square correlation = 0.419, p < 0.001). Conclusions: The present study validates the extended VPP framework that focuses on promoting safety and physical and mental health. Results further provides applications of the extended VPP framework to promote workers' safety and health.

10.
Acta Crystallogr Sect E Struct Rep Online ; 67(Pt 7): m858, 2011 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-21836857

RESUMO

In the title complex, [Ni(C(9)H(9)BrNO)(2)], the Ni(II) ion lies on an inversion centre and is coordinated in a slightly distorted square-planar geometry by two N atoms and two O atoms from two symmetry-related bidentate 4-bromo-2-(ethyl-imino-meth-yl)phenolate ligands. The complex forms a one-dimensional chain in the crystal structure through short C-H⋯Br contacts (H⋯Br = 3.009 Å).

11.
Health Educ Res ; 25(3): 451-63, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20200109

RESUMO

The aim was to comprehensively examine school-based tobacco policy status, implementation and students' perceived smoking at school in regard to gender-specific differences in smoking behavior. We conducted a multilevel-based study to assess two-level effects for smoking among 2350 grades three to six students in 26 randomly selected elementary schools in southern Taiwan. A series of multilevel models were analyzed separately for male and female students. The school-level variables appear to be related to smoking behavior in male students. Among males, the risk of ever-smoking was significantly associated with those schools without antitobacco health education activities or curricula [adjusted odds ratio (aOR) = 6.23, 95% confidence interval (CI): 2.55-15.24], with a high perceived smoking rate (aOR = 3.08, 95% CI: 1.41-6.72) and located in a mountainous region (aOR = 2.53, 95% CI: 1.15-5.58). The risk of ever-smoking among females was significantly associated with those schools without antitobacco activities or curricula (aOR = 3.10, 95% CI: 1.27-7.55). As compared with female counterparts, the specific school that the male students attended had a positive significant effect on the risk of being ever-smokers. The findings suggest that effective tobacco policy implementation should be considered in elementary schools that are currently putting children at the greatest risk for cigarette smoking, especially in regard to male students.


Assuntos
Instituições Acadêmicas/organização & administração , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar , Atitude Frente a Saúde , Criança , Docentes/normas , Feminino , Educação em Saúde/métodos , Humanos , Masculino , Análise Multinível , Política Organizacional , Fatores de Risco , Fatores Sexuais , Taiwan
12.
Acta Crystallogr Sect E Struct Rep Online ; 66(Pt 11): m1399, 2010 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-21588832

RESUMO

In the title compound, [Co(C(10)H(12)NO(2))(3)]·H(2)O, the Co(III) ion is coordinated by three O atoms and three N atoms from three bidentate 2-eth-oxy-6-(methyl-imino-meth-yl)phenolate ligands in a slightly distorted octa-hedral environment. The water mol-ecule connects two ligands by O-H⋯O hydrogen bonds. One terminal methyl group is disordered over two positions, with site-occupancy factors of 0.412 (15) and 0.588 (15).

13.
PLoS One ; 15(3): e0229853, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32176715

RESUMO

OBJECTIVE: Needlestick and sharp injuries (NSIs) experienced by physicians have been identified as a major occupational hazard. Blood-borne pathogens resulting from the NSIs experienced by physicians pose severe physical and psychological threats to them, as well as people who are around them. However, there is little research focusing on physicians' behaviours to prevent NSIs. In the present study, we investigated the roles of safety climate, job demands experienced by physicians, and physicians' self-efficacy in affecting physicians' behaviours to prevent NSIs. METHODS: 401 physicians from four teaching hospitals in Northern Taiwan were recruited to participate in an anonymous survey. Among them, 189 physicians returned the completed survey with a response rate of 47.1%. RESULTS: Overall, respondents reported frequently engaging in NSI prevention behaviours. As expected, safety climate in hospitals and physicians' self-efficacy to prevent NSIs were significantly related to their behaviours to prevent NSIs (r = 0.22 and r = 0.33, respectively). The moderating analysis also revealed that physicians with high self-efficacy tended to engage in NSI prevention behaviours regardless of levels of job demand they experienced. In contrast to our expectation, however, physicians with low self-efficacy engaged in more NSI prevention behaviours when job demands were high than when the demands were low. CONCLUSIONS: Our findings show the important roles safety climate, job demands and self-efficacy play in shaping physicians' NSI prevention behaviours. Hospitals may consider improving safety climate via strengthening management commitments to NSIs prevention, reducing job demands by training physicians to proactively redesign their own jobs, and increasing physicians' self-efficacy via well-designed skill-based training.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Exposição Ocupacional/prevenção & controle , Médicos/psicologia , Feminino , Hospitais , Humanos , Masculino , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/psicologia , Inquéritos e Questionários , Taiwan/epidemiologia
14.
Medicine (Baltimore) ; 98(12): e14950, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30896664

RESUMO

To explore the relationship between baseline information, personal factors, working characteristics and job performance among nurses in emergency department in northern Taiwan.Two-hundred twenty-two nursing staff were interviewed repeated with structured questionnaires for data collection in 3 time points (From August to September, 2008, from February to March, 2009, and from November to December, 2009). The generalized estimating equation (GEE) is used to test the relationship between the domains of independent variables (baseline information, personal factors, working characteristics) and dependent variables (task performance, contextual performance).The mean age of participants is 30.1 ±â€Š5.1 years. 50.0% are junior college or bachelor degrees. From the GEE model, biological protection (ß = 0.17, P value = .002) and safety climate (ß = 0.24, P value < .001) are significantly related to task performance. Contextual performance is strongly affected by safety climate (ß = 0.15, P value < .001).To improve the job performance among nurses in emergency department, it should consider personal psychological and environmental factors.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Recursos Humanos de Enfermagem Hospitalar/psicologia , Desempenho Profissional/organização & administração , Adulto , Fatores Etários , Feminino , Nível de Saúde , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Saúde Ocupacional , Segurança , Fatores Sexuais , Fatores Socioeconômicos , Taiwan , Carga de Trabalho
15.
Expert Rev Gastroenterol Hepatol ; 13(11): 1077-1088, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31648568

RESUMO

Introduction: The 5-year recurrence rate of hepatocellular carcinoma (HCC) after hepatic resection or local ablation is up to 70%. Adjuvant therapies to prevent HCC recurrence have been reported but are not currently recommended by EASL or AASLD guidelines. This review examined evidence from randomized controlled trials, meta-analyses and systematic reviews on the safety and efficacy of adjuvant therapies and chemotherapies in HCC patients after resection or local ablation.Areas covered: PubMed was searched through 15 June 2019. Available evidence was assessed based on the GRADE system.Expert commentary: Transarterial chemoembolization is the best adjuvant therapy for HCC patients at high risk of recurrence, antiviral therapy with nucleoside analogs is effective for preventing recurrence of HBV-related HCC, and interferon-α is effective for preventing recurrence of HCV-related HCC. Further studies are needed to clarify the efficacy of adjuvant immune checkpoint inhibitors. Adjuvant sorafenib appears to offer negligible clinical benefit and high risk of adverse effects.


Assuntos
Técnicas de Ablação , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica , Hepatectomia , Neoplasias Hepáticas/terapia , Técnicas de Ablação/efeitos adversos , Técnicas de Ablação/mortalidade , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/mortalidade , Quimioterapia Adjuvante , Progressão da Doença , Hepatectomia/efeitos adversos , Hepatectomia/mortalidade , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Recidiva Local de Neoplasia , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
16.
Health Policy ; 86(2-3): 213-21, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18082286

RESUMO

OBJECTIVES: Literature on the influence of smoking prevalence at school-level on the smoking initiation among elementary school children is scarce. The aim of the current study was to explore this in school clusters stratified according to student's perceived smoking prevalence in the school while adjusting for social impact of individual students. METHOD: The data was obtained from a survey administered to 13 elementary schools in Taoyuan County, a final sample of 1585 3rd and 4th grade students. Multi-level logistic regression analysis (MLRA) was used to examine the influence variable at school-level as well as individual socio-environment level had on smoking status of elementary schools students. RESULTS: Attending a school where the students reported a perception of high smoking prevalence had a greater effect on smoking behavior in boys than girls when compared with students attending a lower smoking prevalence school, after adjustment for student-level characteristics. CONCLUSIONS: Our study confirmed that a broader school environment with a high student perception of smoking prevalence is associated with children's smoking behavior in boys. The findings further indicate the need for enforcement of anti-smoking policies within schools with higher smoking rates to reduce visibility of smoking among school children.


Assuntos
Fumar/epidemiologia , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Inquéritos e Questionários , Taiwan/epidemiologia
17.
Sci Total Environ ; 376(1-3): 151-9, 2007 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-17316772

RESUMO

Many epidemiological studies have investigated residential exposure to extremely-low-frequency magnetic field (ELF-MF) for children, but exposure at schools where children may stay up to 8 h every weekday was rarely considered. Between March and June 2004, we carried out a field study in Taipei City and County of northern Taiwan to explore ELF-MF exposure pattern among children at schools with high voltage transmission lines (HVTL) running through the campuses. One hundred and one children attending 14 schools with nearby HVTL (exposed group) and 123 children of 18 schools at least 100 m away from HVTL (unexposed group) were monitored for 24-hour personal ELF-MF exposure. Selected classrooms and playgrounds within the buffer regions (i.e., within 30 m of HVTL) and those away from the buffer regions were also assessed, using spot measurements, to determine the extent to which HVTL may contribute to the environmental exposure on campuses. Results show that the two groups didn't differ significantly for both mean exposure and proportion of exposure greater than 0.4 micro-Tesla (microT) estimated for 24 h. However, we noted that 17.8% of the exposed children had a personal mean exposure greater than 0.4 microT during school hours, significantly (p=0.011) higher than that (6.5%) estimated for the unexposed children. An even higher percentage (27.3%) was observed for 11 students with their classrooms intersecting the buffer regions. Playgrounds near buffer regions showed a significantly higher ELF-MF than the other areas of the exposed schools (0.70 vs 0.18 microT, p=0.043). The study demonstrates a wide range of exposures to ELF-MF among school children at campuses adjacent to HVTL. Children attending the exposed schools may have a higher chance of experiencing a mean exposure greater than 0.4 microT during school hours.


Assuntos
Campos Eletromagnéticos , Exposição Ambiental/análise , Instituições Acadêmicas , Criança , Feminino , Humanos , Masculino , Taiwan
18.
Glob Health Promot ; 23(1 Suppl): 18-25, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27199014

RESUMO

INTRODUCTION: The Taiwan Ministry of Health and Welfare and Ministry of Education launched the Health-Promoting School (HPS) program in 2002. One of the most significant barriers to evaluating HPS is the absence of adequate instruments. The main aim of this study is to develop the Taiwan Health-Promoting School Accreditation System (HPSAS) framework and then evaluate its accreditation effectiveness. METHODS: The HPSAS accreditation standards were derived mainly from the World Health Organization (WHO) publication, WHO Health Promoting Schools: A Framework for Action in 2008 and the Taiwan School Health Act. Delphi technique and pilot test were used to confirm the availability and acceptability of the standards and procedures for HPSAS in 2011. After that, two rounds of school evaluations were completed in 2012 (214 participant schools) and 2014 (182 participant schools). The accreditation operation process included documentary reviews, national and international accredited commissioners conducted on-site visits. Descriptive analyses were used to indicate HPS award level distribution. RESULTS: The study established six key HPSAS standards. Each standard had at least two components; overall, there were 21 components and 47 scoring elements. Of the participating schools evaluated in 2012, four were at the gold, 14 silver, and 120 bronze levels, compared with five, 20, and 31, respectively, of schools evaluated in 2014. The study showed that schools at different award levels had different full-score rates in six standards. The schools at the gold level performed exceptionally well. The worst performance among the six standards at each award level was in the skill-based health curriculum. CONCLUSION: The HPSAS is an objective instrument used to evaluate the process and outcomes of the HPS program. In the future, combinations of different types of data (e.g. students' health behaviors, school climate, or teachers' health-teaching innovations) will enable further validation of the HPS effectiveness.


Assuntos
Acreditação , Educação em Saúde/métodos , Promoção da Saúde/métodos , Serviços de Saúde Escolar/organização & administração , Instituições Acadêmicas/organização & administração , Humanos , Avaliação de Programas e Projetos de Saúde , Taiwan , Organização Mundial da Saúde
19.
World J Clin Cases ; 3(7): 599-606, 2015 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-26244151

RESUMO

The knowledge of gallstone disease (GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be the gold standard treatment for patients with symptomatic GSD, expectant management could be viewed as a valid therapeutic method for this disorder. If early treatment of GSD decreases the morbidity or avoids further cholecystectomy, it may save clinical care costs in later disease periods sufficiently to offset the screening and early treatment costs. In addition, whether routine screening for GSD is worthwhile depends on whether patients are willing to pay the ultrasonography screening cost that would reduce the risk of cholecystectomy. In this review we discuss the epidemiology, management, and economic evaluation of screening of GSD among type 2 diabetics.

20.
Asia Pac J Public Health ; 27(2): NP1793-804, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23596266

RESUMO

The authors sought to explore the prevalence and factors related to nonalcoholic fatty liver disease (NAFLD) among occupational population in Taipei, Taiwan. A total of 8347 healthy adults voluntarily admitted to annual physical check-up. Blood samples and ultrasound-proved fatty liver sonography results were collected. The results showed that the prevalence of NAFLD was 48.4% and revealed a statistically significant increase with increasing population age. Males exhibited a greater prevalence of NAFLD than did females (57.8% vs 32.4%, P < .001). Using multiple logistic regression analysis, in addition to male gender, older age, higher body mass index, higher aspartate aminotransferase level, higher alanine aminotransferase level, presence of hypertension, presence of hyperuricemia, presence of hypercholesterolemia, higher fasting plasma glucose, and presence of hypertriglyceridemia were the significant factors associated with NAFLD. The differences in occupational professions were revealed. In conclusion, occupational populations are asymptomatic, and the diagnosis of NAFLD should be considered with older age, hyperuricemia, higher aspartate aminotransferase level, higher alanine aminotransferase level, and metabolic risk factors.


Assuntos
Hospitais de Ensino/estatística & dados numéricos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Ocupações/estatística & dados numéricos , Adulto , Fatores Etários , Povo Asiático , Aspartato Aminotransferases/sangue , Glicemia , Índice de Massa Corporal , Feminino , Humanos , Hipertensão/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Prevalência , Fatores de Risco , Fatores Sexuais , Taiwan/epidemiologia , Ultrassonografia
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