ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The worksite is an ideal forum for cancer risk assessment. We describe here the baseline characteristics of a large cohort. Participants completed surveys that assessed a variety of risk factors and behavioral mediators. Personalized feedback letters identified cancer risks. A total of 4395 surveys were received. Cancer prevalence was 6.5% (range, 4.3% to 11.2%). The most common risk factors were lack of exercise (41%; 32% to 68%), obesity (28%; 24% to 39%), and smoking (14%; 13% to 32%). Cardiovascular risk was also common (25%; 15% to 48%). Screening was fair to good for all cancers except colon cancer. The perceived risk for cancer was less than that for cardiovascular disease (P< 0.0001). Most smokers were in the pre-contemplation phase, whereas action/maintenance phases predominated for breast and colon cancer screening. Modifiable cancer risk factors can be identified in the majority of workers. Inaccurate risk perception is an important target for future interventions.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The purpose of this study was to determine whether people could naturally produce urine sufficiently dilute to meet the federal criteria for a “substituted” specimen. The United States Department of Transportation Regulations (49 Code of Federal Regulations Part 40) defines a urine specimen as substituted if it has a creatinine concentration of ≤5 mg/dLanda specific gravity of ≤1.001 or ≥1.020. These criteria have been criticized based on the contention that an insufficient number of specimens had been tested from the same urine sample for both creatinine and specific gravity measurements. We reviewed the results of 803,130 random urine specimens measured for creatinine and/or specific gravity in a hospital-based laboratory. In this database, 13,467 urine specimens had both creatinine and specific gravity measurements. None of these 13,467 paired urine specimens met the lower limit of specific gravity (≤1.001) and creatinine (≤5 mg/dL) criteria for a Department of Transportation substituted specimen. We also examined the medical records of those patients meeting even one of the two criteria; creatinine concentration ≤5 mg/dL or specific gravity ≤1.001. These patients were neonatal, moribund, or so severely ill that essentially none could have been among the working population. These data in patients with various pathologic states support our belief that normal individuals do not produce urine dilute enough to meet the lower limit of the specific gravity (≤1.001)andcreatinine (≤5 mg/dL) required for meeting substituted specimen criteria. Eleven patients met the criteria for a substituted specimen, with elevated specific gravity of ≥1.020 and creatinine concentration of ≤5 mg/dL; however, these patients were seriously ill or terminally ill.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

To be viewed as successful, corporate health promotion and disease prevention programs must demonstrate that they can improve the risk profile of employees as a whole, and, in particular, those employees at highest risk. This study reports the effectiveness of Johnson & Johnson’s newly configured Health & Wellness Program in reducing the health risks of 4586 employees who participated in two serial health screening programs, with a minimum of 1 year between screenings. The study also examines the impact of participation in a high-risk intervention program called Pathways to Change® on health risk factors. McNemar chi-squared andz-test statistics were used to evaluate changes in health risks over time. Results indicate significant risk reduction in 8 of 13 risk categories examined for all employees who participated in two health risk assessments over an average of 23/4 years. When comparing Pathways to Change participants with non-participants, participants outperformed their non-participant counterparts in six categories but performed worse in five other categories that were not specifically targeted by the high-risk program. In two categories, no differences were found. The study underscores the ability of large-scale, well-attended, and comprehensive corporate health and productivity management programs to positively impact the health and well-being of workers.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Patient satisfaction is an important aspect of quality of care. Little information about injured workers’ satisfaction is available. A survey instrument was developed to assess “What Do Injured Workers Think About Their Medical Care?” Survey domains included access, satisfaction, reports of physician behaviors, and outcomes after work injury. Descriptive analyses were performed on more than 800 responses. Approximately 25% of respondents reported dissatisfaction with care. Satisfaction with choice of provider, interpersonal care, claims handling, and outcomes were major predictors of overall satisfaction. Spanish-speakers were more likely to be dissatisfied with physician communications. Months after injury, many workers reported significant pain and impact on job ability and daily function. Routine evaluation of patient satisfaction with occupational medical care could facilitate quality improvement efforts and informed purchaser and worker choice of occupational health services.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Medical Review Officer interpretation of laboratory results is an important component of drug testing programs. The clinical evaluation of laboratory results to assess the possibility of appropriate medical use of a drug is a task with many different facets, depending on the drug class considered. This intercession prevents the reporting of positive results unless it is apparent that drugs were used illicitly. In addition to the commonly encountered prescribed drugs that yield positive drug testing results, other sources of positive results must be considered. This review describes a series of compounds referred to as “precursor” drugs that are metabolized by the body to amphetamine and/or methamphetamine. These compounds lead to positive results for amphetamines even though neither amphetamine nor methamphetamine were used, a possibility that must be considered in the review of laboratory results. Description of the drugs, their clinical indications, and results seen following administration are provided. This information allows for the informed evaluation of results with regard to the potential involvement of these drugs.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The objectives of this prospective study were to identify predictive factors for sick leave of 8 days or more due to low back pain (LBSL) and to compare them with predictive factors for low back pain with no or shorter sick leave (LB) in a cohort of French workers. The predictive factors for LBSL were a past history of low back pain (odds ratio [OR], 7.2; 95% confidence interval [CI], 4.1 to 13), a low employment grade (OR, 4.3; 95% CI, 1.7 to 11), heavy smoking (OR, 5.5; 95% CI, 2.3 to 13), a pain score different from zero (OR, 4.9; 95% CI, 2.5 to 9.7), required bending backward or forward at work every day repetitively (OR, 7.4; 95% CI, 2.3 to 23), overall social integration (OR, 2.0; 95% CI, 1.3 to 3.3), and low social support at work (OR, 3.4; 95% CI, 1.6 to 7.3). Low social support at work and bending backward or forward at work were more strongly associated with LBSL than with LB (P = 0.02 and P < 0.01, respectively). The implications of the results of this prospective study are that both the level of biomechanical exposure and the psychosocial work environment, especially social support, represents important dimensions to consider in the reduction of work absenteeism.

ISSN:1076-2752    

出版商:OVID    

年代:2002

数据来源: OVID