摘要:

This study determined the cost-effectiveness of one- versus two-stage hypertension screening at small to medium-sized blue collar, multicultural work sites using voluntary health organization and public health unit personnel. Workers with diastolic blood pressure (DBP) ≥90 mm Hg were randomly allocated to one- or two-stage screening with differing physician referral protocols based on blood pressure level and treatment status. At first screening of 7856 workers, 12.5% had DBP ≥90 mm Hg or <90 and on medication with 64% aware of having hypertension, 42% on medication and 30% controlled (DBP <90 mm Hg). One year later, there were no significant differences in effects or cost-effectiveness between groups. Both had significant DBP decrease (8.5 mm Hg), 54% had seen a physician within the recommended time, and 50% were controlled on medication or any treatment. One-stage screening, being easier to implement, is the preferred option.

ISSN:0096-1736    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

To learn more about the causes of nonfatal construction worker injuries, and to identify injury cases for further work-site investigations or prevention programs, an emergency department-based surveillance program was established. Construction workers with work-related injuries or illnesses were identified by reviewing the medical records of all patients treated at the George Washington University Emergency Department between November 1, 1990 and November 31, 1992. Information regarding the worker, the injury, and the injury circumstances were abstracted from medical records. Information was obtained on 592 injured construction workers from numerous trades. Lacerations were the most commonly treated injuries among these workers, followed by strains and sprains, contusions, and eye injuries. Injuries were most commonly caused by sharp objects (n = 155, 26%), falls (n = 106, 18%), and falling objects (n = 70, 12%). Thirty-five percent of injuries were to the hands, wrists, or fingers. Among the twenty-eight injuries severe enough to require hospital admission, eighteen (64%) were caused by falls. Laborers and Hispanic workers were overrepresented among these severe cases. Emergency Department records were a useful surveillance tool for the initial identification and description of work-related injuries. Although E codes were not that useful for formulating prevention strategies, detailed review of injury circumstances from Emergency Department records was valuable and has helped to establish priorities for prevention activities.

ISSN:0096-1736    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The release of the U.S. Preventive Services Task Force guidelines (GUIDELINES) introduces an opportunity to modify patient expectations about the timing of routine examinations. This randomized, controlled study examines the effect of a materials-based educational intervention on knowledge and beliefs about risk-based preventive screening guidelines. The study was conducted in a large multi-specialty group practice participating in a network model HMO in the upper midwest with over 250,000 members. Subjects were selected from patients of a primary care clinic in a suburban section of a major metropolitan area. A 48-page prevention guidebook based on the GUIDELINES was distributed to a randomly assigned treatment group of 200 patients enrolled in an HMO. A 22-item questionnaire on preventive health services that measured respondents' age-adjusted risks and knowledge of risk-based screening guidelines was sent to both experimental and control groups. A 69% response rate was achieved, χ2analysis and t-tests showed that the treatment group was significantly more accurate in identifying recommended GUIDELINES for colon examinations (digital rectal, stool occult, sigmoidoscopy), blood pressure, and Pap tests. No significant differences related to identifying GUIDELINES for mammograms and clinical breast examinations were found between the groups. Communications about new screening guidelines can yield positive but selective changes in knowledge and beliefs about appropriate screening intervals.

ISSN:0096-1736    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1994

数据来源: OVID