The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.
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Cancer is a leading cause of death around the world. Education is at the core of cancer prevention activities, especially programs targeting empowering existing public health workforce. In the past 10 years, researchers at the University of Pittsburgh have been building the Global Health Network Supercourse project, a library of over 4500 online lectures and a network of nearly 50000 public health professionals in 174 countries. As of November, 2010, the overall number of Supercourse participants from Asia exceeds 7000 participants. The Supercourse network has been investigating methods for Internet based recruitment of cancer prevention professionals in order to network cancer experts locally and globally, including the use of mHealth technologies for cancer research education and for NCD registries. Supercourse is a tool that can offer a solution to the challenges of information sharing, especially in the field of NCDs and cancer. In this paper, we highlight the need for the development of Cancer Supercourse with Satellite in Asia and encourage faculty members from Asia to join the network.
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OBJECTIVES Because of the changing life style of Koreans, we have witnessed an increase of patients with back pain. The development of medical knowledge and technology has resulted in more numerous and better treatment methods. However, the outcomes of diverse treatments have been examined by using a few medicine-oriented measures like pain. This study aims at identifing the factors that influence the outcomes of back pain treatments by using two outcome measures (e.g., quality of life and pain). METHODS: We used the questionnaire survey method for data collection. The questionnaires contained 5 categories(treatment methods, clinical conditions, exercise, quality of life and, socio-demographic characteristics). We interviewed 188 back pain patients. We used the regression analysis method to predict the quality of life or pain. RESULTS: Surgery showed a statistically significant effect on the quality of life as well as pain. The illness period, age and exercise were turned out to be significant factors for both of the dependent variables. The social class and surgery methods showed a statistically significant effect solely on the quality of life. CONCLUSIONS: In choosing the surgical methods, doctors need to provide detailed explanations on the quality of life outcomes for each of the surgical methods to the patients.
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Health-Related Quality of Life in Chronic Pain Treated With Tapentadol Versus Oxycodone/Naloxone and Its Determinants: A Real-World, Single-Center Retrospective Cohort Study in Spain Ana M. Peiró, Anna Grimby-Ekman, Jordi Barrachina, Mónica Escorial, César Margarit, Carmen Selva-Sevilla, Manuel Gerónimo-Pardo Value in Health Regional Issues.2024; 44: 101013. CrossRef
Factors Influencing on Quality of Life in Patients with Liver Cirrhosis: Convergence on the Theory of Unpleasant Symptoms Ji-Suk Kim, Young-Sook Seo Journal of Digital Convergence.2015; 13(4): 271. CrossRef
The Korean social life, health and aging project-health examination cohort Ju-Mi Lee, Won Joon Lee, Hyeon Chang Kim, Wungrak Choi, Jina Lee, Kiho Sung, Sang Hui Chu, Yeong-Ran Park, Yoosik Youm Epidemiology and Health.2014; 36: e2014003. CrossRef
Prevalence of Musculoskeletal Symptoms Related With Activities of Daily Living and Contributing Factors in Korean Adults Kyusik Choi, Jae-Hyun Park, Hae-Kwan Cheong Journal of Preventive Medicine and Public Health.2013; 46(1): 39. CrossRef
OBJECTIVES The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. METHODS: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. RESULTS: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant difference between whether the medical utilization in men patients. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant difference between whether the medical utilization in women patients. CONCLUSIONS: The patients who tend to receive less care are those suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.
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Associations Between Fat Mass, Lean Mass, and Knee Osteoarthritis: The Fifth Korean National Health and Nutrition Examination Survey (KNHANES V) Seong Rae Kim, Kyung-Hyun Choi, Go-Un Jung, Doosup Shin, Kyuwoong Kim, Sang Min Park Calcified Tissue International.2016; 99(6): 598. CrossRef
Convergence analysis of determinants affecting on geographic variations in the prevalence of arthritis in Korean women using data mining Yoo-Mi Kim, Sung-Hong Kang Journal of Digital Convergence.2015; 13(5): 277. CrossRef
The relative importance of perceived doctor’s attitude on the decision to consult for symptomatic osteoarthritis: a choice-based conjoint analysis study Domenica Coxon, Martin Frisher, Clare Jinks, Kelvin Jordan, Zoe Paskins, George Peat BMJ Open.2015; 5(10): e009625. CrossRef
Complementary and alternative medicine use of women with breast cancer: Self-help CAM attracts other women than guided CAM therapies Deborah N.N. Lo-Fo-Wong, Adelita V. Ranchor, Hanneke C.J.M. de Haes, Mirjam A.G. Sprangers, Inge Henselmans Patient Education and Counseling.2012; 89(3): 529. CrossRef
OBJECTIVES We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. METHODS: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume(over 16 operations in a year) and low volume institutions, after performance reporting (december 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. RESULTS: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p=0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25-0.95) and 10% (beta=-0.102 p<0.01) and cost was not changed (beta=-0.01, p<0.27). The high volume institutions were more decreased than low volume in length of stay. CONCLUSIONS: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginal shifted from low volume institutions to high volume institutions.
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The factors influencing variation by local areas in antibiotics prescription rate according to the public reporting Yu-Jin Chun, Chang-Yup Kim Health Policy and Management.2012; 22(3): 427. CrossRef
OBJECTIVES Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.
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Evaluation of two-year recall of self-reported pesticide exposure among Ugandan smallholder farmers William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Iris van den Brenk, Hans Kromhout, Ioannis Basinas, Kate Jones, Andrew Povey, Martie van Tongeren, Anne-Helen Harding, Karen S. Galea, Samuel Fuhrimann International Journal of Hygiene and Environmental Health.2022; 240: 113911. CrossRef
Recall of exposure in UK farmers and pesticide applicators: trends with follow-up time William Mueller, Kate Jones, Hani Mohamed, Neil Bennett, Anne-Helen Harding, Gillian Frost, Andrew Povey, Ioannis Basinas, Hans Kromhout, Martie van Tongeren, Samuel Fuhrimann, Karen S Galea Annals of Work Exposures and Health.2022; 66(6): 754. CrossRef
Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea Sungjin Park, Jung Ran Choi, Sung-Kyung Kim, Solam Lee, Kyungsuk Lee, Jang-Young Kim, Sung-Soo Oh, Sang-Baek Koh, Paula Boaventura PLOS ONE.2020; 15(5): e0232531. CrossRef
Exposure to pesticides and the prevalence of diabetes in a rural population in Korea Sungjin Park, Sung-Kyung Kim, Jae-Yeop Kim, Kyungsuk Lee, Jung Ran Choi, Sei-Jin Chang, Choon Hee Chung, Kyu-Sang Park, Sung-Soo Oh, Sang-Baek Koh NeuroToxicology.2019; 70: 12. CrossRef
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Comparison of Questionnaire Items Used to Evaluate the Level of Occupational and Environmental Exposure in Questionnaires for Epidemiological Studies Jiyeon Lim, Hyung-Suk Yoon, Mansuk Park, Young Seoub Hong, Jong-Koo Lee, Se-Eun Oh, Daehee Kang, Kyoung-Mu Lee Korean Journal of Environmental Health Sciences.2016; 42(2): 71. CrossRef
Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province Hyang Seok Lee, Ji Hoon Lee, Soo Yong Roh, Ho Gil Kim, Kyung Jun Lee, Sun Ju Nam-gung, Soon Chan Kwon, Soo Jin Lee Journal of agricultural medicine and community health.2015; 40(4): 228. CrossRef
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Pesticide Exposure and Health Won-Jin Lee Korean Journal of Environmental Health Sciences.2011; 37(2): 81. CrossRef
OBJECTIVES The objective of this study was to calculate sample size and power in an ongoing cohort, Korea radiation effect and epidemiology cohort (KREEC). METHOD: Sample size calculation was performed using PASS 2002 based on Cox regression and Poisson regression models. Person-year was calculated by using data from '1993-1997 Total cancer incidence by sex and age, Seoul' and Korean statistical informative service. RESULTS: With the assumption of relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, sample size calculation was 405 events based on a Cox regression model. When the relative risk was assumed to be 1.5 then number of events was 170. Based on a Poisson regression model, relative risk=1.3, exposure:non-exposure=1:2 and power=0.8 rendered 385 events. Relative risk of 1.5 resulted in a total of 157 events. We calculated person-years (PY) with event numbers and cancer incidence rate in the non-exposure group. Based on a Cox regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, 136 245PY was needed to secure the power. In a Poisson regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, person-year needed was 129517PY. A total of 1939 cases were identified in KREEC until December 2007. CONCLUSIONS: A retrospective power calculation in an ongoing study might be biased by the data. Prospective power calculation should be carried out based on various assumptions prior to the study.
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Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010 Yoon-Ok Ahn, Zhong Min Li Journal of Korean Medical Science.2012; 27(9): 999. CrossRef