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Effects of short-term intensive lifestyle intervention on community patients with impaired glucose regulation

Yuping TANG ; Maolian LI ; Junhua HE ; Yunfei BIAN ; Junnan LI ; Xiumin SHEN ; Aiqing LI ; Xianqing ZHU

Chinese Journal of Health Management.2009;3(4):206-209. doi:10.3760/cma.j.issn.1674-0815.2009.04.006

Objective To evaluate the effects of the short-term intervention lifestyle intervention on metabolic measurements of community patients with impaired glucose regulation (IGR). Methods A total of 90 IGR participants were randomly assigned to the control group (n=45) or the intervention group (n= 45). The subjects in the control group received routine diet and physical exercise advice once a month. The subjects in the intervention group received additional individualized diet counseling and circuit-type resistance training. Metabolic parameters were compared before or after the intervention between the two groups. Results In oral glucose tolerance test (OGTT),2-h plasma glucose (PG) and homeostasis model of insulin resistance index (HOMA-IR) were significantly decreased in the intervention group at 3 months(F= 13.47 or 82.25 ,both P < 0.05). Body mass index (t=-2.44, P<0.05), systolic blood pressure (t= -3.39, P<0.05), diastolic blood pressure (t=-3.97, P<0.05), fasting plasma glucose (t=-3.89, P<0.05),2-h PG (t=-7.22,P <0.05) ,total cholesterol (t=-2.72,P<0.05),low-density lipoprotein cholesterol (t=-2.74, P<0.05), and glycosylated hemoglobin A1 C (t=-3.73, P<0.05) were significantly declined in the intervention group compared to the control group (all P<0.05). Conclusions Intensive lifestyle intervention can significantly improve the metabolic markers of IGR subjects and should be used to prevent type 2 diabetes.

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Rehabilication research of mentally ill in community health service organization based on health management

Yong BAO ; Hongmin ZHU ; Enhong DONG ; Huizhen PENG

Chinese Journal of Health Management.2009;3(4):198-201. doi:10.3760/cma.j.issn.1674-0815.2009.04.003

Objective To evaluate the present rehabilitation status of mentally ill patients at community health service centers in Shanghai. Method Investigation on mental disorder network, present prevalence, community disease classification, and cost-effect assessment was conducted in 201 health service centers in Shanghai in 2007. Result Working condition, staff-member constitution, and finical investment were unoptimistic. However, the community health service centers consider the outcomes of community rehabilitation and management were satisfactory. Conclusion It should be necessary to facilitate the development of community mental health service system, achieve various community rehabilitation and health care, and improve social security system of community healthcare providers.

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Preparation, reliability and validity of health status questionnaire

Jingfa TIAN ; Li PAN ; Xiaomin WANG

Chinese Journal of Health Management.2009;3(4):216-218. doi:10.3760/cma.j.issn.1674-0815.2009.04.008

Objective To develop a set of health status questionnaire in line with health management demands for different physical examination reeeivers. Methods Based on literature review and clinical practice, sleep, pain, anxiety, depression, stress, fatigue, habits and social adaptation could be used as health items. An item database was set according to domestic or abroad established questionnaires. The items were screened to constitute our health status questionnaire. A total of 2866 individuals were randomly chosen to get the reliability or validity test. Results The correlation coefficient of single item with total score was 0.361-0.683. The Cronbach'α of sub-scales was ≥ 0.945, the retested reliability coefficient of was ≥ 0.677, and split-half reliability coefficient was ≥0.835. Eight factors in exploratory factor analysis explained 69.37% of total variance. Confirmatory factor analysis showed high degree of fitting. Conclusion Our health status questionnaire has higher reliability and validity and can be used for health data collection.

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Current Status of health management service-related institutions in China

Lan ZHANG ; Jianshi HUANG ; Yu WANG ; Ming LI ; Shuzhong BAI

Chinese Journal of Health Management.2009;3(4):210-215. doi:10.3760/cma.j.issn.1674-0815.2009.04.007

Objective To investigate the current status, performance,challenges and demands of the health management service-related institutions in China so as to provide evidence for effective policy-making. Methods A cross-sectional study design was used in this report. The health management service-related institutions were identified based on web site searching and government business registration records. Web or mail-based questionnaire was used for data collection. Telephone interview was conducted to confirm the validity and reliability of the data. Results Of 5744 health management service-related institutions in China,585 were investigated for type of organization, personnel profile, business strategy and investment. Since 2000, the number of health management service-related institutions in China had kept increasing in an average rate of 52%. The services included physical check, health education, and disease intervention,etc. Conclusions In China,health management is still at its early stage although an increasing trend could be found and a large number of related- institutions have emerged. However, health management system in China still faces the challenge of poor professional services and insufficient healthcare providers.

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Effectiveness of health management in rural areas with high incidence of hypertension and cerebrovascular disease

Xun HAN ; Jianxin GONG ; Ning LU ; Qingxia FANG ; Bing DU ; Wenhong QIAN

Chinese Journal of Health Management.2009;3(4):202-205. doi:10.3760/cma.j.issn.1674-0815.2009.04.004

Objective To analyze the effectiveness of chronic disease management among suburb residents to secure an optimal health management model. Methods Since 2002, physical examinations had been conducted for rural residents aged≥40. Hypertensive patients detected on health check received medical evaluation and risk factor intervention. Results The incidence of high blood pressure decreased from 26.57% in 2002 to 11.99% in 2007-2008. The mortality of cerebrovascular disease declined from 68.00% to 5.26%. The incidence, disability rate, and death rate of hypertension related-stroke were also significantly reduced. Conclusion Primary healthcare center-based chronic disease screening, along with the health management network, can largely decrease the incidence, disability rate, and mortality of stroke associated with high blood pressure.

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A non-invasive risk model for prediction of diseases

Hong ZHAO

Chinese Journal of Health Management.2009;3(3):166-169. doi:10.3760/cma.j.issn.1674-0815.2009.03.010

Objective To develop a method for nou-invasive risk model that can be used in health management system and primary healthcare centers. Methods Based on systematic phenotype measurement and modified superviser-based machine learning, an applicable and low-cost method for non-invasive disease risk prediction model was developed. Invasive risk assessment model for Chinese isehemic cardiovascular diseases (ICVD) was used as a supervised standard reference to provide evidence based non-invasive model with skin resistance on 24 acupeints. Results A total of 4606 cases from a physical examination system were collected to develop the model. For those reasonable evaluation indeies, the coincidence of non-invasive with invasive risk prediction model was > 90% on average level. Conclusions This method could be used to develop non-invasive risk assessment model for the common diseases.

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Ten-year risk of ischemic cardiovascular diseases in middle-aged adults in Henan province

Lei ZHANG ; Shufang ZHANG ; Aiping LIU ; Dongsheng HU ; Peiyu WANG

Chinese Journal of Health Management.2009;3(3):159-162. doi:10.3760/cma.j.issn.1674-0815.2009.03.008

Objective To evaluate 10-year risk of ischemic cardiovascular diseases (ICVD) in middle-aged adults in Henan province to provide evidence for improved health status. Methods The 10- year risk of ICVD in 12 064 middle-aged adults was evaluated by using simplified risk estimation model. Results About 96. 35% of male and 98. 29% of female had a probability of < 10% to develop ICVD over 10 years; 3.65% of male and 1.71% of female had a probability of ≥ 10% to develop ICVD over 10 years; and 0.68% of male and 0.23% of female had a probability of≥20% to develop ICVD over 10 years. The prevalence of risk factors for ICVD in two absolute risk groups ( ≥10% vs < 10% ) was significantly different. Conclusions The risk of ICVD in the middle-aged residents of Henan province may be similar to that in the middle-aged Chinese adults. The risk assessment for ICVD could be used for high- risk populations.

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Comparing three screening schemes of colorectal cancer in general population

Angao XU ; Zhijin YU ; Xuhui ZHONG ; Aihua GAN ; Jihong LIU

Chinese Journal of Health Management.2009;3(3):155-158. doi:10.3760/cma.j.issn.1674-0815.2009.03.007

Objective Comparing three screening schemes of colorectal cancer in general population to provide scientific basis for coiorectal cancer screening in communities. Methods Questionnaire screening among high-risk population and immunoassay fecal occult blood test (FOBT) were used for colorectal cancer detection. Colonescopy and pathological test were considered as gold standard of screening results. Results Nine coloreetal cancers and 796 colorectal adenomas were detected in 68 953 participants. Mean onset age of coloreetal adenoma was 7. 7 years earlier than colorectal cancer. For questionnaire and FOBT,the sensitivity was 44.4% ,77.8% and 100.0% ,while the specificity was 98.6%, 95.5% and 94.4%, respectively. The Youden index of questionnaire, FOBT, and questionnaire-FOBT sequential method was 0.4,0.7,and 0.9,and the likelihood ratio ( +/- ) was 32.7/0.6,17. 2/0.2,and 17.8/0.0,respectively. When 50 was used as initial age of screening, screening receivers accounted for 9.7% ,and 66. 7% colorectal cancer could be detected. When 40 was used as initial age of screening, screening receivers and cost increased by 57.1% ,and only 11.1% more patients with colorectal cancer could be detected. Conclusions Questionnaire-FOBT sequential method has high sensitivity and specificity of colorectal cancer screening. Screening at 50 year-old may be better for community residents. The time of colorectal adenoma developed to colorectal cancer is about 8 years.

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Health status of medical staff

Jun TANG ; Bin Lü ; Yafang ZHU ; Lihua WANG ; Jia SONG ; Jie SUN

Chinese Journal of Health Management.2009;3(3):163-165. doi:10.3760/cma.j.issn.1674-0815.2009.03.009

Objective To investigate health status of medical staff and its impacting factors so as to provide useful health guidance. Methods Health examination data from 2 hospitals in Zhejiang province were collected. The medical staff group was classified into 5 subgroups according to the departments; the control group was composed of other mental labors. The health examinations included clinical, laboratory and special testing. SPSS 11.0 software was used for data analysis. Results Compared with the control group, the morbidity rate of the medical staff group was higher, especially in those aged < 50 (χ2 = 6. 651,8. 883, and 7. 446; all P < 0.05 ). All medical staff subgroups showed significant difference in morbidity rate ( χ2 = 39. 099 ,P < 0.05 ). Hyperlipidemia,cervical erosion,and breast hyperplasia were the most common diseases found in medical staff; while the control group developed more breast hyperplasia, hyperlipidemia, and retinal arteriosclerosis. Conclusions Health status of medical staff could not be optimal. Effective health education would be needed to improve life style and relieve stress.

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Obesity parameters and obstructive sleep apnea-hypopnea syndrome in aircrew

Gumi LIANG ; Ning SHANG ; Weihua FAN

Chinese Journal of Health Management.2009;3(2):88-91. doi:10.3760/cma.j.issn 1674-0815.2009.02.008

Objective To investigate the relationship between obesity parameters and obstructive sleep apnea-hypopnea syndrome (OSAHS) in aircrew. Methods A questionnaire survey in aircrew members was performed. Outcome measurement included body height, body weight, neck circumference ( NC), waist circumference (WC), and body mass index (BMI). Those with snoring during sleep and/or Epworth sleepiness scale (ESS)score ≥ 9 were screened with pulse oxygen saturation test during overnight sleep. Those with oxygen saturation decrease index ≥ 10 times/h and suspected OSAHS were tested by polysomnography (PSG). The objects were then assigned to three groups: the OSAHS group,the snore group and the normal group. The relationship between obesity parameters and OSAHS was analyzed. Results There were 399 ( 37. 54% ) overweight, 36 ( 3. 39% ) obesity, 130 ( 12. 23% ) increased NC, and 354 (33.30%)increased WC in 1063 aircrew members (OSAHS group ＞ snore group ＞ normal group; P＜O. 05). The mean value of BMI, NC and WC in the three groups were dittos. Multiple logistic regression analysis showed that overweight, obesity and increased WC were significantly associated with snoring (P ＜0.05) and snoring enlarged NC was significantly correlated with OSAHS (P＜ 0.05). Conclusion Increased BMI, NC and WC may be risk factors of OSAHS among aircrew. Effective prevention and treatment of OSAHS should be needed.

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