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Kobo O, Abramov D, Volgman AS, Mieres JH, Wijeysundera HC, Van Spall HGC, Mamas MA. Causes of Death Among Health Care Professionals in the United States. Popul Health Manag 2023; 26:294-302. [PMID: 37643310 DOI: 10.1089/pop.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Specific causes of mortality among various types of health care professionals (HCPs), including those characterized by age, gender, and race, have not been well described. The National Occupational Mortality Surveillance data for deaths in 26 US states in 1999, 2003-2004, and 2007-2014 were queried to address this question. Proportionate mortality ratios (PMRs) were calculated to compare specific causes of mortality among HCPs compared with those among the general population. HCPs were less likely to die from heart disease (PMR 93, 95% confidence intervals [CI] 92-94), alcoholism (PMR 62, 95% CI 57-68), drugs (PMR 80, 95% CI 70-90), and more likely to die from cerebrovascular disease (PMR 105, 95% CI 104-107) and diabetes (PMR 107, 95% CI 105-109). HCPs aged 18-64 years were more likely to die by suicide (PMR 104, 95% CI 101-107), whereas those aged 65-90 years were less likely to die by suicide (PMR 84, 95% CI 77-91), with physicians (PMR 251, 95% CI 229-275) and other HCPs having high PMR for suicide. Among all HCPs, suicide PMR was similarly increased, whereas heart disease PMRs are similarly decreased among Black compared with those among White HCPs and those among male compared with those among female HCPs. HCPs as a group and specific types of HCPs demonstrate causes of mortality that differ in important ways from the general population. Race and gender-based trends in PMRs for key causes of mortality among HCPs suggest that employment in a health care field may not alter race and gender disparities noted among the general population.
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Affiliation(s)
- Ofer Kobo
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom
| | - Dmitry Abramov
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, California, USA
| | - Annabelle Santos Volgman
- Division of Cardiology, Department of Internal Medicine, Rush Medical College, Chicago, Illinois, USA
| | - Jennifer H Mieres
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - Harindra C Wijeysundera
- Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, California, USA
| | - Harriette G C Van Spall
- Department of Medicine and Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
- Research Institute of St. Joseph's, Hamilton, Ontario, Canada
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom
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Shih HM, Tsai WC, Wu PY, Chiu LT, Kung PT. Risk of rapid progression to dialysis in patients with type 2 diabetes mellitus with and without diabetes-related complications at diagnosis. Sci Rep 2023; 13:16366. [PMID: 37773429 PMCID: PMC10541444 DOI: 10.1038/s41598-023-43513-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023] Open
Abstract
Many adults with diabetes mellitus are unaware worldwide. The study objectives aimed to evaluate the risk of dialysis within 5 years of diagnosis between patients with newly diagnosed diabetes with and without diabetes-related complications. A retrospective longitudinal nationwide cohort study was conducted. Patients diagnosed with diabetes between 2005 and 2013 were followed up until 2018. They were categorized based on the presence or absence of complications, the number of complications, and the diabetes complications severity index (DCSI) scores. Dialysis outcomes were determined through the Registry of Catastrophic Illness from the National Health Insurance Research Database. Among the analyzed patients, 25.38% had complications at diagnosis. Patients with complications at diagnosis had a significantly higher risk of dialysis within 5 years (adjusted hazard ratio: 9.55, 95% confidence interval CI 9.02-10.11). Increasing DCSI scores and the number of complications were associated with higher dialysis risks. Patients with one complication had a 7.26-times higher risk (95% CI 6.83-7.71), while those with ≥ 3 complications had a 36.12-times higher risk (95% CI 32.28-40.41). In conclusion, newly diagnosed diabetes patients with complications face an increased risk of dialysis within 5 years. The severity and number of complications are directly linked to the risk of dialysis within this timeframe.
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Affiliation(s)
- Hong-Mo Shih
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Pei-Yu Wu
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Li-Ting Chiu
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Pei-Tseng Kung
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
- Department of Healthcare Administration, Asia University, 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan.
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Yen CK, Tan TH, Feng IJ, Ho CH, Hsu CC, Lin HJ, Wang JJ, Huang CC. Comparison of Risk for End-Stage Renal Disease Between Physicians and the General Population: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122211. [PMID: 31234478 PMCID: PMC6617167 DOI: 10.3390/ijerph16122211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 11/30/2022]
Abstract
Physicians experience high stress and have much responsibility during a night shift, which contributes to increased sympathetic activity, the risk factor for renal disease. The risk for end-stage renal disease (ESRD) in physicians is still unclear. Therefore, we conducted a nationwide population-based cohort study to clarify this issue. Using Taiwan’s National Health Insurance Research Database, we identified 30,268 physicians and 60,536 individuals from the general population matched with a ratio of 1:2 by age and sex. All participants who had ESRD before 2006 and residents were excluded. ESRD risk between physicians and the general population and among physician subgroups was compared by following up their medical histories until 2012. We also compared the treatments between both cohorts with ESRD. Physicians had a lower ESRD risk than the general population (adjusted odds ratio (AOR): 0.5; 95% confidence interval (CI): 0.4–0.7), particularly in the middle-age subgroup (35–64 years) (AOR: 0.4; 95% CI: 0.3–0.7); however, there was no difference in the older age subgroup (≥65 years) (AOR: 1.0; 95% CI: 0.6–1.7). More physicians received peritoneal dialysis (63.0% vs. 11.1%) and renal transplantation (5.6% vs. 1.7%) than the general population after being diagnosed with ESRD. Compared with the general population, physicians had a lower ESRD risk and higher treatment selection for peritoneal dialysis and renal transplantation after being diagnosed with ESRD. Better medical knowledge, a greater awareness of diseases and their risk factors, more rigorous implementation of preventive measures, and easy access to medical care may play a role in this aspect. Further studies are warranted for elucidating the associated mechanisms.
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Affiliation(s)
- Chin-Kai Yen
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
| | - Tian-Hoe Tan
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
| | - I-Jung Feng
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan.
| | - Chung-Han Ho
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan.
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan.
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Jhi-Joung Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Allied AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan.
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
- Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan.
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Huang HL, Kung CY, Pan CC, Kung PT, Wang SM, Chou WY, Tsai WC. Comparing the mortality risks of nursing professionals with diabetes and general patients with diabetes: a nationwide matched cohort study. BMC Public Health 2016; 16:1054. [PMID: 27716138 PMCID: PMC5053173 DOI: 10.1186/s12889-016-3734-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/30/2016] [Indexed: 11/10/2022] Open
Abstract
Background Nursing professionals have received comprehensive medical education and training. However, whether these medical professionals exhibit positive patient care attitudes and behaviors and thus reduce mortality risks when they themselves are diagnosed with chronic diseases is worth exploring. This study compared the mortality risks of female nurses and general patients with diabetes and elucidated factors that caused this difference. Methods A total of 510,058 female patients newly diagnosed with diabetes between 1998 and 2006 as recorded in the National Health Insurance Research Database were the participants in this study. Nurses with diabetes and general population with diabetes were matched with propensity score method in a 1:10 ratio. The participants were tracked from the date of diagnosis to 2009. The Cox proportional hazards model was utilized to compare the mortality risks in the two groups. Results Nurses were newly diagnosed with diabetes at a younger age compared with the general public (42.01 ± 12.03 y vs. 59.29 ± 13.11 y). Nevertheless, the matching results showed that nurses had lower mortality risks (HR: 0.53, 95 % CI: 0.38–0.74) and nurses with diabetes in the < 35 and 35–44 age groups exhibited significantly lower mortality risks compared with general patients (HR: 0.23 and 0.36). A further analysis indicated that the factors that influenced the mortality risks of nurses with diabetes included age, catastrophic illnesses, and the severity of diabetes complications. Conclusion Nurses with diabetes exhibited lower mortality risks possibly because they had received comprehensive medical education and training, may had more knowledge regarding chronic disease control and change their lifestyles. The results can serve as a reference for developing heath education, and for preventing occupational hazards in nurses.
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Affiliation(s)
- Hsiu-Ling Huang
- Department of Aged Welfare and Social Work, Toko University, Taiwan, Republic Of China.,Department of Public Health and Department of Health Services Administration, China Medical University, Taiwan, Republic Of China
| | - Chuan-Yu Kung
- Department of Nursing, Hengchun Tourism Hospital, Ministry of Health and Welfare, Taiwan, Republic Of China
| | - Cheng-Chin Pan
- Department of Urology, Hengchun Tourism Hospital, Ministry of Health and Welfare, Taiwan, Republic Of China
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, Republic Of China
| | - Shun-Mu Wang
- Department of Aged Welfare and Social Work, Toko University, Taiwan, Republic Of China
| | - Wen-Yu Chou
- Department of Health Services Administration, China Medical University, 91, Hsueh-Shih Road, Taichung, Taiwan, 40402, Republic Of China
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, 91, Hsueh-Shih Road, Taichung, Taiwan, 40402, Republic Of China.
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Sugimoto M, Asakura K, Masayasu S, Sasaki S. Relationship of nutrition knowledge and self-reported dietary behaviors with urinary excretion of sodium and potassium: comparison between dietitians and nondietitians. Nutr Res 2015; 36:440-51. [PMID: 27101762 DOI: 10.1016/j.nutres.2015.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 11/19/2022]
Abstract
The effectiveness of better nutrition knowledge and dietary behavior on healthier dietary intake is still controversial. We hypothesized that nutritional knowledge and dietary behavior are associated with sodium and potassium intake in adult women. A cross-sectional study was conducted at welfare facilities located in 20 areas of Japan. Ninety-nine female dietitians and 117 nondietitians aged 20 to 69 years participated. Sodium and potassium intake were assessed with two 24-hour urine collections and 4-day semiweighed diet records. Nutritional knowledge and dietary behavior were accessed with 3 questionnaires. Analysis of covariance was performed to compare sodium and potassium excretion and selected nutrition and food intake between dietitians and nondietitians. After adjustment for age and smoking habit, sodium and potassium excretion did not significantly differ between the 2 groups (3857 vs 3959 mg/d, P = .57, and 2016 vs 1886 mg/d, P = .10, respectively). Sodium/potassium ratio was significantly lower in the dietitians (P = .044). The dietitians used food labels for sodium contents more often than the nondietitians and consumed more fruits and vegetables (P = .048 and P < .0001, respectively) and less sugar and confectionaries and fat and oils (P = .016 and P = .010, respectively). In conclusion, the higher level of nutritional knowledge and better dietary behavior were not associated with either sodium or potassium excretion but were moderately associated with sodium/potassium ratio.
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Affiliation(s)
- Minami Sugimoto
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Tokyo 113-0033, Japan.
| | - Keiko Asakura
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo 113-0033, Japan.
| | | | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan.
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