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Volume 37(3); August 2004
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Notes
Imputation of Missing values.
Sung Cheol Yun
J Prev Med Public Health. 2004;37(3):209-211.
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No abstract available.
Summary
Multi-level Analysis.
Moo Song Lee
J Prev Med Public Health. 2004;37(3):212-216.
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No abstract available.
Summary
Relative Survival Rate.
Jong Myon Bae
J Prev Med Public Health. 2004;37(3):217-219.
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No abstract available.
Summary
Original Articles
Sexual Behavioral Characteristics and the Knowledge of HIV/AIDS among Men who have Sex with Men in Republic of Korea.
Mee Kyung Kee, Chul Min Park, Chang Gok Chang, Un Yeong Go
J Prev Med Public Health. 2004;37(3):220-224.
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OBJECTIVES
To investigate the sexual behavioral characteristics and HIV/AIDS knowledge among men who have sex with men (MSM), one of the HIV high risk groups. METHODS: A three month survey among individuals who were able to be contacted was carried out over the entire Republic of Korea, between May and August, 2001. 348 individuals completed a self-administered questionnaire. The data collected included demographic information, sexual behavior and AIDS knowledge. RESULTS: Eighty-seven and ninety-two per cent of the 348 MSM were aged 20-39 years and had never been married, respectively. Fifty-five per cent of participants reported at least one sexual contact with women, and a quarter of the MSM surveyed had engaged in high-risk sexual behavior (more than 6 partners) during the previous year. About twenty per cent of the MSM had anal sex as their favorite way of having sex, and seventy-four per cent did not use condoms regularly due to loss of enjoyment, and were more likely to be engaged in risky behaviors. Only ten per cent had a regular HIV test history, and most had obtained knowledge or information on HIV/AIDS through the mass media. CONCLUSIONS: A large proportion of the MSM in Korea still remain at an elevated risk for contracting HIV infection. Change in high-risk sexual behaviors will prevent the spread of HIV infection among the MSM population, which requires public health education for preventive interventions, and should be culturally and socially specific in order to be effective.
Summary
Influence of Smoking on Blood Cadmium Concentration in University Students.
Joo Youn Shin, Jong Han Lim, Sin Goo Park, Jee Na Lee, Mi Jang, Chung Song Huh, Dae Hee Kang, Yun Chul Hong
J Prev Med Public Health. 2004;37(3):225-231.
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OBJECTIVES
This study was performed to examine the influence of smoking on the blood cadmium concentration in university students. METHODS: The study included 300 university students. A questionnaire interview was used to collect data. The urine cotinine and blood cadmium levels were measured as biological exposure indices. The data were analyzed using t-tests ANOVA and ANCOVA. RESULTS: The median value of blood cadmium concentration was equal in both males and females (0.8microgram/liter). This level was relatively low in comparison with the reference value suggested by WHO (2001). ANCOVA showed that smoking related variables, urine cotinine and smoking amount, were significantly associated with the blood cadmium level (P=0.004, 0.015). However, the values with regard to traffic related air pollution were not significantly associated with the blood cadmium level. CONCLUSIONS: Smoking is an important source of nonoccupational cadmium exposure in young people. The Blood cadmium level is at least 10% higher in active smokers than in passive or nonsmokers. The level of urine cotinine can be used as an indicator of non-occupational exposure of respirable cadmium due to smoking, as there is a good correlation bestween smoking amount and the urine cotinine level.
Summary
A Study of the Relationship between Parental Alcohol Problems and Alcohol Use among Adolescent Females in Republic of Korea.
Dong Eok Shin, Jorge Delva
J Prev Med Public Health. 2004;37(3):232-237.
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OBJECTIVES
The study was designed to test if alcohol use and alcohol-related problems among adolescent females are related to their parents' level of alcohol problems. METHODS: In 2001, a stratified sample of 2077 adolescent females, grades 10-11, from twelve female-only high schools located in a large metropolitan city in the Republic of Korea completed a questionnaire about alcohol use, parental attention, and parental alcohol consumption, and other risk and protective factors. Data were analyzed with chi-square and regression analyses. RESULTS: Nearly 63% of the student drinkers had experienced at least one to two alcohol-related problems in their lives. Two-thirds of all 2077 students indicated that at least one of their parents had an alcohol-related problem and that approximately 29% had experienced several problems. Results of random effects ordinal logistic regression analyses suggest a dose-response relationship between parental and youth alcohol-related problems. Youth who report having parents with some and many alcohol problems were 30% (Odds Ratios [OR] = 1.30; 95% Confidence Interval [CI] = 1.10 - 1.53) and 55% (OR = 1.55; 95%CI = 1.23 - 1.95) more likely to experience alcoholrelated problems than youth whose parents do not have alcohol problems, respectively, after statistically adjusting for important covariates. CONCLUSIONS: This study presents evidence that alcoholrelated problems among adolescent female students is highly prevalent. Also, the study findings reveal a high percentage of parents with alcohol problems, as reported by students. This study presents evidence of what might be a hidden problem among adults and youths in the Republic of Korea that merits serious attention.
Summary
Smoking Behaviors and Its Relationships with Other Health Behaviors among Medical Students.
Soon Woo Park, Jung Han Park, Sang Won Lee, Hyun Sul Lim, Jong Tae Lee, Yune Sik Kang
J Prev Med Public Health. 2004;37(3):238-245.
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OBJECTIVES
This study was conducted to examine the smoking behaviors and the relationship between smoking and other health behaviors among medical students. METHODS: A self-administrated questionnaire was administered to a sample of 1, 775 students from four medical schools between April and May 2003. Due to the small number of female smokers, the characteristics of smoking behaviors were analyzed only for males. RESULTS: A total of 1, 367 students (920 males and 447 females) completed the questionnaires, with an overall response rate of 77.7%. The smoking rates for males and females were 31.5, and 2.2%, respectively. Among the male smokers, 70.7% smoked daily, and 39.0% smoked one pack or more per day. Male students on medical course were more likely to smoke daily, and one pack or more per day, than those on premedical course. Male daily smokers desired to quit smoking less than occasional smokers, and 65.0% of male daily smokers were not ready to quit compared with 37.8% of the occasional smokers. Among the male daily smokers, 29.6% were severely nicotine dependent. The most common reason for not to quit smoking among male smokers was 'no alternative stress coping method' (44.4%), followed by 'lack of will power' (25.4%), and 'no need to quit' (19.4%). Compared with male non-smokers, male smokers were more likely to drink alcohol more often and in larger amounts, take coffee more often, eat breakfast less regularly, and be overweight or obese. CONCLUSIONS: The results of this study suggest that many male medical students were serious smokers, especially those on medical course. It is necessary to install a smoking prevention program for pre-medical students, provide effective smoking cessation methods for smokers, teach positive stress coping methods, and make the school environment suitable for coping with stress.
Summary
Factors Associated with Performance of National Cancer Screening Program in Korea.
Kui Son Choi, Jeong Hee Yang, Su Yeon Kye, Sun Hee Lee, Eun Cheol Park, Hai Rim Shin, Chang Min Kim
J Prev Med Public Health. 2004;37(3):246-252.
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OBJECTIVES
Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. METHODS: To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. RESULTS: Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. CONCLUSIONS: It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.
Summary
A seroepidemiological Study of Hepatitis B and C Virus (HBV and HCV) Infections in the Young Population in parts of Busan, Korea.
Young Hee Ju, Hai Rim Shin, Jin Kyoung Oh, Dong IL Kim, Duk Hee Lee, Byeong Kweon Kim, Jung Il Kim, Kap Yeol Jung
J Prev Med Public Health. 2004;37(3):253-259.
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OBJECTIVES
To investigate the prevalence of hepatitis B and C virus infections and determine the associated risk factors among young adults in Busan, Korea, which is known to have a high incidence of liver cancer. METHODS: The study population consisted of volunteer participants in a health survey during 2002, which included 1, 350 students (515 males and 835 females) aged between 16 and 24 years, from three different schools in Busan. The participating students were asked to fill in a selfadministered questionnaire which included lifestyle habits and risk factors of hepatitis. Sera obtained from the participants were studied for HBsAg, anti-HBs, and Anti- HCV by enzyme immunoassay (EIA) method and for liver function tests. RESULTS: Among the study subjects (N=1, 350), the seropositivities of HBsAg 7.9% (95% CI=7.8-8.0), 7.6% (95% CI=7.6-7.7) in male and 8.1% (95% CI=8.0-8.2) in female. And the seropositivity of Anti-HBs was 69.7% (95% CI=69.0- 70.4), 70.5% (95% CI=69.8-71.2) in male and 69.2% (95% CI=68.5-69.9) in female. The seropositivity of Anti-HCV was 0.4%, 0.2% in male and 0.5% in female. The seropositivity for HBsAg in the subjects not having a hepatitis B vaccination history was twice (95% CI=1.0-4.4) that of those that did. Also, the seropositivity for HBsAg in subjects having experienced sexual intercourse was 1.7 times (95% CI=0.9-3.0) that of the subjects who had not. CONCLUSIONS: The present study confirmed the high prevalence of HBsAg seropositivity and sexual transmission of HBV among adolescents and young adults may occur. Further studies to evaluate the relationship between HBV vaccination and sexual transmission are required for the young population in Korea.
Summary
Impacts of Implementing Case Payment System to Medical Aid Hemodialysis Patients on Dialysis Frequencies and Expenditure.
Sunhee Lee, Hanjoong Kim, Seungho Shin, Woohyun Cho, Hye Young Kang
J Prev Med Public Health. 2004;37(3):260-266.
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OBJECTIVES
To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. METHODS: Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2, 167 MA and 2, 928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. RESULTS: There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p< 0.05), whereas a significant increase was observed for the MI patients, 2.5% (p< 0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ( (=-70725, p< 0.05). CONCLUSION: The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.
Summary
Comparative Study
The Relation between Type of Insurance and Acute Appendicitis Rupture Rate.
Baeg Ju Na, Jee Young Hong, Keon Yeop Kim, Moo Sik Lee, Hae Sung Nam, Jeong Soo Im, Jung Ae Rhee
J Prev Med Public Health. 2004;37(3):267-273.
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OBJECTIVES
This study was aimed at investigating the medical service utilization pattern of patients who use public medical aid compared to those who have health insurance. METHODS: We selected every patient between the age of 18 and 69 who used public medical aid from January 1, 1999, to December 31, 2001, in Gwangju metropolitan city, South Korea. For comparison, a list of patients with health insurance was gathered for same period. Then the medical records of those who had been hospitalized for acute appendicitis were selected among both groups. Of those records, we compared the number of cases of ruptured appendicitis to cases of whole acute appendicitis in both groups. Regarding coding for ruptured appendicitis, International Classification of Diseases - 10 (ICD-10) was used. Multiple logistic regression was used as a statistical tool to determine the effectiveness of risk factors. RESULTS: Even after adjusting for risk factors, such as age and sex, the proportion of perforation of acute appendicitis among public medical aid patients was found to be significantly higher than among insured patients. CONCLUSIONS: This comparative study on ruptured appendicitis among public medical aid patients and insured patients, indicates that the proportion of perforation of acute appendicitis could be an index showing that these types of patients utilize medical services differently than insured patients. We know that when abdominal pain is not properly treated at the outset, it easily develops into ruptured appendicitis complicated with peritonitis. Considering this data analysis, we guess the public medical aid system to have significant problem with medical accessibility. So additional and systematic research on the pattern of utilization of medical services of public medical aid patients is needed.
Summary
Original Articles
Non-Fatal Injuries among Preschool Children in Daegu and Kyungpook.
Soon Woo Park, Youn Jeong Heo, Sang Won Lee, Jung Han Park
J Prev Med Public Health. 2004;37(3):274-281.
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AbstractAbstract PDF
OBJECTIVES
This study was performed to investigate the injury rates and risk factors for preschool children in Daegu city and Kyungpook province. METHOD : A questionnaire survey about medically attended injuries during the preschool period was performed in nine primary schools located in Daegu city, Pohang city and Goryung County. The overall injury rate was estimated using person-year. The causes and patterns of the injuries, and their risk factors were examined. RESULT : A total of 469 medically attended injuries were reported in 330 of the 959 study subjects during the preschool period. The overall annual injury rate was 7.5 per 100 children. The injury rate increased sharply during the period from infant (2.4) to 1 year of age (7.5), and the peak injury rate (9.2) was reported for 5 year olds. The most common causes of injuries were falling (36.0%), followed by being struck by an object (23.7%), and traffic accidents (14.1%). Among the traffic accidents, 72.8% occurred while playing on the road, riding a bicycle or roller-skating. A proportional hazard model showed that males (hazard ratio=1.49, p< 0.001 compared with female) and the mother's higher education level (hazard ratio of college or higher= 1.51, p=0.013; high school=1.32, p=0.085 compared with those of middle school or lower) were significant risk factors of childhood injury. CONCLUSION: The results of this study suggested that efforts for children's safety should be made, especially from the toddler stage, and in male children. To develop a more specific childhood injury prevention program, a surveillance system for injuries should be established. Further study of the relationship between mother's occupation and injury rates is also needed.
Summary
A Relationship of Care Time with Functional Status and Patients Characteristics among Patients in Long-term Care Hospitals.
Jee Jeon Yi, Sang Wook Yi, Jeong In Kim, Seung Hm Yu, Hyeong Sik Yoo
J Prev Med Public Health. 2004;37(3):282-291.
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OBJECTIVES
The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. METHODS: The functional stati of 1001 patients in 8 longterm care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. RESULTS: The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. CONCLUSIONS: Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.
Summary

JPMPH : Journal of Preventive Medicine and Public Health