Journal of Preventive Medicine and Public Health

Original Articles

Mental Disorders Mediate the Relationship Between Adverse Childhood Experiences and Suicidal Behavior in a High-risk Population: A Counterfactual Analysis From Jeju Island: Yeon Woo Oh, Dongkyu Lee, Young-Eun Jung, Sun Jae Jung; J Prev Med Public Health. 2025;58(5):505-515. Published online May 7, 2025; DOI: https://doi.org/10.3961/jpmph.25.120

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Abstract Summary PDF Supplementary Material: Objectives
Jeju Island, Korea, is characterized by a significantly higher prevalence of adverse childhood experiences (ACE, 32.4%), elevated rates of mental disorders (34.6 vs. 22.9%), and lifetime suicidal thoughts (20.6 vs. 10.7%) compared to national averages. We investigated the mediating role of mental disorders in the pathway from ACE to suicidal behavior in Jeju.
Methods
Data from the Jeju Special Self-Governing Province Mental Health Survey 2023 (n=703) were analyzed. Exposure was defined as experiencing at least one ACE from the 10-item Adverse Childhood Experience International Questionnaire. Depressive disorder, anxiety disorder, and alcohol use disorder were diagnosed using the Korean-Composite International Diagnostic Interview. Suicidal behavior was defined as experiencing suicidal ideation, planning, or attempts. A counterfactual mediation model was used to evaluate the natural direct effect and natural indirect effect (NIE) of mental disorders.
Results
The total effect of ACE on suicidal behavior showed a risk difference of 35.3 percntage points (%p). When considering all three mental disorders simultaneously, the NIE was 27.6%p, accounting for 78.1% of the total effect. Stratification analyses revealed stronger total effects in women and older adults, while the proportion mediated was higher in women and younger adults.
Conclusions
In this ACE-prevalent population, mental disorders collectively mediated approximately three-quarters of the pathway from ACE to suicidal behavior. These findings, derived through robust counterfactual analysis, suggest that strengthening screening and management protocols for mental disorders among adults with a history of ACE may effectively prevent suicide in populations with high ACE prevalence.; Summary

Korean summary
이 연구는 제주도 성인 인구를 대상으로 아동기 역경 경험(ACE)이 자살 행동에 미치는 영향 중 정신질환(우울, 불안, 알코올 사용장애)이 약 78%를 매개한다는 것을 확인했다. 이는 ACE가 높은 지역사회에서 정신질환 대한 체계적인 선별검사와 관리가 자살 예방에 효과적일 수 있음을 시사한다.

Key Message
This study found that mental disorders(depression, anxiety, and alcohol use disorders) mediate approximately 78% of the pathway from adverse childhood experiences (ACE) to suicidal behavior in Jeju Island's adult population. The findings suggest that systematic screening and management of mental disorders could effectively prevent suicide in communities with high ACE prevalence.

Global Trends in Childhood Sexual Abuse and Bullying Victimization in 204 Countries: A Comprehensive Analysis From 1990 to 2019: Nasrin Borumandnia, Mohammadamin Sabbagh Alvani, Payam Fattahi, Mahmood Reza Gohari, Yashar Kheirolahkhani, Hamid Alavimajd; J Prev Med Public Health. 2024;57(6):530-539. Published online August 15, 2024; DOI: https://doi.org/10.3961/jpmph.24.007

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Objectives
No comprehensive analysis has yet been published regarding global trends in childhood sexual abuse (CSA) and bullying victimization (BV). The present study offers a longitudinal perspective on their prevalence worldwide.
Methods
CSA and BV rates were extracted from the Global Burden of Disease study, spanning the years 1990 to 2019 across 204 countries. Trends by gender, region, and human development index (HDI) were examined.
Results
For both boys and girls, and in both high-HDI and low-HDI countries, CSA rates did not significantly change from 1990 to 2019 (p>0.05). However, BV rates increased significantly in high-HDI and low-HDI countries for both genders (p<0.001). Subsequently, we analyzed trends separately by gender across all countries, without considering development level. In this analysis, CSA rates among girls decreased from 1990 to 2000, followed by an increasing tendency after 2000; overall, an upward trend was evident between 1990 and 2019 (p=0.029). In contrast, no significant pattern was observed for boys. Notably, BV demonstrated an increasing trend across all regions when HDI was not considered (p<0.05), with African populations experiencing the most pronounced rise (p<0.001). Globally, boys consistently exhibited higher BV rates than girls.
Conclusions
Our research indicates that, on a global scale, rates of CSA among girls have been rising. Additionally, BV rates have increased in all regions for both boys and girls. Notably, this trend in BV rates is occurring irrespective of HDI. These findings underscore the necessity for targeted interventions in areas with high rates of CSA and BV.

Summary

Key Message
This study analyzes global trends in childhood sexual abuse (CSA) and bullying victimization (BV) from 1990 to 2019 across 204 countries. Results indicate a significant rise in BV rates globally, with boys consistently exhibiting higher rates than girls. While CSA rates among girls show an upward trend, no significant change is observed for boys. These findings highlight the urgent need for targeted interventions to address CSA and BV worldwide.

Citations

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Shadows of doubt: Ambivalent acknowledgment of abuse and identification with the aggressor
Edna Porat-Moeller, Anastasia Keidar, Lee Gafter, Yael Lahav
Child Abuse & Neglect.2025; 163: 107401. CrossRef
Sensory modulation difficulties and complex PTSD among child abuse survivors
Nitzan Avigail Kidra, Lee Gafter, Tami Bar-Shalita, Yael Lahav
European Journal of Psychotraumatology.2025;[Epub] CrossRef
Global burden of noncommunicable diseases attributable to modifiable behavioral risks among adolescents and young adults aged 10–24 years, 1990–2021
Yunfei Feng, Da Sun, Xuren Sun, Qiqiang Guo, Jing Zhang, Yongze Li
BMC Medicine.2025;[Epub] CrossRef
Adverse experiences in childhood and young adulthood, genetic susceptibility, and neurodegenerative disease incidence: a lifespan analysis
Jie Li, Xiaoqin Xu, Ying Sun, Yanqi Fu, Xiao Tan, Ningjian Wang, Yingli Lu, Jiang Li, Bin Wang
European Journal of Psychotraumatology.2025;[Epub] CrossRef
The mediating role of self-esteem in the link between childhood adversities and criminality among North African adult males: A case-control study
Imen Mlouki, Arij Soussi, Emna Hariz, Aya Ajmi Blout, Marwa Boussaid, Ahmed Moustafa, Abir Aissaoui, Sana El Mhamdi
Child Abuse & Neglect.2025; 169: 107718. CrossRef

The Influence of Family Adversities on Longitudinal Changes in Physical Inactivity Among Korean Adolescents During the COVID-19 Pandemic: Tae Kyoung Lee, Jing Zhu, Young Mi Kim, Ze-Kai Jiang, Meilin Zhang, Won Ha Choi, Tae-Young Pak, Hana Song; J Prev Med Public Health. 2024;57(5):443-450. Published online August 4, 2024; DOI: https://doi.org/10.3961/jpmph.24.236

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Abstract Summary PDF Supplementary Material: Objectives
Lack of physical activity has a critical effect on the physical and mental health of adolescents. This study examined the influence of family adversities on the longitudinal changes in physical inactivity among adolescents during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
The study used multi-wave data from the Korean Children and Youth Panel Survey, including 2590 Korean adolescents aged 12-14 years. The longitudinal trajectory of physical inactivity among adolescents and the effects of related factors were estimated using a latent growth modeling method.
Results
Our results revealed a significant increase in physical inactivity among adolescents over time. At the onset of the pandemic, approximately one-seventh of Korean middle schoolers reported a lack of physical activity. However, 3 years later, during the quarantine, nearly one-fifth of these adolescents reported a significant increase in their physical inactivity. Initially, low level parental education was predictive of adolescents’ physical inactivity, but this effect diminished over time, becoming statistically insignificant by the end of the 3-year period. Moreover, the increase in physical inactivity over the 3 years was significantly influenced by parental rejection.
Conclusions
These findings suggest that adolescents who experience parental rejection are more likely to report an increase in sedentary behaviors in contexts such as the COVID-19 pandemic.; Summary

Korean summary
본 연구는 팬데믹 기간 동안 청소년의 신체 활동 변화와 신체 활동 부족에 대한 부정적 가정 환경의 영향을 조사했다. 한국 청소년 2,590명을 대상으로 한 3년간의 종단 패널 데이터를 잠재 성장 모형으로 분석하여 신체 활동 부족의 변화를 추적하였다. 그 결과, 팬데믹 기간 동안 청소년들의 신체 활동 부족이 현저히 증가했으며, 부모의 거부가 이러한 증가에 유의한 영향을 미친 것으로 나타났다.

Key Message
This study examined the impact of family adversities on the longitudinal changes in physical inactivity among 2,590 Korean adolescents during the COVID-19 pandemic. Over the 3-year period, physical inactivity increased significantly, with parental rejection playing a key role in this rise. While low parental education initially predicted higher levels of inactivity, its influence diminished over time.

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia: Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito; J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024; DOI: https://doi.org/10.3961/jpmph.24.246

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

Summary

Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.

Citations

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Multidimensional energy poverty and childhood respiratory health across 26 low and lower middle income countries
Cailiang Xia, Maryam Sadiq, Sidra Younas
Scientific Reports.2026;[Epub] CrossRef
Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Reiko Saito
Infectious Diseases of Poverty.2025;[Epub] CrossRef
Geographical variation in community-acquired pneumonia prevalence during the COVID-19 pandemic in northern Sumatra, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
Discover Public Health.2025;[Epub] CrossRef

Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach: Vadivelan Kanniappan, Abishek Jayapal Rajeswari, Pearlyn Esther Padma Lawrence, Subash Sundar; J Prev Med Public Health. 2024;57(2):157-166. Published online January 21, 2024; DOI: https://doi.org/10.3961/jpmph.23.426

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Abstract Summary PDF Supplementary Material

Objectives
Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics.
Methods
For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis.
Results
A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients’ parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists.
Conclusions
Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

Summary

Key Message
The paper investigates the views of pediatricians in Chennai, Tamil Nadu, India, about pediatric physiotherapy. It finds themes including the value of a multidisciplinary approach, the function of experienced physiotherapists, and parental access restrictions via qualitative interviews with ten doctors. To maximize patient outcomes, recommendations include raising awareness, strengthening multidisciplinary cooperation, and creating centralized pediatric rehabilitation centers.

Citations

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Knowledge and awareness of developmental delays, the role of physiotherapy in gross motor delays, and effective lifting and carrying techniques among parents of children with developmental delays – An observational study
Sachin Chaudhary, Megha Rao, Neha Sachin Chaudhary, Sarika Shrivastav, Sakshi Uttamchandani, Snehal Samal
Physiotherapy - The Journal of Indian Association of Physiotherapists.2025; 19(2): 147. CrossRef
“This is Something Else, It is Not Like Physical Therapy in the Clinic”: Perspectives of Stakeholders About School-Based Physical Therapy
Nilly Waiserberg, Paula Feder-Bubis
Physical & Occupational Therapy In Pediatrics.2025; : 1. CrossRef
Impact of model physiotherapy centres in reducing the burden among the caregivers of children with neurodevelopmental disorders in the rural area of Tamil Nadu: a study protocol
Vadivelan Kanniappan, Prakash Muthuperumal, P. Venkataraman, T. S. Veeragoudhaman, Balaji Chinnasami, Manikumar Muthiah, Abishek Jayapal Rajeswari, Manju Bashini Manoharan, Shrisruthi Suresh, Ashok Natesan
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef

Association of Infant Feeding Characteristics With Dietary Patterns and Obesity in Korean Childhood: Kyoung-Nam Kim, Moon-Kyung Shin; J Prev Med Public Health. 2023;56(4):338-347. Published online June 26, 2023; DOI: https://doi.org/10.3961/jpmph.22.504

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Abstract Summary PDF Supplementary Material

Objectives
Young children’s feeding characteristics can play an important role in eating habits and health during later childhood. This study was conducted to examine the associations of feeding characteristics with dietary patterns and obesity in children.
Methods
This study utilized data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2017. In total, 802 toddlers were included, with information on their demographic characteristics, feeding practices and duration, and 24-hour recall obtained from their parents. Feeding characteristics were categorized into feeding type, duration of total breastfeeding, duration of total formula feeding, duration of exclusive breastfeeding, and age when starting formula feeding. Dietary patterns were identified based on factor loadings for the food groups for 3 major factors, with “vegetables & traditional,” “fish & carbohydrates,” and “sweet & fat” patterns. Overweight/obesity was defined as ≥85th percentile in body mass index based on the 2017 Korean National Growth charts for children and adolescents. Multiple regression analysis was conducted to examine associations between feeding characteristics and dietary patterns. The association between dietary patterns and obesity was analyzed using multivariable logistic regression analysis.
Results
The early introduction of formula feeding was inversely associated with the “vegetables & traditional” pattern (β=-0.18; 95% confidence interval [CI], -0.34 to -0.02). A higher “vegetables & traditional” intake was associated with a lower risk of obesity (odds ratio, 0.48; 95% CI, 0.24 to 0.95).
Conclusions
Feeding characteristics are associated with dietary patterns in later childhood, and dietary patterns were shown to have a potential protective association against obesity.

Summary

Korean summary
생애 초기 수유 형태는 유아의 식습관 형성에 영향을 주고 아울러 성장기의 식습관에도 중요한 바탕이 된다. 특히, 생애 초기 수유 형태는 유아기의 성장 발달 또는 비만과 관련됨이 알려져 있다. 과일과 채소 섭취 증가 및 다양한 식품의 섭취는 비만을 예방하는 대표적인 식습관 중의 하나이다. 본 연구에는 영아 시기의 수유 형태가 이후 유아기의 식사 패턴에 미치는 영향 및 유아기 비만과의 관련성을 살펴보고자 수행되었다. 이에 본 연구에서는 국민건강영양조사2013-2017년까지 만2-3세 유아 802명 대상으로 수유 형태에 따른 식사 패턴 분석 결과, 4개월 이전 분유 수유를 시작할 경우 ‘vegetables & traditional’패턴 점수가 감소하였다. 식사 패턴과 비만 유병률 결과, ‘vegetables & traditional’ 패턴 요인 점수가 증가할수록 비만 유병률이 감소하는 경향을 보였다. 이에 본 연구 결과들을 통해 생애 초기 수유 형태에 따라 유아기(미취학아동)의 식습관에 영향을 미치는 요인으로 판단되며, 그 식습관이 반영됨에 따라 소아 비만과 관련이 있음을 나타냈다. 따라서 국내 대규모의 표본을 대상으로 한 연구 결과로 건강하고 다양한 식습관 지도를 위한 영양 교육 프로그램의 근거 자료로 활용될 수 있다고 생각된다.

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Comparison of the growth and nutritional status of low birth weight and normal birth weight children
Hye-Young Kim
Journal of Nutrition and Health.2024; 57(6): 630. CrossRef

Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey: Ichtiarini Nurullita Santri, Yuniar Wardani, Yohane Vincent Abero Phiri, Gunchmaa Nyam, Tyas Aisyah Putri, Khoiriyah Isni, Dyah Suryani, Grace Sambo; J Prev Med Public Health. 2023;56(3):255-263. Published online April 18, 2023; DOI: https://doi.org/10.3961/jpmph.22.470

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Abstract PDF

Objectives
The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age.
Methods
A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia.
Results
The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father’s smoking frequency, which were considered the sample’s socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father’s smoking frequency, and a low education level were all linked to ARI symptoms.
Conclusions
The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father’s smoking frequency and low education level were associated with ARI symptoms.

Summary

Citations

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Factors Associated with Acute Respiratory Infections in Children Under Five Years Old: Analysis of the Demographic and Family Health Survey
Diego A. Polo-Pucho, Javier J. Gonzales-Carrillo, Miguel A. Arce-Huamani
Children.2025; 12(9): 1242. CrossRef
Indoor air pollution exposure and acute respiratory infection among under-five children in low- and middle-income countries: a systematic review and meta-analysis of epidemiological studies
Belay Desye, Abebe Kassa Geto, Chala Daba, Gete Berihun, Leykun Berhanu
BMC Infectious Diseases.2025;[Epub] CrossRef

Scoping Review

Pre-pregnancy Diet to Maternal and Child Health Outcome: A Scoping Review of Current Evidence: Fadila Wirawan, Desak Gede Arie Yudhantari, Aghnaa Gayatri; J Prev Med Public Health. 2023;56(2):111-127. Published online March 13, 2023; DOI: https://doi.org/10.3961/jpmph.22.472

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Objectives
Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map ‘what has been researched’ on pre-pregnancy diet and maternal and child health.
Methods
Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide.
Results
Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%.
Conclusions
Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

Summary

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Original Articles

Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran: Mahdieh Niknam, Nasrin Omidvar, Parisa Amiri, Hassan Eini-Zinab, Naser kalantari; J Prev Med Public Health. 2023;56(1):77-87. Published online January 10, 2023; DOI: https://doi.org/10.3961/jpmph.22.409

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Abstract PDF Supplementary Material

Objectives
It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran.
Methods
A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively.
Results
The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions.
Conclusions
By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.

Summary

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Implementation science in higher education: Identifying key determinants in the selection of evidence-based alcohol and substance prevention and treatment
Ashley C. Helle, Karla T. Washington, Joan Masters, Kenneth J. Sher, Gregory A. Aarons, Kristin M. Hawley
Journal of Substance Use and Addiction Treatment.2025; 170: 209617. CrossRef
Improving community readiness among Iranian local communities to prevent childhood obesity
Mahdieh Niknam, Nasrin Omidvar, Hassan Eini-Zinab, Naser Kalantari, Keyvan Olazadeh, Parisa Amiri
BMC Public Health.2023;[Epub] CrossRef

Prediction of Stunting Among Under-5 Children in Rwanda Using Machine Learning Techniques: Similien Ndagijimana, Ignace Habimana Kabano, Emmanuel Masabo, Jean Marie Ntaganda; J Prev Med Public Health. 2023;56(1):41-49. Published online January 6, 2023; DOI: https://doi.org/10.3961/jpmph.22.388

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Abstract PDF

Objectives
Rwanda reported a stunting rate of 33% in 2020, decreasing from 38% in 2015; however, stunting remains an issue. Globally, child deaths from malnutrition stand at 45%. The best options for the early detection and treatment of stunting should be made a community policy priority, and health services remain an issue. Hence, this research aimed to develop a model for predicting stunting in Rwandan children.
Methods
The Rwanda Demographic and Health Survey 2019-2020 was used as secondary data. Stratified 10-fold cross-validation was used, and different machine learning classifiers were trained to predict stunting status. The prediction models were compared using different metrics, and the best model was chosen.
Results
The best model was developed with the gradient boosting classifier algorithm, with a training accuracy of 80.49% based on the performance indicators of several models. Based on a confusion matrix, the test accuracy, sensitivity, specificity, and F1 were calculated, yielding the model’s ability to classify stunting cases correctly at 79.33%, identify stunted children accurately at 72.51%, and categorize non-stunted children correctly at 94.49%, with an area under the curve of 0.89. The model found that the mother’s height, television, the child’s age, province, mother’s education, birth weight, and childbirth size were the most important predictors of stunting status.
Conclusions
Therefore, machine-learning techniques may be used in Rwanda to construct an accurate model that can detect the early stages of stunting and offer the best predictive attributes to help prevent and control stunting in under five Rwandan children.

Summary

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Prevalence and Predictors of Complementary Feeding Practices Among Children Aged 6-23 Months in Indonesia: Siti Nurokhmah, Lucinda Middleton, Aryono Hendarto; J Prev Med Public Health. 2022;55(6):549-558. Published online October 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.199

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Objectives
Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD).
Methods
We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children’s Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design.
Results
The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali.
Conclusions
It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

Summary

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Determinants of appropriate complementary feeding practices among mothers of children aged 6–23 months in Bokoji town, Oromia region, Ethiopia
Abdurehman Kalu Tololu, Bekele Teshome, Hiwot Zelalem Fessaha, Abdene Weya Kaso
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Prevalence and associated factors of complementary feeding practices of mothers having children 6–23 months in rural disadvantaged areas, Ben Tre province, Vietnam: a cross-sectional study
Thuy Ngoc Vuong, Hang Thi Diem Tran
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DEVELOPING AN INSTRUMENT FOR DETERMINANTS OF INFANT AND YOUNG CHILD FEEDING (IYCF) PRACTICES USING THEORETICAL INTEGRATION APPROACH
Ira Dwijayanti, Anugrah Linda Mutiarani, Merry Sunaryo, Angelina Putri Firdaus, Eka Harum Lestari
Journal of Nutrition College.2025; 14(2): 123. CrossRef
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Women’s empowerment-related inequalities in complementary feeding practices among children aged 6–23 months in Indonesia: a decomposition analysis
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Social-demographic and behavioral predictors of core indicators of complementary feeding practices among mothers of children aged 6–23 months: baseline results from a cluster-randomized trial in rural Ethiopia
Tadele Amente, Yohannes Kebede, Tefera Belachew
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Joyeuse Ukwishaka, Sekou Samadoulougou, Vincent Sezibera, Fati Kirakoya-Samadoulougou, Geneviève Lefebvre
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Surmita Surmita, Rini Sekartini, Aria Kekalih, Dian Novita Chandra
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Naomi Shume, Sophie Ochola, Eunice Njogu
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Iqlima Dwi Kurnia, Praba Diyan Rachmawati, Yuni Sufyanti Arief, Ilya Krisnana, Pratuma Rithpho, Hidayat Arifin
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Women’s Empowerment Facilitates Complete Immunization in Indonesian Children: A Cross-sectional Study: Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Putu Harrista Indra Pramana, Made Yuliantari Dwi Astiti, Jovvita Jonathan, Fitriana Melinda, Teo Wijaya; J Prev Med Public Health. 2022;55(2):193-204. Published online March 8, 2022; DOI: https://doi.org/10.3961/jpmph.21.592

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Abstract PDF

Objectives
The primary objective of this study was to examine the effect of women’s empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association.
Methods
We utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12-23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women’s empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women’s empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group.
Results
The primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women’s empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles.
Conclusions
To our knowledge, this study is the first to explore women’s empowerment as a determinant of child immunization in Indonesia. The results indicate that women’s empowerment must be considered in Indonesia’s child immunization program. Women’s empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women’s empowerment on health outcomes.

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Associations Between Parental Depression and Early Childhood Development in Indonesia: A Cross-sectional Study: Ika Saptarini, Anissa Rizkianti, Prisca Petty Arfines, Suparmi , Iram Barida Maisya; J Prev Med Public Health. 2021;54(6):451-460. Published online November 10, 2021; DOI: https://doi.org/10.3961/jpmph.21.158

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Objectives
This study aimed to determine the associations between parental depression and early childhood development among children aged 36 months to 59 months in Indonesia.
Methods
From Indonesia’s Basic Health Survey (RISKESDAS) 2018, this study included 6433 children aged 36 months to 59 months and their parents. Maternal and paternal depression was examined using the Mini International Neuropsychiatric Interview survey instrument, which was previously translated into Indonesian. The study also used the Early Child Development Index to measure child development and its 4 domains (cognitive, physical, socio-emotional, and learning). Multivariate logistic regression analysis was performed to determine the association between parental depression and early childhood development.
Results
Overall, 10.3% of children aged 36 months to 59 months were off-track for development. After adjusting for biological, parental, and social characteristics, children born to parents with depression were found to be 4.72 times more likely to be off-track for development (95% confidence interval, 1.83 to 12.15).
Conclusions
Children of depressed parents were more likely to be off-track for development. The findings highlight the need for early diagnosis and timely intervention for parental depression to promote early childhood development.

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The Effect of the Physical Factors of Parents and Children on Stunting at Birth Among Newborns in Indonesia: Kencana Sari, Ratu Ayu Dewi Sartika; J Prev Med Public Health. 2021;54(5):309-316. Published online August 29, 2021; DOI: https://doi.org/10.3961/jpmph.21.120

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664 Download
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Abstract PDF

Objectives
This study examined stunting at birth and its associations with physical factors of parents and children in Indonesia.
Methods
This study analyzed secondary data from the national cross-sectional Indonesian Basic Health Survey 2018, conducted across 34 provinces and 514 districts/cities. Birth length data were available for 756 newborns. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between the physical factors of parents and children and stunting at birth.
Results
In total, 10.2% of children aged 0 months were stunted at birth (10.7% of males and 9.5% of females). Stunting at birth was associated with the mother’s age at first pregnancy, parity, parents’ heights, parents’ ages, and gestational age. Children from mothers with short statures (height <145.0 cm) and fathers with short statures (height <161.9 cm) had an almost 6 times higher likelihood of being stunted at birth (adjusted odds ratio, 5.93; 95% confidence interval, 5.53 to 6.36). A higher maternal age at first pregnancy had a protective effect against stunting. However, other variables (firstborn child, preterm birth, and both parents’ ages being <20 or >35 years) corresponded to a 2-fold higher likelihood of stunting at birth compared to the reference.
Conclusions
These findings provide evidence that interventions to reduce stunting aimed at pregnant females should also consider the parents’ stature, age, and parity, particularly if it is the first pregnancy and if the parents are short in stature or young. Robust programs to support pregnant females and monitor children’s heights from birth will help prevent intergenerational stunting.

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Associations Between Thyroid Hormone Levels and Urinary Concentrations of Bisphenol A, F, and S in 6-Year-old Children in Korea: Yoonyoung Jang, Yoon-Jung Choi, Youn-Hee Lim, Kyung-Shin Lee, Bung-Nyun Kim, Choong Ho Shin, Young Ah Lee, Johanna Inhyang Kim, Yun-Chul Hong; J Prev Med Public Health. 2021;54(1):37-45. Published online November 23, 2020; DOI: https://doi.org/10.3961/jpmph.20.310

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Abstract Summary PDF Supplementary Material

Objectives
Bisphenol A (BPA) is used in the electrical, mechanical, medical, and food industries. Previous studies have suggested that BPA is an endocrine disruptor. Regulation of BPA has led to increased use of bisphenol F (BPF) and bisphenol S (BPS). However, few studies have investigated the associations of BPF and BPS with thyroid dysfunction in children. Our study investigated the associations of prenatal BPA and early childhood BPA, BPF, and BPS exposure with thyroid function in 6-year-old children.
Methods
Prenatal BPA concentrations were measured during the second trimester of pregnancy in an established prospective birth cohort. We measured urinary BPA, BPF, and BPS concentrations and thyroid hormone levels (thyroid-stimulating hormone, total T₃, and free T₄) in 6-year-old children (n=574). We examined the associations between urinary bisphenol concentrations and percentage change of thyroid hormone concentrations using multivariate linear regression. We also compared thyroid hormone levels by dividing the cohort according to BPA, BPF, and BPS concentrations.
Results
The associations between prenatal BPA and total T₃ levels were statistically significant in all models, except for girls when using a crude model. The associations between urinary BPA and BPS concentrations and levels of all thyroid hormones were not statistically significant. However, we observed that lower free T₄ levels (-1.94%; 95% confidence interval, -3.82 to -0.03) were associated with higher urinary BPF concentrations in girls only.
Conclusions
Our findings identified significant associations between prenatal BPA exposure and total T₃ levels in all children and between BPF exposure and free T₄ levels in girls only.

Summary

Korean summary
비스페놀 A의 건강위해성에 대한 역학적 근거들이 축적되어 비스페놀 A 대신 BPF와 BPS와 같은 대체물질이 사용되고 있다. 본 논문에서는 어머니의 산전 비스페놀 A 노출과 6세 어린이의 비스페놀 A, 비스페놀 F, 비스페놀 S 노출 정도에 따라 어린이의 갑상선호르몬 농도에 어떠한 영향을 미치는가 보고자 하였다. 어머니의 산전 비스페놀 A 노출은 어린이의 total T3 농도에 유의하게 영향을 미쳤으며, 특히 여자아이에게서 비스페놀 F 노출이 한 단위 증가할수록 free T4 농도가 유의하게 감소하는 것을 관찰하였다. 본 논문의 의의는 비스페놀 F, S가 어린이의 갑상선기능에 어떠한 영향을 미치는지 역학적 근거를 제시하였다는 점이나, 인과적 연관성을 위해서는 시간적 선후관계를 고려한 더 많은 연구가 필요하다.

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The Effect of Prenatal Cadmium Exposure on Attention-deficit/Hyperactivity Disorder in 6-Year-old Children in Korea: Woosung Kim, Yoonyoung Jang, Youn-Hee Lim, Bung-Nyun Kim, Choong Ho Shin, Young Ah Lee, Johanna Inhyang Kim, Yun-Chul Hong; J Prev Med Public Health. 2020;53(1):29-36. Published online November 14, 2019; DOI: https://doi.org/10.3961/jpmph.19.175

8,776 View
185 Download
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Abstract Summary PDF Supplementary Material

Objectives
Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age.
Methods
As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age.
Results
Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model.
Conclusions
Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

Summary

Korean summary
이 연구의 목적은 산모와 아이의 코호트 추적조사 상 임신 중 혈중의 중금속 카드뮴 농도가 6세 아이의 주의력결핍 과잉행동 장애(ADHD)와 연관이 있는지를 확인하는 것이다. 자료원으로는 환경부와 식약처 지원 어린이 코호트인 환경노출과 어린이 성장 코호트 (EDC)를 이용하였다. 총 479쌍의 산모-아이 쌍을 대상으로 다변수 선형 회귀분석을 통해 연관성을 살펴보았다. 연구 결과, 임신 중 산모의 혈중 카드뮴 농도가 2배 증가함에 따라 6세 여아의 한국어판 주의력결핍장애(ADHD) 평점척도 (K-ARS) 점수가 22.3% 증가하는 것으로 나타났다.

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Review

The Protective Effect of Maternal Folic Acid Supplementation on Childhood Cancer: A Systematic Review and Meta-analysis of Case-control Studies: Wan Rosmawati Wan Ismail, Raudah Abdul Rahman, Nur Ashiqin Abd Rahman, Azman Atil, Azmawati Mohammed Nawi; J Prev Med Public Health. 2019;52(4):205-213. Published online July 2, 2019; DOI: https://doi.org/10.3961/jpmph.19.020

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Abstract PDF

Objectives
Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer.
Methods
A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review.
Results
Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19).
Conclusions
Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

Summary

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Original Articles

Trends in the Prevalence of Childhood Asthma in Seoul Metropolitan City, Korea: The Seoul Atopy ∙ Asthma-friendly School Project: Yong Min Cho, Chea-Bong Kim, Kyung Nam Yeon, Eun Sun Lee, KyooSang Kim; J Prev Med Public Health. 2018;51(6):275-280. Published online October 8, 2018; DOI: https://doi.org/10.3961/jpmph.18.090

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Abstract Summary PDF

Objectives
The project Seoul Atopy ∙ Asthma-friendly School investigated the current status of childhood asthma to enable formulation of a preventative policy. We evaluated the current prevalence of childhood asthma in Seoul and its trends and related factors.
Methods
The project was conducted annually from 2011 to 2016 and involved around 35 000 children aged 1-13 years. Based on the International Study of Asthma and Allergies in Childhood guidelines, the survey involved parents. The associations of the particulate matter (PM10) concentration, and the number of days on which the daily air quality guidance level was exceeded in the 25 districts of Seoul, with the prevalence of asthma were assessed.
Results
The age-standardized asthma prevalence in 2011 and 2016 was 6.74 and 4.02%, respectively. The prevalence of lifetime asthma treatment and treatment during the last 12 months tended to decrease from 2011 to 2016. Asthma treatment was significantly correlated with the number of days on which the daily air quality guidance level was exceeded, but not with the PM10 concentration.
Conclusions
This study reports the prevalence of asthma among children in Seoul and confirmed the relationship between childhood asthma and known risk factors in a large-scale survey.

Summary

Korean summary
서울시 아토피 천식 안심학교 사업을 통하여 2011년부터 2016년까지 약 25만명의 아동들을 대상으로 천식 유병률을 파악하고 관련 요인을 분석하였다. 천식의 연령표준화 유병률은 2011년 6.745에서 2016년 4.02%로 감소 추세를 보였다. 미세먼지(PM10)의 농도가 기준을 초과한 일수는 천식으로 인한 병원 치료 건 수와 상관성을 보였다.

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Association of exposure to indoor molds and dampness with allergic diseases at water-damaged dwellings in Korea
Seokwon Lee, Seung-Hun Ryu, Woo Jun Sul, Seunghyun Kim, Dohyeong Kim, SungChul Seo
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Trends (2007–2019) of major atopic diseases throughout the life span in a large Mexican population
Martín Becerril-Ángeles, Mario H. Vargas, Ismael Seth Medina-Reyes, Ramón Alberto Rascón-Pacheco
World Allergy Organization Journal.2023; 16(1): 100732. CrossRef
Association between Socioeconomic Status and Healthcare Utilization for Children with Allergic Diseases: Korean National Health and Nutritional Examination Survey (2015–2019)
Jeoungmi Kim, Bomgyeol Kim, Do Hee Kim, Yejin Kim, Vasuki Rajaguru
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Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019
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Changing Trends in School Absenteeism and Identification of Associated Factors in Adolescents with Atopic Dermatitis
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Forecasting the Effects of Real-Time Indoor PM2.5 on Peak Expiratory Flow Rates (PEFR) of Asthmatic Children in Korea: A Deep Learning Approach
Jiyoung Woo, Ji-Hyun Lee, Yeonjin Kim, Guillaume Rudasingwa, Dae Hyun Lim, Sungroul Kim
IEEE Access.2022; 10: 19391. CrossRef
Incidence of Asthma, Atopic Dermatitis, and Allergic Rhinitis in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutrition Examination Survey
Hyo Geun Choi, So Young Kim, Yeon-Hee Joo, Hyun-Jin Cho, Sang-Wook Kim, Yung Jin Jeon
International Journal of Environmental Research and Public Health.2022; 19(21): 14274. CrossRef
Factors associated with electronic cigarette use among adolescents asthma in the Republic of Korea
Chang Hoon Han, Jae Ho Chung
Journal of Asthma.2021; 58(11): 1451. CrossRef
Evaluation of changing trend in depression, suicidal ideation, and suicide attempts among adolescents with asthma and identification of associated factors: 11-year national data analysis in 788,411 participants
Yechan Kyung, Young Joo Han, Ju Suk Lee, Jun Hwa Lee, Seon Hui Jo, Sung Hoon Kim
Journal of Asthma.2021; 58(7): 921. CrossRef
The role of the environment in shaping the trends of childhood asthma – An Asian perspective
Agnes S. Y. Leung, Elizabeth Huiwen Tham, Jing Li, Punchama Pacharn, Takumi Takizawa, Eun Lee, Yuhan Xing, Ting‐Fan Leung, Soo‐Jong Hong, Gary W. K. Wong, Ömer Kalaycı
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Association of ambient air pollution with depressive and anxiety symptoms in pregnant women: A prospective cohort study
Dirga Kumar Lamichhane, Dal-Young Jung, Yee-Jin Shin, Kyung-Sook Lee, So-Yeon Lee, Kangmo Ahn, Kyung Won Kim, Youn Ho Shin, Dong In Suh, Soo-Jong Hong, Hwan-Cheol Kim
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Association between ambient air pollution and perceived stress in pregnant women
Dirga Kumar Lamichhane, Dal-Young Jung, Yee-Jin Shin, Kyung-Sook Lee, So-Yeon Lee, Kangmo Ahn, Kyung Won Kim, Youn Ho Shin, Dong In Suh, Soo-Jong Hong, Hwan-Cheol Kim
Scientific Reports.2021;[Epub] CrossRef
Ten-Year trends and prevalence of asthma, allergic rhinitis, and atopic dermatitis among the Korean population, 2008–2017
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Risk Reduction of Breast Cancer by Childbirth, Breastfeeding, and Their Interaction in Korean Women: Heterogeneous Effects Across Menopausal Status, Hormone Receptor Status, and Pathological Subtypes: Seok Hun Jeong, Yoon Suk An, Ji-Yeob Choi, Boyoung Park, Daehee Kang, Min Hyuk Lee, Wonshik Han, Dong Young Noh, Keun-Young Yoo, Sue K. Park; J Prev Med Public Health. 2017;50(6):401-410. Published online November 10, 2017; DOI: https://doi.org/10.3961/jpmph.17.152

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Abstract PDF Supplementary Material

Objectives
The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype.
Methods
BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs).
Results
BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ≥13 months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58).
Conclusions
This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ≥13 months can reduce their BC risk by about 50%.

Summary

Citations

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Novel Breast Cancer Risk Assessment Tools for Pre- and Postmenopausal Asian Women: Development and Validation in a Nationwide Mammographic Screening Cohort
Wonyoung Jung, Yong-Moon Mark Park, Sang Hyun Park, Kyungdo Han, Junhee Park, Yohwan Yeo, Jung Kwon Lee, Dale P. Sandler, Dong Wook Shin
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Association of reproductive risk factors and breast cancer molecular subtypes: a systematic review and meta-analysis
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Housing Conditions Contribute to Underweight in Children: An Example From Rural Villages in Southeast Sulawesi, Indonesia: Tasnim Tasnim, Gouranga Dasvarma, Lillian Mwanri; J Prev Med Public Health. 2017;50(5):328-335. Published online September 7, 2017; DOI: https://doi.org/10.3961/jpmph.17.046

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Abstract PDF

Objectives
The prevalence of underweight in children under 5 years of age is anomalously high in Konawe District, Southeast Sulawesi Province, Indonesia. This state of affairs may be related to poor housing conditions, such as limited access to clean water, the absence of a sanitary latrine, and the use of poor housing materials. Therefore, this study aimed to examine the effect of housing conditions on underweight in under-5 children in Konawe District. Methods: This study was conducted in 2013 in 5 health centres in Konawe District, Southeast Sulawesi Province, and used a case-control study design. The study recruited 400 under-5 children, including 100 of whom were cases and 300 of whom were age-matched controls (1:3). Cases were underweight children, while the controls were children with a normal nutritional status. The independent variables were the availability and types of water and latrine facilities and housing materials (roof, wall, and floor). The statistical analysis used Cox regression. Results: A lack of water availability (odds ratio [OR], 5.0; 95% confidence interval [CI], 2.7 to 9.5; p<0.001), a lack of latrine availability in the home (OR, 2.5; 95% CI, 1.5 to 4.0; p<0.001), and poor-quality roofing materials (OR, 1.7; 95% CI, 1.1 to 2.7; p<0.02) significantly contributed to underweight in children. In contrast, the walls and the floors did not contribute to under-5 year children being underweight (p=0.09 and p=0.71, respectively). Conclusions: Sanitation facilities and roofing were identified as important factors to address in order to improve children’s nutritional status. Children’s health status was directly impacted by food intake via their nutritional status.

Summary

Citations

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Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010: Abdollah Almasian Kia, Aziz Rezapour, Ardeshir Khosravi, Vajiheh Afzali Abarghouei; J Prev Med Public Health. 2017;50(3):201-209. Published online May 10, 2017; DOI: https://doi.org/10.3961/jpmph.17.028

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Abstract PDF

Objectives
The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality.
Methods
Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children.
Results
Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children’s sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant.
Conclusions
This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

Summary

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Yousef Moradi, Fatemeh Khosravi Shadmani, Kamyar Mansori, Shiva Mansouri Hanis, Rozhin Khateri, Hossein Mirzaei
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Associations Between Preschool Education Experiences and Adulthood Self-rated Health: Jeehye Lee, Jinwook Bahk, Young-Ho Khang; J Prev Med Public Health. 2017;50(4):228-239. Published online May 10, 2017; DOI: https://doi.org/10.3961/jpmph.16.110

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Abstract PDF Supplementary Material

Objectives
This study aimed to examine the association between preschool education experiences and adulthood self-rated health using representative data from a national population-based survey. Methods: Data from the Korean Labor and Income Panel Study in 2006 and 2012 were used. A total of 2391 men and women 21-41 years of age were analyzed. Log-binomial regression analyses were conducted to examine the associations between preschool education experience and self-rated health in adulthood. Parental socioeconomic position (SEP) indicators were considered as confounders of the association between preschool education experience and adulthood subjective health, while current SEP indicators were analyzed as mediators. Age-adjusted prevalence ratios (PRs) and the associated 95% confidence intervals (CIs) were estimated. Results: Compared with men without any experience of preschool education, those with both kindergarten and other preschool education experiences showed a lower prevalence of self-rated poor health (PR, 0.65; 95% CI, 0.47 to 0.89). In women, however, such an association was not evident. The relationship of preschool education experiences with self-rated poor health in adulthood among men was confounded by parental SEP indicators and was also mediated by current SEP indicators. After adjustment for parental and current SEP indicators, the magnitude of the associations between preschool education experiences and adulthood subjective health was attenuated in men. Conclusions: Preschool education experience was associated with adulthood self-rated health in men. However, this association was explained by parental and current SEP indicators. Further investigations employing a larger sample size and objective health outcomes are warranted in the future.

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Self-rated health and its determinants in patients with hypertension in Isfahan in 2019
Asieh Mansouri, Alireza Khosravi Farsani, Noushin Mohammadifard, Fatemeh Nouri, Mahnaz Jozan, Ghazaal Alavi Tabatabaei, Rezvan Salehidoost, Hamed Rafiee
BMC Public Health.2024;[Epub] CrossRef

Unsafe Disposal of Child Faeces: A Community-based Study in a Rural Block in West Bengal, India: Preeti PS, Sanjaya Kumar Sahoo, Dhiraj Biswas, Aparajita Dasgupta; J Prev Med Public Health. 2016;49(5):323-328. Published online September 8, 2016; DOI: https://doi.org/10.3961/jpmph.16.020

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Abstract PDF

Objectives
A clean India is the responsibility of all Indians. One of the objectives of the Swachh Bharat Abhiyan (Clean India Initiative) is to bring about behavioural changes regarding healthy sanitation practices. While large-scale programs in India have increased latrine coverage, they have to some extent failed to bring behavioural changes ensuring optimal latrine use, including the safe disposal of child faeces, which is a significant source of exposure to faecal pathogens. Hence, this study was done to explore child faeces disposal practices in rural West Bengal and to elicit the determinants of unhygienic faeces disposal.
Methods
Data collection was done using an interview method among the mothers of 502 under-5 children, following a pre-designed, semi-structured schedule during house-to-house visits in a set of villages in the Hooghly district of West Bengal.
Results
The prevalence of unsafe disposal of child faeces was 72.4%, and maternal education, per capita income, and water source were found to be significantly associated with unsafe child faeces disposal.
Conclusions
This study draws attention to the unsafe disposal of child faeces in this area of India and raises questions about the efficiency of sanitation campaigns in rural India that focus on expanding coverage rather than emphasizing behavioural changes, which are crucial to ensure the safe disposal of child faeces. Thus, it is urgently necessary to strengthen efforts focusing on behavioural changes regarding the safe disposal of child faeces in order to minimise adverse health outcomes.

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No Child’s Play: Under-five Child Feces Management in a Rural Area of Bengaluru Urban District, India
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Indian Journal of Community Medicine.2024; 49(1): 138. CrossRef
Effect of Positive Deviance Approach on Promotion of Safe Disposal of Child’s Feces in Rural Tamil Nadu: A Community-Based Quasi-Experimental Study
S. Nancy, S Gayathri, K. Mujibur Rahman, P. K. Govindarajan
Indian Journal of Community Medicine.2024; 49(1): 46. CrossRef
Exploring drivers of unsafe disposal of child stool in India using hierarchical regression model
Margubur Rahaman, Avijit Roy, Pradip Chouhan, Md. Juel Rana, Pintu Paul
PLOS ONE.2024; 19(3): e0295788. CrossRef
Decomposing rural-urban gap in unsafe disposal practice of child stool in India using nationwide sample survey data
Avijit Roy, Margubur Rahaman, Pradip Chouhan
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Bewuketu Terefe, Nega Tezera Assimamaw, Bogale Chekole
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Allan Ssembuusi, Solomon Tsebeni Wafula, David Musoke, Simon Kasasa
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Lina Agestika, Neni Sintawardani, Umi Hamidah, Sikopo Nyambe, Taro Yamauchi
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Moges Addis, Walelegn Worku, Laekemariam Bogale, Alebachew Shimelash, Eniyew Tegegne
Environmental Health Insights.2022;[Epub] CrossRef
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Gloria D. Sclar, Valerie Bauza, Alokananda Bisoyi, Thomas F. Clasen, Hans-Joachim Mosler, Alison Parker
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Lauren Sprouse, Anna Liles, Ryan Cronk, Valerie Bauza, James B. Tidwell, Musa Manga
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Biniyam Sahiledengle, Zinash Teferu, Yohannes Tekalegn, Tadesse Awoke, Demisu Zenbaba, Kebebe Bekele, Abdi Tesemma, Fikadu Seyoum, Demelash Woldeyohannes, Harvie P. Portugaliza
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Review

Short-term Effect of Fine Particulate Matter on Children’s Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis: Hyungryul Lim, Ho-Jang Kwon, Ji-Ae Lim, Jong Hyuk Choi, Mina Ha, Seung-Sik Hwang, Won-Jun Choi; J Prev Med Public Health. 2016;49(4):205-219. Published online July 14, 2016; DOI: https://doi.org/10.3961/jpmph.16.037

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Abstract PDF

Objectives
No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter (PM_2.5) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies.
Methods
Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger’s test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3.
Results
We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of PM_2.5 on children’s hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children’s hospital admissions and emergency department visits for asthma were positively associated with a short-term 10 μg/m³ increase in PM_2.5 (relative risk, 1.048; 95% CI, 1.028 to 1.067; I²=95.7%). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe.
Conclusions
We strengthened the evidence on the short-term effect of PM_2.5 on children’s hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.

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Original Articles

Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys: Dong Hee Ryu, Sin Kam, Young-Taek Doo; J Prev Med Public Health. 2016;49(2):118-128. Published online March 24, 2016; DOI: https://doi.org/10.3961/jpmph.16.003

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Abstract PDF

Objectives
The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services.
Methods
The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012.
Results
At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only (‘I’-only) and of fixed amount+indemnity-type (‘F+I’) increased, whereas the proportion of holders with fixed amount-type only (‘F’-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with ‘F’-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with ‘I’-only PMI or ‘F+I’ PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for ‘I’-only: 1.39, 1.63, and 1.38, respectively; ORs for ‘F+I’: 1.67, 2.09, and 1.37, respectively).
Conclusions
The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

Summary

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Medical insurance coverage and its associated factors among children in urban and rural Chongqing, China
Caihui Hu, Jingyu Chen, Lanling Chen, Xinyuan Yao, Shunqing Luo, Xiaoping Jiang, Lan Chen, Fengming Wang, Jie Li, Jian Liu, Shihai Zheng, Xiaohua Liang
International Health.2025;[Epub] CrossRef
Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
Dong-Hee Ryu, Yong-jun Choi, Jeehye Lee
Children.2022; 9(8): 1101. CrossRef
Community-Based Health Insurance Increased Health Care Utilization and Reduced Mortality in Children Under-5, Around Bwindi Community Hospital, Uganda Between 2015 and 2017
Nahabwe Haven, Andrew E. Dobson, Kuule Yusuf, Scott Kellermann, Birungi Mutahunga, Alex G. Stewart, Ewan Wilkinson
Frontiers in Public Health.2018;[Epub] CrossRef

Factors Determining Children’s Private Health Insurance Enrolment and Healthcare Utilization Patterns: Evidence From the 2008 to 2011 Health Panel Data: Jawoon Shin, Tae-Jin Lee, Sung-il Cho, Seung Ah Choe; J Prev Med Public Health. 2015;48(6):319-329. Published online November 16, 2015; DOI: https://doi.org/10.3961/jpmph.15.057

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Abstract PDF

Objectives
Parental socioeconomic status (SES) exerts a substantial influence on children’s health. The purpose of this study was to examine factors determining children’s private health insurance (PHI) enrolment and children’s healthcare utilization according to PHI coverage.
Methods
Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084).
Results
The factors determining children’s PHI enrolment included children’s age and sex and parents’ educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly.
Conclusions
Children’s PHI enrolment was influenced by parents’ SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

Summary

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Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia
Mohd Adli Abd Khalim, Surianti Sukeri, Gopal Ashish Sharma
PLOS ONE.2023; 18(1): e0278404. CrossRef
Equity in the public social healthcare protection in Tanzania: does it matter on household healthcare financing?
Felician Andrew Kitole, Robert Michael Lihawa, Eliaza Mkuna
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Does health insurance solve health care utilization puzzle in Tanzania?
Felician Andrew Kitole, Robert Michael Lihawa, Thobias Edward Nsindagi, Felister Y. Tibamanya
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Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys
Dong Hee Ryu, Sin Kam, Young-Taek Doo
Journal of Preventive Medicine and Public Health.2016; 49(2): 118. CrossRef

Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data: Seung Ah Choe, Sung-Il Cho; J Prev Med Public Health. 2014;47(6):336-342. Published online November 7, 2014; DOI: https://doi.org/10.3961/jpmph.14.024

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Abstract PDF

Objectives
Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea.
Methods
Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012.
Results
The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012).
Conclusions
In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Summary

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Child mortality of twins and singletons among late preterm and term birth: a study of national linked birth and under-five mortality data of Korea
Young Shin Kim, Minku Kang, Young June Choe, Joohon Sung, Ji Yeon Lee, Seung-Ah Choe
European Journal of Pediatrics.2022; 181(5): 2109. CrossRef

Special Articles

Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome: Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2013;46(4):173-182. Published online July 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.4.173

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Abstract PDF

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

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Giuliano Di Pietro, Damaris Santana Cardoso, Heloisa Mendonça Bernini Soares da Silva, Jessyca Costa Santos, Jordana Rosa dos Santos, Rodrigo Almeida Simões
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Overview of the Burden of Diseases in North Korea: Yo Han Lee, Seok-Jun Yoon, Young Ae Kim, Ji Won Yeom, In-Hwan Oh; J Prev Med Public Health. 2013;46(3):111-117. Published online May 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.3.111

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Abstract PDF

This article evaluates the overall current disease burden of North Korea through the recent databases of international organizations. It is notable that North Korea as a nation is exhibiting a relatively low burden from deaths and that there is greater burden from deaths caused by non-communicable diseases than from those caused by communicable diseases and malnutrition. However, the absolute magnitude of problems from communicable diseases like TB and from child malnutrition, which will increase the disease burden in the future, remains great. North Korea, which needs to handle both communicable and nutritional conditions, and non-communicable diseases, whose burden is ever more increasing in the nation, can now be understood as a country with the 'double-burden' of disease.

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Original Article

The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence: Hye Ah Lee, Won Kyung Lee, Kyoung-Ae Kong, Namsoo Chang, Eun-Hee Ha, Young Sun Hong, Hyesook Park; J Prev Med Public Health. 2011;44(5):226-233. Published online September 28, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.5.226

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Abstract PDF

Objectives

Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined.

Methods

The subjects consisted of 261 children aged 7-9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests.

Results

A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2-3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82).

Conclusions

This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.

Summary

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Comparative Study

Body Weight at Birth and at Age Three and Respiratory Illness in Preschool Children.: Yoolwon Jeong, Kyunghee Jung-Choi, Jin Hwa Lee, Hwa Young Lee, Eun Ae Park, Young Ju Kim, Eunhee Ha, Se Young Oh, Hyesook Park; J Prev Med Public Health. 2010;43(5):369-376.; DOI: https://doi.org/10.3961/jpmph.2010.43.5.369

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OBJECTIVES
The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. METHODS: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. RESULTS: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). CONCLUSIONS: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.

Summary

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English Abstract

The Relationship between Physical Activity and Clustering of Metabolic Abnormalities in Children.: Hyun Jin Son, Mi Kyung Kim, Hyun Ja Kim, Ho Kim, Bo Youl Choi; J Prev Med Public Health. 2008;41(6):427-433.; DOI: https://doi.org/10.3961/jpmph.2008.41.6.427

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OBJECTIVES
This study was performed to assess the association between physical activity and the clustering of metabolic abnormalities among Korean children. The effect of substituting moderate to vigorous physical activity for the time spent in inactivity was examined as well. METHODS: The study subjects were comprised of 692 (354 boys, 338 girls) 4th grade elementary school students. We used a modified form of the physical activity questionnaire that was developed in the Five-City Project. The subjects with clustering of metabolic abnormalities were defined as having two or more of the following five characteristics: waist circumference > or =90 %, systolic or diastolic blood pressure > or =90 %, fasting glucose > or =110 mg/dl, triglycerides > or =110 mg/dl and HDL cholesterol < or =40 mg/dl. We calculated the odds ratios to assess the effect of substituting moderate to vigorous physical activity for time spent in inactivity. RESULTS: The risk of clustered metabolic abnormalities was inversely correlated with the increased time spent on moderate to vigorous physical activity, but the correlation was not significant. The odds ratio for clustering of metabolic abnormalities that represented the effect of substituting moderate to vigorous physical activity for 30minutes of sedentary activity was 0.87 (95% CI=0.76-1.01). CONCLUSIONS: These findings suggest that substituting moderate to vigorous physical activity for sedentary activity could decrease the risk of clustered metabolic abnormalities.

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Original Articles

Nutritional Status and the Characteristics Related to Malnutrition in Children Under Five Years of Age in Nghean, Vietnam.: Nguyen Ngoc Hien, Sin Kam; J Prev Med Public Health. 2008;41(4):232-240.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.232

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Abstract PDF

OBJECTIVES
This study was conducted to assess the nutritional status and characteristics related to malnutrition in children less than five years of age in Nghean, Vietnam. METHODS: In this study, which was conducted in November 2007, 650 child-mother pairs were selected using a two-stage cluster sampling methodology. A structured questionnaire was then administered to the mothers in their home settings. Anthropometric measurement was then used to determine if children were underweight (weight-for-age), wasting (weight-for-height) and stunting (height-for-age) based on reference data from the National Center for Health Statistics (NCHS)/World Health Organization (WHO). Logistic regression analysis was then used to describe the hierarchical relationships between potential risk factors and malnutrition. RESULTS: The mean Z-scores for weight-for-age, heightfor-age and weight-for-height were -1.46 (95% CI=-1.57, -1.35), -1.44 (95% CI=-1.56, -1.32) and -0.71 (95% CI=-0.82, -0.60), respectively. Of the children included in this study, 193 (31.8%) were underweight, 269 (44.3%) were stunting and 72 (11.9%) were wasting. Region of residence, the mother's level of education and occupation, household size, number of children in the family, weight at birth and duration of exclusive breastfeeding were found to be significantly related to malnutrition. CONCLUSIONS: The findings of this study indicate that malnutrition is still an important problem among children less than five years of age in Nghean, Vietnam. In addition, maternal, socio-economic and environment factors were found to be significant factors for malnutrition among children under five.

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Associations between Air Pollution and Asthma-related Hospital Admissions in Children in Seoul, Korea: A Case-crossover Study.: Jong Tae Lee; Korean J Prev Med. 2003;36(1):47-53.

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Abstract PDF: OBJECTIVES
I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea METHODS: I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. RESULTS: Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3) ; 1.05 (95% CI, 1.00-1.09) for nitrogen dioxide (IQR=14.6ppb) ; 1.02 (95% CI, 0.97-1.06) for sulfur dioxide (IQR=4.4ppb) ; 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb) ; and 1.03 (95% CI, 0.99-1.08) for carbon monoxide (IQR=1.0ppm). CONCLUSIONS: This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution, at levels below the current ambient air quality standards of Korea, is harmful to sensitive subjects, such as asthmatic children.; Summary

Trend of the Changes in the Level of Blood Lead, Urinary Arsenic and Urinary Cadmium of Children in Ulsan: 3-year Follow-up Study.: Choong Ryeol Lee, Cheol In Yoo, Ji Ho Lee, Hun Lee, Yangho Kim; Korean J Prev Med. 2001;34(2):166-174.

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Abstract PDF: OBJECTIVES
To obtain basic data on blood lead level and urinary level of arsenic and cadmium of children living near a petrochemical estate and a suburban area in Ulsan, Korea and to observe the trend of the changes in the level of these metals in these children. METHODS: The study subjects comprised 626 children living near a petrochemical estate and 299 children living in a suburban area of Ulsan. We analyzed the level of lead, arsenic and cadmium using atomic absorption spectrometer. RESULTS: The mean levels of blood lead in children living near the petrochemical estate were 5.25 microgram/dl, 5.24 microgram/dl, and 7.24 microgram/dl in the years 1997, 1999, and 2000, respectively, whereas those of children living in the suburban area were 3.81 microgram/dl, 4.75 microgram/dl, and 7.19 microgram/dl respectively. The mean levels of urinary arsenic in children living near the petrochemical estate were 4.57 microgram/g creatinine, 4.78 microgram/g creatinine, and 6.02 microgram /g creatinine in the year 1997, 1999, and 2000 respectively, whereas those of children living in suburban area were 2.35 microgram/g creatinine, 4.75 microgram/g creatinine, and 7.07 microgram/g creatinine, respectively. The mean levels of urinary cadmium in children living near the petrochemical estate were 1.15 microgram/g creatinine, 1.05 microgram/g creatinine, and 1.71 microgram/g creatinine in the year 1997, 1999, and 2000, respectively, whereas those of the children living in the suburban area were 0.74 microgram/g creatinine, 1.29 microgram/g creatinine, and 1.48 microgram/g creatinine, respectively. There were increasing trends in the level of blood lead, urinary arsenic and cadmium of children in Ulsan, and the differences in the level of these metals were disappearing between the children living in other areas year by year. CONCLUSIONS: These results suggest that the amount of exposure to lead, arsenic, and cadmium is increasing from year to year, and there is a need for periodic biological and atmospheric monitoring of these metals in Ulsan.; Summary

Timing of Menarche and Physical Growth during Childhood and Adolescence: The Kangwha Study.: Chang Soo Kim, Chung Mo Nam, Duck Hi Kim, Hyun Chang Kim, Kang Hee Lee, Sun Ha Jee, Il Suh; Korean J Prev Med. 2000;33(4):521-529.

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Abstract PDF: OBJECTIVES
To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.; Summary

Respiratory Health of the Children Living near the Petrochemical Estate in Ulsan.: Choong Ryeol Lee, Cheol In Yoo, Ji Ho Lee, Yangho Kim; Korean J Prev Med. 2000;33(2):174-183.

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Abstract PDF: OBJECTIVES
To evaluate the effect of low-level exposure of air pollutants on the respiratory tract of the children living near the petrochemical estate in Ulsan. METHODS: The study design was cross-sectional, and the study subjects consisted of 150 children(76 boys, 74 girls) living near the petrochemical estate and 100 children(53 boys, 47 girls) living in a suburban area. We investigated respiratory health using self-administered questionnaires(ATS-DLD-78), radiological examination, and pulmonary function test such as FVC and FEV1. RESULTS: There were higher prevalence rates of respiratory symptoms in the children living near the petrochemical estate than the children living in a suburban area. And the results of FVC and FEV1 of 11-years old children living near the petrochemical estate were lower than those of the children living in a suburban area. CONCLUSIONS: Chronic exposure of low-level air pollutants would affect respiratory health of the children. Therefore, further a longitudinal study of respiratory health will be needed for children living near the petrochemical estate in Ulsan.; Summary

Heart Diseases Prevalence of Elementary School Children in Kyonggi Province.: Byung Chul Chun, Soon Duck Kim, Yong Tae Yum; Korean J Prev Med. 2000;33(1):36-44.

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Abstract PDF: OBJECTIVE
The heart diseases are known as a major cause of sudden death, as well as a cause of poor life-quality of school-age children. But there have been few mass screening of heart diseases in these children in Korea. This study was done to estimate the prevalence of heart diseases of these population. METHODS: We screened all elementary students(grade 1) in 12 cities and 16 counties(Gun) in Kyonggi province from 1992 to 1995. The first screening was done by auscultation of doctors and simultaneously by checking using 'auto-interpreter of EKG-cardiac sound'(Fukuda Densi ECP 50A). We conducted futher examinations to whom classified as being abnormal condition in first screening, by using EKG, chest x-ray, doppler echocardiograpy(if needed). RESULTS: The total number of examined students was 161,308(92% of the population), the male were 83,238 and female were 78,070. The congenital heart diseases(CHD) patients were 290(18 per 10,000) - male 155(18.6 per 10,000) and female 135(17.3 per 10,000). The most frequent disease was ventricula septal defect(VSD, 45.5%), Atrial septal defect(ASD, 14.8%), Tetralogy of Follot(TOF, 11.7%), and Patent Dutus Arteriosis(PDA, 7.6%) in order. In female, the order was VSD(48.1%), ASD(13.3%), TOF(11.1%), and PDA(10.4%). The total number of EKG abnormality were 433(62.7 per 10,000) among 69,056 screened children in 1995. The complete right bundle branch block(CRBBB) and paroxymal ventricular contraction(PVC) were frequent(26.6%, 26.3% in each), and incomplete right bunddle branch block(IRBBB,14.6%), paroxymal atrial contraction(PAC, 6.7%), abnormal Q(5.8%), Wolf-Pakinson-White syndrom (5.5%) in order. In female, the most frequent abnormality was PVC(29.8%), and CRBBB(19.9%) in order. CONCLUSION: We could present the stable prevalence of the rare heart disease. The prevalence of congenital heart diseases was 18.0 per 10,000 and of EKG abnormality was 62.7 per 10,000 among school children.; Summary

A Study on the Health Status of Korean Vietnam Veterans' Children: A Result of Questionnaire Survey on Vietnam Veterans of Pusan Area Who Diagnosed as Cases by Korean Veteran's Hospital Diagnostic Criteria.: Jin Ho Chun, Hak Joon Kim, Hae Sook Sohn, Sang Hwa Urm, Soo Kyung Park, Byung Chul Yu, Jong Tae Lee; Korean J Prev Med. 2000;33(1):17-24.

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Abstract PDF: OBJECTIVES
To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. METHODS: Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower(<18.0), moderate(18-53), high(> or =53) exposure group. RESULTS: The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was 18.1+/-9.9, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p<0.05). About half of the children(90 cases, 49.5%) hold the abnormal health status: those were skin pigmentation 38 cases, rash 23 cases, congenital anomaly 15 cases, general weakness 12 cases, purpura 8 cases, visual disturbance 8 cases, etc. These health problems had no association with father's exposure level(p>0.05). CONCLUSIONS: These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.; Summary

Prediction Equations for FVC and FEV1 among Korean Children Aged 12 Years.: Jong Won Kang, Yeong Su Ju, Joohon Sung, Soo Hun Cho; Korean J Prev Med. 1999;32(1):60-64.

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Abstract PDF: OBJECTIVES
Changes in lung function are frequently used as biological markers to assess the health effects of criteria air pollutants. We tried to formulate the prediction models of pulmonary functions based on height, weight, age and gender, especially for children aged 12 years who are commonly selected for the study of health effects of the air pollution. METHODS: The target pulmonary function parameters were forced vital capacity(FVC) and forced expiratory volume in one second(FEV1). Two hundreds and fifity-eight male and 301 female 12-year old children were included in the analysis after excluding unsatisfactory tests to the criteria recommended by American Thoracic Sosiety and excluding more or less than 20% predicted value by previous prediction equations. The weight prediction equation using height as a independent variable was calculated, and then the difference of observed weight and predicted weight (i.e. residual) was used as the independent variable of pulmonary function prediction equations with height. RESULTS: The prediction equations of FVC and FEV1 for male are FVC(ml) = 50.84 x height(cm) + 7.06 x weight residual - 4838.86, FEV1(ml) = 43.57 x height(cm) + 3.16 x weight residual - 4156.66, respectively. The prediction equations of FVC and FEV1 for female are FVC(ml) = 42.57 x height(cm) + 12.50 x weight residual - 3862.39, FEV1(ml) = 36.29 x height(cm) + 7.74 x weight residual - 3200.94, respectively.; Summary

Urinary Levels of Arsenic, Cadmium, and Zinc of Children in Ulsan Industrial Area.: Choong Ryeol Lee, Cheol In Ryu, Ji Ho Lee, Sung Ryul Kim, Jin Young Jeong; Korean J Prev Med. 1999;32(1):1-8.

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Abstract PDF: OBJECTIVES
We conducted this study to obtain basic data of urinary levels of arsenic, cadmium, and zinc in children of Ulsan industrial area and to evaluate the difference in urinary levels of these metals between industrial area and suburban area. METHODS: The study subjects were composed of 348(male 182, female 166) school children residing in industrial area and 100(male 50, female 50) school children of suburban area. We analyzed urinary levels of arsenic, cadmium, and zinc using atomic absorption spectrophotometer. RESULTS: The geometric means of urinary levels of arsenic, cadmium, and zinc of study participants were 3.69, 0.99, 282.49 microgram/L respectively. The adjusted geometric means of urinary levels of arsenic, cadmium, and zinc of study participants were 3.92, 1.05, 299.92 microgram/g creatinine respectively. CONCLUSIONS: The children residing in industrial area had the higher urinary levels of arsenic and cadmium than suburban children with statistical significance(p<0.01).; Summary

Characteristics of Traffic Accident for the Primary School Students and Its Affecting Factors.: Am Park, Yeon Kyung Lee, Jeong Yun Kim, Tae Yong Lee, Sok Goo Lee, Young Chae Cho, Dong Bae Lee; Korean J Prev Med. 1998;31(3):372-383.

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Abstract PDF: For the purpose to analysis the characteristics of traffic accidents(TA) and investigate the relationship between traffic accidents and children attention problem rating scale(CAP) and, family environment scale(FES), this questionnaire survey was conducted to the 16 primary school students in Taejon from July 14 to August 26, 1997. The number of study subjects who had an experience of traffic accidents from July 1, 1996 to June 30, 1997 were 195, and the number of control subjects were 512. The main results were as follows; 1. The traffic accident rates was 0.9% as a whole, but those were 1.4% in boys, 0.7% in girls, 1.3% in low (1st-3rd) grade, and 0.8% in high (4th-6th) grade. 2. The rates of traffic accidents were high in spring, friday, afternoon and a driveway around home. TA occurred during walking with friends most frequently. 3. In CAP the score of inattention was lower in TA group than control group, and hyperactivity was higher in TA group but they didn't showed significantly different. In FES, cohesion score was higher in TA group than control group, but Conflict score and Expressiveness score were in control group, but they didn't showed significantly different. 4. In CAP the odds ratio of inattention score for TA group was 0.84, but that of hyperactivity score was 1.15. In FES, the odds ratio of cohesion score was 1.06, but that of expression score and conflict score was 0.94 and 0.96, respectively. In conclusion, the relationships between TA and CAP, TA and FES in this study were not clear to explain personal characteristics and environmental conditions.; Summary

Blood Lead Levels of Children in Ulsan Industrial Area.: Cheol In Yoo, Ji Ho Lee, Choong Ryeol Lee, Sung Ryul Kim, Seon Ho Lee; Korean J Prev Med. 1998;31(2):240-248.

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Abstract PDF: We conducted this study, to obtain basic data of lead concentrations in children of Ulsan industrial area and to evaluate the difference in blood lead levels between industrial area and suburban area. The study subjects were composed of 348 school children residing in industrial area and 100 school children of suburban area. There is no difference in age and sex distribution of study participants between industrial and suburban area. The obtained results were as follows: l. The geometric means of blood lead levels of study participants were 4.90 ng/dl, which is lower than current acceptable value 10 ng/dl. 2. The children residing in industrial area had the higher blood lead levels(5.26 ng/dl) than suburban children(3.81 ng/dl) with statistical significance(P<0.001).; Summary

Factors influencing weight control behavior and intention of obese children and adolescents.: Yunju Kang, Myongsei Sohn, Kinam Jin, HanJoong Kim, Heechoul Ohr, Sungjae Shin; Korean J Prev Med. 1998;31(2):199-214.

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Abstract PDF: This study was undertaken to explain weight control behavior and intention of obese children and adolescents as measured by the elements of the health belief model. A total of 732 obese students from 28 schools in Seoul metropolitan area and their mothers were assessed with a self-administered questionnaire. The analyzed results are as follows; l. Among obese students, 45.3% of male students and 57.2% of female students, a significantly higher portion than male students, reported that they had tried to lose weight within the recent year. Exercise was the most frequently used method to lose weight followed by diet control, drug use, and specialized clinic visits, in descending order. 2. Male students were more likely to try to lose weight if they perceived a low threat level and their mother had a job, and female students were more likely to try to lose weight if they were younger in age, perceived a low threat level and had strong external motivating factors. 3. Female students showed a significantly higher level of intention to obesity control than male students, and the intention level of their mothers also showed the same trend. 4. In male students, the degree of weight dissatisfaction, weight control experience, the level of obesity related beliefs of students, the educational level of the mother and economic status of the family were significant predictors of intention to obesity control, and in females, age, the level of obesity related beliefs of students and intention of their mothers were significant. In the mothers of male students, obesity index of students, age of the mother and the level of obesity related beliefs of the mother were significant predictors of intention of the mother, and in the mothers of female students, obesity index of students, occupational status of the mother and obesity related beliefs of the mother were significant. 5. According to the path model of intention to obesity control, the degree of weight dissatisfaction had the most powerful effect in male students, and perceived net benefit level was the most important variable in female students. Since the weight control behavior and intention of obese students were more predictable by the degree of weight dissatisfaction than the obesity index, we can conclude that only the students dissatisfied with their weight are well motivated for obesity control. There can be a discrepancy between the mother and her child's beliefs and intention status(especially in male students), so the therapists should also assess the student's opinion as well as the mother's. In female students, the perceived net benefit level was the most important predictor of intention to obesity control, therefore the intervention program should pay particular attention to the positive benefits of weight control rather than negative aspects(threats) of obesity.; Summary

A Study on Serum Lipid Levels of Children in Pusan.: Soo Yong Kang, Byung Mann Cho, Su Ill Lee, In Kyong Hwang, Yeung Wook Kim, Young Sil Kim, Ae Ri Cha, I Ho Ha, Chel Ho Lee, Don Kyoun Kim; Korean J Prev Med. 1997;30(4):686-696.

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Abstract PDF: This is a cross-sectional study to evaluate the serum lipid levels of children living in Pusan in 1996. The distribution of age is from 2 years old to 12 years old. In female children mean total cholesterol is 171.4+/-26.2mg/dl, triglyceride is 104.7+/-50.6mg/dl, HDL-cholesterol is 54.4+/-14.8mg/dl, and LDL-cholesterol is 95.4+/-32.9mg/dl. In male children mean total cholesterol is 167.9+/-25.2mg/dl, triglyceride is 90.6+/-45.5mg/dl, HDL-cholesterol is 55.4+/-11.7mg/dll, and LDL-cholesterol is 94.4+/-23.6mg/dl. The percentile of serum lipid levels is measured in children. The 95th percentile of serum total cholesterol is 210mg/dl in male children, and 214mg/dl in female children. And, the 95th percentile of serum triglyceride is 184mg/dl in male children, and 191mg/dl in female children. And, the 95th percentile of LDL-cholesterol is 133mg/dl in male children, and 135mg/dl in female children. Serum total cholesterol is positively related to age(r=0.18), height(r=0.08), weight(r=0.17), obesity index(r=0.12), and negatively related to father's education level(r=-0.13), mother's education level(r=-0.13). Serum triglyceride is positively related to weight(r=0.23), age(r=0.31) and negatively related to father's education level(r=-0.12), mother's education level(r=-0.18). Serum HDL-C was positively related to mother's education level(r=0.07) and negatively related to height(r=-0.12), weight(r=-0.09). Conclusively, the serum lipid levels of children living in Pusan is generally so high that the family and school must try to control the serum lipid levels.; Summary

Completeness Estimation of the Korean Medical Insurance Data in Childhood Asthma.: M N Ha, H J Kwon, D H Kang, S H Cho, K Y Yoo, Y S Joo, J H Sung, J W Kang, D S Kim, S I Lee; Korean J Prev Med. 1997;30(2):428-436.

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Abstract PDF: OBJECTIVES
: The purpose of this paper is to estimate the completeness of the Korean Medical Insurance Data in childhood asthma. METHODS : Capture-recapture method was used to estimate the prevalence of childhood asthma and case ascertainment rate(completeness) of Korean Medical Insurance Data using two source model, 'Korean Medical Insurance Committee Data (KMICD)' and 'Nationwide Study of Asthma and Allergies in Korean Children'. The asthma cases were restricted to those who were born from 1981 to 1989 and were identified by their Resident Register Number. Asthma cases in Korean Medical Insurance Data were defined as cases coded by ICD-9 493 and ICD-10 J45. In 'Nationwide Study of Asthma and Allergies in Korean Children', asthma cases were defined as the children who had been diagnosed asthma and had experienced symptoms of asthma during the past 12 months. The defined cases in two data sources were matched by 13 digits Resident Register Number. The numbers of matched patients in two data sources were 245 of 32,825 eligible total subjects. Chapman and Wittes' nearly unbiased estimation was used for capture-recapture analysis of two data sources. RESULTS : Observed prevalence rate of childhood asthma was 5.3% and estimated prevalence rate by capture-recapture analysis was 11.6%. The highest prevalence rate was observed in 6-7 age group and the older the rate decreased. The completeness (the proportion of cases ascertained by KMICD to the total observed cases by two data sources) was 20.6%, and ranged from 10.8% to 28.8% by area. CONCLUSIONS : Invalid diagnosis of cases might overestimate the prevalence of childhood asthma and might underestimate the completeness of Korean Medical Insurance Committee Data in this study; Summary

Normal Predicted Values of Pulmonary Function of the Primary School Children in Rural Area and Sensitive Index of Respiratory Symptoms.: Byung Sun Choi, Jung Duck Park, Yeon Pyo Hong, Im Won Chang; Korean J Prev Med. 1995;28(3):690-705.

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Abstract PDF: Pulmonary function tests were conducted on 815 healthy primary school children (390 males and 425 female) in rural area using Collins Survey Spirometer (warren E. collins, Inc, U. S. A.) with X-Y Recorder. Respiratory symptoms(cough, sputum, sore throat, chest pain, chest tightness, dyspnea, coryza) were surveyed by the interviews. Multiple regression analysis and regression diagnostics were done for prediction equations of FVC, FEV1, PEFR and FEF25-75% . FVC, FEV1, PEFR and FEF25-75% values in 3 groups of children classified by the number of symptom were compared each other through standard variable value. FVC, FEV1, PEFR and FEF25-75% showed highly significant correlation with age, height and weight. Prediction equations for FVC, FEV1, PEER, FEF25-75% are functions of height only in both male and female children aged between 6 and 12 years old. PEFR showed a significant difference related with the number of symptom in female. These results suggest that the PEFR is sensitive PFT parameter in this study.; Summary

The levels of blood lead and zinc protoporphyrin for healthy urban population in Korea.: Dong Il Kim, Yong Kyu Kim, Jung Man Kim, Kap Yull Jung, Joon Youn Kim; Korean J Prev Med. 1992;25(3):287-302.

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Abstract PDF: Hemoglobin(Hb), zinc protoporphyrin(ZPP) and blood lead(PbB) levels were determined for 1,851 blood samples collected from healthy urban population to establish reliable baselines for Hb, ZPP and PbB levels by age and sex. ZPP values were analyzed with a Hmatofluorometer and PbB determinations were concurrently carried out using flameless atomic absorption spectrophotometry. The blood sampling period was about 6 months from May, 1991 and the summarized results were as follows; 1. The mean value of Hb in male female were 14.55+/-1.81 g/dl and 12.61+/-1.81 g/dl respectively and there was statistically significant difference(p<0.05). 2. The mean value of ZPP in pre-schoolchildren was 37.49+/-13.31 microgram/dl for male, 35.77+/-11.85 microgram/dl for female and that of ZPP in after 7 years groups was 31.91+/-8.23 microgram/dl for male, 30.11+/-9.11 microgram/dl for female and there was statistically significant difference(p<0.05). 3. The mean value of PbB in pre-schoolchildren was 25.10+/-5.21 microgram/dl for male, 24.45+/-4.18 microgram/dl for female and that of PbB in after 7 years groups was 24.28+/-3.00 microgram/dl for male, 21.99+/-5.05 microgram/dl for female and there was statistically significant difference(p<0.05).; Summary

A survey on child battering among elementary school children and related factors in urban and rural areas.: Kae Soon Jeon, Jung Han Park; Korean J Prev Med. 1991;24(2):232-242.

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Abstract PDF: To determine the incidence rate of child battering and related factors, a questionnaire survey was conducted on 1,255 children in 4th and 5th grades of two elementary schools (one in the upper economic class area with 519 students and the other in the lower economic class area with 504 students) in Taegu and two schools in rural areas of Kyungpook province (120 and 112 students, respectively) from 1st May to 10th May 1990. Total number of children who were battered during one-month period (1-30 April 1990) prior to the survey was 918 (73.1%)> Among the battered children 87 (6.9%) were severely battered (twice or more in a month by kicking or more severe method) and 831 children (66.2%) were moderately battered (all other battering than severe battering). The percentage of battered children and degree of battering were not significantly different between two schools in Taegu and between urban and rural areas. Common reasons for battering were disobediance (61.9%), making troubles (34.9%), and poor school performance (33.3%). However, 16.1% of severely battered children responded that the perpetrators battered them to wreak their anger and 5.7% of them did not know the reason why they were battered. A majority of the battered children (65%) regretted their fault after being battered but 20.7% of the severely battered children wanted to run away and 9.2% of them had an urge to commit suicide. While most of the physical injuries due to battering were minor as bruise (52.7%) but some of them were severe, e.g., bone fracture (2.5%), skin laceration (1.5%), and loss of consciousness (0.2%). The common psycho-behavioral complaints of the severely battered children were unwillingness to study (31%), unwillingness to live (17.2%), and reluctance to go home (13.8%). The incidence rate of severe battering was significantly higher (p=0.018) among the children living in a quarter attached to a store (14.0%) than the children living in an apartment (6.6%) and individual louse (6.2%). The incidence rate of severe battering was higher among children living in a rental house (8.4%) than children living in their own house (6.3%) (p=0.005). The children of father only working (5.1%) and mother only working (4.5%) had a lower incidence rate of severe battering than the children of both parents working (9.1%) and both parents unemployed (20.7%) (p=0.006). More children were battered when there was a sick family member (80.8%) compared with the children without a sick family member (71.4%) (p=0.001). The incidence rates of severe and moderate battering increased as the frequency of quarreling between mother and father increased (P=0.000). The percentage of unbattered children was higher among children whose father's occupation was professional (39.4%) than that of the total study subjects (26.9%) (p<0.001).; Summary

Tracking of blood pressure during childhood.: Soon Young Lee, Il Seo, Jeung Mo Nam; Korean J Prev Med. 1991;24(2):161-170.

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Abstract PDF: The purpose of this study is to find the tracking blood pressure in primary school-age children. A follow-up study was conducted from 1986 to 1990 on 330 first grade children attending primary schools in Kangwha County, Kyungki-Do. Basically we employed a linear regression model with random coefficients to figure out the relation between blood pressure changes and initial blood pressure. We obtained the following results; 1. The mean blood pressures were increased grade went up in both sexs and were generally higher in female than male except for the systolic blood pressure at first grade. The size of difference was about 0.8 mmHg in mean systolic blood pressure and 1.5 mmHg in mean diastolic blood pressure. 2. The average annual increasing rates of systolic blood pressure were 2.5 mmHg in male and 3.1 mmHg in female respectively. For the diastolic blood pressure IV the average annual increasing rates were observed to be 3.0 mmHg in male and 2.9 mmHg in female respectively. Increasing rate of systolic blood pressure was significantly higher in female than male. 3. The adjusted regression coefficient of systolic blood pressure change on initial value was -0.11 in male and -0.13 in female and that coefficient of diastolic blood pressure change on initial value was -0.01 in male and -0.11 in female. This result shows that children with higher initial blood pressure do not pick up their blood pressure faster than others with lower initial blood pressure. There is no evidence of tracking of blood pressure in children. It is essential to find the earliest age having the tracking of blood pressure and we leave it for the further study.; Summary

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