Journal of Preventive Medicine and Public Health

Original Articles

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.

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.

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

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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Abstract PDF Supplementary Material: 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

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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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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Predicting stunting in Rwanda using artificial neural networks: a demographic health survey 2020 analysis
Similien NDAGIJIMANA, Ignace KABANO, Emmanuel MASABO, Jean Marie NTAGANDA
F1000Research.2024; 13: 128. CrossRef
Child stunting prevalence determination at sector level in Rwanda using small area estimation
Innocent Ngaruye, Joseph Nzabanita, François Niragire, Theogene Rizinde, Joseph Nkurunziza, Jean Bosco Ndikubwimana, Charles Ruranga, Ignace Kabano, Dieudonne N. Muhoza, Jeanine Ahishakiye
BMC Nutrition.2023;[Epub] CrossRef

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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Abstract PDF Supplementary Material: 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

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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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.

Summary

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Health Beliefs and Socioeconomic Determinants of COVID-19 Booster Vaccine Acceptance: An Indonesian Cross-Sectional Study
Gede Benny Setia Wirawan, Ngakan Putu Anom Harjana, Nur Wulan Nugrahani, Pande Putu Januraga
Vaccines.2022; 10(5): 724. CrossRef

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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Abstract PDF Supplementary Material

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.

Summary

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Impact of adverse childhood experiences (ACE) on the development of 18-months-old children
Mariana Lacerda Gontijo, Janaína Matos Moreira, Thiago Rosental Silva, Claudia Regina Lindgren Alves
Journal of Affective Disorders Reports.2022; 10: 100401. CrossRef

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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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.

Summary

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How do household living conditions and gender-related decision-making influence child stunting in Rwanda? A population-based study
Jean Nepo Utumatwishima, Ingrid Mogren, Aline Umubyeyi, Ali Mansourian, Gunilla Krantz, Olutosin Ademola Otekunrin
PLOS ONE.2024; 19(3): e0290919. CrossRef
Understanding Pediatric Health Trends in Papua: Insights From SUSENAS, RISKESDAS, Remote Sensing, and Its Relevance to Prabowo and Gibran’s Free Lunch and Milk Program
Rezzy Eko Caraka, Khairunnisa Supardi, Puspita Anggraini Kaban, Robert Kurniawan, Prana Ugiana Gio, Yunho Kim, Syihabuddin Ahmad Mufti, Rung-Ching Chen, Muhammad Khahfi Zuhanda, Avia Enggar Tyasti, Noor Ell Goldameir, Bens Pardamean
IEEE Access.2024; 12: 51536. CrossRef
Stunting at birth: linear growth failure at an early age among newborns in Hawassa city public health hospitals, Sidama region, Ethiopia: a facility-based cross-sectional study
Haileyesus Ejigu, Zelalem Tafese
Journal of Nutritional Science.2023;[Epub] CrossRef
Socio-economic and agricultural factors associated with stunting of under 5-year children: findings from surveys in mountains, dry zone and delta regions of rural Myanmar (2016–2017)
Min Kyaw Htet, Tran Thanh Do, Thet Wah, Thant Zin, Myat Pan Hmone, Shahreen Raihana, Elizabeth Kirkwood, Lwin Mar Hlaing, Michael J Dibley
Public Health Nutrition.2023; 26(8): 1644. CrossRef
Predictor of Stunting Among Children 0-24 Months Old in Indonesia: A Scoping Review
Via Eliadora Togatorop, Laili Rahayuwati, Raini Diah Susanti
Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini.2023; 7(5): 5654. CrossRef
Determinants of Incident Stunting in Elementary School Children in Endemic Area Iodine Deficiency Disorders Enrekang Regency
Nur Abri, Saifuddin Sirajuddin, Burhanuddin Bahar, Nurhaedar Jafar, Syamsiar S. Russeng, Zakaria Zakaria, Veni Hadju, Abdul Salam, Abdul Razak Thaha
Open Access Macedonian Journal of Medical Sciences.2022; 10(E): 161. CrossRef

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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Relationship between bisphenol A and autoimmune thyroid disease in women of childbearing age
Ning Yuan, Jianbin Sun, Xin Zhao, Wei Li
Frontiers in Endocrinology.2024;[Epub] CrossRef
Temporal trends in risk of bisphenol A, benzophenone-3 and triclosan exposure among U.S. children and adolescents aged 6–19 years: Findings from the National Health and Nutrition Examination Survey 2005–2016
Ruiqiang Li, Wenqiang Zhan, Jingyi Ren, Fan Zhang, Xin Huang, Yuxia Ma
Environmental Research.2023; 216: 114474. CrossRef
A case-control study of urinary concentrations of bisphenol A, bisphenol F, and bisphenol S and the risk of papillary thyroid cancer
Lei Zhang, Jiahuai Zhang, Sai Fan, Yuxin Zhong, Jingguang Li, Yunfeng Zhao, Song Ni, Jiaying Liu, Yongning Wu
Chemosphere.2023; 312: 137162. CrossRef
Transient developmental exposure to low doses of bisphenol F negatively affects neurogliogenesis and olfactory behaviour in adult mice
Pieter Vancamp, Lucile Butruille, Anni Herranen, Anita Boelen, Jean-Baptiste Fini, Barbara A. Demeneix, Sylvie Remaud
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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

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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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324 Download
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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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156 Download
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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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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)
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Yechan Kyung, Young Joo Han, Ju Suk Lee, Jun Hwa Lee, Seon Hui Jo, Sung Hoon Kim
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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

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