• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.193-204
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• 2010

Objectives: The objective of this study was to analyze the causal relationship between smoking and depression using longitudinal data. Methods: Two waves of the Korea Welfare Panel collected in 2006 and 2007 were used. The sample consisted of 14 426 in 2006 and 13 052 in 2007 who were aged 20 and older. Smoking was measured by smoking amount (none/$\geq$ two packs). Depression was defined when the summated CESD (center for epidemiological studies depression)-11 score was greater than or equal to 16. The causal relationship between smoking and depression was tested using logistic regression. In order to test the causal effect of smoking on depression, depression at year 2 was regressed on smoking status at year 1 only using the sample without depression at year 1. Likewise, smoking status at year 2 was regressed on depression at year 1 only using those who were not smoking at year 1 in order to test the causal effect of depression on smoking. The statistical package used was Stata 10.0. Sampling weights were applied to obtain the population estimation. Results: The logistic regression testing for the causal relationship between smoking and depression showed that smoking at year 1 was significantly related to depression at year 2. Smoking amounts associated with depression were different among age groups. On the other hand, the results from the logistic regression testing for the opposite direction of the relationship between smoking and depression found no significant association regardless of age group. Conclusions: The study results showed some evidence that smoking caused depression but not the other way around.

• Journal of Preventive Medicine and Public Health
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• 제44권1호
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• pp.2-8
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• 2011

Objectives: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. Methods: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. Results: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. Conclusions: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.

• 보건행정학회지
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• 제31권2호
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• pp.158-172
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• 2021

Background: Metabolic syndrome has been known as a risk of cardiovascular disease. Meanwhile, high sensitivity C-reactive protein (hs-CRP) is used as a predictor of cardiovascular disease. In this paper, we aimed to investigate the association between hs-CRP and metabolic syndrome. Method: A total of 7,633 were chosen as the study population from the 7th Korea National Health and Nutrition Examination Survey dataset (2016-2017). Our dependent variable was whether an individual had metabolic syndrome or not, and the independent variable of interest was hs-CRP which was categorized into three groups. The chi-square tests and hierarchical logistic regression analyses reflecting survey characteristics were conducted. All analyses were stratified by gender. Results: According to the adjusted model with all covariates, compared to individuals having the low risk of hs-CRP, those having its average risk were more likely to have metabolic syndrome in men (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.12-1.76) and women (OR, 1.69; 95% CI, 1.33-2.16). Individuals having the high risk was not significantly different in men; however, they were more likely to have metabolic syndrome in women (OR, 2.03; 95% CI, 1.28-3.23). Conclusion: In an upcoming aging society, it is important to reduce the risk of metabolic syndrome to improve population health. This study suggests that hs-CRP may be used as a marker of the risk of metabolic syndrome in a gender-specific way, thereby contributing to enhancing awareness of the risk of metabolic syndrome among the general public.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.385-394
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• 2021

Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

• 성인간호학회지
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• 제21권6호
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• pp.580-592
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• 2009

Purpose: The purpose of this study was to investigate the factors related to Breast cancer Screening using Mammography and CBE of Korean women over 40 years of age. Methods: The participants for this study were 183 Korean women living in 3 urban cities and aged from 40 to 75. The data were collected using structured questionnaires which included sociodemographic factors (11 items), frequency and regularity of mammography and clinical breast examination (7 items), knowledge (16 items), health belief model scale (28 items), and family support (4 items) about breast cancer and breast cancer screening. Frequencies, Chronbach's alpha for reliability, Chi-square, t-test and logistic regression with the SPSS/WIN 12 program were used to analyze the data. Results: The percentages of Korean women who had a mammography and CBE for breast cancer screening were 60.1 and 31.1, respectively. Logistic regression analyses demonstrated that regular check ups and perceived barriers were significant predictors of mammography and CBE use for breast cancer screening. Conclusion: In order to increase the frequency of breast cancer screening practices, educational support and a health care delivery system is needed to improve the chance of regular health check ups.

• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.166-173
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• 2010

Objectives: On December 7, 2007, the Hebei Spirit oil tanker spilled out 12,547 kl of crude oil on the Yellow Sea 10 km away from the cost of Taean Province, Korea. As the coastline has been contaminated, local residents have been exposed to crude oil. Because the residents were showing many symptoms, we investigated the acute health effects of this oil spill on them. Methods: We conducted a cross-sectional study consisting of the heavy and moderately oil soaked area in Taean and the lightly oil soaked area in Seocheon. Ten seashore villages were selected from each area, and 10 male and female adults were selected from each village. We interviewed the subjects using a structured questionnaire on the characteristics of residents, the cleanup activities, the perception of oil hazard, depression and anxiety, and the physical symptoms. The odds ratios and 95% confidence intervals were analyzed using logistic regression analysis. The logistic regression model was adjusted for age, gender, education, smoking, the perception of oil hazard and anxiousness. Results: The more highly contaminated the area, the more likely it was for residents to be engaged in cleanup activities and have a greater chance of exposure to oil. The indexes of anxiety and depression were higher in the heavy and moderately oil soaked areas. The increased risks of headache, nausea, dizziness, fatigue, tingling of limb, hot flushing, sore throat, cough, runny nose, shortness of breath, itchy skin, rash, and sore eyes were significant. Conclusions: The results suggest that exposure to crude oil is associated with various acute physical symptoms. Long-term investigation is required to monitor the residents' health.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6553-6558
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• 2014

Background: This study was conducted to gauge how the demographic profile of smokeless tobacco (SLT) users from Gujarat and Andhra Pradesh, India, differs from that of smokers. It also addresses how factors associated with the initiation and continuation of smokeless tobacco vary by age, gender, and education. Materials and Methods: We analyzed 2011 cross-sectional survey data collected from 4,759 respondents (smokers/SLT users/non-users) in both states. Chi-square analysis was used to make comparisons between the demographic profiles of smokers and SLT users. Multivariable logistic regression analysis was used to obtain the odds ratios (ORs) for initiation and continuation factors regressed on socio-demographic variables (age, gender, education). Results: Initiation-women were less likely than men to report "peer pressure", "fashion statement", and "stress/coping" as relevant factors for SLT use (OR: 0.45 CI: 0.30-0.70; OR: 0.42 CI: 0.24-0.74; OR: 2.47, CI: 1.47-4.15). Older age groups had lower odds of choosing "peer pressure" than the 15-24 year olds. Respondents with 11 or more years of education were more likely to report "stress/coping" than those with no education (OR: 2.82, CI: 1.06-7.48). Continuation-women were less likely than men to choose "relaxation", and "distance from family" as important continuation factors (OR: 0.50, CI:0.32-0.80; OR: 0.20, CI: 0.06-0.65). All age groups were less likely to choose "stimulation" as a factor than the youngest group. Conclusions: Along with confirming and expanding upon previous literature, the findings of this study should encourage further SLT research in women and younger age groups (15-24 and 24-44). They also confirm the need for SLT prevention and cessation interventions in India in other community-based settings, besides schools.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4427-4432
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• 2016

Background: Fear and fatalism have been proposed as factors affecting breast cancer screening, but the evidence is not strong. This study aimed to determine relationships of fear and fatalism with breast cancer screening behavior among Tabriz women in Iran. Materials and Methods: In a cross- sectional study, 370 women referred to 12 health centers in Tabriz were selected with two-stage cluster sampling and data regarding breast cancer screening, fatalism and fear of breast cancer were collected respectively with a checklist for screening performance, Champions Fear and Pow Fatalism Questionnaires. Data were analyzed by logistic regression with SPSS software version 16. Results: Only 43% and 23% of participants had undergone breast self- examination and clinical breast examination. Among women older than 40 years, 38.2% had mammography history and only 2.7% of them had done it annually. Although fatalism and fear had a stimulating effects on breast cancer screening performance th relationships were not significant (P>0.05). There was a negative significant correlation between fear and fatalism (r= -0.24, p=0.000). On logistic regression analysis, age (OR=1.037, p<0.01) and income status (OR= 0.411, p<0.05) significantly explained BSE and age (OR=1.051, p<0.01) and body mass index (OR= 0.879, p<0.01) explained CBE. Also BMI (OR= 0.074, p<0.05) and income status (OR=0.155, p<0.01) was significantly effective for mammography following. Conclusions: Breast cancer screening behavior is inappropriate and affected by family livelihood status and lifestyle leads to weight gain, so that for promoting of screening behaviors, economic support to families, lifestyle modification and public education are suggested.

• Journal of Preventive Medicine and Public Health
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• 제40권3호
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• pp.249-258
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• 2007

Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.31.1-31.10
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• 2023

Background: With modernization, air pollution has become increasingly serious, and its effects on health have been revealed. As a result, public interest in environmental pollution has become critical for regulating air pollution. In our study, we aim to evaluate the impact of air pollution levels on public attention to environmental issues and examine whether awareness of the residential environment's impact on health acts as a mediator in this relationship. Methods: We conducted an analysis on 400 individuals surveyed in the preliminary feasibility study on adverse health effects in the Pohang Industrial Complex, to examine the relationship between particulate matter 2.5 (PM2.5) and attention to environmental issues. Logistic regression analysis was performed, and mediation analysis was used to determine whether awareness of the residential environment's impact on health mediated the relationship. Results: The logistic regression analysis results showed that PM2.5 levels were associated with attention to environmental issues (adjusted odds ratio [AOR]: 2.1; 95% confidence interval [CI]: 1.3-3.5; p = 0.003) and awareness of health impacts (AOR: 3.4; 95% CI: 1.6-7.1; p = 0.001). The PM2.5 levels showed 9.9% (95% CI: 5.4-14.0) increase in the prevalence of high attention to environmental issues, of which, only 1.0% (95% CI: 0.2-2.3) were mediated by health impact awareness. In the overall analysis, 10% of the total effect of PM2.5 on attention to environmental issues was mediated by health impact awareness. Conclusions: According to this study's results, there was a correlation between air pollution levels and attention to environmental issues. Awareness of the health impacts of air pollution partially mediated the effect of air pollution levels on attention to environmental issues. In future studies, it is recommended to identify other mediators to further understand this structure.