Comparative Study of the Impact of Intoxication on Injuries in China and Korea

Objectives

Alcohol misuse has been widely studied as a substantial contributor to injured patients'' visits to emergency departments. The current research studied differences in alcohol-related injury variables in China and Korea.

Methods

Data were collected from a sample of 4,509 patients (2,862 males and 1,667 females) reporting at emergency departments in China and Korea using the World Health Organization collaborative study on alcohol and injuries protocol.

Results

More injuries were reported by men, young people aged 25–34 years, employed individuals, and persons who had at least a high-school education. The proportion of injury cases among intoxicated patients was 14% for Chinese and 20% for Koreans. The odds of intentional injuries to intoxicated patients increased significantly when the perpetrator had been drinking, especially for severely intoxicated victims in both countries. The odds of injuries for intoxicated persons in both countries were high during sports and leisure activities; odds ratio (OR) = 3.93, 95% confidence interval (CI) = 2.76–5.59 for Chinese and OR = 10.97, 95% CI = 6.06–19.85 for Koreans.

Conclusion

These findings are a contribution to research in the two Asian countries about the effect of intoxication on injuries especially when both victim and perpetrator are intoxicated.     

Hand,foot and mouth disease in China: evaluating an automated system for the detection of outbreaks

Objective

To evaluate the performance of China’s infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease.

Methods

We estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff.

Findings

The alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 – a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days.

Conclusion

The automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China.     

Seroprevalence of Hepatitis A and E Viruses Based on the Third Korea National Health and Nutrition Survey in Korea

Objectives

The purpose of this study was to investigate the seroprevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) in Korea during 2005.

Methods

Study subjects were selected from across Korea using a stratified multistage probability sampling design, and HAV and HEV seroprevalence was compared on the basis of sex, age, and residency. A total of 497 rural and urban people aged 10–99 years of age (mean ± SD age = 28.87 ± 17.63 years) were selected by two-stage cluster sampling and tested serologically for anti-HAV and anti-HEV IgG using an enzyme-linked immunosorbent assay.

Results

Among this population, the overall seroprevalence of HAV was 63.80% (55.21% aged in their 20s and 95.92% in their 30s, p < 0.01) and that of HEV was 9.40% (5.21% aged in their 20s and 7.14% in their 30s, p < 0.01). Seroprevalence also varied according to area of residence. HEV prevalence in rural areas was higher than that of urban regions based on the anti-HEV antibody, odds ratio 3.22 (95% confidence interval: 1.46–7.10, p < 0.01). There were no significant differences between male and female against anti-HAV/HEV antibodies.

Conclusion

Our study suggested that the seropositive rates of HAV and HEV might be related to age and environmental conditions.     

Identifying Barriers to Human Immunodeficiency Virus Testing for Men Who Have Sex with Men in South Korea

Objectives

The principal objective of this study was to identify the barriers to testing for men who have sex with men (MSM) in Korea, something that might prove useful in future studies of this nature.

Methods

This study was conducted at gay bars nationwide in Korea. After considering several offline locations (gay bars) where MSM candidates are commonly located, random recruitment was performed using time–location sampling. A total of 944 individuals participated in this survey. A total sample of 921 cases (23 cases were excluded) was used for analysis. A self-administered questionnaire measuring the individuals'' demographics, human immunodeficiency virus (HIV)/AIDS knowledge, stigma, phobia, optimism bias, self-efficacy for condom use, and sexual practices was used.

Results

About 61.8% (N = 569) of respondents reported having been tested at least once in their lifetime, and 38.9% (N = 358) acknowledged being tested within the past 12 months. After adjusting for age, education, and number of partners in a logistic regression analysis, awareness of testing place [odds ratio (OR) = 4.04], exposure to HIV prevention campaign (1.54), fear (OR = 1.13), and discrimination toward people with HIV/AIDS (OR = 0.94) were the main factors associated with HIV testing.

Conclusion

To accomplish widespread HIV testing for Korean MSM, the accessibility of testing centers and advertisement of voluntary counseling and testing to MSM are needed.     

The relationship between body mass index and uric acid: a study on Japanese adult twins

Objectives

The present study aimed to investigate the association between body mass index (BMI) and uric acid (UA) using the twin study methodology to adjust for genetic factors.

Methods

The association between BMI and UA was investigated in a cross-sectional study using data from both monozygotic and dizygotic twins registered at the Osaka University Center for Twin Research and the Osaka University Graduate School of Medicine. From January 2011 to March 2014, 422 individuals participated in the health examination. We measured height, weight, age, BMI, lifestyle habits (Breslow’s Health Practice Index), serum UA, and serum creatinine. To investigate the association between UA and BMI with adjustment for the clustering of a twin within a pair, individual-level analyses were performed using generalized linear mixed models (GLMMs). To investigate an association with adjustment for genetic and family environmental factors, twin-pair difference values analyses were performed.

Results

In all analysis, BMI was associated with UA in men and women. Using the GLMMs, standardized regression coefficients were 0.194 (95 % confidence interval: 0.016–0.373) in men and 0.186 (95 % confidence interval: 0.071–0.302) in women. Considering twin-pair difference value analyses, standardized regression coefficients were 0.333 (95 % confidence interval: 0.072–0.594) in men and 0.314 (95 % confidence interval: 0.151–0.477) in women.

Conclusions

The present study shows that BMI was significantly associated with UA, after adjusting for both genetic and familial environment factors in both men and women.     

Estimating the measles effective reproduction number in Australia from routine notification data

Objective

To estimate the measles effective reproduction number (R) in Australia by modelling routinely collected notification data.

Methods

R was estimated for 2009–2011 by means of three methods, using data from Australia’s National Notifiable Disease Surveillance System. Method 1 estimated R as 1 − P, where P equals the proportion of cases that were imported, as determined from data on place of acquisition. The other methods estimated R by fitting a subcritical branching process that modelled the spread of an infection with a given R to the observed distributions of outbreak sizes (method 2) and generations of spread (method 3). Stata version 12 was used for method 2 and Matlab version R2012 was used for method 3. For all methods, calculation of 95% confidence intervals (CIs) was performed using a normal approximation based on estimated standard errors.

Findings

During 2009–2011, 367 notifiable measles cases occurred in Australia (mean annual rate: 5.5 cases per million population). Data were 100% complete for importation status but 77% complete for outbreak reference number. R was estimated as < 1 for all years and data types, with values of 0.65 (95% CI: 0.60–0.70) obtained by method 1, 0.64 (95% CI: 0.56–0.72) by method 2 and 0.47 (95% CI: 0.38–0.57) by method 3.

Conclusion

The fact that consistent estimates of R were obtained from all three methods enhances confidence in the validity of these methods for determining R.     

Mediating and Moderating Effects in Ageism and Depression among the Korean Elderly: The Roles of Emotional Reactions and Coping Reponses

Objectives

This study evaluated the relationship between ageism and depression, exploring the stress-mediating and stress-moderating roles of emotional reactions and coping behaviors.

Methods

Data were from the 2013 Ageism and Health Study (n = 816), a cross-sectional survey of urban and rural community-dwelling seniors aged 60–89 years in South Korea. Participants with at least one experience of ageism reported on their emotional reactions and coping responses. The measure yielded two types of coping: problem-focused (taking formal action, confrontation, seeking social support) and emotion-focused (passive acceptance, emotional discharge).

Results

Although ageism was significantly associated with depressive symptoms (B = 0.27, p < 0.0001), the association was entirely mediated by emotional reactions such as anger, sadness, and powerlessness. Problem-focused coping, especially confrontation and social support, seemingly reduced the impact of emotional reactions on depression, whereas emotion-focused coping exacerbated the adverse effects.

Conclusion

These findings support the cultural characterization explanation of ageism and related coping processes among Korean elderly and suggest that regulating emotional reactions may determine the efficacy of coping with ageism.     

Modification of AxSYM Human Immunodeficiency Virus Assay to Identify Recent Human Immunodeficiency Virus Infections in Korean Human Immunodeficiency Virus-Positive Individuals

Objectives

To estimate human immunodeficiency virus (HIV) incidence using HIV avidity assays in Korea, we established a serological testing method to differentiate recent HIV infections from long-standing ones.

Methods

We adopted two incidence assays, the BED HIV-1 incidence test (Calypte Biomedical) and an HIV avidity assay (using Abbott AxSYM HIV Antigen/Antibody Combo), and performed them on Korean HIV samples obtained from 81 HIV seroconverters (n = 193), 135 HIV-positive samples, and three HIV commercial incidence panels (PRB965, PRB933, and PRB601 from SeaCare). To determine the most optimal concentration of the chaotropic agent (Guanidine) and the cutoff value for the avidity assay, we evaluated the sensitivity and specificity of the assay at different concentration levels.

Results

We determined that the concentration of Guanidine to be used in the avidity assay was 1.5M. The cutoff value of the avidity index (AI) was 0.8, and the sensitivity and specificity were 90.2% and 83.8%, respectively, under this condition. The gray zone for the avidity assay was 0.75–0.85 AI. The mean of coefficient of variation was low, at 5.43%.

Conclusion

An optimized avidity assay for the diagnosis of recent HIV infections using Korean samples was established. This assay will be applied to investigate the level of recent infection and will provide basic data to the HIV prevention policy in Korea.     

Association of serum hs-CRP and lipids with obesity in school children in a 12-month follow-up study in Japan

Objectives

To investigate the association of serum lipids and high-sensitivity C-reactive protein (hs-CRP) with obesity in school children and to explore whether hs-CRP levels could be used to predict the presence or absence of obesity 12 months later.

Methods

The subjects were school children (6–11 years old) in Japan. Blood sampling and physical measurements were performed in school (2001); low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hs-CRP levels were measured. Data from children who could be followed 12 months later were analyzed. Subjects weighing 20 % or more over his/her standard weight were regarded as obese, and the association of obesity with serum parameters was analyzed.

Results

Data from 612 subjects were analyzed (follow-up rate, 75.4 %). The mean of each serum parameter was significantly higher (inverse for HDL-C; lower) in obese than that in non-obese children. Logistic regression analysis for obesity at baseline showed that the odds ratio (OR) of hs-CRP was the highest [OR, 2.15; 95 % confidence interval (CI), 1.65–2.78 for an interquartile rage (IQR) increase]; the association with triglycerides and LDL-C/HDL-C was significant. At the 12-month follow-up, the OR of high hs-CRP remained the highest of all serum parameters (2.09; 95 % CI, 1.63–2.69 for an IQR increase).

Conclusions

High levels of triglycerides, LDL-C/HDL-C, and hs-CRP increased the risk of obesity in school children. Hs-CRP is considered to be a better predictor of obesity 12 months later than is LDL-C/HDL-C.     

Suicidal Ideation and its Correlates among Juvenile Delinquents in South Korea

Objectives

This study investigated suicidal ideation and its correlates among juvenile delinquents in South Korea.

Methods

Suicidal ideation, psychological health status, and health-related behaviors were assessed using a self-administered questionnaire in 1682 juvenile offenders aged between 15 and 18 years in 2012.

Results

The prevalence of suicidal ideation in juvenile delinquents was 15.2%. Girls were more likely to report suicidal thoughts than boys (30.3% vs. 12.7%). Suicidal ideation was more common among adolescents who were not living with their family prior to entering detention centers (22.6% vs. 13.2%) than their counterparts. The likelihood of suicidal ideation was significantly associated with problem drinking [odds ratio (OR) = 1.84], psychedelic drug use (OR = 2.04), feeling unhappy (OR = 3.05), feeling sad or depressed (OR = 13.37) after controlling for sociodemographic factors, other health behaviors and perceptions.

Conclusion

The present study provides evidence for an association between suicidal ideation and psychological health and health risk behaviors among juvenile delinquents. It also highlights the importance of mental health and behavioral interventions for this population to prevent suicidality.     

Does Temperature Modify the Effects of Rain and Snow Precipitation on Road Traffic Injuries?

Background

There are few data on the interaction between temperature and snow and rain precipitation, although they could interact in their effects on road traffic injuries.

Methods

The integrated database of the Korea Road Traffic Authority was used to calculate the daily frequency of road traffic injuries in Seoul. Weather data included rain and snow precipitation, temperature, pressure, and fog from May 2007 to December 2011. Precipitation of rain and snow were divided into nine and six temperature range categories, respectively. The interactive effects of temperature and rain and snow precipitation on road traffic injuries were analyzed using a generalized additive model with a Poisson distribution.

Results

The risk of road traffic injuries during snow increased when the temperature was below freezing. Road traffic injuries increased by 6.6% when it was snowing and above 0°C, whereas they increased by 15% when it was snowing and at or below 0°C. In terms of heavy rain precipitation, moderate temperatures were related to an increased prevalence of injuries. When the temperature was 0–20°C, we found a 12% increase in road traffic injuries, whereas it increased by 8.5% and 6.8% when it was <0°C and >20°C, respectively. The interactive effect was consistent across the traffic accident subtypes.

Conclusions

The effect of adverse weather conditions on road traffic injuries differed depending on the temperature. More road traffic injuries were related to rain precipitation when the temperature was moderate and to snow when it was below freezing.Key words: injuries, precipitation, snow, traffic accidents, weather     

The change in lifestyle data during 9?years: the reliability and continuity of baseline health practices

Objectives

To reveal change patterns in self-reported lifestyle data for 9 years, and examine the characteristics of changes by type of lifestyle and ageing.

Methods

The authors used the lifestyle data of 7,080 male workers aged 20–59 who received checkups for 9 years. The proportions of change patterns during the 9 years were determined in seven health practices; smoking, eating breakfast, sleeping hours, working hours, physical exercise, eating nutritional balanced diets, and mental stress.

Results

Among seven health practices, the keep rate of good health practice was highest for the non-smoking (90.8 %), followed by eating breakfast (69.0 %);and the lowest was physical exercise (13.7 %). The keep rate of poor health practice was highest for smoking (73.8 %), followed by non-physical exercise (67.1 %). The lowest rate of multiple changes during 10 years was smoking (7.1 %); the highest was mental stress (68.5 %).

Conclusions

As for the life style on smoking and eating breakfast seemed to be stable, using the data obtained at a specific point in time wouldn’t much affect the results. On the contrary, for other life styles, they showed poor continuity during 9 years, so it would be necessary to take into consideration the time point of data collection.     

Relationship between cigarette smoking and one leg with eyes closed balance in Japanese men

Objective

To investigate the link between cigarette smoking and one leg with eyes closed balance in Japanese men.

Subjects and methods

We used data from 4224 Japanese men, aged 43.3 ± 13.9 years, in this cross-sectional study. Balance, such as one leg with eyes closed balance was measured. In addition, cigarette smoking habits were obtained by well-trained medical staff. The effect of cigarette smoking on one leg with eye closed balance was evaluated.

Results

A total of 1613 men (38.2 %) had smoking habit and 1471 men (34.8 %) regularly exercised. Age-related changes in one leg with eyes closed balance were noted. One leg with eyes closed balance in subjects with cigarette smoking (30.9 ± 31.8 s) was significantly lower than those in subjects without cigarette smoking (32.4 ± 33.5 s) even after adjusting for confounding factors i.e. age, body weight and exercise habits.

Conclusion

Cigarette smoking might be associated with one leg with eyes closed balance in Japanese men.     

H5N8 Highly Pathogenic Avian Influenza in the Republic of Korea: Epidemiology During the First Wave,from January Through July 2014

Objectives

This study describes the outbreaks of H5N8 highly pathogenic avian influenza (HPAI) in Korea during the first wave, from January 16, 2014 through July 25, 2014. Its purpose is to provide a better understanding of the epidemiology of H5N8 HPAI.

Methods

Information on the outbreak farms and HPAI positive wild birds was provided by the Animal and Plant Quarantine Agency. The epidemiological investigation sheets for the outbreak farms were examined.

Results

During the 7-month outbreak period (January–July 2014), H5N8 HPAI was confirmed in 212 poultry farms, 38 specimens from wild birds (stools, birds found dead or captured). Ducks were the most frequently infected poultry species (159 outbreak farms, 75.0%), and poultry in 67 (31.6%) outbreak farms was asymptomatic.

Conclusion

As in the previous four H5N1 epidemics of HPAI that occurred in Korea, this epidemic of H5N8 proved to be associated with migratory birds. Poultry farms in Korea can hardly be free from the risk of HPAI introduced via migratory birds. The best way to overcome this geographical factor is to reinforce biosecurity to prevent exposure of farms, related people, and poultry to the pathogen.     

Factors associated with tuberculosis cases in Semarang District,Indonesia: case–control study performed in the area where case detection rate was extremely low

Objectives

Indonesia is ranked as the 4th highest contributor to tuberculosis (TB) in the world. Semarang District in Central Java displays extremely low case detection rate (CDR), possibly contributing to the local prevalence of TB.

Methods

A case–control study was performed to explore the factors that cause such low CDR. We recruited 129 TB cases and 83 controls that visited the same centers and were not diagnosed with TB.

Results

The cases had 7.5 ± 2.3 symptoms/person on average, indicating the delay in diagnosis because the controls only displayed 1.0 ± 1.7. The multiple logistic regression analysis comparing the cases/controls extracted following factors as a risk to have TB: farmer, close contact with TB patients, ignorance of whether Bacillus Calmette-Guérin (BCG) was accepted or no, smoking, low income, a lot of people living in the same room, irregular hand wash before meals, not wash hands after blow, soil floor, and no sunlight and no ventilation in the house.

Conclusions

Neither the cases nor the controls knew the symptoms and how to avoid TB infection, which probably caused the delay in diagnosis. It is difficult to change the current living conditions. Thus, the amendment of the community-based education program of TB seems to be required.     

The Characteristics of Middle Eastern Respiratory Syndrome Coronavirus Transmission Dynamics in South Korea

Objectives

The outbreak of Middle Eastern respiratory syndrome coronavirus (MERS-CoV) was one of the major events in South Korea in 2015. In particular, this study pays attention to formulating a mathematical model for MERS transmission dynamics and estimating transmission rates.

Methods

Incidence data of MERS-CoV from the government authority was analyzed for the first aim and a mathematical model was built and analyzed for the second aim of the study. A mathematical model for MERS-CoV transmission dynamics is used to estimate the transmission rates in two periods due to the implementation of intensive interventions.

Results

Using the estimates of the transmission rates, the basic reproduction number was estimated in two periods. Due to the superspreader, the basic reproduction number was very large in the first period; however, the basic reproduction number of the second period has reduced significantly after intensive interventions.

Conclusion

It turned out to be the intensive isolation and quarantine interventions that were the most critical factors that prevented the spread of the MERS outbreak. The results are expected to be useful to devise more efficient intervention strategies in the future.     

Knowledge and Attitude Toward Informed Consent Among Private Dental Practitioners in Bathinda City,Punjab, India

Objectives

A study was conducted with the purpose to assess the knowledge and attitude towards informed consent among private dental practitioners in Bathinda City, Punjab, India.

Methods

A cross-sectional survey was conducted among all private dental practitioners in Bathinda City. A self-administered structured questionnaire consisting of 14 items was used to assess their knowledge and attitude regarding informed consent. The response format was based on a 3-point Likert scale. One-way analysis of variance, independent sample t test, and stepwise multiple linear regression analysis were utilized for statistical analysis. Confidence level and level of significance were set at 95% and 5%, respectively.

Results

The mean scores for knowledge and attitude were 19.37 ± 31.82 and 9.40 ± 1.72, respectively. Analysis revealed that qualification and years of experience was statistically significant among both dependent variables (p ≤ 0.05).

Conclusion

An unbalanced knowledge of informed consent among the current dentists has suggested the need for awareness programs to fill the knowledge gaps and instill positive attitudes.     

Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons

Objective

To improve the Zambia Prisons Service’s implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing.

Methods

For both tuberculosis and HIV, we implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. We also established routine systems – with inmates as peer educators – for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia’s prisons.

Findings

In a period of 9 months, we screened 7638 individuals and diagnosed 409 new patients with tuberculosis. We tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments – 6.4% (6428/100 000) – is 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive.

Conclusion

Both tuberculosis and HIV infection are common within Zambian prisons. We enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. Our observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere.     

The Recency Period for Estimation of Human Immunodeficiency Virus Incidence by the AxSYM Avidity Assay and BED-Capture Enzyme Immunoassay in the Republic of Korea

Objectives

Measurement of the incidence of the human immunodeficiency virus (HIV) is very important for epidemiological studies. Here, we determined the recency period with the AxSYM avidity assay and the BED-capture enzyme immunoassay (BED-CEIA) in Korean seroconverters.

Methods

Two hundred longitudinal specimens from 81 seroconverters with incident HIV infections that had been collected at the Korea National Institute of Health were subjected to the AxSYM avidity assay (cutoff = 0.8) and BED-CEIA (cutoff = 0.8). The statistical method used to estimate the recency period in recent HIV infections was nonparametric survival analyses. Sensitivity and specificity were calculated for 10-day increments from 120 days to 230 days to determine the recency period.

Results

The mean recency period of the avidity assay and BED-CEIA using a survival method was 158 days [95% confidence interval (CI), 135–181 days] and 189 days (95% CI, 170–208 days), respectively. Based on the use of sensitivity and specificity, the mean recency period for the avidity assay and BED-CEIA was 150 days and 200 days, respectively.

Conclusion

We determined the recency period to estimate HIV incidence in Korea. These data showed that the nonparametric survival analysis often led to shorter recency periods than analysis of sensitivity and specificity as a new method. These findings suggest that more data from seroconverters and other methodologies are needed to determine the recency period for estimating HIV incidence.