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Volume 5(4); August 2014
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Editorial
Summing Up Again
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2014;5(4):177-178.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.07.001
  • 1,610 View
  • 14 Download
PDF
Review Article
Management of Hospital Infection Control in Iran: A Need for Implementation of Multidisciplinary Approach
Setareh Mamishi, Babak Pourakbari, Mostafa Teymuri, Abdolreza Babamahmoodi, Shima Mahmoudi
Osong Public Health Res Perspect. 2014;5(4):179-186.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.001
  • 1,922 View
  • 17 Download
  • 11 Citations
AbstractAbstract PDF
Nosocomial, or hospital-acquired, infections are considered the most common complications affecting hospitalized patients. According to results obtained from studies conducted in the Children Medical Center Hospital, a teaching children's hospital and a tertiary care referral unit in Tehran, Iran, improvements in infection control practices in our hospital seem necessary. The aim of this study was to identify risk management and review potential hospital hazards that may pose a threat to the health as well as safety and welfare of patients in an Iranian referral hospital. Barriers to compliance and poor design of facilities, impractical guidelines and policies, lack of a framework for risk management, failure to apply behavioral-change theory, and insufficient obligation and enforcement by infection control personnel highlight the need of management systems in infection control in our hospital. In addition, surveillance and early reporting of infections, evaluation of risk-based interventions, and production of evidence-based guidelines in our country are recommended.
Original Articles
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
Hye-Kyung Yu, Tae-Young Heo, Na-Young Kim, Jin-Sook Wang, Jae-Kyeong Lee, Sung Soon Kim, Mee-Kyung Kee
Osong Public Health Res Perspect. 2014;5(4):187-192.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.002
  • 1,650 View
  • 16 Download
  • 1 Citations
AbstractAbstract PDF
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.
High Prevalence of Class 1 to 3 Integrons Among Multidrug-Resistant Diarrheagenic Escherichia coli in Southwest of Iran
Mohammad Kargar, Zahra Mohammadalipour, Abbas Doosti, Shahrokh Lorzadeh, Alireza Japoni-Nejad
Osong Public Health Res Perspect. 2014;5(4):193-198.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.003
  • 2,024 View
  • 21 Download
  • 30 Citations
AbstractAbstract PDF
Objectives
Horizontal transfer of integrons is one of the important factors that can contribute to the occurrence of multidrug-resistant (MDR) bacteria. This study aimed to determine the prevalence of integrons among MDR Escherichia coli strains isolated from stool specimens and investigate the associations between the existence of integrons and MDR properties in the southwest of Iran.
Methods
There were 164 E. coli strains isolated from January 2012 to June 2012. Fecal specimens identified as E. coli by the conventional methods. Subsequently the antibiotic resistance was assessed using Clinical and Laboratory Standard Institute criteria. The presence of class 1–3 integrons and embedded gene cassettes was verified using specific primers by multiplex polymerase chain reaction assay.
Results
Among a total of 164 studied samples, 69 (42.07%) isolates were multidrug resistant. Class 1 and class 2 integrons were present in 78.26% and 76.81% MDR isolates, respectively. For the first time in Iran, class 3 integron was observed in 26.09% MDR isolates. Significant correlations were identified between: class 1 integron and resistance to amikacin, gentamicin, chloramphenicol, ampicillin, tetracycline, nalidixic acid, and co-trimoxazole; class 2 integron and resistance to aminoglycosides, co-trimoxazole, cefalexin, ampicillin, and chloramphenicol; and class 3 integron and resistance to gentamicin, kanamycin, and streptomycin.
Conclusion
Our results indicate that integrons are common among MDR isolates and they can be used as a marker for the identification of MDR isolates. Therefore, due to the possibility of a widespread outbreak of MDR isolates, molecular surveillance and sequencing of the integrons in other parts of the country is recommended.
Knowledge of Diabetes Mellitus: Does Gender Make a Difference?
Patrício Fernando Lemes dos Santos, Poliana Rodrigues dos Santos, Graziele Souza Lira Ferrari, Gisele Almeida Amaral Fonseca, Carlos Kusano Bucalen Ferrari
Osong Public Health Res Perspect. 2014;5(4):199-203.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.004
  • 1,996 View
  • 15 Download
  • 12 Citations
AbstractAbstract PDF
Objective Diabetes mellitus (DM) is a chronic disease considered an important public health problem. In recent years, its prevalence has been exponentially rising in many developing countries. Chronic complications of DM are important causes of morbidity and mortality among patients, which impair their health and quality of life. Knowledge on disease prevention, etiology, and management is essential to deal with parents, patients, and caregivers. The aim of this study was to evaluate the knowledge regarding DM in an adult population from a Middle-western Brazilian city.
Methods
This was a cross-sectional study covering 178 adults, aged 18–64 years, who answered a diabetes knowledge questionnaire. In order to identify the difference between groups, analysis of variance was used.
Results
Higher knowledge scores were found regarding the role of sugars on DM causality, diabetic foot care, and the effects of DM on patients (blindness, impaired wound healing, and male sexual dysfunction). However, lower scores were found amongst types of DM, hyperglycemic symptoms, and normal blood glucose levels. Females tended to achieve better knowledge scores than males.
Conclusion
Women had better knowledge regarding types of DM, normal blood glucose values, and consequences of hyperglycemia revealed that diabetes education should be improved.
Relationship between Serum Levels of Body Iron Parameters and Insulin Resistance and Metabolic Syndrome in Korean Children
Hye-Ja Lee, Han Byul Jang, Ji Eun Park, Kyung-Hee Park, Jae Heon Kang, Sang Ick Park, Jihyun Song
Osong Public Health Res Perspect. 2014;5(4):204-210.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.005
  • 1,766 View
  • 22 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
An increase in serum ferritin and levels of the cleaved soluble form of transferrin receptor (sTfR) are related to several metabolic conditions. We evaluated the relationship between body iron status indicators, including ferritin and sTfR, and insulin resistance and metabolic syndrome (MetS) in Korean children.
Methods
A cross-sectional study was conducted on 1350 children in Korea. Anthropometrical parameters; lipid profiles; levels of glucose, insulin, and leptin; and iron status indicators, including sTfR, serum ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TS), were analyzed.
Results
Although serum sTfR levels were significantly higher in boys than in girls (2.20 vs. 2.06 mg/L, p < 0.0001), serum iron and TS were higher in girls than in boys (101.38 vs. 95.77 mg/L, p = 0.027 and 30.15 vs. 28.91%, p = 0.04, respectively). Waist circumference (WC) and leptin were most significantly associated with body iron indicators when adjusted for age and sex. After adjusting for age, sex, and WC, sTfR levels showed the strongest positive association with leptin levels (p = 0.0001). Children in the highest tertile for homeostasis model assessment-insulin resistance (HOMA-IR) had higher TIBC (p = 0.0005) and lower serum iron (p = 0.0341), and the lowest TS (p < 0.0001) after adjustment for confounders. Children with higher sTfR were most significantly associated with risk of MetS compared with those lower sTfR (p = 0.0077).
Conclusion
The associations of serum levels of iron metabolism markers with leptin levels, HOMA-IR, and MetS suggest that iron-related factors may involve insulin resistance and MetS.
A Novel Approach for Predicting Disordered Regions in A Protein Sequence
Meijing Li, Seong Beom Cho, Keun Ho Ryu
Osong Public Health Res Perspect. 2014;5(4):211-218.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.006
  • 1,577 View
  • 18 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
A number of published predictors are based on various algorithms and disordered protein sequence properties. Although many predictors have been published, the study of protein disordered region prediction is ongoing because different prediction methods can find different disordered regions in a protein sequence.
Methods
Therefore we have used a new approach to find the more varying disordered regions for more efficient and accurate prediction of protein structures. In this study, we propose a novel approach called “emerging subsequence (ES) mining” without using the characteristics of the disordered protein. We first adapted the approach to generate emerging protein subsequences on public protein sequence data. Second, the disordered and ordered regions in a protein sequence were predicted by searching the generated emerging protein subsequence with a sliding window, which tends to overlap. Third, the scores of the overlapping regions were calculated based on support and growthrate values in both classes. Finally, the score of predicted regions in the target class were compared with the score of the source class, and the class having a higher score was selected.
Results
In this experiment, disordered sequence data and ordered sequence data was extracted from DisProt 6.02 and PDB respectively and used as training data. The test data come from CASP 9 and CASP 10 where disordered and ordered regions are known.
Conclusion
Comparing with several published predictors, the results of the experiment show higher accuracy rates than with other existing methods.
Dental Procedures, Oral Practices, and Associated Anxiety: A Study on Late-teenagers
Rahul Bhola, Reema Malhotra
Osong Public Health Res Perspect. 2014;5(4):219-232.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.007
  • 1,616 View
  • 12 Download
  • 6 Citations
AbstractAbstract PDF
Objectives
The study aims to determine the degree of anxiety pertaining to dental procedures and various oral hygiene practices among college teenagers.
Methods
Corah's Modified Dental Anxiety Scale was administered on a randomly chosen sample of 100 Indian college students (50 males and 50 females) of Delhi University, belonging to the age group of 17–20 years.
Results
Descriptive statistical computations revealed 12.14 years as the mean age of first dental visit, with moderately high levels of anxiety (60.75%) for various dental procedures among the Indian teenagers and 5% lying in the “phobic or extremely anxious” category. With merely 4.16% people going for regular consultations, general check-ups evoked 78.3% anxiety and having an injection or a tooth removed was perceived as the most threatening. The sample subgroup not using mouthwash and mouthspray, smokers, and alcohol drinkers with improper oral hygiene practices experienced much higher anxiety towards routine dental procedures.
Conclusion
The majority of the Indian youngsters had an evasive attitude of delaying dental treatment. The core problems lay in deficient health care knowledge, lack of patient-sensitive pedagogy to train dental professionals, inaccessibility of services, and a dismissive attitude towards medical help. The feelings of fear and anxiety prevalent among the Indian youth offer significant insights into causes and preventive measures for future research and practice. Methods of education and motivation could be developed to dissipate the anxiety amongst Indian teenagers that prevent routine dental visits and maintenance of adequate oral hygiene.
A Differential Equation Model for the Dynamics of Youth Gambling
Tae Sug Do, Young S. Lee
Osong Public Health Res Perspect. 2014;5(4):233-241.   Published online August 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.06.008
  • 1,853 View
  • 12 Download
  • 6 Citations
AbstractAbstract PDF
Objectives
We examine the dynamics of gambling among young people aged 16–24 years, how prevalence rates of at-risk gambling and problem gambling change as adolescents enter young adulthood, and prevention and control strategies.
Methods
A simple epidemiological model is created using ordinary nonlinear differential equations, and a threshold condition that spreads gambling is identified through stability analysis. We estimate all the model parameters using a longitudinal prevalence study by Winters, Stinchfield, and Botzet to run numerical simulations. Parameters to which the system is most sensitive are isolated using sensitivity analysis.
Results
Problem gambling is endemic among young people, with a steady prevalence of approximately 4–5%. The prevalence of problem gambling is lower in young adults aged 18–24 years than in adolescents aged 16–18 years. At-risk gambling among young adults has increased. The parameters to which the system is most sensitive correspond to primary prevention.
Conclusion
Prevention and control strategies for gambling should involve school education. A mathematical model that includes the effect of early exposure to gambling would be helpful if a longitudinal study can provide data in the future.

PHRP : Osong Public Health and Research Perspectives