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Volume 7(1); February 2016
Editorial
A Disease Around the Corner
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2016;7(1):1-2.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.02.001
• 1,222 View
• 3 Citations
PDF
Original Articles
Mediating and Moderating Effects in Ageism and Depression among the Korean Elderly: The Roles of Emotional Reactions and Coping Reponses
Il-Ho Kim, Samuel Noh, Heeran Chun
Osong Public Health Res Perspect. 2016;7(1):3-11.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.012
• 1,405 View
• 15 Citations
Abstract PDF
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.
Effects of Electromagnetic Radiation from Smartphones on Learning Ability and Hippocampal Progenitor Cell Proliferation in Mice
Yu-Jin Choi, Yun-Sik Choi
Osong Public Health Res Perspect. 2016;7(1):12-17.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.12.009
• 1,303 View
• 9 Citations
Abstract PDF
Objectives
Nonionizing radiation is emitted from electronic devices, such as smartphones. In this study, we intended to elucidate the effect of electromagnetic radiation from smartphones on spatial working memory and progenitor cell proliferation in the hippocampus.
Methods
Both male and female mice were randomly separated into two groups (radiated and control) and the radiated group was exposed to electromagnetic radiation for 9 weeks and 11 weeks for male and female mice, respectively. Spatial working memory was examined with a Y maze, and proliferation of hippocampal progenitor cells were examined by 5-bromo-2′-deoxyuridine administration and immunohistochemical detection.
Results
When spatial working memory on a Y maze was examined in the 9th week, there was no significant difference in the spontaneous alternation score on the Y maze between the two groups. In addition, there was no significant difference in hippocampal progenitor cell proliferation. However, immunoreactivity to glial fibrillary acidic protein was increased in exposed animals. Next, to test the effect of recovery following chronic radiation exposure, the remaining female mice were further exposed to electromagnetic radiation for 2 more weeks (total 11 weeks), and spontaneous alternation was tested 4 weeks later. In this experiment, although there was no significant difference in the spontaneous alternation scores, the number of arm entry was significantly increased.
Conclusion
These data indicate that although chronic electromagnetic radiation does not affect spatial working memory and hippocampal progenitor cell proliferation it can mediate astrocyte activation in the hippocampus and delayed hyperactivity-like behavior.
Factors associated with health services utilization between the years 2010 and 2012 in Korea: using Andersen's Behavioral model
Han-Kyoul Kim, Munjae Lee
Osong Public Health Res Perspect. 2016;7(1):18-25.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.007
• 1,594 View
• 41 Citations
Abstract PDF
Objectives
This study aimed to examine the factors associated with health services utilization using Andersen's behavioral model.
Methods
We collected Korea Health Panel data between the years 2010 and 2012 from the consortium of the National Health Insurance Service and the Korea Institute for Health and Social Affairs, and analyzed the data to determine the outpatients and inpatients of health services utilization.
Results
Health services utilization was more significantly explained by predisposing and need factors than enabling factors. The outpatients were examined more specifically; sex, age, and marital status as predisposing factors, and chronic illness as a need factor were the variables that had significant effects on health-services-utilization experience. The inpatients were examined more specifically: sex, age, and marital status in predisposing factors; education level, economic activities, and insurance type in enabling factors; and chronic illness and disability status in need factors were the significant variables having greater effects on health-services-utilization experience.
Conclusion
This study suggests the practical implications for providing health services for outpatients and inpatients. Moreover, verifying the general characteristics of outpatients and inpatients by focusing on their health services utilization provides the baseline data for establishing health service policies and programs with regard to the recently increasing interest in health services.
Are Free Maternity Services Completely Free of Costs?
Jeevan Acharya
Osong Public Health Res Perspect. 2016;7(1):26-31.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.002
• 1,192 View
• 8 Citations
Abstract PDF
Objectives
The Government of Nepal revised free maternity health services, “Aama Surakshya Karyakram”, beginning at the start of Fiscal Year 2012/13, which specifies the services to be funded, the tariffs for reimbursement, and the system for claiming and reporting on free deliveries each month. This study was designed to investigate the amount of monetary expenditure incurred by families using apparently free maternity services.
Methods
Between August 2014 and December 2014, a hospital-based cross-sectional study was conducted at Manipal Teaching Hospital and Western Regional Hospital. Nepalese women were not involved with family finances and had very little knowledge of income or expenditures. Therefore, face-to-face interviews with 384 postpartum mothers with their husbands or the head of the family household were conducted at the time of discharge by using a pre-tested semi-structural questionnaire.
Results
The average monthly family income was 19,272.4 NRs (189.01 US$), the median duration of hospital stay was 4 days (range, 2−19 days), and the median patient expenditure was equivalent to 13% of annual family income. The average total visible cost was 3,887.07 NRs (38.1 US$). When the average total hidden cost of 27,288.5 NRs (267.6 US$) was added, then the average total maternity care expenditure was 31,175.6 NRs (305.76 US$), with an average cost per day of 7,167.5 NRs (70.29 US$). The mean patient expenditure on food and drink, clothes, transport, and medicine was equivalent to 53.07%, 9.8%. 7.3%, and 5.6% of the mean total maternity care expenditure, respectively. The earnings lost by respondent women, husbands, and heads of household were 5,963.7 NRs (58.4 US$), 7,429.3 NRs (72.9 US$), and 6,175.9 NRs (60.6 US$), respectively.
Conclusion
The free maternity service in Nepal has high out-of-pocket expenditures, and did not represent a system completely free of costs. Therefore, arrangements should be made by hospitals free of cost to provide medicine that is not included as essential during the hospital stay and at discharge time. Similarly, arrangements for liquid, food, and hot water, as well as clothes for mothers and newborns, should be made by the hospital in order to enhance hospital attendance.
Drug Resistance Pattern of Mycobacterium tuberculosis Isolates From Patients Referred to TB Reference Laboratory in Ahvaz
Osong Public Health Res Perspect. 2016;7(1):32-35.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.10.010
• 1,326 View
• 3 Citations
Abstract PDF
Objectives
Tuberculosis remains one of the top three infectious disease killers. The prevalence of multidrug-resistant tuberculosis (MDR-TB) has increased substantially in the past 20 years. When drug resistance is not detected, MDR-TB patients cannot access life-saving treatment; this puts their communities at risk of ongoing MDR-TB transmission. We aimed to determine the patterns of resistance to antituberculosis drugs among Mycobacterium tuberculosis isolates from Khuzestan province in Iran.
Methods
A total of 850 clinical specimens from patients suspected of active TB were cultured in 2015. Drug susceptibility testing to the first line antiTB drugs for culture positive MTB was performed on Lowenstein–Jensen medium using the proportion method.
Results
Of 850 cultured specimens, 272 (32%) were culture positive for mycobacteria. Of 64 MTB isolates that were analyzed by the proportion method, 62 (96.8%) were pan-susceptible and two (3.1%) were MDR.
Conclusion
An important way to prevent the emergence of MDR and XDR TB, and the principles of full implementation of the strategy is directly observed treatment, short-course (DOTS). The efficient diagnosis and timely treatment of MDR-TB patients can prevent disease transmission, reduce the risk of drug resistance developing, and avoid further lung damage.
Impact of Community-Based Approach as Policy Tool: World Health Organization-Designated Safe Communities of Korea and Health Action Zones of the United Kingdom
Changhyun Kang, Jihyung Shin, Bob Matthews
Osong Public Health Res Perspect. 2016;7(1):36-42.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.10.005
• 1,275 View
• 2 Citations
Abstract PDF
Objectives
The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK).
Methods
The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea.
Results
The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased.
Conclusion
When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives.
Tae Sug Do, Young S. Lee
Osong Public Health Res Perspect. 2016;7(1):43-48.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.12.012
• 1,358 View
• 11 Citations
Abstract PDF
Objectives
This study aims to create a mathematical model to better understand the spread of Ebola, the mathematical dynamics of the disease, and preventative behaviors.
Methods
An epidemiological model is created with a system of nonlinear differential equations, and the model examines the disease transmission dynamics with isolation through stability analysis. All parameters are approximated, and results are also exploited by simulations. Sensitivity analysis is used to discuss the effect of intervention strategies.
Results
The system has only one equilibrium point, which is the disease-free state (S,L,I,R,D) = (N,0,0,0,0). If traditional burials of Ebola victims are allowed, the possible end state is never stable. Provided that safe burial practices with no traditional rituals are followed, the endemic-free state is stable if the basic reproductive number, R0, is less than 1. Model behaviors correspond to empirical facts. The model simulation agrees with the data of the Nigeria outbreak in 2004: 12 recoveries, eight deaths, Ebola free in about 3 months, and an R0 value of about 2.6 initially, which signifies swift spread of the infection. The best way to reduce R0 is achieving the speedy net effect of intervention strategies. One day's delay in full compliance with building rings around the virus with isolation, close observation, and clear education may double the number of infected cases.
Conclusion
The model can predict the total number of infected cases, number of deaths, and duration of outbreaks among others. The model can be used to better understand the spread of Ebola, educate about prophylactic behaviors, and develop strategies that alter environment to achieve a disease-free state. A future work is to incorporate vaccination in the model when the vaccines are developed and the effects of vaccines are known better.
The Characteristics of Middle Eastern Respiratory Syndrome Coronavirus Transmission Dynamics in South Korea
Yunhwan Kim, Sunmi Lee, Chaeshin Chu, Seoyun Choe, Saeme Hong, Youngseo Shin
Osong Public Health Res Perspect. 2016;7(1):49-55.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.01.001
• 2,080 View
• 54 Citations
Abstract PDF
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.
Jeong-Hee Kang, Chul-Woung Kim, Sang-Yi Lee
Osong Public Health Res Perspect. 2016;7(1):56-62.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.10.015
• 1,259 View
• 23 Citations
Abstract PDF
Objectives
The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events.
Methods
A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis.
Results
Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events—falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)—more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28).
Conclusion
The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.
Factors Affecting Korean Registered Nurses' Intention to Implement Smoking Cessation Intervention
Sook-Hee Choi, Yun-Hee Kim
Osong Public Health Res Perspect. 2016;7(1):63-70.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.11.008
• 1,418 View
• 14 Citations
Abstract PDF
Objectives
Nurses have been identified as an instrumental partner in tobacco reduction. This study aimed to examine factors affecting Korean nurses' intention to implement smoking cessation intervention in Busan, Korea.
Methods
The participants were a total of 215 Korean registered nurses. A self-administered questionnaire evaluated predisposing factors, motivational factors (attitude, social influence, and self-efficacy) and intention to implement smoking cessation intervention. Data were analyzed by t tests, Pearson's correlation, and hierarchical multiple regression.
Results
The mean age of the participants was 28.12 ± 5.72 years. The majority of the participants were staff nurses (85.6%), and 64.2% of the sample had < 5 years of work experience. Significant predictors of intention to implement smoking cessation intervention included perceived barrier of smoking cessation intervention (β = −0.128, p = 0.023), willingness to receive smoking cessation training (β = 0.123, p = 0.034), more positive attitude (β = 0.203, p = 0.002), higher social influence (β = 0.292, p < 0.001), and higher self-efficacy toward smoking cessation intervention (β = 0.151, p = 0.021), which explained 45% of the total variance of intention to implement smoking cessation intervention.
Conclusion
Attitude, social influence, and self-efficacy towards smoking cessation intervention had a significant positive influence in determining the intention to implement smoking cessation intervention. These findings can be used to develop evidence-based smoking cessation training programs for nurses in Korea. The programs should aim for positive attitude, higher social influence, and higher self-efficacy in hospital settings.
Brief Report
Comparison of the Epidemiological Aspects of Imported Dengue Cases between Korea and Japan, 2006–2010
Young Eui Jeong, Won-Chang Lee, Jung Eun Cho, Myung-Guk Han, Won-Ja Lee
Osong Public Health Res Perspect. 2016;7(1):71-74.   Published online February 28, 2016
DOI: https://doi.org/10.1016/j.phrp.2015.12.001
• 1,350 View