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Volume 8(4); August 2017
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Editorial
The Story of Korean Health Insurance System
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2017;8(4):235-236.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.01
  • 1,604 View
  • 23 Download
  • 2 Citations
PDF
Review Article
Biomarker for the Prediction of Major Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Myocardial Infarction
Ho Sun Shon, Jang-Whan Bae, Kyoung Ok Kim, Eun Jong Cha, Kyung Ah Kim
Osong Public Health Res Perspect. 2017;8(4):237-246.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.02
  • 1,821 View
  • 21 Download
  • 4 Citations
AbstractAbstract PDF

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths (p = 0.016), myocardial infarction (p = 0.000), and coronary artery bypass grafting (CABG) (p = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) (p = 0.037) and the maximum creatinine kinase (max-CK) (p = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.

Original Articles
Analyzing the Historical Development and Transition of the Korean Health Care System
Sang-Yi Lee, Chul-Woung Kim, Nam-Kyu Seo, Seung Eun Lee
Osong Public Health Res Perspect. 2017;8(4):247-254.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.03
  • 1,943 View
  • 25 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system.

Methods

We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power. This study focuses on how the relationships among social forces can change as a nation’s economic development or governing strategy changes in response to changes in international circumstances such as globalization.

Results

The corporatist Social Health Insurance (SHI) system (multiple insurers) introduced in 1977 was transformed into the single-insurer NHI in July 2000. These changes were influenced externally by globalization and internally by political democratization, keeping Korea’s private-dominant health care provision system unchanged over several decades.

Conclusion

Major changes such as integration reform occurred, when high levels of state autonomy were ensured. The state’s power (its policy capability), based on health care infrastructures, acts to limit the direction of any change in the health care system because it is very difficult to build the infrastructure for a health care system in a short timeframe.

Correlation between Scapular Asymmetry and Differences in Left and Right Side Activity of Muscles Adjacent to the Scapula
Seong-Gil Kim
Osong Public Health Res Perspect. 2017;8(4):255-259.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.04
  • 2,129 View
  • 28 Download
AbstractAbstract PDF
Objectives

The aim of this study was to analyze the correlation between scapular asymmetry in young female adults and differences in left and right side activity of muscles adjacent to the scapula.

Methods

This study included 60 female students from U university in Korea. In order to examine scapular asymmetry, the lateral scapular slide test (LSST) was used. The LSST was performed in 3 different postures (LSST-1, LSST-2, and LSST-3; i.e., 0°, 45°, and 90° of upper limb abduction, respectively). Muscle activity was measured during external and internal rotation of the shoulder joints. Muscle activity was measured at the upper, middle, and lower trapezius, and the serratus anterior.

Results

In external shoulder rotation, there was a significant correlation (R = 0.450) between LSST-2 and the middle trapezius. In internal shoulder rotation, there was a significant correlation (R = 0.472) between LSST-2 and the upper trapezius, and between LSST-3 and the lower trapezius (R = 0.657); these results demonstrated a moderate positive linear correlation.

Conclusion

There was a positive correlation between left and right scapular asymmetry and the difference in left and right muscle activity of the trapezius in female adults. Problems in the trapezius may lead to scapular asymmetry.

Aflatoxin M1 Contamination Levels in Cheeses Sold in Isfahan Province, Iran
Ali Sharifzadeh, Payam Ghasemi-Dehkordi, Mohsen Foroughi, Elham Mardanpour-Shahrekordi, Shahin Ramazi
Osong Public Health Res Perspect. 2017;8(4):260-263.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.05
  • 2,034 View
  • 18 Download
  • 8 Citations
AbstractAbstract PDF
Objectives

Aflatoxin M1 (AFM1)-contaminated dairy products pose serious human health risks, causing liver and renal failure if consumed. They are also related to decreased milk and egg production in infected animals. This study investigated the AFM1 contamination levels in cheeses sold in Isfahan province, Iran, by enzyme-linked immunosorbent assay (ELISA).

Methods

A total of 100 white cheese samples were randomly collected from supermarkets in Isfahan province and after extraction using dichloromethane were prepared for the ELISA.

Results

Of the 100 samples, 52 (52%) were contaminated by AFM1, at levels ranging from 50.2 to 424.4 ng/kg. The remaining 48% of the samples had undetectable AFM1 levels (< 50 ng/kg). Based on the standard limit set by the European Commission and Iran, 8% (8/100) of the AFM1-positive samples (with concentrations between 250.2 and 424.4 ng/kg) had levels higher than the permissible value of 250 ng/kg.

Conclusion

Although the percentage of cheese samples in Isfahan province with AFM1 levels exceeding the national permissible limit was low, the examination of cheeses and the milk used for their production is nevertheless important for ensuring public health. Furthermore, optimum storage conditions of animal feed should be ensured, and livestock nutrition must be monitored for the presence of AFM1 and other aflatoxins.

Influence of Socioeconomic Status, Comorbidity, and Disability on Late-stage Cancer Diagnosis
Bo Ram Park, So Young Kim, Dong Wook Shin, Hyung Kook Yang, Jong Hyock Park
Osong Public Health Res Perspect. 2017;8(4):264-270.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.06
  • 1,839 View
  • 24 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

Understanding factors affecting advanced stage at diagnosis is vital to improve cancer outcomes and overall survival. We investigated the factors affecting later-stage cancer diagnosis.

Methods

Patients completed self-reported questionnaires. We collected cancer stage data from medical records review. Logistic regression analyses were performed to identify factors associated with later stage cancer at diagnosis by gender.

Results

In total, 1,870 cancer patients were included in the study; 55.8% were men, 31.1% had more than one comorbid condition, and 63.5% had disabilities. About half of the patients were smokers, and drank alcohol, and 58.0% were diagnosed at an advanced stage. By cancer type, lung and liver cancers (both genders), prostate (men), colorectal, cervical, and thyroid cancer (women) were more likely to be diagnosed at a later stage. After controlling for socioeconomic factors, comorbidity (odds ratio [OR], 1.48 in men) and disability (OR, 1.64 in men and 1.52 in women) remained significantly associated with late-stage diagnosis.

Conclusion

In this nationwide study, using combined information from patients and medical records, we found that male patients with comorbidities or disabilities, and female patients with disabilities were more likely to have advanced stage cancer at diagnosis. Targeted approaches by cancer type and health conditions are recommended.

Effects of Exercise on Cervical Angle and Respiratory Function in Smartphone Users
Na Kyung Lee, Sang In Jung, Do Youn Lee, Kyung Woo Kang
Osong Public Health Res Perspect. 2017;8(4):271-274.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.07
  • 1,850 View
  • 42 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

The aim of this study was to determine whether exercises can change the cervical angle and respiratory function in smartphone users.

Methods

Thirty healthy volunteers were recruited. The subjects were randomly divided into an exercise group and a control group. All participants used a smartphone for 1 hour while maintaining a sitting posture. Then, each group performed their assigned activity. The exercise group performed two types of exercises and the control group maintained routine activities for 20 minutes. To investigate the changes in cervical angle and respiratory function, we measured the craniovertebral angle by using a spirometer.

Results

Statistically significant differences were noted in the craniovertebral angle, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure of the two groups (p < 0.05).

Conclusion

Our findings showed that proper exercise could be a good method of improving the cervical angle and respiratory function in smartphone users.

Body-related Perspectives and Weight Control Methods of Korean-Chinese Nursing School Students in Yanbian, China: A Pilot Study
Jounghee Lee, Meixiang Jin, Heejung Son, Wenying Cui
Osong Public Health Res Perspect. 2017;8(4):275-281.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.08
  • 1,953 View
  • 21 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

This study aimed at identifying the current nutrition knowledge, body-related perspectives, and weight control behaviors of Korean-Chinese college students.

Methods

We conducted a pilot study by employing a healthy weight education program targeting Korean-Chinese nursing school students at the Yanbian University of Science and Technology in Yanbian, China.

Results

This pilot study included 40 participants (38 women and 2 men; mean age, 20.5 years). The current weight status of the participants was as follows: 7.9% underweight, 78.9% normal weight, 7.9% overweight, and 5.3% obese. However, nearly two-thirds of the participants were dissatisfied with their current body size (43.6% a little dissatisfied; 20.5% very dissatisfied). Fifty percent of the participants perceived their current body size as being either slightly fat (35.0%) or very fat (15.0%). The following unhealthy weight control methods were commonly used among the 24 participants who practiced weight control: (1) laxatives or diuretics (91.7%), (2) saunas or spas (87.5%), and (3) a one-food diet (79.2%). In addition, the nutrition knowledge of the participants increased by 24 points from 117 points (pretest) to 141 points (posttest) through the healthy weight education program.

Conclusion

The findings of this study indicate an urgent need to educate Korean-Chinese college students on healthy weight control methods and body-related perspectives.

Seroprevalence of Brucellosis in Human Immunodeficiency Virus Infected Patients in Hamadan, Iran
Fariba Keramat, Mohammad Mehdi Majzobi, Jalal Poorolajal, Zohreh Zarei Ghane, Maryam Adabi
Osong Public Health Res Perspect. 2017;8(4):282-288.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.09
  • 1,666 View
  • 19 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

Brucellosis is a systemic disease with a wide spectrum of clinical manifestations. This study aimed to determine the seroprevalence of brucellosis in human immunodeficiency virus (HIV) infected patients in Hamadan Province in the west of Iran.

Methods

A total of 157 HIV-infected patients were screened through standard serological tests, including Wright’s test, Coombs’ Wright test, and 2-mercaptoethanol Brucella agglutination test (2ME test), blood cultures in Castaneda media, and CD4 counting. Data were analyzed using Stata version 11.

Results

Wright and Coombs’ Wright tests were carried out, and only 5 (3.2%) patients had positive serological results. However, all patients had negative 2ME results, and blood cultures were negative for Brucella spp. Moreover, patients with positive serology and a mean CD4 count of 355.8 ± 203.11 cells/μL had no clinical manifestations of brucellosis, and, and the other patients had a mean CD4 count of 335.55 ± 261.71 cells/μL.

Conclusion

Results of this study showed that HIV infection is not a predisposing factor of acquiring brucellosis.

Brief Report
Lyme Disease and YouTubeTM: A Cross-Sectional Study of Video Contents
Corey H. Basch, Lindsay A. Mullican, Kwanza D. Boone, Jingjing Yin, Alyssa Berdnik, Marina E. Eremeeva, Isaac Chun-Hai Fung
Osong Public Health Res Perspect. 2017;8(4):289-292.   Published online August 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.4.10
  • 2,024 View
  • 24 Download
  • 8 Citations
AbstractAbstract PDFSupplementary Material
Objectives

Lyme disease is the most common tick-borne disease. People seek health information on Lyme disease from YouTubeTM videos. In this study, we investigated if the contents of Lyme disease-related YouTubeTM videos varied by their sources.

Methods

Most viewed English YouTubeTM videos (n = 100) were identified and manually coded for contents and sources.

Results

Within the sample, 40 videos were consumer-generated, 31 were internet-based news, 16 were professional, and 13 were TV news. Compared with consumer-generated videos, TV news videos were more likely to mention celebrities (odds ratio [OR], 10.57; 95% confidence interval [CI], 2.13–52.58), prevention of Lyme disease through wearing protective clothing (OR, 5.63; 95% CI, 1.23–25.76), and spraying insecticides (OR, 7.71; 95% CI, 1.52–39.05).

Conclusion

A majority of the most popular Lyme disease-related YouTubeTM videos were not created by public health professionals. Responsible reporting and creative video-making facilitate Lyme disease education. Partnership with YouTubeTM celebrities to co-develop educational videos may be a future direction.


PHRP : Osong Public Health and Research Perspectives