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The role of risk perception, risk communication, and demographic factors in COVID-19 preventive behaviors: an online survey in Iran
Mansour Rezaei, Nader Rajabi Gilan, Ali Almasi, Mehdi Khezeli, Fatemeh Jamshidi Nazar, Zahra Jorjoran Shushtari, Yahya Salimi, Farid Najafi, Neda Sarabi, Shahram Saeidi, Saeid Saeidi
Osong Public Health Res Perspect. 2022;13(4):282-289.   Published online August 31, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0345
  • 297 View
  • 17 Download
AbstractAbstract PDF
Objectives
This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample.
Methods
This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8.
Results
The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r=0.320, p<0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (β=−0.482), risk perception (β=0.047), and risk communication (β=0.662) were significant determinants.
Conclusion
Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.
Characteristics of COVID-19 outbreaks and risk factors for transmission at an army training center in South Korea from June to August 2021
U Jin Cho, Seongjin Wang, Seonju Yi, Yeon Hwa Choi, Eun-Young Kim, Jin A Kim, Sanghwan Bae, Jungyeon Yu, Jangkyu Choi, Young-Joon Park
Osong Public Health Res Perspect. 2022;13(4):263-272.   Published online July 27, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0149
  • 628 View
  • 59 Download
AbstractAbstract PDF
Objectives
It is crucial to establish the characteristics of coronavirus disease 2019 (COVID-19) outbreaks at army training centers to develop preventive measures. Therefore, this study aimed to determine the COVID-19 transmission patterns and risk factors in a sequence of outbreaks at an army training center from June to August 2021.
Methods
This study included 1,324 trainees at an army training center where outbreaks occurred from June to August 2021. The outbreak was qualitatively analyzed according to the period, attack rate, demographic characteristics, vaccination history, and living areas. An aerodynamic experiment was performed to evaluate aerosol transmission in living areas.
Results
Three outbreaks occurred at the army training center from June to August 2021. The first, second, and third outbreaks lasted for 32, 17, and 24 days, and the attack rates were 12.8%, 18.1%, and 8.9%, respectively. Confirmed cases were distributed in all age groups. Recruits and the unvaccinated were at higher risk for COVID-19. The aerodynamic experiment verified the possibility of aerosol transmission within the same living area.
Conclusion
COVID-19 transmission at army training centers should be minimized through quarantine and post-admission testing during the latency period as part of integrated measures that include facility ventilation, vaccination, indoor mask-wearing, and social distancing.
Analysis of risk factors affecting suicidal ideation in South Korea by life cycle stage
Ji-Young Hwang, Il-Su Park
Osong Public Health Res Perspect. 2021;12(5):314-323.   Published online October 26, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0208
  • 2,123 View
  • 86 Download
AbstractAbstract PDF
Objectives
This study analyzed risk factors for suicidal ideation in South Koreans from a life cycle perspective.
Methods
A secondary analysis was conducted of data collected in 2015 as part of the 6th Korea National Health and Nutrition Examination Survey (KNHANES). The participants comprised 5,935 individuals aged 12 years or older. The statistical analysis reflected the complex sampling design of the KNHANES, and the Rao-Scott chi-square test and multiple logistic regression analysis were performed.
Results
The prevalence of suicidal ideation was 5.7% in adolescents, 3.7% in young adults, 5.4% in middle-aged adults, and 7.0% in older adults. Depression and stress were risk factors in every stage of the life cycle. In those aged 12 to 19 years, activity restrictions were significantly associated with suicidal ideation. Education and subjective health status were risk factors in adults aged 20 to 39 years, and education, activity restrictions, and quality of life were the major risk factors in those aged 40 to 64 years. For adults 65 years of age or older, the risk of suicidal ideation was higher among those with inappropriate sleep time.
Conclusion
The risk factors for suicidal ideation were found to be different across stages of the life cycle. This suggests a need for individualized suicide prevention plans and specific government policies that reflect the characteristics of each life cycle stage.
Sex differences in the relationship between depression and cardiovascular disease risk: a nationwide study in Korea
Seol-bin Kim, Ihn Sook Jeong
Osong Public Health Res Perspect. 2021;12(2):105-114.   Published online April 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.2.08
  • 3,811 View
  • 71 Download
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to identify sex differences in the association between depression and the risk of developing cardiovascular disease (CVD).
Methods
A secondary analysis was conducted of data from the fifth to seventh waves (2010−2018) of the Korea National Health and Nutrition Examination Survey. The participants were adults aged 30−74 years who had no diagnosis of CVD. The CVD risk was calculated using the Framingham Risk Score algorithm. Multiple linear regression analysis was conducted to identify the association between depression and CVD risk using a complex sample design.
Results
The mean CVD risk was higher in males and females with current depression (14.72% vs. 6.35%, respectively) than in males without current depression (11.67% and 4.42%, respectively). Current depression showed a significant association with CVD risk after controlling for only health-related characteristics, but the significance disappeared in both males and females when demographic characteristics were additionally controlled.
Conclusion
The presence of depression was not associated with CVD risk regardless of sex after controlling for confounding factors. Further studies are recommended to investigate the relationship between depression and CVD risk in a larger sample of both males and females with depression.
Risk Assessment Program of Highly Pathogenic Avian Influenza with Deep Learning Algorithm
Hachung Yoon, Ah-Reum Jang, Chungsik Jung, Hunseok Ko, Kwang-Nyeong Lee, Eunesub Lee
Osong Public Health Res Perspect. 2020;11(4):239-244.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.13
  • 3,342 View
  • 52 Download
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Objectives

This study presents the development and validation of a risk assessment program of highly pathogenic avian influenza (HPAI). This program was developed by the Korean government (Animal and Plant Quarantine Agency) and a private corporation (Korea Telecom, KT), using a national database (Korean animal health integrated system, KAHIS).

Methods

Our risk assessment program was developed using the multilayer perceptron method using R Language. HPAI outbreaks on 544 poultry farms (307 with H5N6, and 237 with H5N8) that had available visit records of livestock-related vehicles amongst the 812 HPAI outbreaks that were confirmed between January 2014 and June 2017 were involved in this study.

Results

After 140,000 iterations without drop-out, a model with 3 hidden layers and 10 nodes per layer, were selected. The activation function of the model was hyperbolic tangent. Precision and recall of the test gave F1 measures of 0.41, 0.68 and 0.51, respectively, at validation. The predicted risk values were higher for the “outbreak” (average ± SD, 0.20 ± 0.31) than “non-outbreak” (0.18 ± 0.30) farms (p < 0.001).

Conclusion

The risk assessment model developed was employed during the epidemics of 2016/2017 (pilot version) and 2017/2018 (complementary version). This risk assessment model enhanced risk management activities by enabling preemptive control measures to prevent the spread of diseases.

Educational Needs Associated with the Level of Complication and Comparative Risk Perceptions in People with Type 2 Diabetes
Youngji Hwang, Dongsuk Lee, Yeon Sook Kim
Osong Public Health Res Perspect. 2020;11(4):170-176.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.05
  • 3,242 View
  • 140 Download
AbstractAbstract PDF
Objectives

This study aimed to identify the educational needs of people with type 2 diabetes according to risk perceptions and the level of severity of complications.

Methods

There were 177 study participants who were outpatients of the internal medicine department at a university hospital located in the Republic of Korea, who consented to participate in the survey from December 10, 2016 to February 10, 2017. The data were analyzed using descriptive statistics, Pearson correlation, ANOVA with post-hoc comparison, and multiple regression analysis. Type 2 diabetes complications were classified into 3 groups: no complications, common complications, and severe complications.

Results

There were statistically significant positive correlations between educational needs and comparative risk perceptions, and the level of complication and comparative risk perception. Multiple regression analysis revealed that the factor predicting educational needs of type 2 diabetes people was their comparative risk perceptions, rather than the severity of diabetes complications or sociodemographic variables.

Conclusion

Since risk perception is the factor that indicates the educational needs of people with type 2 diabetes, there is a need to explore factors which increase risk perception, in order to meet educational needs. The findings suggest that a more specific and individualized educational program, which focuses on each person's risk perceptions, should be developed.

KCDC Risk Assessments on the Initial Phase of the COVID-19 Outbreak in Korea
Inho Kim, Jia Lee, Jihee Lee, Eensuk Shin, Chaeshin Chu, Seon Kui Lee
Osong Public Health Res Perspect. 2020;11(2):67-73.   Published online April 30, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.2.02
  • 10,192 View
  • 593 Download
  • 15 Citations
AbstractAbstract PDF
Objectives

This study aims to evaluate the risk assessments of coronavirus 2019 (COVID-19) in the Korea Centers for Disease Control and Prevention (KCDC), from the point of detection to the provision of basic information to the relevant public health authorities.

Methods

To estimate the overall risk of specific public health events, probability, and impact at the country-level were evaluated using available information. To determine the probability of particular public health events, the risk of importation and risk of transmission were taken into consideration. KCDC used 5 levels (“very low,” “low,” “moderate,” “high,” and “very high”) for each category and overall risk was eventually decided.

Results

A total of 8 risk assessments were performed on 8 separate occasions between January 8th to February 28th, 2020, depending on the detection and report of COVID-19 cases in other countries. The overall risk of the situation in each assessment increased in severity over this period: “low” (first), “moderate” (second), “high” (third), “high” (fourth), “high” (fifth), “high” (sixth), “high” (seventh), and “very high” (eighth).

Conclusion

The KCDC’s 8 risk assessments were utilized to activate national emergency response mechanisms and eventually prepare for the pandemic to ensure the containment and mitigation of COVID-19 with non-pharmaceutical public health measures.

Risk Factors in Early Life for Preschool Children in Korea that are Associated with Being Overweight or Obese
Jin Suk Ra, Hyun Jung Yun
Osong Public Health Res Perspect. 2020;11(1):15-26.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.04
  • 3,888 View
  • 121 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

The present study addressed the risk factors in early life for Korean preschool children that are associated with being overweight or obese.

Methods

A descriptive cross-sectional design was used to conduct this study, which included 507 mothers with preschool children aged 3–5 years, who attended daycare centers. Data were acquired via a self-administered questionnaire completed by the mothers. Of the 650 questionnaires that were distributed, 507 (78%) were completed and sent back. Multivariate logistic regression analyses were used to identify risk factors in early life, which may contribute to being overweight or obese in preschool children.

Results

Fifty-eight (11.4%) preschool children were overweight and 41 (8.1%) were obese. Multivariate logistic regression analysis with adjustment for covariates, revealed a significant association with the introduction of solid foods before 4 months of age [adjusted odds ratio (aOR) = 9.49, p = 0.029] and a nonresponsive feeding style (aOR = 2.80, p = 0.043) with being overweight or obese in preschool children.

Conclusion

The findings of this study highlighted the need for parenting education programs on feeding practices to increase their understanding of hunger and satiety cues in infants, and appropriate timing for the introduction of solid foods.

The Occurrence and Risk Assessment of Exposure to Aflatoxin M1 in Ultra-High Temperature and Pasteurized Milk in Hamadan Province of Iran
Amir Sasan Mozaffari Nejad, Ali Heshmati, Tayebe Ghiasvand
Osong Public Health Res Perspect. 2019;10(4):228-233.   Published online August 31, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.4.05
  • 4,439 View
  • 125 Download
  • 14 Citations
AbstractAbstract PDF
Objectives

Aflatoxins are a category of poisonous compounds found in most plants, milk and dairy products. The present research was carried out to detect the presence of aflatoxin M1 (AFM1) in samples of milk collected from Hamadan province, Iran.

Methods

Twenty five samples of ultra-high temperature (UHT) and 63 samples of pasteurized milk were collected and the amount of AFM1 was measured by an Enzyme-Linked Immunosorbent Assay method. In addition, the estimated daily intake (EDI) and hazard index (HI) of AFM1 was determined by the following equations:(EDI= mean concentration of AFM1 × daily consumption of milk/body weight; HI= EDI/Tolerance Daily Intake).

Results

AFM1 was detected in 21 (84%) UHT milk samples and in 55 (87.30%) pasteurized milk samples. Seven (28%) samples of UHT and 21 (33.33%) pasteurized milk samples had higher AFM1 content than the limit allowed in the European Union and Iranian National Standard Limits (0.05 μg/kg). None of the samples exceeded the US Food and Drug Administration limit (0.5 μg/kg) for AFM1. EDI and HI for AM1 through milk were 0.107 ng/kg body weight/day, and 0.535, respectively.

Conclusion

A significant percentage of milk produced by different factories in Iran (84% of UHT and 87.3% of pasteurized milk) was contaminated with AFM1. Therefore, more control and monitoring of livestock feeding in dairy companies may help reduce milk contamination with AFM1. As the HI value was lower than 1, it can be assumed that there was no risk of developing liver cancer due to milk consumption.

Enteroparasitism and Risk Factors Associated with Clinical Manifestations in Children and Adults of Jalisco State in Western Mexico
María de la Luz Galván-Ramírez, Ana Luisa Madriz-Elisondo, Cynthia Guadalupe Temores Ramírez, Jorge de Jesús Romero Rameño, Dania Araceli de la O Carrasco, Marco Antonio Cardona López
Osong Public Health Res Perspect. 2019;10(1):39-48.   Published online February 28, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.1.08
  • 5,486 View
  • 112 Download
  • 8 Citations
AbstractAbstract PDF
Objectives

To determine the prevalence and risk factors associated with intestinal parasites in the population of San Juan Cosala, Jalisco, Mexico.

Methods

A total of 277 samples from 104 participants were analysed using direct smear, flotation, formaldehyde/ethyl acetate, and modified Kinyoun’s acid-fast stain methods. The Graham method was applied only for samples from children under 12 years of age for the diagnosis of Enterobius vermicularis.

Results

The prevalence of parasite infections in the study population was 77.9% including: Entamoeba histolytica/E. dispar/E. moshkovskii/E. bangladeshi (37.5%), Giardia intestinalis (11.5%); commensals: Endolimax nana (44.2%), Entamoeba coli (27.9%), Chilomastix mesnili (6.7%) and Iodamoeba bütschlii, (2.9%); emerging intestinal protozoans: Blastocystis spp. (49%), Cryptosporidium spp. (7.7%) and Cyclospora cayetanensis (2.9%); and helminths: Enterobius vermicularis (18.3%) and Ascaris lumbricoides (5.8%). The results also showed that 58.64% of the studied population presented polyparasitism. A significant association was found between protozoan infections and housewives, and houses that were not built with concrete ceilings, brick walls and cement floors (p < 0.05).

Conclusion

Polyparasitism was observed in over half the study population. The most prevalent parasite was Blastocystis spp, whilst the prevalence of helminths was less than that of protozoans. The risk factors for infection to intestinal parasites were being a housewife and not having solid brick, cement and concrete materials for house construction.

Developing the High-Risk Drinking Scorecard Model in Korea
Jun-Tae Han, Il-Su Park, Suk-Bok Kang, Byeong-Gyu Seo
Osong Public Health Res Perspect. 2018;9(5):231-239.   Published online October 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.5.04
  • 14,272 View
  • 96 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

This study aimed to develop a high-risk drinking scorecard using cross-sectional data from the 2014 Korea Community Health Survey.

Methods

Data were collected from records for 149,592 subjects who had participated in the Korea Community Health Survey conducted from 2014. The scorecard model was developed using data mining, a scorecard and points to double the odds approach for weighted multiple logistic regression.

Results

This study found that there were many major influencing factors for high-risk drinkers which included gender, age, educational level, occupation, whether they received health check-ups, depressive symptoms, over-moderate physical activity, mental stress, smoking status, obese status, and regular breakfast. Men in their thirties to fifties had a high risk of being a drinker and the risks in office workers and sales workers were high. Those individuals who were current smokers had a higher risk of drinking. In the scorecard results, the highest score range was observed for gender, age, educational level, and smoking status, suggesting that these were the most important risk factors.

Conclusion

A credit risk scorecard system can be applied to quantify the scoring method, not only to help the medical service provider to understand the meaning, but also to help the general public to understand the danger of high-risk drinking more easily.

Cardiovascular Disease Risk Factors and Obesity Levels in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey, 2007–2015
Kwanjun Park, Sunmi Lim, Yoonhyung Park, Woong Ju, Yoonhee Shin, Hansol Yeom
Osong Public Health Res Perspect. 2018;9(4):150-159.   Published online August 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.4.03
  • 3,392 View
  • 32 Download
  • 7 Citations
AbstractAbstract PDF
Objectives

The increase in the obesity rate in adult males in Korea is higher than countries in the Organization for Economic Co-operation and Development and other Asian countries. We examined the trends and prevalence of major risk factors for cardiovascular disease by evaluating the weight status amongst adults from 2007 to 2015.

Methods

The study included 37,402 adults, who participated in the Korea National Health and Nutrition Examination Survey. The prevalence trends of cardiovascular disease risk factors were estimated for each body mass index group.

Results

From 2007 to 2015, significant increases in the prevalence of hypertension, diabetes, and hypercholesterolemia were observed in normal weight adults (0.03 percentage point (%p), 0.06%p, and 0.13%p, respectively). Amongst the overweight and obese adults, a significant increase in the prevalence of hypercholesterolemia was observed, During this period, the prevalence of smoking decreased amongst obese adults and no significant changes in drinking habits and physical activity were noted across all body mass index groups.

Conclusion

The prevalence of obesity in Korean adults is increasing, and it is necessary to implement interventions to prevent further weight gain and obesity-associated cardiovascular disease.

Age-differentiated Risk Factors of Suicidal Ideation among Young and Middle-aged Korean Adults
Ahra Jo, Minho Jeon, Heeyoung Oh
Osong Public Health Res Perspect. 2017;8(3):201-210.   Published online June 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.3.07
  • 2,409 View
  • 28 Download
  • 12 Citations
AbstractAbstract PDF
Objectives

This study aimed to determine the prevalence of suicidal ideation among young and middle-aged adults, and explore the risk factors that affect suicidal ideation.

Methods

A descriptive study design was used for secondary data analysis. A total sample of 5,214 was drawn from two waves (2012–2013) of the 7th Korea Health Panel (KHP) survey. The KHP data were collected by a well-trained interviewer using the face-to-face method during home visits as well as self-report method. Descriptive statistics of frequency, percentage, chi-square test, and logistic regression analysis were performed using SPSS 22.0.

Results

The prevalence of suicidal ideation in young and middle-aged adults was 4.4% and 5.6%, respectively. For young adults, suicidal ideation risk was higher among those with low income or heavy drinking habits. In middle-aged adults, low income, poor perceived health status, negative perception of peer-compared health status, and negative social perspective were the major risk factors.

Conclusion

There is considerable risk of suicidal ideation in adulthood. Opportunities for increased income, avoidance of heavy drinking, and the construction of positive subjective health status and social perspective should be considered in suicide prevention interventions for Korean young and middle-aged adults.

Prevalence and Determinants of Preterm Birth in Tehran, Iran: A Comparison between Logistic Regression and Decision Tree Methods
Payam Amini, Saman Maroufizadeh, Reza Omani Samani, Omid Hamidi, Mahdi Sepidarkish
Osong Public Health Res Perspect. 2017;8(3):195-200.   Published online June 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.3.06
  • 2,783 View
  • 29 Download
  • 7 Citations
AbstractAbstract PDF
Objectives

Preterm birth (PTB) is a leading cause of neonatal death and the second biggest cause of death in children under five years of age. The objective of this study was to determine the prevalence of PTB and its associated factors using logistic regression and decision tree classification methods.

Methods

This cross-sectional study was conducted on 4,415 pregnant women in Tehran, Iran, from July 6–21, 2015. Data were collected by a researcher-developed questionnaire through interviews with mothers and review of their medical records. To evaluate the accuracy of the logistic regression and decision tree methods, several indices such as sensitivity, specificity, and the area under the curve were used.

Results

The PTB rate was 5.5% in this study. The logistic regression outperformed the decision tree for the classification of PTB based on risk factors. Logistic regression showed that multiple pregnancies, mothers with preeclampsia, and those who conceived with assisted reproductive technology had an increased risk for PTB (p < 0.05).

Conclusion

Identifying and training mothers at risk as well as improving prenatal care may reduce the PTB rate. We also recommend that statisticians utilize the logistic regression model for the classification of risk groups for PTB.

Low Levels of Extensively Drug-resistant Tuberculosis among Multidrug Resistant Tuberculosis Isolates and Their Relationship to Risk Factors: Surveillance in Tehran, Iran; 2006 to 2014
Alireza Hadizadeh Tasbiti, Shamsi Yari, Mostafa Ghanei, Mohammad Ali Shokrgozar, Abolfazl Fateh, Ahmadreza Bahrmand
Osong Public Health Res Perspect. 2017;8(2):116-123.   Published online April 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.2.03
  • 2,287 View
  • 24 Download
  • 3 Citations
AbstractAbstract PDF
Objectives

Extensively drug-resistant tuberculosis (XDR-TB) is more expensive and difficult to treat than multidrug-resistant tuberculosis (MDR-TB), and outcomes for patients are much worse; therefore, it is important that clinicians understand the magnitude and distribution of XDR-TB. We conducted a retrospective study to compare the estimated incidence of and risk factors for M/XDR-TB with those of susceptible TB controls.

Methods

Sputum culture and drug susceptibility testing (DST) were performed in patients with known or suspected TB. Strains that were identified as MDR were subjected to DST for second-line drugs using the proportion method.

Results

Among 1,442 TB patients (mean age, 46.48 ± 21.24 years) who were culture-positive for Mycobacterium tuberculosis, 1,126 (78.1%) yielded isolates that were resistant to at least one first-line drug; there were 33 isolates (2.3%) of MDR-TB, of which three (0.2%) were classified as XDR-TB. Ofloxacin resistance was found in 10 (0.7%) isolates. Women were 15% more likely than men to yield M/XDR-TB isolates, but this difference was not significant. In a multivariate analysis comparing susceptible TB with X/MDR-TB, only one variable—the number of previous treatment regimens—was associated with MDR (odds ratio, 1.06; 95% confidence interval, 1.14–21.2).

Conclusion

The burden of M/XDR-TB cases is not sizeable in Iran. Nonetheless, strategies must be implemented to identify and cure patients with pre-XDR-TB before they develop XDR-TB. Our results provide a greater understanding of the evolution and spread of M/XDR-TB in an environment where drug-resistant TB has a low incidence.


PHRP : Osong Public Health and Research Perspectives