Journal of Preventive Medicine and Public Health

Volume 47(6); November 2014

Original Articles

Incidence of and Factors for Self-reported Fragility Fractures Among Middle-aged and Elderly Women in Rural Korea: An 11-Year Follow-up Study: Soon-Ki Ahn, Sin Kam, Byung-Yeol Chun; J Prev Med Public Health. 2014;47(6):289-297. Published online October 2, 2014; DOI: https://doi.org/10.3961/jpmph.14.020

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Objectives
This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea.
Methods
The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs).
Results
Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture.
Conclusions
Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.

Summary

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Comparison of intraoperative radiation exposure with and without use of distal targeting device: a randomized control study
Jun-Il Yoo, Hojin Jeong, Jaeboem Na, Sang-Youn Song, Jung-Taek Kim, Yong-Han Cha, Chan Ho Park
Archives of Orthopaedic and Trauma Surgery.2019; 139(11): 1579. CrossRef

Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis: Yukyung Park, Chang-yup Kim, Myoung Soon You, Kun Sei Lee, Eunyoung Park; J Prev Med Public Health. 2014;47(6):298-308. Published online November 11, 2014; DOI: https://doi.org/10.3961/jpmph.14.029

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Abstract PDF: Objectives
To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs.
Methods
We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts (‘gu’s) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer.
Results
The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively.
Conclusions
Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.; Summary

The Impact of an Emergency Fee Increase on the Composition of Patients Visiting Emergency Departments: Hyemin Jung, Young Kyung Do, Yoon Kim, Junsoo Ro; J Prev Med Public Health. 2014;47(6):309-316. Published online November 24, 2014; DOI: https://doi.org/10.3961/jpmph.14.044

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Abstract PDF: Objectives
This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits.
Methods
We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions.
Results
The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes.
Conclusions
A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.; Summary

Serum Uric Acid Level and the Incidence of Metabolic Syndrome in Middle-aged Korean Men: A 5-Year Follow-up Study: Jong-Keun Lee, Jae-Hong Ryoo, Joong-Myung Choi, Sung Keun Park; J Prev Med Public Health. 2014;47(6):317-326. Published online November 4, 2014; DOI: https://doi.org/10.3961/jpmph.14.028

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Abstract PDF

Objectives
Elevated serum uric acid (UA) has been known to be associated with the prevalence of metabolic syndrome (MetS). However, no prospective studies have examined whether serum UA levels are actually associated with the development of MetS. We performed a prospective study to evaluate the longitudinal effects of baseline serum UA levels on the development of MetS.
Methods
A MetS-free cohort of 14 906 healthy Korean men, who participated in a medical check-up program in 2005, was followed until 2010. MetS was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Cox proportional hazards models were performed.
Results
During 52 466.1 person-years of follow-up, 2428 incident cases of MetS developed between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence intervals) for incident MetS for the second, the third, and the fourth quartile to the first quartile of serum UA levels were 1.09 (0.92-1.29), 1.22 (1.04-1.44), and 1.48 (1.26-1.73), respectively (p for trend <0.001). These associations were also significant in the clinically relevant subgroup analyses.
Conclusions
Elevated serum UA levels were independently associated with future development of MetS in Korean men during the 5-year follow-up period.

Summary

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Which Clusters of Metabolic Syndrome Are the Most Associated with Serum Uric Acid?
Jurgita Mikolaitytė, Jolita Badarienė, Roma Puronaitė, Alma Čypienė, Irma Rutkauskienė, Jolanta Dadonienė, Aleksandras Laucevičius
Medicina.2022; 58(2): 297. CrossRef
Association between serum uric acid and metabolic syndrome: a cross-sectional study in Bangladeshi adults
Nurshad Ali, Rakib Miah, Mahmudul Hasan, Zitu Barman, Ananya Dutta Mou, Jaasia Momtahena Hafsa, Aporajita Das Trisha, Akibul Hasan, Farjana Islam
Scientific Reports.2020;[Epub] CrossRef
Association between uric acid and metabolic syndrome in elderly women
Hui-Juan Wang, Lei-Zhi Shi, Cun-Fei Liu, Shi-Min Liu, Song-Tao Shi
Open Medicine.2018; 13(1): 172. CrossRef
The Associations of Serum Uric Acid with Obesity-Related Acanthosis nigricans and Related Metabolic Indices
Cuiling Zhu, Ran Cui, Mingming Gao, Sharvan Rampersad, Hui You, Chunjun Sheng, Peng Yang, Hui Sheng, Xiaoyun Cheng, Le Bu, Shen Qu
International Journal of Endocrinology.2017; 2017: 1. CrossRef
Association between Serum Uric Acid and Mortality among Chinese Patients with Coronary Artery Disease
Qing Li, Yuan Zhang, Ding Ding, Yunou Yang, Qian Chen, Chaoqun Liu, Xinrui Li, Changjiang Hong, Wenhua Ling
Cardiology.2016; 134(3): 347. CrossRef

Medical Care Expenditure in Suicides From Non-illness-related Causes: Jungwoo Sohn, Jaelim Cho, Ki Tae Moon, Mina Suh, Kyoung Hwa Ha, Changsoo Kim, Dong Chun Shin, Sang Hyuk Jung; J Prev Med Public Health. 2014;47(6):327-335. Published online November 4, 2014; DOI: https://doi.org/10.3961/jpmph.14.038

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Abstract PDF

Objectives
Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated.
Methods
Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status.
Results
Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women.
Conclusions
Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

Summary

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Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
BMC Public Health.2022;[Epub] CrossRef
Impact of intergenerational support and medical expenditures on depression: Evidence from rural older adults in China
Congrong Li, Qing Han, Jinrong Hu, Zeyu Han, Hongjuan Yang
Frontiers in Public Health.2022;[Epub] CrossRef

Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data: Seung Ah Choe, Sung-Il Cho; J Prev Med Public Health. 2014;47(6):336-342. Published online November 7, 2014; DOI: https://doi.org/10.3961/jpmph.14.024

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Abstract PDF

Objectives
Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea.
Methods
Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012.
Results
The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012).
Conclusions
In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Summary

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Child mortality of twins and singletons among late preterm and term birth: a study of national linked birth and under-five mortality data of Korea
Young Shin Kim, Minku Kang, Young June Choe, Joohon Sung, Ji Yeon Lee, Seung-Ah Choe
European Journal of Pediatrics.2022; 181(5): 2109. CrossRef

Correspondence

The Need for Cognitive Neuropsychological Assessments for Estimating Risk Factors for Obesity in Adolescents: Ram Nidhi; J Prev Med Public Health. 2014;47(6):343-344. Published online September 11, 2014; DOI: https://doi.org/10.3961/jpmph.14.033

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