Journal of Preventive Medicine and Public Health

Original Articles

Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study: Seung Hoon Kim, Minah Park, Sung Hoon Jeong, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2021;54(5):317-329. Published online August 14, 2021; DOI: https://doi.org/10.3961/jpmph.21.077

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Objectives
The aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).
Methods
Data of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.
Results
Compared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.
Conclusions
The residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.

Summary

Korean summary
2018년 지역사회건강조사를 이용하여 190 365명을 대상으로 가족 중 치매환자 유무 및 치매환자와의 동거여부와 수면의 질 사이의 연관성을 분석하였다. 치매환자와의 동거여부와 상관없이 가족 중 치매환자가 존재하는 것은 낮은 수면의 질과 유의한 연관성이 있었다. 가족 중 치매환자가 있지만 동거하지 않는 가족 구성원의 경우 치매환자가 혼자 살 때 낮은 수면의 질과의 연관성이 가장 높게 나타났다.

Citations

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Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2022; 55(2): 173. CrossRef
Association of compliance with COVID-19 public health measures with depression
Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
Scientific Reports.2022;[Epub] CrossRef

Household Overcrowding in Iran, a Low-middle-income Country: How Major of a Public Health Concern Is It?: Leila Jansar Hosseini, Ali Hussein Samadi, Abraha Woldemichael, Masoumeh Najaf Gharebelagh, Satar Rezaei, Enayatollah Homaie Rad; J Prev Med Public Health. 2021;54(1):73-80. Published online January 11, 2021; DOI: https://doi.org/10.3961/jpmph.20.568

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Objectives
Household overcrowding (HC) can contribute to both physical and mental disorders among the members of overcrowded households. This study aimed to measure the status of HC and its main determinants across the provinces of Iran.
Methods
Data from 39 864 households from the 2016 Iranian Household Income and Expenditures Survey were used in this study. The Equivalized Crowding Index (ECI) and HC index were applied to measure the overcrowding of households. Regression models were estimated to show the relationships between different variables and the ECI.
Results
The overall, urban, and rural prevalence of HC was 8.2%, 6.3%, and 10.1%, respectively. The highest prevalence of HC was found in Sistan and Baluchestan Province (28.7%), while the lowest was found in Guilan Province (1.8%). The number of men in the household, rural residency, the average age of household members, yearly income, and the household wealth index were identified as the main determinants of the ECI and HC.
Conclusions
The study demonstrated that the ECI and HC were higher in regions near the borders of Iran than in other regions. Therefore, health promotion and empowerment strategies are required to avoid the negative consequences of HC, and screening programs are needed to identify at-risk families.

Summary

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Social determinants of health and diabetes: Results from a cohort study in Iran
SeyedJalal Hashemi, Mehrnoosh Jasemzadeh, Nader Saki, Bahman Cheraghian, Sara Sarvandian, Ali Montazeri, Maedeh Raeisizadeh, Marzieh Araban
Asian Journal of Social Health and Behavior.2023; 6(2): 86. CrossRef
Inadequate housing and pulmonary tuberculosis: a systematic review
Ju-Yeun Lee, Namhee Kwon, Ga-yeon Goo, Sung-il Cho
BMC Public Health.2022;[Epub] CrossRef

Association Between Parental Marital Status and Types of Suicidal Behavior Among Korean Adolescents: A Cross-sectional Study: Yoon Sik Park, Eun-Cheol Park; J Prev Med Public Health. 2020;53(6):419-428. Published online September 21, 2020; DOI: https://doi.org/10.3961/jpmph.20.004

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Abstract PDF

Objectives
Adolescent suicide is a global problem. This study aimed to identify associations between parental marital status and suicidal behavior.
Methods
This study analyzed 118 715 middle and high school students from the 13th and 14th Korea Youth Risk Behavior Web-based Survey. The odds ratios (ORs) of suicidal ideation, planning, and attempts were calculated based on parental marital status, living situation, and socioeconomic factors. The data were analyzed using multiple logistic regression.
Results
When compared to those living with 2 married biological parents, the ORs of suicidal ideation among adolescents living with either remarried or no parents were 1.34 (95% confidence interval [CI], 1.17 to 1.53) and 1.36 (95% CI, 1.11 to 1.66), respectively. For suicidal planning, the OR of those living with 1 remarried biological parent was 1.24 (95% CI, 1.01 to 1.52), and that of those living without parents was 1.28 (95% CI, 0.95 to 1.73), when compared to adolescents living with 2 married biological parents. For suicide attempts, when compared to adolescents with 2 married biological parents, the OR of those living with 1 remarried biological parent was 1.48 (95% CI, 1.17 to 1.87) and that of those living without parents was 2.02 (95% CI, 1.44 to 2.83). For adolescents living with 1 remarried biological parent, suicidal behavior was strongly associated with having no siblings and were weakly associated with not living with grandparents.
Conclusions
Suicidal behavior among adolescents was associated with the remarriage and loss of parents. Therefore, special attention and interventions are needed for adolescents in those situations.

Summary

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Family Functioning and Suicide Attempts in Mexican Adolescents
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Experiences and needs of parents whose child has attempted suicide
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Role of Information and Communication Technology and Women’s Empowerment in Contraceptive Discontinuation in Indonesia: Omas Bulan Samosir, Ayke Soraya Kiting, Flora Aninditya; J Prev Med Public Health. 2020;53(2):117-125. Published online February 12, 2020; DOI: https://doi.org/10.3961/jpmph.19.300

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Abstract PDF

Objectives
This study investigated the role of information and communication technology and women’s empowerment in contraceptive discontinuation in Indonesia.
Methods
The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis.
Results
The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status.
Conclusions
After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.

Summary

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Contraceptive switch and abandonment among women using the pill, condoms and injectables in Brazil
Christiane Borges do Nascimento Chofakian, Ana Luiza Vilela Borges
The European Journal of Contraception & Reproductive Health Care.2024; 29(1): 15. CrossRef
Prevalence of discontinuation of contraceptives due to failure among women aged 14 to 49 years in Uganda: a nation wide cross-sectional survey
Ruth Ketty Kisuza, Saviour Kicaber, Derrick Bary Abila, Felix Bongomin, Christopher Orach Garimoi
Contraception and Reproductive Medicine.2023;[Epub] CrossRef
The Nexus between Economic Features and Contraceptive Switching in Indonesia
Wilson Rajagukguk, Fajar Lamhot Gultom, Muhammad Alfarabi
Balkan Journal of Interdisciplinary Research.2023; 9(3): 33. CrossRef
Predicting COVID-19 health behaviour initiation, consistency, interruptions and discontinuation among social media users in Nigeria
Eke Kalu Oyeoku, Felix Olajide Talabi, David Oloyede, Aiyesimoju Ayodeji Boluwatife, Verlumun Celestine Gever, Ibe Ebere
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Does Digital Literacy Empower Adolescent Girls in Low- and Middle-Income Countries: A Systematic Review
Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi
Frontiers in Public Health.2021;[Epub] CrossRef
Pattern and Determinant of Contraceptive Use among Women in Indonesia from 2007 to 2017: Evidence from Demographic and Health Survey
Desy Nuri Fajarningtiyas, Dedik Sulistiawan, Margareth Maya Parulianta Naibaho, Riza Fatma Arifa
Open Access Macedonian Journal of Medical Sciences.2021; 9(E): 1363. CrossRef

Perceptions of Contraception and Patterns of Switching Contraceptive Methods Among Family-planning Acceptors in West Nusa Tenggara, Indonesia: Yuli Amran, Narila Mutia Nasir, Dini Dachlia, Fitra Yelda, Budi Utomo, Iwan Ariawan, Rita Damayanti; J Prev Med Public Health. 2019;52(4):258-264. Published online July 19, 2019; DOI: https://doi.org/10.3961/jpmph.18.198

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Abstract PDF

Objectives
The perceptions of family-planning (FP) acceptors regarding contraception influence the reasons for which they choose to switch their method of contraception. The objective of this study was to analyze the perceptions of contraception and rationales for switching contraceptive methods among female FP acceptors in West Nusa Tenggara, Indonesia.
Methods
This study involved the analysis of secondary data from the Improve Contraceptive Method Mix study, which was conducted in 2013 by the Center for Health Research, University of Indonesia. The design of the study was cross-sectional. We performed 3 stages of sampling using the cluster technique and selected 4819 women who were FP acceptors in West Nusa Tenggara Province, Indonesia as the subjects of this study. The data were analyzed using multiple logistic regression.
Results
The predominant pattern of switching contraceptive methods was switching from one non-long-term method of contraception to another. Only 31.0% of the acceptors reported a rational pattern of switching contraceptive methods given their age, number of children, and FP motivations. Perceptions of the side effects of contraceptive methods, the ease of contraceptive use, and the cost of the contraceptives were significantly associated (at the level of α=0.05) with rational patterns of switching contraceptive methods.
Conclusions
Perceptions among FP-accepting women were found to play an important role in their patterns of switching contraceptive methods. Hence, fostering a better understanding of contraception through high-quality counseling is needed to improve perceptions and thereby to encourage rational, effective, and efficient contraceptive use.

Summary

Citations

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Influence of internet, mobile phone use, and sociodemographic factors on women’s knowledge and attitude towards contraception in Indonesia
Achmad Kemal Harzif, Amalia Shadrina, Edward Christopher Yo, Nia Reviani, Andon Hestiantoro
Obstetrics & Gynecology Science.2023; 66(1): 42. CrossRef
Building trust through quality of service mediated with satisfaction to acceptors of family planning in the province of South Kalimantan
Misransyah, Semuel Risal, Mukhlan Khariry, Cici Asmawatiy, Riki Welly Saputra, Sri Sulandjari, Roosganda Elizabeth
Heliyon.2023; 9(2): e13142. CrossRef
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Fatma KORUK, Kafiye EROĞLU, İbrahim KORUK
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Indonesia mixed contraception method skewness background 1997-2012: A mixed method study
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The use of Method Information Index (MII) to monitor the amount of information given to women users of modern contraceptives in Indonesia: results from an analysis of the 2007, 2012 and 2017 demographic and health surveys
Meiwita P. Budiharsana, Wiji Wahyuningsih, Peter Heywood
BMC Women's Health.2022;[Epub] CrossRef
Improving Communication Messages by Using Perceptual Mapping: Family Planning Survey in East Java and West Nusa Tenggara, Indonesia
Sarah Handayani, Rita Damayanti, Iwan Ariawan, Fitra Yelda, Sarah Harlan, Yunita Wahyuningrum, Douglas Storey
SAGE Open Medicine.2021; 9: 205031212199328. CrossRef
Pattern and Determinant of Contraceptive Use among Women in Indonesia from 2007 to 2017: Evidence from Demographic and Health Survey
Desy Nuri Fajarningtiyas, Dedik Sulistiawan, Margareth Maya Parulianta Naibaho, Riza Fatma Arifa
Open Access Macedonian Journal of Medical Sciences.2021; 9(E): 1363. CrossRef

Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression: Youngdae Cho, Yongwoo Jeon, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2018;51(2):100-108. Published online February 19, 2018; DOI: https://doi.org/10.3961/jpmph.17.166

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Abstract PDF Supplementary Material

Objectives
Family members are often cancer patients’ primary source of social and emotional support and make a major contribution to how well patients manage their illness. We compared the prevalence of depression in the family members of cancer patients and the general population. Methods: This study used the data from the fourth, fifth, and sixth rounds of the Korea National Health and Nutrition Examination Survey. The variable of interest was the presence of a cohabitating cancer patient in the family and the dependent variable was the presence of diagnosed depression. Results: The odds of having medically diagnosed depression in those with a cohabitating cancer patient in the family were significantly higher than among those who did not have cancer patients in their families (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.12 to 2.17; p=0.009). The OR for females was 1.59, and this increase was statistically significant (95% CI, 1.09 to 2.31; p=0.02). Conclusions: We need to invest more effort into diagnosing and managing depression in the family members of cancer patients. This will have an impact both on their quality of life and on the well-being of patients, as supporters and caregivers play an instrumental role in helping patients manage their illness.

Summary

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Association between changes in having of cancer patients in the family and depression: A longitudinal panel study
Yun Seo Jang, Na-Young Yoon, Kyungduk Hurh, Eun-Cheol Park, Min Jin Ha
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Socioeconomic Status and Number of Children Among Korean Women: The Healthy Twin Study: Jinseob Kim, Joohon Sung; J Prev Med Public Health. 2013;46(1):50-60. Published online January 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.1.50

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Abstract PDF

Objectives

This study aimed to evaluate whether the birth rate is associated with socioeconomic status in the women of the Republic of Korea, where the birth rate is rapidly decreasing.

Methods

This study included 732 females from the Healthy Twin Study, a family-twin cohort. The participants were classified into 3 socioeconomic groups according to their average income, education, and occupation. The association between socioeconomic status and number of children was assessed using gamma regression analysis with a generalized linear mixed model, adjusting for the age group, smoking/alcohol status, and family relationships.

Results

The group with the highest education level had significantly fewer children compared with the group with the lowest education level (p=0.004). However, no significant associations were found according to household income level. The non-manual labor group had significantly fewer children compared with those working as homemakers (p=0.008).

Conclusions

This study aimed to explain the causal relationship between socioeconomic status and number of children. Associations between some socioeconomic status and number of children were found in Korea.

Summary

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English Abstract

Association between the Physical Activity of Korean Adolescents and Socioeconomic Status.: In Hwan Oh, Goeun Lee, Chang Mo Oh, Kyung Sik Choi, Bong Keun Choe, Joong Myung Choi, Tai Young Yoon; J Prev Med Public Health. 2009;42(5):305-314.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.305

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Abstract PDF

OBJECTIVES
The physical activity of Korean adolescents and its distribution based on social characteristics have not yet been fully assessed. This study intends to reveal the distribution of physical activity by its subgroups and offer possible explanatory variables. METHODS: The 3rd Korea Youth Risk Behavior Web-based Survey was analyzed for this study. The appropriateness of physical activity was defined by Korea's Health Plan 2010 and physical inactivity was assessed independently. Family affluence scale, parents' education levels, subjective economic status, grade, and school location were considered explanatory variables. All statistical analysis was conducted using SAS ver. 9.1. RESULTS: The proportion of participants engaging in vigorous physical activity was high in males (41.6%), at a low grade (38.5%), within the high family affluence scale group (35.5%). The distribution of participants engaging in moderate physical activity showed similar patterns, but the overall proportion was lower (9.8%). Low family affluence and students with lower subjective economic status reported a higher prevalence of physical inactivity. In multiple logistic regression analysis for physical activity, significant factors included family affluence scale (p<0.05). For physical inactivity, family affluence scale, parents education levels, and subjective economic status were included as significant factors (p<0.05). CONCLUSIONS: The results suggest that the physical activity and inactivity of adolescents may be affected by socioeconomic variables, such as family affluence scale. This implies the need to take proper measures to address these socio-economic inequalities.

Summary

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Original Articles

A Study on the Association between Healthcare Utilization and the Burden of Families Caring for the Elderly in the Last 6 Months of Life.: Jee Jeon Yi, Hee Na Lee, Heechoul Ohrr, Hye Young Jung, Sang Wook Yi; Korean J Prev Med. 2003;36(4):332-338.

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Abstract PDF: OBJECTIVE
To investigate the relationship between medical expenses and the burden of families caring for the elderly in the last 6 months of life, and to evaluate the factors relating to the burden of family caregivers. METHODS: The families of 301 persons older than 65 years, who died between 1 July and 31 December 2001, and were registered in Resident-based- Health Insurance Programs in Seoul, were interviewed. The medical expenses and length of stay among the elderly were collected from Korean Health Insurance Corporations. RESULTS: 31 percents of the elderly had no medical expenses in the last 6 months of life. On average, the objective burden (4.92) was higher than the subjective burden (3.35). Families caring for male elderly had a higher burden. With increasing age at death, the objective burden was significantly increased. The burden on a family seemed to be influenced more by the family income than the property of the elderly. With increasing total health care costs, the objective burden on the family caregivers was significantly increased, but with increasing medical expenses, the subjective burden was significantly decreased. CONCLUSION: An association between healthcare utilization and burden on families was observed. The reason for the decreasing subjective burden when medical expenses were decreased was unclear. Further research will be needed.; Summary

A Study on the Family Burden of the Mentally Ill in a Rural Area.: Weon Young Lee, Young Jeon Shin, Jung Hoe Kim, Chung Hyun Nam, Ok Ryun Moon; Korean J Prev Med. 1999;32(3):400-414.

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Abstract PDF: OBJECTIVES
This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. METHODS: Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. RESULTS: Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. CONCLUSIONS: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.; Summary

Characteristics of Traffic Accident for the Primary School Students and Its Affecting Factors.: Am Park, Yeon Kyung Lee, Jeong Yun Kim, Tae Yong Lee, Sok Goo Lee, Young Chae Cho, Dong Bae Lee; Korean J Prev Med. 1998;31(3):372-383.

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Abstract PDF: For the purpose to analysis the characteristics of traffic accidents(TA) and investigate the relationship between traffic accidents and children attention problem rating scale(CAP) and, family environment scale(FES), this questionnaire survey was conducted to the 16 primary school students in Taejon from July 14 to August 26, 1997. The number of study subjects who had an experience of traffic accidents from July 1, 1996 to June 30, 1997 were 195, and the number of control subjects were 512. The main results were as follows; 1. The traffic accident rates was 0.9% as a whole, but those were 1.4% in boys, 0.7% in girls, 1.3% in low (1st-3rd) grade, and 0.8% in high (4th-6th) grade. 2. The rates of traffic accidents were high in spring, friday, afternoon and a driveway around home. TA occurred during walking with friends most frequently. 3. In CAP the score of inattention was lower in TA group than control group, and hyperactivity was higher in TA group but they didn't showed significantly different. In FES, cohesion score was higher in TA group than control group, but Conflict score and Expressiveness score were in control group, but they didn't showed significantly different. 4. In CAP the odds ratio of inattention score for TA group was 0.84, but that of hyperactivity score was 1.15. In FES, the odds ratio of cohesion score was 1.06, but that of expression score and conflict score was 0.94 and 0.96, respectively. In conclusion, the relationships between TA and CAP, TA and FES in this study were not clear to explain personal characteristics and environmental conditions.; Summary

A Telephone Survey on the Opinions about Family Doctor.: Hong Gwan Seo, Jae Heon Kang, Cheol Hwan Kim, Seong Won Kim; Korean J Prev Med. 1998;31(2):310-322.

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Abstract PDF: In order to reinforce the role of primary care physician and to improve doctor-patient relationship, the Korean government tried to introduce 'Family Doctor Registration Program' into Seocho-Gu in Seoul, Ansung-Gun and Paju city in Kyunggi-Do in Oct. 1996. Community residents and doctors in those area did not show much interest in this project because of low incentives. We have done this study to see how much people know 'Family Doctor Registration Program' and what is people's real needs about 'Family Doctor Registration Program. We selected l,800 telephone numbers in Seoul, Chongju city, and Ansung-Gun by multi-stage stratified random sampling. Three trained survey personnels called them and got answers to the premade questionnaire until they completed the questionnaires of 200 persons in each community. The calling time was 7-9 p.m. from Monday to Friday, 3-9 p.m. on Saturday, and 9 a.m. to 9 p.m. on Sunday. We dropped out the persons who did not respond 3 times. The subjects consisted of 222 male and 367 female residents. Their ages ranged from 20 to 78: 24.8% in their 30s, 23.4% in their 20s, 22.5% in their 40s in male, and 35.2% in their 30s, 22.5% in their 40s, 18.5% in their 20s in female. 9.9% of male and 13.2% of female had their Family Doctors. The specialties of their Family, Doctors were internists in 56.2%, general surgeons in ll.0%. The persons who did not have their family, doctors were asked which doctors they would prefer if they had choices of family doctor. The results were internists in 50.3%, family physicians in 13.0%, pediatricians in 4.8%. Only 16.0% residents knew that government tried to introduce Family Doctor Registration Program. The 'Family Doctor Registration Program' was not well known to people. The results of our study showed that more effective incentives and public notifications are needed to activate this program.; Summary

A Case-Control Study of Primary Liver Cancer and Liver Disease History.: Dong Hyun Kim, Byung Joo Park, Keun Young Yoo, Yoon Ok Ahn, Hyo Suk Lee, Chung Yong Kim, Sang Il Lee, Moo Song Lee, Hyung Sik Ahn, Heon Kim, Tae Soo Park; Korean J Prev Med. 1994;27(2):217-225.

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Abstract PDF: The relationship between past liver disease history and the risk of primary liver cancer was analyzed in a hospital-based case-control study conducted in Seoul on 165 patients with histologically or serologically confirmed hepatocellular carcinoma and individually age-and sex-matched 165 controls in hospital for ophthalmologic, ontologic, or nasopharyngeal problems. Significant association were observed for liver diseases occurring 5 or more years before liver cancer diagnosis[OR, 4.9;97% confidence interval(CI), 1.6~14.0) and family history of liver disease(OR, 9.0;95% CI, 2.1~38.8). These associations were mot appreciably modified by allowance for major identified potential confounding factors, From these results, it is possible to speculate that liver cell injuries caused by Considering the significant effect of family history of liver diseases on PLCA risk after adjusting past liver disease history, there might be genetic susceptibility in the carcinogenic mechanism of liver cancer. Further investigations are needed to clarify the effect of family history of liver disease on PLCA risk.; Summary

A study on the practice variations according to physician characteristics.: Eun Kyeong Jeong, Ok Ryun Moon, Chang Yup Kim; Korean J Prev Med. 1993;26(4):614-627.

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Abstract PDF: It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount(total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners(GP), 107 regular family physicians(FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites(urban-rural). Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.; Summary

English Abstract

Effects of Bisphenol A on the Placental Function and Reproduction in Rats.: Chae Kwan Lee, Seog Hyun Kim, Deog Hwan Moon, Jeong Ho Kim, Byung Chul Son, Dae Hwan Kim, Chang Hee Lee, Hwi Dong Kim, Jung Won Kim, Jong Eun Kim, Chae Un Lee; J Prev Med Public Health. 2005;38(3):330-336.

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Abstract PDF: OBJECTIVE
The aim of this study was to investigate the effects of bisphenol A (BPA), an estrogen-like environmental endocrine disrupter, on the placental function and reproduction in rats. The mRNA levels of the placental prolactin-growth hormone (PRL-GH) gene family, placental trophoblast cell frequency and reproductive data were analyzed. METHODS: The pregnancies of F344 Fisher rats (160 g +/- 20 g) were detected by the presence of the copulatory plug or sperm in the vaginal smear, which marked Day 0 of pregnancy. Pregnant rats were divided into three groups. The control group was intraperitoneally injected with a sesame oil vehicle. The two remaining groups were injected with 50 or 500 mg/kg B.W/day of BPA, resuspended in sesame oil, on either days 7 to 11 or 16 to 20 of pregnancy, with the rats sacrificed on either day 11 or 20, respectively. The mRNA levels of PRL-GH and Pit-1a and b isotype genes were analyzed by Northern blot hybridization and reverse transcription-polymerase chain reaction. The hormone concentrations were analyzed by radioimmunoassay, and the frequency of the placental trophoblast cells observed by a histochemical study. Reproductive data, such as the placental weight and litter size, were surveyed on day 20. The fetal weight was surveyed for 4 weeks after birth. A statistical analysis was carried out using the SAS program (version 8.1). RESULTS: The mRNA levels of the PRL-GH gene family, such as placental lactogen I, Iv and II, prolactin like protein A, C and Cv, and decidual prolactin-related protein were significantly reduced due to BPA exposure. The mRNA levels of the Pit-1a and b isotype genes, which induce the expression of the PRL-GH gene family in the rat placenta, were also reduced due to BPA exposure. The PL-Iv and PL-II concentrations were reduced in the BPA exposed group. During the middle to last stage of pregnancy (Days 11-20), a high dose of BPA exposure reduced the frequency of spongiotrophoblast cells, which are responsible for the secretion of the PRL-GH hormones. Reproductive data, such as the placental and fetal weights and the litter size, were reduced, but that of the pregnancy period was extended in the BPA exposed compared to the control group. CONCLUSIONS: BPA disrupts the placental functions in rats, which leads to reproductive disorders.; Summary

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