Journal of Preventive Medicine and Public Health

Original Articles

Modern Contraception and Anaemia Among Reproductive-age Women in India: Results From a Household Survey: Mihir Adhikary, Poulami Barman, Bharti Singh, Abhishek Anand; J Prev Med Public Health. 2024;57(4):339-346. Published online June 19, 2024; DOI: https://doi.org/10.3961/jpmph.23.504

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Abstract Summary PDF Supplementary Material: Objectives
Chronic anaemia is a significant health concern, particularly among women of childbearing age. Factors such as menstrual blood loss, childbirth, inadequate nutrition, closely spaced pregnancies, and recurrent gastrointestinal bleeding increase the risk of anaemia. This study investigated whether current contraceptive methods are associated with anaemia in Indian women of reproductive age.
Methods
Cross-sectional data from the fifth round of the National Family Health Survey, conducted in 2019-2021, were used for this investigation. We included only non-pregnant and non-amenorrhoeic women in our analysis, resulting in a final analytical sample of 673 094 women aged 15-49. Bivariate cross-tabulations and multivariable logistic regression were employed to analyse the data.
Results
The prevalence of anaemia was 57%, and the adjusted regression models found no significant association between the use of any contraceptive methods and women’s haemoglobin status. Women using traditional contraceptive methods had 1.08 (95% confidence interval, 1.05 to 1.11) times higher odds of having anaemia. Among the modern methods, other than injectables, all other methods—such as an intrauterine device, barrier use, and sterilisation—were associated with higher odds of anaemia compared to women who used contraceptive pills.
Conclusions
This study explored the relationship between modern contraceptives and haemoglobin levels in India, revealing that injectables were associated with a notable reduction in the odds of anaemia, whereas traditional contraceptives and other modern methods exhibited positive associations with anaemia. These findings prompt policymakers to focus on anaemia reduction and safe contraceptives. More research is needed to inform decisions, given the scant literature.; Summary

Key Message
This study investigated the association between contraceptive methods and anaemia in Indian women of reproductive age using data from the 2019-2021 National Family Health Survey. Results indicated that traditional contraceptives and several modern methods, except injectables, were associated with higher odds of anaemia. These findings suggest the need for policymakers to focus on anaemia reduction and the promotion of safer contraceptive options.

Classification of Healthy Family Indicators in Indonesia Based on a K-means Cluster Analysis: Herti Maryani, Anissa Rizkianti, Nailul Izza; J Prev Med Public Health. 2024;57(3):234-241. Published online May 5, 2024; DOI: https://doi.org/10.3961/jpmph.23.497

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Objectives
Health development is a key element of national development. The goal of improving health development at the societal level will be readily achieved if it is directed from the smallest social unit, namely the family. This was the goal of the Healthy Indonesia Program with a Family Approach. The objective of the study was to analyze variables of family health indicators across all provinces in Indonesia to identify provincial disparities based on the status of healthy families.
Methods
This study examined secondary data for 2021 from the Indonesia Health Profile, provided by the Ministry of Health of the Republic of Indonesia, and from the 2021 welfare statistics by Statistics Indonesia (BPS). From these sources, we identified 10 variables for analysis using the k-means method, a non-hierarchical method of cluster analysis.
Results
The results of the cluster analysis of healthy family indicators yielded 5 clusters. In general, cluster 1 (Papua and West Papua Provinces) had the lowest average achievements for healthy family indicators, while cluster 5 (Jakarta Province) had the highest indicator scores.
Conclusions
In Indonesia, disparities in healthy family indicators persist. Nutrition, maternal health, and child health are among the indicators that require government attention.

Summary

Key Message
This paper explores disparities in family health status across provinces using cluster analysis with the K-means approach applied to 10 family health indicator variables. Secondary data analysis was used from the 2021 Indonesian Health Profile and statistics on people’s welfare. The study identified five distinct clusters, each with different characteristics. Papua and West Papua demonstrate the lowest average level in terms of healthy family indicators, whereas DKI Jakarta shows the greatest indicator level. To eliminate the disparities, the government should prioritize the following indicators: maternal health, infant health, and nutrition.

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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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Abstract Summary PDF Supplementary Material

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.

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Glenna Brewster, Irene Yang, Jordan Pelkmans, Melinda Higgins, Drenna Waldrop, Sandra B. Dunbar, Katherine A. Yeager
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Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
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Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
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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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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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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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Ashim Kumar Nandi, Ann-Zofie Duvander
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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
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Amanuel Defar Bande, Tilahun Bayene Handiso, Habtamu Wude Hanjelo, Belayneh Hamdela Jena
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Desy Nuri Fajarningtiyas, Dedik Sulistiawan, Margareth Maya Parulianta Naibaho, Riza Fatma Arifa
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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

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Influence of internet, mobile phone use, and sociodemographic factors on women’s knowledge and attitude towards contraception in Indonesia
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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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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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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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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

Citations

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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

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