OBJECTIVES: Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea. METHODS: The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender. RESULTS: Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly. CONCLUSIONS: Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.
Adolescent ; Adolescent Behavior/*psychology ; Female ; Humans ; Male ; Prevalence ; Questionnaires ; Republic of Korea ; Rural Population ; Smoking/epidemiology/prevention & control/*trends ; Urban Population

OBJECTIVE: This study was designed to describe the trends in body mass index (BMI) during 6 years (2002 - 2008) and to identify associations between these trends and the amount of physical activity of South Korean career soldiers. METHOD: This study targeted the 40 993 (38 857 men and 2136 women) of the 58 657 career soldiers who had undergone four (2002, 2004, 2006, and 2008) biennial medical examinations conducted by the National Health Insurance Corporation; 17 664 soldiers with missing data on height, weight, and physical activity were excluded. A linear mixed-regression model was used to categorize changes in BMI due to age versus those due to amount of physical activity. RESULTS: Career soldiers experienced significant increases in BMI compared with baseline data gathered in 2002. The increases in each age group were as follows: men aged 20- 29: 1.16, men aged 30 - 39: 0.61, men aged 40 - 49: 0.05, women aged 20- 29: 0.35, women aged 30- 39: 0.30, women aged 40-49: 0.26, and women aged 50- 59: 0.21. However, men aged 50 or older showed significant decreases (as high as 0.5) in BMI compared with baseline data obtained in 2002. They also experienced significant decreases in BMI compared with those who reported no physical activity. The differences between baseline and final BMIs were: 0.02 for men exercising 1- 2 times per week, -0.07 for men exercising 3-4 times per week, -0.19 for men exercising 5-6 times per week, -0.21 for men exercising seven times per week, -0.05 for women exercising 1- 2 times per week, -0.19 for women exercising 3- 4 times per week, -0.30 for women exercising 5-6 times per week, and -0.30 for women exercising seven times per week. CONCLUSIONS: Obesity in South Korean career soldiers increased markedly between 2002 and 2008, and our data showed that the amount of physical activity was inversely related to increases in BMI. Policies to prevent obesity are needed to reduce this trend.
Adult ; *Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Military Personnel/*statistics & numerical data ; *Motor Activity ; Obesity/diagnosis ; Regression Analysis ; Republic of Korea

OBJECTIVES: This study was conducted to show the intraocular pressure (IOP) distribution and the factors affecting IOP in subjects with type 2 diabetes mellitus (DM) in India. METHODS: We measured the anthropometric and biochemical parameters for confirmed type 2 DM patients. A comprehensive ocular examination was performed for 1377 subjects aged > 40 years and residing in Chennai. RESULTS: A significant difference in IOP (mean +/- standard deviation) was found between men and women (14.6+/-2.9 and 15.0+/-2.8 mmHg, p = 0.005). A significantly elevated IOP was observed among smokers, subjects with systemic hypertension and women with clinically significant macular edema (CSME). After a univariate analysis, factors associated significantly with higher IOP were elevated systolic blood pressure, elevated resting pulse rate and thicker central corneal thickness (CCT). In women, elevated glycosylated hemoglobin was associated with a higher IOP. After adjusting for all variables, the elevated resting pulse rate and CCT were found to be associated with a higher IOP. CONCLUSIONS: Systemic hypertension, smoking, pulse rate and CCT were associated with elevated intraocular pressure in type 2 DM. Women with type 2 DM, especially those with CSME, were more prone to have an elevated IOP.
Adult ; Aged ; Blood Pressure ; Cornea/physiology ; Diabetes Mellitus, Type 2/complications/*physiopathology ; Female ; Heart Rate ; Hemoglobin A, Glycosylated/metabolism ; Humans ; Hypertension/complications ; India ; Intraocular Pressure/*physiology ; Macular Edema/complications ; Male ; Middle Aged ; Risk Factors ; Smoking

OBJECTIVE: The purpose of the present study was to examine the relationship between the use of senior center and health-related quality of life in Korean older adults. METHODS: A questionnaire survey was conducted to two types of older adults who lived in Busan, Korea: 154 older adults who used a senior center and 137 older adults who did not use a senior center. The Korean version of short-form 36-item health survey was administered to assess the health-related quality of life. Demographic variables were obtained from a questionnaire. These were gender, age, family status, marital status, education, monthly income, present illness, body mass index and physical activity. RESULTS: The 8-domain scales of physical function and role-physical were significantly higher in the users of the senior center compared with the non-users (F=4.87, p=0.027 and F=7.02, p=0.009, respectively). The 8-domain scales of vitality was also significantly higher in the users of the senior center compared with the non-users (F=7.48, p=0.007). CONCLUSIONS: The present study showed that the users of the senior center have higher physical function, role-physical and vitality compared with the non-users. These findings suggest that although the results are unable to specify causal relationships using the senior center may lead to some improvement in health-related quality of life.
Aged ; Aged, 80 and over ; Female ; *Health Status ; Humans ; Male ; Motor Activity ; *Quality of Life ; Questionnaires ; Republic of Korea

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.
Health Status Disparities ; Humans ; Influenza Vaccines/*administration & dosage ; Influenza, Human/epidemiology/*prevention & control ; Patient Acceptance of Health Care ; United States/epidemiology ; Vaccination/*trends/utilization

OBJECTIVES: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. METHODS: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. RESULTS: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. CONCLUSIONS: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.
Child ; Child, Preschool ; Female ; *Health Policy ; Humans ; Immunization/*statistics & numerical data ; Immunization Programs/standards/*statistics & numerical data ; Korea

OBJECTIVES: This study aims to determine the risk factors predicting rehospitalization by comparing three models and selecting the most successful model. METHODS: In order to predict the risk of rehospitalization within 28 days after discharge, 11 951 inpatients were recruited into this study between January and December 2009. Predictive models were constructed with three methods, logistic regression analysis, a decision tree, and a neural network, and the models were compared and evaluated in light of their misclassification rate, root asymptotic standard error, lift chart, and receiver operating characteristic curve. RESULTS: The decision tree was selected as the final model. The risk of rehospitalization was higher when the length of stay (LOS) was less than 2 days, route of admission was through the out-patient department (OPD), medical department was in internal medicine, 10th revision of the International Classification of Diseases code was neoplasm, LOS was relatively shorter, and the frequency of OPD visit was greater. CONCLUSIONS: When a patient is to be discharged within 2 days, the appropriateness of discharge should be considered, with special concern of undiscovered complications and co-morbidities. In particular, if the patient is admitted through the OPD, any suspected disease should be appropriately examined and prompt outcomes of tests should be secured. Moreover, for patients of internal medicine practitioners, co-morbidity and complications caused by chronic illness should be given greater attention.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Decision Trees ; Female ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; *Models, Theoretical ; Neural Networks (Computer) ; Patient Admission/statistics & numerical data ; Patient Readmission/*statistics & numerical data ; Predictive Value of Tests ; Risk Factors ; Young Adult

OBJECTIVES: The purpose of this paper was to elucidate the potential methylation levels of adjacent normal and cancer tissues by comparing them with normal colorectal tissues, and to describe the correlations between the methylation and clinical parameters in Korean colorectal cancer (CRC) patients. METHODS: Hypermethylation profiles of nine genes (RASSF1, APC, p16INK4a, Twist1, E-cadherin, TIMP3, Smad4, COX2, and ABCB1) were examined with 100 sets of cancer tissues and 14 normal colorectal tissues. We determined the hypermethylation at a given level by a percent of methylation ratio value of 10 using quantitative methylation real-time polymerase chain reaction. RESULTS: Nine genes' hypermethylation levels in Korean CRC patient tissues were increased more higher than normal colorectal tissues. However, the amounts of p16INK4a and E-cadherin gene hypermethylation in normal and CRC tissues were not significantly different nor did TIMP3 gene hypermethylation in adjacent normal and cancer tissues differ significantly. The hypermethylation of TIMP3, E-cadherin, ABCB1, and COX2 genes among other genes were abundantly found in normal colorectal tissues. The hypermethylation of nine genes' methylation in cancer tissues was not significantly associated with any clinical parameters. In Cohen's kappa test, it was moderately observed that RASSF1 was related with E-cadherin, and Smad4 with ABCB1 and COX2. CONCLUSIONS: This study provides evidence for different hypermethylation patterns of cancer-associated genes in normal and CRC tissues, which may serve as useful information on CRC cancer progression.
Colorectal Neoplasms/*genetics ; *DNA Methylation ; Disease Progression ; *Gene Expression Profiling ; Humans ; Prognosis ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVES: The purpose of the study was to examine the relationships among the psychological, social, and environmental factors influencing the utilization of senior centers among older adults in Korea. METHODS: A questionnaire survey was administered to two types of older adults who lived in Seoul, Korea: 262 older adults who used senior centers (3 places) and 156 older adults who did not use senior centers. RESULTS: Our results showed clearly that the utilization of the senior centers in Korea is affected by higher self-efficacy (odds ratio [OR], 6.08; 95% confidence interval [CI], 3.31 to 12.32), higher perceived benefits (OR, 1.71; 95% CI, 1.16 to 4.36), lower perceived barriers (OR, 6.43; 95% CI, 3.07 to 11.45), higher family support (OR, 4.21; 95% CI, 2.02 to 8.77), and higher support from friends (OR, 4.08; 95% CI, 2.38 to 7.81). The results also showed that participants whose total travel time was 15 to 29 minutes (OR, 2.84; 95% CI, 1.21 to 3.64) or less than 14 minutes (OR, 4.68; 95% CI, 3.41 to 8.41) were more likely to use a senior center than those who had to travel more than 30 minutes. CONCLUSIONS: This study showed that the utilization of senior centers in Korea is affected by psychological, social, and environmental factors, specifically by self-efficacy, perceived benefits, perceived barriers, social support, convenience of transportation, and total travel time to the senior centers. The effects of longer-term utilization of the senior centers by non-users on health-related outcomes in a large population warrant attention.
Aged ; Aging/*psychology ; Community Health Centers/statistics & numerical data/*utilization ; Cross-Sectional Studies ; *Environment ; Female ; Health Services for the Aged/statistics & numerical data/*utilization ; Health Surveys ; Humans ; Korea ; Male ; Questionnaires ; Self Efficacy ; *Social Behavior ; Social Support ; Time Factors ; Travel

OBJECTIVES: Nail has been a substitute DNA source for genotyping. To investigate the integrity and consistency of nail DNA amplification for biomarker study, nail clippings from 12 subjects were collected at monthly intervals. The possibility of longer amplification and existence of GAPDH RNA/protein, were also investigated with three nail samples. METHODS: Three primer sets were designed for quantitative amplification of nuclear and mitochondrial genes and analysis of their consistency. The mean threshold cycles in amplification of the target genes were compared to test the consistency of polymerase chain reaction (PCR) performance among individual factors including age groups, sex, family, the nail source, and by the size of the amplification segments. RESULTS: The amplification of the target genes from nail DNA showed similar integrity and consistency between the nail sources, and among the serial collections. However, nail DNA from those in their forties showed earlier threshold cycles in amplification than those in their teens or seventies. Mitochondrial DNA (mtDNA) showed better DNA integrity and consistency in amplification of all three targets than did nuclear DNA (nucDNA). Over 9 kb of mtDNA was successfully amplified, and nested quantitative PCR showed reliable copy numbers (%) between the two loci. Reverse transcription PCR for mRNA and immunoblotting for GAPDH protein successfully reflected their corresponding amounts. Regarding the existence of RNA and protein in nails, more effective extraction and detection methods need to be set up to validate the feasibility in biomarker study. CONCLUSIONS: Nail DNA might be a feasible intra-individual monitoring biomarker. Considering integrity and consistency in target amplification, mtDNA would be a better target for biomarker research than nucDNA.
Adult ; Age Factors ; Aged ; Biological Markers/analysis ; Child ; DNA/*analysis/isolation & purification ; DNA Primers ; DNA, Mitochondrial/analysis ; Feasibility Studies ; Female ; Gene Amplification ; Humans ; Male ; Middle Aged ; Nails/*chemistry ; Pilot Projects