OBJECTIVES: The accumulated evidence shows that adult disease may have origins during the fetal period and maternal environmental exposure may affect fetus and infant health. To assess the environmental health of fetus and infants and examine women's concerns about environmental health, we designed and conducted an environmental health survey in reproductive-aged women in 2011. METHODS: A stratified multi-stage design was adopted for our survey, and 1,000 reproductive-aged women aged 25 to 39 years participated. The participants were asked to complete an electronic questionnaire using the computer-assisted web interviewing method. All the participants were married woman, and 80% had experienced pregnancy before completing the survey. RESULTS: In the study, 86.3% of the participants responded that they are worried about the environmental problems that may affect the fetus and infant. The participants responded that they were most worried about global warming and climate change (36.2%), electromagnetic waves (31.4%), and endocrine disrupting chemicals (25.1%). Moreover, participants responded that environmental problem can cause children's allergic disease, such as atopic dermatitis, metabolic syndrome and growth development. CONCLUSION: We found reproductive-aged women have high awareness of children's environmental health. We also recommended that additional surveys on mother and child environmental health be conducted to make a health policy for women, fetus and infant.
Adult ; Child ; Climate Change ; Dermatitis, Atopic ; Electromagnetic Radiation ; Endocrine Disruptors ; Environmental Exposure ; Environmental Health* ; Female ; Fetus* ; Global Warming ; Health Policy ; Health Surveys ; Humans ; Infant Health ; Infant* ; Methods ; Mothers ; Pregnancy

BACKGROUND: Early identification and appropriate management of mild chronic renal failure has been increasingly recognized as an important opportunity to delay the progression of renal disease. Many physicians rely on serum creatinine (Scr) as a screening test for renal impairment; however, Scr levels can remain within the normal range even when renal function is significantly impaired in certain group of patients. METHODS: The subjects were 20, 245 persons who were enrolled a regular health check up program, Jan. 1997 to Jun. 2001, at Ajou University Hospital, Korea. We identified GFR below 60 mL/min/1.73 m2 as abnormal and found the percentage of patients with Scr value from 1.1 mg/dL to 1.4 mg/dL and their sex and age distribution, using GFRs calculated by Cockroft-Gault Equation, MDRD Equation, and Kang's Equation. RESULTS: Average Scr was 1.07+-0.13 mg/dL in male and 0.82+-0.11 mg/dL in female. Among 34 University hospital in metro Seoul area, 11 hospital used 1.4 mg/dL as normal upper limit of Scr and 7 hospital used 1.3 mg/dL. Taking normal Scr upper limit as 1.3 or 1.4 mg/dL, the frequency of GFR below 60 mL/min/1.73 m2 was 3.9-50% in males and 75-100% in females, although some differences existed according to the equation used. CONCLUSION: Currently used normal Scr upper limit 1.3, 1.4 mL/dL was found to be much too high and we concluded a downward adjustment is needed and one-time test is not adequate to conclude renal impairment but several regular tests are required.
Age Distribution ; Creatinine* ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic ; Korea ; Male ; Mass Screening ; Reference Values* ; Seoul

OBJECTIVES: This study was to examine the effectiveness of computerized cognitive ability enhancement program (CCAEP) using Smart-toy. The CCAEP using Smart-toy which can interact with children via bluetooth is a kids-friendly and convenient method for improving children's cognitive abilities by increasing their motivation for performing the program. We developed the CCAEP which designed to train auditory-verbal memory, visual-spatial memory, auditory-verbal working memory, and visual-spatial working memory. METHODS: Eighteen children aged 8 to 10 participated in CCAEP individual training composed of 8 sessions of 40 minutes each for 4 weeks. The effect of the training was measured with Smart Toyweb's cognitive assessment tasks (smart device based assessment) as well as traditional neuropsychological tests before and after the training. RESULTS: Children showed significant improvement in auditory-verbal memory, visual-spatial memory, auditory-verbal working memory and visual-spatial working memory abilities after the training. CONCLUSION: This study demonstrated promising results suggesting the effectiveness of CCAEP using Smart-Toy in clinical settings as well as school and home situations. Further controlled study with larger sample size including various clinical groups is needed to confirm the present results.
Child* ; Humans ; Memory ; Memory, Short-Term ; Methods ; Motivation ; Neuropsychological Tests ; Sample Size

OBJECTIVES: The purpose of this study was to evaluate gender differences with respect to the internalization or externalization of symptoms according to the amount of time spent engaged in extracurricular education. METHODS: The study included a community sample of 755 boys and girls (mean age, 6.6 years), collected from five elementary schools in Gunpo, South Korea. Primary caregivers completed a questionnaire which included information on demographics, the amounts of time children spent in extracurricular education and with other activities, and an adapted form of the Behavior Assessment System for Children (BASC-2). Gender differences regarding externalizing and internalizing behavior problems were examined according to extracurricular education. RESULTS: With respect to the boys, there was a difference in the frequency of those who had externalizing behavior problems according to their time spent in extracurricular education. In contrast, the girls exhibited no difference. With respect to those children who spent a lot of time engaged in extracurricular education, there was a gender-specific difference only with respect to externalizing behavior problems. CONCLUSION: A gender-specific difference exists only in terms of externalizing behavior problems according to time spent engaged in extracurricular education.
Caregivers ; Child ; Demography ; Humans ; Republic of Korea ; Surveys and Questionnaires

OBJECTIVES: The aim of this study was to develop auditory-verbal and visual-spatial memory tasks using smart devices for children aged 8 to 10 years and examine their validity. METHODS: One-hundred and fourteen school-aged children were recruited through internet advertising. We developed memory tasks assessing auditory-verbal memory, visual-spatial memory, and working memory, and then examined their construct validity by examining the developmental trend of the children's mean scores with age. In order to examine the concurrent validity of the tasks, we conducted correlation analyses between the children's scores on the newly developed auditory-verbal, visual-spatial memory and working memory tasks and their scores on well-known standardized tests of memory and working memory, including the auditory-verbal memory subtests of the Korean Luria-Nebraska Neuropsychological Battery for Children, Korean Rey-Osterrieth Complex Figure Test, digit span and arithmetic subtest of Korean Educational Development Institute Wechsler Intelligence Scale for Children Revised, and Corsi block test. RESULTS: The memory and working memory scores measured by the newly developed tasks tended to increase with age. Further, there were significant correlations between the scores of the four cognitive tasks and the corresponding scores of the standardized assessment tools. CONCLUSION: This study revealed promising evidence for the validity of the memory tasks using smart devices, suggesting their utility for school-aged children in research and clinical settings.
Child* ; Humans ; Intelligence ; Internet ; Luria-Nebraska Neuropsychological Battery ; Memory* ; Memory, Short-Term

Objective: We aimed to identify the association between low serum total cholesterol levels and the risk of out-of-hospital cardiac arrest (OHCA). Methods: This case-control study was performed using datasets from the Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES) project and the Korea National Health and Nutrition Examination Survey (KNHANES). Cases were defined as emergency medical service-treated adult patients who experienced OHCA with a presumed cardiac etiology from the CAPTURES project dataset. Four controls from the KNHANES dataset were matched to each case based on age, sex, and county. Multivariable conditional logistic regression analysis was conducted to evaluate the effect of total cholesterol levels on OHCA. Results: A total of 607 matched case-control pairs were analyzed. We classified total cholesterol levels into six categories (<148, 148-166.9, 167-189.9, 190-215.9, 216.237.9, and ≥238 mg/dL) according to the distribution of total cholesterol levels in the KNHANES dataset. Subjects with a total cholesterol level of 167-189.9 mg/dL (25th.49th percentile of the KNHANES dataset) were used as the reference group. In both the adjusted models and sensitivity analysis, a total cholesterol level of <148 mg/dL was significantly associated with OHCA (adjusted odds ratio [95% confidence interval], 6.53 [4.47.9.56]). Conclusion We identified an association between very-low total cholesterol levels and an increased risk of OHCA in a large, community-based population. Future prospective studies are needed to better understand how a low lipid profile is associated with OHCA.

To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs' epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved > or = 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6-5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals' resources.
Accidents, Traffic/statistics & numerical data ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biohazard Release/statistics & numerical data ; Chemical Hazard Release/statistics & numerical data ; Child ; Child, Preschool ; Cross-Sectional Studies ; Databases, Factual ; *Emergency Medical Services ; Female ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Male ; Mass Casualty Incidents/*statistics & numerical data ; Middle Aged ; Retrospective Studies ; Young Adult

PURPOSE: Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. MATERIALS AND METHODS: Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. RESULTS: Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. CONCLUSION: K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created.
Autism Spectrum Disorder ; Behavior Rating Scale ; Child* ; Cross-Cultural Comparison ; Humans ; Parents* ; Psychometrics ; Psychopathology ; Reproducibility of Results

BACKGROUND: Injury is a major public health problem and accounts for 10% of the global burden of disease. This study intends to present the temporal trend in the injury burden in Korea and to compare the burden size by injury mechanism and age group. METHODS: This study was a nationwide population-based observational study. We used two data sets, the death certificates statistics and the Korean National Hospital Discharge Survey data (2004–2012). We calculated age-standardized disability-adjusted life year (DALY) from years of life lost (YLL) and years lived with disability (YLD) and trend analysis. RESULTS: The DALYs of road injury decreased (P = 0.002), falls did not exhibit a trend (P = 0.108), and self-harm increased overall (P = 0.045). In the road injury, the YLLs decreased across all 4 age groups (0–14, 15–49, 50–79, ≥ 80) and the YLDs decreased in the 0–14-year-old group. In total, the DALYs of road injuries decreased in the 0–14-year-old group. In the fall injury, although the YLLs decreased in the over 80-year-old group, the YLDs increased in the 50–79-year-old group and the over 80-year-old group. The burden of self-harm injury was high in the age group 15 years and over, especially in the 15–49-year-old group. CONCLUSION: The leading causes of the injury burden were road injuries, falls, and self-harm. The burden of road injury and self-harm have recently shown a gradual decreasing tendency. On the other hands, that of fall injuries are continually high in the age group over 50 years of age.
Accidental Falls ; Accidents, Traffic ; Aged, 80 and over ; Dataset ; Death Certificates ; Hand ; Health Care Surveys ; Humans ; Korea* ; Observational Study ; Public Health ; Suicide

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6–18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.