OBJECTIVES: Lyme disease is the most common tick-borne disease. People seek health information on Lyme disease from YouTube™ videos. In this study, we investigated if the contents of Lyme disease-related YouTube™ videos varied by their sources. METHODS: Most viewed English YouTube™ videos (n = 100) were identified and manually coded for contents and sources. RESULTS: Within the sample, 40 videos were consumer-generated, 31 were internet-based news, 16 were professional, and 13 were TV news. Compared with consumer-generated videos, TV news videos were more likely to mention celebrities (odds ratio [OR], 10.57; 95% confidence interval [CI], 2.13–52.58), prevention of Lyme disease through wearing protective clothing (OR, 5.63; 95% CI, 1.23–25.76), and spraying insecticides (OR, 7.71; 95% CI, 1.52–39.05). CONCLUSION: A majority of the most popular Lyme disease-related YouTube™ videos were not created by public health professionals. Responsible reporting and creative video-making facilitate Lyme disease education. Partnership with YouTube™ celebrities to co-develop educational videos may be a future direction.
Cross-Sectional Studies* ; Education ; Health Communication ; Insecticides ; Lyme Disease* ; Protective Clothing ; Public Health ; Social Media ; Tick-Borne Diseases

OBJECTIVES: The aim of this study was to determine whether exercises can change the cervical angle and respiratory function in smartphone users. METHODS: Thirty healthy volunteers were recruited. The subjects were randomly divided into an exercise group and a control group. All participants used a smartphone for 1 hour while maintaining a sitting posture. Then, each group performed their assigned activity. The exercise group performed two types of exercises and the control group maintained routine activities for 20 minutes. To investigate the changes in cervical angle and respiratory function, we measured the craniovertebral angle by using a spirometer. RESULTS: Statistically significant differences were noted in the craniovertebral angle, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure of the two groups (p < 0.05). CONCLUSION: Our findings showed that proper exercise could be a good method of improving the cervical angle and respiratory function in smartphone users.
Cervical Vertebrae ; Exercise ; Female ; Forced Expiratory Volume ; Healthy Volunteers ; Methods ; Posture ; Respiratory Function Tests ; Smartphone* ; Vital Capacity

OBJECTIVES: Aflatoxin M1 (AFM1)-contaminated dairy products pose serious human health risks, causing liver and renal failure if consumed. They are also related to decreased milk and egg production in infected animals. This study investigated the AFM1 contamination levels in cheeses sold in Isfahan province, Iran, by enzyme-linked immunosorbent assay (ELISA). METHODS: A total of 100 white cheese samples were randomly collected from supermarkets in Isfahan province and after extraction using dichloromethane were prepared for the ELISA. RESULTS: Of the 100 samples, 52 (52%) were contaminated by AFM1, at levels ranging from 50.2 to 424.4 ng/kg. The remaining 48% of the samples had undetectable AFM1 levels (< 50 ng/kg). Based on the standard limit set by the European Commission and Iran, 8% (8/100) of the AFM1-positive samples (with concentrations between 250.2 and 424.4 ng/kg) had levels higher than the permissible value of 250 ng/kg. CONCLUSION: Although the percentage of cheese samples in Isfahan province with AFM1 levels exceeding the national permissible limit was low, the examination of cheeses and the milk used for their production is nevertheless important for ensuring public health. Furthermore, optimum storage conditions of animal feed should be ensured, and livestock nutrition must be monitored for the presence of AFM1 and other aflatoxins.
Aflatoxin M1* ; Aflatoxins* ; Animal Feed ; Animals ; Cheese* ; Dairy Products ; Enzyme-Linked Immunosorbent Assay ; Humans ; Iran* ; Liver ; Livestock ; Methylene Chloride ; Milk ; Ovum ; Public Health ; Renal Insufficiency

OBJECTIVES: Understanding factors affecting advanced stage at diagnosis is vital to improve cancer outcomes and overall survival. We investigated the factors affecting later-stage cancer diagnosis. METHODS: Patients completed self-reported questionnaires. We collected cancer stage data from medical records review. Logistic regression analyses were performed to identify factors associated with later stage cancer at diagnosis by gender. RESULTS: In total, 1,870 cancer patients were included in the study; 55.8% were men, 31.1% had more than one comorbid condition, and 63.5% had disabilities. About half of the patients were smokers, and drank alcohol, and 58.0% were diagnosed at an advanced stage. By cancer type, lung and liver cancers (both genders), prostate (men), colorectal, cervical, and thyroid cancer (women) were more likely to be diagnosed at a later stage. After controlling for socioeconomic factors, comorbidity (odds ratio [OR], 1.48 in men) and disability (OR, 1.64 in men and 1.52 in women) remained significantly associated with late-stage diagnosis. CONCLUSION: In this nationwide study, using combined information from patients and medical records, we found that male patients with comorbidities or disabilities, and female patients with disabilities were more likely to have advanced stage cancer at diagnosis. Targeted approaches by cancer type and health conditions are recommended.
Comorbidity* ; Diagnosis* ; Early Detection of Cancer ; Female ; Humans ; Liver Neoplasms ; Logistic Models ; Lung ; Male ; Medical Records ; Prostate ; Social Class* ; Socioeconomic Factors ; Thyroid Neoplasms

OBJECTIVES: The aim of this study was to analyze the correlation between scapular asymmetry in young female adults and differences in left and right side activity of muscles adjacent to the scapula. METHODS: This study included 60 female students from U university in Korea. In order to examine scapular asymmetry, the lateral scapular slide test (LSST) was used. The LSST was performed in 3 different postures (LSST-1, LSST-2, and LSST-3; i.e., 0°, 45°, and 90° of upper limb abduction, respectively). Muscle activity was measured during external and internal rotation of the shoulder joints. Muscle activity was measured at the upper, middle, and lower trapezius, and the serratus anterior. RESULTS: In external shoulder rotation, there was a significant correlation (R = 0.450) between LSST-2 and the middle trapezius. In internal shoulder rotation, there was a significant correlation (R = 0.472) between LSST-2 and the upper trapezius, and between LSST-3 and the lower trapezius (R = 0.657); these results demonstrated a moderate positive linear correlation. CONCLUSION: There was a positive correlation between left and right scapular asymmetry and the difference in left and right muscle activity of the trapezius in female adults. Problems in the trapezius may lead to scapular asymmetry.
Adult ; Anthropometry ; Electromyography ; Female ; Humans ; Korea ; Muscles* ; Posture ; Scapula* ; Shoulder ; Shoulder Joint ; Superficial Back Muscles ; Upper Extremity

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths (p = 0.016), myocardial infarction (p = 0.000), and coronary artery bypass grafting (CABG) (p = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) (p = 0.037) and the maximum creatinine kinase (max-CK) (p = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.
Coronary Artery Bypass ; Coronary Artery Disease ; Creatinine ; Death ; Diagnosis ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Humans ; Korea ; Logistic Models ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Phosphotransferases ; Prognosis ; Risk Factors ; ROC Curve

No abstract available.
Insurance, Health*

OBJECTIVES: Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system. METHODS: We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power. This study focuses on how the relationships among social forces can change as a nation’s economic development or governing strategy changes in response to changes in international circumstances such as globalization. RESULTS: The corporatist Social Health Insurance (SHI) system (multiple insurers) introduced in 1977 was transformed into the single-insurer NHI in July 2000. These changes were influenced externally by globalization and internally by political democratization, keeping Korea’s private-dominant health care provision system unchanged over several decades. CONCLUSION: Major changes such as integration reform occurred, when high levels of state autonomy were ensured. The state’s power (its policy capability), based on health care infrastructures, acts to limit the direction of any change in the health care system because it is very difficult to build the infrastructure for a health care system in a short timeframe.
Delivery of Health Care* ; Economic Development ; Health Care Reform ; Health Expenditures ; Insurance ; Insurance, Health ; Internationality ; Korea ; National Health Programs ; Privatization

OBJECTIVES: General health examinations (GHE) have become an increasingly common measure for preventive medicine in Vietnam. However, little is known about the factors among Viet-namese people who attend or miss GHE. Budget or time constraints remain to be evaluated for better-informed policy making. This study investigates factors affecting behaviors in attending periodic GHE. The main objectives are as follows: (1) to explore empirical relationships between influencing factors and periodic GHE frequencies, and (2) to predict the probabilities of attending GHE under associated conditions. METHODS: The study used a 2,068-observational dataset, obtained from a Vietnamese survey in 2016. The analysis was then performed using the methods of baseline-category logits for establishing relationships between predictor and response variables. RESULTS: Significant relationships were found among the expenditure and time consumption, health priority and sensitivity to health data, insurance status, and frequency of GHE, with most p-values = 0.01. CONCLUSION: Generally, people attended the GHE when they had the resources and health priorities (72.7% probability). Expenditure and time remain key obstacles to the periodic GHE. Health priority and health data are important in improving rates for GHEs. Health insurance should play a positive role in promoting the GHE.
Asian Continental Ancestry Group* ; Budgets ; Cross-Sectional Studies* ; Dataset ; Health Expenditures ; Health Priorities ; Humans ; Insurance Coverage ; Insurance, Health ; Policy Making ; Preventive Medicine ; Vietnam

OBJECTIVES: To investigate the relationship between dyslipidemia and obesity status among Viet-namese adolescents. METHODS: In this case-control study, 282 adolescents (6–11 years), including 88 obese cases and 194 normal-weight controls, were recruited from a population-based cross-sectional study from two provinces in Vietnam. The anthropometric, blood lipid, and other laboratory test results of the study subjects were analyzed. RESULTS: Obese children tended to have more visceral fat (Pearson's r = 0.795, p < 0.0001) than subcutaneous fat (Pearson's r = 0.754, p < 0.0001), and this difference was associated with an increase in blood triglyceride level (Pearson's r = 0.232, p < 0.05) and a strikingly high rate of hypertriglyceridemia (38.6%). We also found that birth weight and parental body mass index were related to the status of obesity among the study subjects. However, only birth weight was significantly higher in the obese group than in the normal weight group. These findings indicate the effect of prenatal nutrition on childhood obesity. Furthermore, high-birth weight children had a surprisingly high rate of obesity. CONCLUSION: Together, our data suggest that obesity increased the risk for hypertriglyceridemia, which was, at least partially, due to prenatal nutrition.
Adolescent ; Birth Weight ; Body Mass Index ; Case-Control Studies* ; Child ; Cross-Sectional Studies ; Dyslipidemias ; Humans ; Hypertriglyceridemia* ; Intra-Abdominal Fat ; Obesity ; Parents ; Pediatric Obesity* ; Subcutaneous Fat ; Triglycerides ; Vietnam*