Evaluation of COVID-19 vaccine effectiveness in different high-risk facility types during a period of Delta variant dominance in the Republic of Korea: a crosssectional study

Objectives@#We evaluated the effectiveness of coronavirus disease 2019 vaccination in high-risk facilities in the Republic of Korea during the period when the highly transmissible Delta variant was prevalent. Additionally, we aimed to explore any disparities in vaccine effectiveness (VE) across various types of institutions, specifically distinguishing between non-medical and medical establishments. @*Methods@#We examined 8 outbreak clusters covering 243 cases and 895 contacts from 8 highrisk facilities divided into 2 groups: group A (4 non-medical institutions) and group B (4 medical institutions). These clusters were observed from July 27, 2021 to October 16, 2021 for the attack rate (AR) and VE with respect to disease severity. A generalized linear model with a binomial distribution was used to determine the odds ratio (OR) for disease severity and death. @*Results@#AR was notably lower in group B (medical institutions). Furthermore, VE analysis revealed that group A exhibited higher effectivity for disease severity and death than group B. The OR for disease severity was 0.24 (95% confidence interval [CI], 0.03–2.16) for group A and 0.27 (95% CI, 0.12–0.64) for group B, with the OR for death at 0.12 (95% CI, 0.01–1.32) in group A and 0.34 (95% CI, 0.14–0.87) in group B. @*Conclusion@#Although VE may vary across institutions, our findings underscore the importance of implementing vaccinations in high-risk facilities. Customized vaccination programs, tailored response plans, and competent management personnel are essential for effectively addressing and mitigating public health challenges.

Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea

Objectives@#Healthcare facilities are high-risk sites for infection. This study analyzed the epidemiological characteristics of a coronavirus disease 2019 (COVID-19) outbreak in a tertiary hospital after COVID-19 vaccination had been introduced in Republic of Korea. Vaccine effectiveness (VE) and shared anti-infection strategies are also assessed. @*Methods@#The risk levels for 4,074 contacts were evaluated. The epidemiological characteristics of confirmed cases were evaluated using the chi-square test. The “1 minus relative risk” method was used to determine VE in preventing infection, progression to severe disease, and death. In the largest affected area (the 8th floor), a separate relative risk analysis was conducted. A multivariate logistic regression analysis (with 95% confidence interval [CIs]) was used to identify transmission risk factors with a significance level <10% via the backward elimination method. @*Results@#In total, 181 cases of COVID-19 were confirmed, with an attack rate of 4.4%. Of those cases, 12.7% progressed to severe disease, and 8.3% died. In the cohort isolation area on the 8th floor, where 79.0% of the confirmed cases occurred, the adjusted odds ratio was 6.55 (95% CI, 2.99–14.33) and 2.19 (95% CI, 1.24–3.88) for caregivers and the unvaccinated group, respectively. VE analysis revealed that 85.8% of the cases that progressed to severe disease and 78.6% of the deaths could be prevented by administering a second vaccine. @*Conclusion@#Caregiver training for infection prevention and control is necessary to reduce infection risk. Vaccination is an important intervention to reduce the risk of progression to severe disease and death.

Importation and Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern in Korea, November 2021

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

Humidifier disinfectant lung injury, how do we approach the issues?

A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone/methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies.

Social Network, Social Support, Social Conflict and Mini-Mental State Examination Scores of Rural Older Adults : Differential Associations across Relationship Types

OBJECTIVE: This study aimed to examine the effects of the social engagement (size of the social networks, social support, social conflict) by relationship types (spouse, family and kin, and neighbor and friends) on the cognitive functions of older adults in rural communities. METHODS: The participants of this study were normal older adults who participated in the first wave of the Korean Social Life, Health and Aging Project. Five hundred two older adults (men 218, women 284) aged 60 and over (mean age=71.44±6.81) participated. We analyzed the effects of different types of social engagement on Mini-Mental State Examination for Dementia Screening (MMSE-DS) performance using hierarchical multiple regression analysis. RESULTS: The result showed that, after controlling for the education level and age, the social support from the spouse, the conflict with neighbors or friends, the number of neighbors or friends significantly predicted MMSE-DS scores. These three variables accounted for additional 5.2% of the total variance of MMSE-DS. CONCLUSION: Our findings suggest that social engagement (network size, support, conflict) is associated with cognitive function among older adults. However, social engagement in different types of social relationship may contribute differently to cognitive function of older adults.

Nutrients and Dish Intake by Fasting Blood Glucose Level

The nutrient intake and association between dish group intake and blood glucose and serum lipid level (TG, cholesterol, LDL and HDL) was analyzed among 3 groups: 452 subjects in normal blood glucose group (NG: fasting blood glucose or = 140 mg/dL) and 101 subjects in diabetic group (DG: fasting blood glucose > or = 126 mg/dL and 2 hours postprandial blood glucose > or = 140 mg/dL). The data were obtained from the 2005 National Health and Nutrition Survey of Korea. The 811 subjects were adults aged 40~64 without dietary treatment. In nutrients intake, IFG was the highest and DG the lowest in both quantity and quality. DG, especially, had the lowest intake in carbohydrates, fiber, proteins, Ca, P, K, vitamins B1 and C, and consumed the highest amount of alcohol. In macronutrients distribution ratio, the DG diet showed a lower energy intake from carbohydrates but higher from fat than the NG diet, while IFG showed a higher energy intake from carbohydrates and lower intake from fat in supper out of 3 meals and snacks. IFG preferred salt-fermented foods and DG preferred soups, braised foods and kimchi compared to other groups. NG preferred multi-grain cooked rice and both IFG and DG preferred plain white cooked rice. Regarding the association between dish group intake and blood glucose, cooked rice, soups, salt-fermented foods and kimchi were significantly related to blood glucose. In blood lipids, steamed-foods, beverages and fruits were inversely related to the risk of developing type 2 diabetes, whereas cooked rice, stews, saltfer- mented foods, seasoned-fermented foods and seasoned vegetables were directly proportional to the risk of developing type 2 diabetes and related diseases. Therefore, it is beneficial to avoid rich, salty and fatty foods and heavy alcohol consumption for controlling blood glucose and blood lipids, while steamed foods, foods rich in fiber (like multigrain rice) as a staple, and fruits and teas are recommended for preventing or managing type 2 diabetes risks.

Comparison of Dietary Patterns by Sex and Urbanization in Different Economic Status / 대한지역사회영양학회지

The purpose of this study is to find differences in dietary patterns through menu analysis by economic status. The data was obtained from the 1998 and 2001 National Health and Nutrition Survey of Korea. The main variables were economic status, sex, and area by urbanization. The economic status was classified into low, middle, high, and top classes using a poverty line based on the 1998 and 2001 minimum standard cost of living. The areas were divided into metropolis, small city, and rural areas. The dishes of 3 meals were classified into 29 categories by cooking method. The most frequent pattern was "rice + soup + kimchi". The frequency of this Korean basic dietary pattern was the lowest in the top income class and metropolis areas, while the highest in the low income class and rural areas. The frequency of Korean recommended dietary pattern, that is, "rice + soup or stew + kimchi + side dish" was the highest in the top income class. The metropolis group preferred side dishes using meat and a cooking method that saved time, but the rural group preferred side dishes using vegetables and cooking methods that take a longer time. In comparison of dietary pattern between male and female by economic status, the higher economic status, the male's dietary patterns showed more side dishes than those of female. But the main side dish was kimchi in male low class. onsequently, the major dietary pattern in Korea is rice-style, though the western pattern is increasing in the top income class, especially in metropolis areas. Therefore, to make a better dietary pattern, we should develop and spread low-priced recipes of various side dishes and teach financial skills such as ability to make a food budget for lower income classes. Also, we should emphasize the importance of the balance between meat and vegetables and traditional diet and western diet for the top income class, especially in the metropolis areas.

Dietary Quality Evaluation by Menu Analysis of Korea Antarctic Expedition

The purpose of this study is to evaluate dietary quality of Korea Antarctic expedition by menu analysis. Basic menu pat-tern, intake of dish and dish group, DDS (dietary diversity score ), daily nutrients supply, and NAR (nutrient adequacy ratio )& MAR (mean adequacy ratio )were analyzed using 1 year menu list for the 10th Korea Antarctic expedition. Most frequently served basic menu patterns were [Rice +Soup +2 Side dish +Kimchi (53.5%)]and [Rice +Stew +2 Side dish +Kimchi (13.4%)]. In the analysis of dish group, excluding Rice and Kimchi,[Grilled foods ]and [Pan-fried foods ]were served more than 25% per month. Most frequently served dishes were "pan-fried rolled egg", "grilled sea-weed", "kimchi soup", "fruits cocktail, canned" and "salt-fermented squid". The kinds of served dishes were very res-trictive. The average score of DDS showed 2.88 for summer and 2.97 for winter. Dairy group was almost not served. Fruit & Vegetable groups were also served a little as canned product. The energy ratio of Carbohydrate : Fat : Protein was 56.5 : 23.9 : 19.2, and 56.9 : 24.5 : 18.3, for summer and winter, respectively. Both seasons had higher ratio of carbohydrate and lower ratio of fat compared to the recommended ratio (44 : 40 : 16 )in polar area. Ca : P ratio was very poor, 0.40 in both seasons. NAR scores of Ca, vitamin A, vitamin B 2 and vitamin C were also very low, ranged from 0.6 to 0.7. Consequently, a well-planned menu supplying adequate amount of dairy, fruit and vegetable is necessarily required including Ca, vitamin D, vitamin A, vitamin B 2 and vitamin C intake, and some nutritionally well-educated members are urgently needed to join in the expedition.

Dietary Pattern by Sex and Age with Menu Analysis Using 1998, 2001 National Health and Nutrition Survey of Korea / 대한지역사회영양학회지

The purpose of this study is to compare menu patterns by sex and age (3-6, 7-12, 13-19, 20-29, 30-49, 50-64, 65 over years old) between the 1998 and 2001 National Health and Nutrition Surveys of Korea. Frequently consumed menu patterns were investigated using the 24-hour recall data for 19,809 subjects (1998:10,102; 2001:9,707). To analyze patterns, dishes were classified into 29 categories by cooking method (KHIDI 2003). The results are as follows: the most frequent menu patterns were "rice + soup + kimchi" and "rice + stew + kimchi" in both men and women in both 1998 and 2001. Intake frequency of these menu patterns, a traditional Korean menu pattern, was higher with increased age. Intake frequency of "noodles" and "bread" increased in 2001 in both men and women, compared to 1998. And these patterns increased in the younger age groups, especially women in their twenties. Menu patterns of 2001 showed greater variety than those of 1998. Overall, the men's menu patterns showed more side dishes than those of women; intake frequencies of "seasoned vegetables", "stir-fried foods", and "grilled foods" were higher in men than in women. In short, so far the main menu pattern has been "rice-style" in both men and women, and in all age groups in Korea, whereas the Western menu pattern is increasing in younger age groups. The diet of 2001 showed more side dishes than that of the 1998 menu pattern; however, certain groups such as female and males in adolescents and young adults were still a simple menu pattern. Consequently, to make recommended menu patterns and nutrition education programs for Koreans should take into consideration sex and age.

Evaluation of Diet Quality according to Nutrient Intake between Highly Educated, Married, Unemployed and Employed Women

This study was conducted to provide foundation data for making health care policy for married women by assessing the dietary intake between highly educated married, employed and unemployed women. It is a direct interview, cross-sectional study with 24-hour recall method for one day. In selecting the subjects for this study, married, unemployed women were selected from a certain area (Daedeok Science Town) in Daejeon where there are high rates of highly educated women, and the married, employed women were selected from the teaching profession in order to avoid confounding due to including a variety of jobs. According to the Korean Standard Classification of Occupations, teaching is the representational occupation of highly educated, married women. Then, to prevent confounding due to age, we selected the subjects out of each age group at the same rate through random sampling. Women who had not graduated college, worked only part-time, or had no current spouse were excluded. As a result, 486 highly-educated, married, unemployed (250) and employed (236) women were used for analyzing data. The unemployed women consumed a higher amount of fat, cholesterol, sodium, vitamin C and folic acid while the employed women consumed a higher amount of iron, vitamin B1 and vitamin B2. P/M/S ratio being 1/1.18/1.05 and 1/1.05/0.87, for the unemployed women and the employed women, respectively, unemployed respondents had a higher saturated fat intake than those of employed. It is in excess of the standard ratio (1/1/1) of the Korean RDA. At the same time, in unemployed respondents the percent of energy intake from fat (24.8%, 23.2%) and animal fat (12.4%, 11.4%) were higher than those of employed respondents. The mean daily nutrient intake of calcium, zinc, and iron for both groups of respondents were lower than the Korean RDA. Both groups had phosphorus as the highest nutrient and calcium as the lowest nutrient of INQ (Index of Nutritional Quality) while nutrients with the INQ being less than 1 were calcium and iron. To sum up, the following conclusions can be made: Nutrition education and guidance for reduction of the intake of fat, especially animal fat, are necessary for unemployed women. In addition, highly educated, married, unemployed and employed women should increase the consumption of foods rich in iron and calcium to prevent anemia and osteoporosis, while decreasing the intake of phosphorus to balance proportions of calcium and phosphorus.

Evaluation of Diet Quality according to Food Consumption between Highly Educated, Married, Unemployed and Employed Women

The differences in food consumption between highly educated, married, unemployed and employed women were analyzed by food group and common food item intake, DDS (dietary diversity score), and DVS (dietary variety score) and DVSS (dietary variety score including condiment). In food group intake, the total amount of food intake of the unemployed women (1,554.0 g) were significantly higher than those of the employed (1,477.9 g), while the amount of food from fungi and mushrooms (4.2 g), seaweeds (2.4 g), and fish and shellfish (60.5 g) of the unemployed women was significantly lower than those of the employed. And the amount of meat, poultry and their products (102.8 g), eggs (29.9 g), and animal oil and fats (4.0 g) was significantly higher than those of the employed. Moreover, the common food items of the unemployed women were ranked as eggs (29.7 g), pork (28.9 g), chicken (27.2 g), and beef (26.7 g) at 7, 8, 9, and 10, respectively. When counting the major food groups consumed, DDS = 4 has the highest proportion in both groups (unemployed 47.4%, employed 49.1%). In case of the subjects who had not consumed one particular food group in DDS = 4, dairy group was the first (83%), followed by fruit, meat, and vegetables. This order is same in other DDS levels. In dietary variety score (DVS and DVSS), the average number of foods consumed per day of employed women was higher than those of the unemployed. The level of DVSS in the employed women (31.9), especially, is significantly higher than in the unemployed women (30.6). Consequently, highly educated women should pay more attention to increasing dairy intake, and they have need of various foods, over thirty foods without condiments in their diet every day. In addition, encouraging unemployed women to have a nutritionally balanced diet, and offering nutrition education and guidance, such as appropriate choices about animal foods, are needed.