Assessing the Fear Factor of Coronavirus Disease 2019 (COVID-19) in Korea Using the COVID-19 Phobia Scale: A Cross-Sectional Study

Background@#A study on coronavirus disease 2019 (COVID-19) phobia among students revealed that fear of contracting COVID-19 was associated with commuting to school and spending time with others at school. Therefore, it is the need-of-the-hour for the Korean government to identify factors affecting COVID-19 phobia among university students and to consider these factors while framing the policy direction for the process of returning to normalcy in university education. Consequently, we aimed to identify the current state of COVID-19 phobia among Korean undergraduate and graduate students and the factors affecting COVID-19 phobia. @*Methods@#This cross-sectional survey was conducted to identify the factors affecting COVID-19 phobia among Korean undergraduate and graduate students. The survey collected 460 responses from April 5 to April 16, 2022. The questionnaire was developed based on the COVID-19 Phobia Scale (C19P-S). Multiple linear regression was performed on the C19P-S scores using five models with the following dependent variables: Model 1, total C19P-S score; Model 2, psychological subscale score; Model 3, psychosomatic subscale score; Model 4, social subscale score; and Model 5, economic subscale score. The fit of these five models was established, and a P-value of less than 0.05 (F test) was considered statistically significant. @*Results@#An analysis of the factors affecting the total C19P-S score led to the following findings: women significantly outscored men (difference: 4.826 points, P = 0.003); the group that favored the government’s COVID-19 mitigation policy scored significantly lower than those who did not favor it (difference: 3.161 points, P = 0.037); the group that avoided crowded places scored significantly higher than the group that did not avoid crowded places (difference: 7.200 points, P < 0.001); and those living with family/friends scored significantly higher than those in other living situations (difference: 4.606 points, P = 0.021). Those in favor of the COVID-19 mitigation policy had significantly lower psychological fear than those who were against it (difference: -1.686 points, P = 0.004). Psychological fear was also significantly higher for those who avoided crowded places compared to those who did not difference: 2.641 points, P < 0.001). Fear was significantly higher in people cohabitating than those living alone (difference: 1.543 points, P= 0.043). @*Conclusion@#The Korean government, in their pursuit of a policy that eases COVID-19-related restrictions, will also have to spare no efforts in providing correct information to prevent the escalation of COVID-19 phobia among people with a high fear of contracting the disease. This should be done through trustworthy information sources, such as the media, public agencies, and COVID-19 professionals.

Differences in Environmental Tobacco Smoke Exposure between Self-reporting and Cotinine Test: The Application of Biomarkers / 보건행정학회지

Background@#In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. @*Methods@#This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. @*Results@#As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%–29.0%, the specificity was 16.4%–19.5%, and the kappa value was 2.0%–5.8%. @*Conclusion@#The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker’s exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.

Differences in Environmental Tobacco Smoke Exposure between Self-reporting and Cotinine Test: The Application of Biomarkers / 보건행정학회지

Background@#In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. @*Methods@#This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. @*Results@#As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%–29.0%, the specificity was 16.4%–19.5%, and the kappa value was 2.0%–5.8%. @*Conclusion@#The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker’s exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.

The Government Policies of New Tobacco Products: Strategies for Managing Electronic Cigarettes and Heated Tobacco Products / 보건행정학회지

The term new tobacco products (NTPs) refers to the new alternatives to conventional cigarettes. There are several kinds of NTPs in South Korea. The present study discusses the most widely used NTPs namely electronic cigarette (ECs) and heated tobacco products (HTPs). The aims of this study are to evaluate the risk related to the use of ECs and HTPs, introduce policy examples across different countries of management of this issue, and finally, present some policy implications of the problem and our response strategies. Since the advent of ECs, there has been a lot of debate about its risk. Some studies have reported that ECs are less harmful than conventional cigarettes and that they are effective in aiding smoking cessation. Nevertheless, the efficacy of ECs in smoking cessation and its potential health risks are still unclear. However, the obvious fact is that it is not harmless. Regulations on ECs differ from country to country. In many countries, they are strictly regulated as tobacco or toxic substances; however, in the United Kingdom, the use of ECs are included as part of their smoking cessation policy, and in Japan, they are treated as a form of medication. On the other hand, HTPs are the most recently introduced NTPs and they have attained sensational popularity because of the wrongly held belief that they are less harmful to health. So, what about our policy response to these two tobacco products? The research on ECs requires more systematic statistical monitoring, such as monitoring the ratio of dual-users. Further, the new EC smokers should be identified taking into account that the arguments for the use of ECs often emphasize smoking cessation or less risks to health, the government should further strengthen its policy to prevent those claims. The HTPs market experienced a very sharp growth and continues to grow because the government policy is too passive. Taking this as a lesson, it is necessary to approach NTPs, such as HTPs, proactively and increase their contribution to the National Health Promotion Fund by imposing greater taxes on them. Finally, considering the likelihood of NTPs being promoted as a less harmful tobacco product, it is essential to strictly regulate tobacco companies' publicity from the very beginning to ensure that potential consumer s are not mislead.

Determinants of Health in Korea: A Comparative Analysis among Organization for Economic Cooperation and Development Countries / 보건행정학회지

BACKGROUND: This study aims to utilize Organization for Economic Cooperation and Development (OECD) data to identify macroscopic determinants of health at national level and to utilize it in health policy development through comparison and analysis with Korea. METHODS: The potential years of life lost (PYLL) were used as dependent variables and 19 indicators were selected as health determinants to be independent variables based on the results of previous studies. Data analysis was done using SAS ver. 9.4 package (SAS Institute Inc., Cary, NC, USA) and model used in technical statistics concerning PYLL by countries, multi-linearity test between independent variables and OECD economic studies were modified and used. RESULTS: From 1994 to 2012, the average PYLL for OECD countries was 4,262.9 years, the highest in Estonia and the lowest in Iceland. As a result of the analysis using the fixed effect model, the significant variables affecting PYLL were four variables: gross domestic product, nitric oxide, tobacco consumption, and number of doctors. The health determinants that had more influence on the PYLL of Korean people compared to other OECD countries were tobacco consumption, calorie consumption, fat intake and total health expenditure. CONCLUSION: In order to effectively reduce unnecessary deaths, we must continue to strengthen our smoking policy and nutrition policies such as calorie and fat intake. It is necessary to prevent the increase of total health expenditure due to the increase in the prevalence of chronic diseases and to strengthen the public health aspect.

The Effects of Formaldehyde Exposure on Self-reported Symptoms of Respiratory-eye Mucosa and Integumentary System during Anatomy Practices among Korean Medical Students / 체질인류학회지

This study aims to determine the effects of formaldehyde exposure on self-reported symptoms of respiratory-eye mucosa and integumentary system during anatomy practices among Korean medical students. Data were collected using the web-based survey. Study subjects in 1st and 2nd grade medical student, and having anatomy dissection in medical college and medical graduate school. A total of 463 students from the 14 medical college and medical graduate school participated in this study. The results show that 261 (56.4%) of the participants responded feeling discomfort above moderate at anatomy dissection. After anatomy dissection, 104 (43.2%) students responded aggravating the symptom allergic rhinitis, xerophthalmia and so on. 209 (95.0%) of them responded the new symptom's appearance. In the result of multiple logistic regression, women (OR: 2.000, 95% CI: 1.169~3.421) and the students with feeling discomfort (OR: 3.190, 95% CI: 1.807~5.632) were more likely to increase the risk of pre-existing respiratory · eye mucosal system symptom's aggravation than the counter parts. For pre-existing integumentary system symptom's aggravation, risk is significantly higher in elder age group (OR: 2.612, 95% CI: 1.187~5.750) and with disapproval protective equipments (OR: 2.217, 1.006~4.885). In case of new symptom's appearance, people with feeling discomfort above moderate (OR: 5.097, 95% CI: 1.075~24.160) in respiratory · eye mucosal system were more likely to increase the risk of new symptom's appearance. And for integumentary system, risk was higher in people with feeling discomfort (OR: 1.921, 95% CI: 1.218~3.031), in woman (OR: 1.711, 1.090~2.686) and without enough protective equipments preparation (OR: 1.953, 1.189~3.210). This study confirms the protective equipments for minimizing exposure from chemicals for cytological fixation (e,g formaldehyde) is not worn enough and students in anatomy dissection experience discomfort and disease after anatomy dissection. Therefore, this study indicates that the safe guideline in anatomy dissection should be enhanced and institutional strategy to protect student's right of health should be provided.

From Visiting a Physician to Expecting Antibiotics: Korean Perspectives and Practices toward Respiratory Tract Infections

Antibiotic resistance is steadily rising worldwide. Respiratory tract infections (RTIs) are common indications, mostly imprudent, for antibiotic prescriptions in outpatient setting. In Korea, antibiotic prescription rate for RTIs is still high. As physician visit and antibiotic prescribing are influenced by patient's perceptions and beliefs, we aimed to explore the general public's perspectives and practices toward RTIs and to develop the ‘RTI clinical iceberg.’ A cross-sectional survey was conducted in Wonju Severance Christian Hospital (WSCH) among 550 adults attending outpatient departments during January 2016. Differences in distributions between groups were examined using two-tailed Pearson χ² test. Using the Andersen's behavioral model as a conceptual framework, we constructed logistic regression models to assess factors associated with physician visit. Of 547 participants with complete questionnaires, 62.9% reported having experienced an RTI in the previous six months; 59.3% visited a physician for the illness, most commonly because the symptoms were severe or prolonged, and approximately 16% of them expected an antibiotic prescription from the visit. Perceptions of symptoms severity, the need factor, most strongly influenced physician visit. Predisposing and enabling factors such as inappropriate expectations for antibiotic for a sore throat or having national health insurance also influenced physician visit. Almost all participants who reported asking for an antibiotic were prescribed one, with a 37.1% non-adherence rate. Conclusively, public education on self-care for RTI symptoms that addresses their main concerns may reduce physician visits. Improving physician-patient relationship and informing patients about the lack of antibiotic benefit for most RTIs may also reduce antibiotic prescriptions.

Induced Abortion Trends and Prevention Strategy Using Social Big-Data / 보건행정학회지

BACKGROUND: The purpose of this study is to investigate the trends on the induced abortion in Korea using social big-data and confirm whether there was time series trends and seasonal characteristics in induced abortion. METHODS: From October 1, 2007 to October 24, 2016, we used Naver's data lab query, and the search word was ‘induced abortion’ in Korean. The average trend of each year was analyzed and the seasonality was analyzed using the cosinor model. RESULTS: There was no significant changes in search volume of abortion during that period. Monthly search volume was the highest in May followed by the order of June and April. On the other hand, the lowest month was December followed by the order of January, and September. The cosinor analysis showed statistically significant seasonal variations (amplitude, 4.46; confidence interval, 1.46–7.47; p<0.0036). The search volume for induced abortion gradually increased to the lowest point at the end of November and was the highest at the end of May and declined again from June. CONCLUSION: There has been no significant changes in induced abortion for the past nine years, and seasonal changes in induced abortion have been identified. Therefore, considering the seasonality of the intervention program for the prevention of induced abortion, it will be effective to concentrate on the induced abortion from March to May.

Induced Abortion Trends and Prevention Strategy Using Social Big-Data / 보건행정학회지

BACKGROUND: The purpose of this study is to investigate the trends on the induced abortion in Korea using social big-data and confirm whether there was time series trends and seasonal characteristics in induced abortion. METHODS: From October 1, 2007 to October 24, 2016, we used Naver's data lab query, and the search word was ‘induced abortion’ in Korean. The average trend of each year was analyzed and the seasonality was analyzed using the cosinor model. RESULTS: There was no significant changes in search volume of abortion during that period. Monthly search volume was the highest in May followed by the order of June and April. On the other hand, the lowest month was December followed by the order of January, and September. The cosinor analysis showed statistically significant seasonal variations (amplitude, 4.46; confidence interval, 1.46–7.47; p<0.0036). The search volume for induced abortion gradually increased to the lowest point at the end of November and was the highest at the end of May and declined again from June. CONCLUSION: There has been no significant changes in induced abortion for the past nine years, and seasonal changes in induced abortion have been identified. Therefore, considering the seasonality of the intervention program for the prevention of induced abortion, it will be effective to concentrate on the induced abortion from March to May.

A Study on the Research Trends of Healthy Cities in Korea (1990-2014) / 보건행정학회지

BACKGROUND: Healthy cities of Korea have engaged in various activities regarding the Korea Healthy Cities Partnership, and research activities on healthy cities is one of the important area. In the present context, due to the current policy to pursue Sustainable Development Goals locally and globally, it is essential to emphasize the importance of healthy city. Therefore, it is important to identify the research trend related to healthy city. The aim of this study was to find out research trend of healthy city studies from 1990 to 2014 by reviewing published papers and studies systematically. Based on the finding of the study, the necessary implications on future research directions of the healthy city are obtained. METHODS: The area of this study is domestic journal (Korea), international journal, thesis, and research report focusing on healthy city from 1990 to 2014. The selection of data was performed using keyword is based on domestic and international database. The analysis criteria were divided into year of publication, type of study, subjects, study methods, and study area. RESULTS: One hundred twenty papers were selected for the analysis. Papers related to the healthy city issue were published 4.8 times in an average in a year during that the period. However, the number of papers published increased dramatically in the recent 4 years. Of total, 28 papers (44.4%) focused on the healthy city policy and urban environmental improvement, 18 papers (28.6%) focused on health promotion, and the remaining were program centered. Most papers (71 out of 120) used quantitative study methods. Of total studies, studies have conducted in Jinju city (9), Wonju city (8), Changwon city (6) and Gangnam-gu (5), respectively, as a study area of healthy city. CONCLUSION: First, domestic healthy city researches has been gradually increasing every year, over the past 10 years which has heightened interest in healthy cities. Second, the expansion of the various areas of research is required in order to contribute to future sustainable healthy city. Third, in recent years, by taking advantage of a variety of research methods, conducting the qualitative and mixed method research is considered to be a desirable change.

Comparison of Health-related Behaviors in Pregnant Women and Breast-feeding Mothers vs Non-pregnant Women

PURPOSE: The aim of this study was to assess health-related behavior of pregnant women and breastfeeding mothers by investigating relevant risk factors. METHODS: Data of 10,396 women (age 19 to 49 years) from the Korea National Health and Nutrition Examination Survey report from 2007 to 2012 was used to analyze factors associated with health-related behavior. The subjects were divided into pregnant women; breastfeeding mothers; and non-pregnant women. Bottle feeding mothers were excluded. RESULTS: Current smoking rate including self-reported smoker and/or positive cotinine urine test were lower for pregnant or breast-feeding group than non-pregnant group. Heavy-drinking was not different among groups while monthly drinking rate was higher in non-pregnant group. Rate of stress recognition was lower in pregnant and breast-feeding group than non-pregnant group. Rate of experience for depressive symptoms and rate of suicidal ideation were not different among groups. CONCLUSION: Pregnant women and breast-feeding mothers maintain a good pattern of health-related behavior compared to non-pregnant women. However, substantial proportion of pregnant women and breast-feeding mothers continue to drink and smoke. This shows the need for a plan that will modify health-related behavior.

A Clinical Trial on Antihypertensive Effect of Tripamide(Normonal(R))

Antihypertensive effect and side effect of Tripamide(Normonal(R)) was studied in 22 cases of essential hypertension using 15mg once daily regimen for average period of 9 weeks. 1) Antihypertensive effect Average reduction of 25mmHg in systolic and 19mmHg in systolic and 19 mmHg in diastolic pressure was observed and reduction rate was 15.7% and 17.6% respectively. The overall effect rate was 86%. The blood pressure lowered significantly in 1 week of treatment both in systolic and diastolic pressure and the extent of fall in systolic pressure approached near the level of maximum reduction in 2 weeks of administration and that of diastolic after 5 weeks of treatment. 2) Laboratory tests and side effect There was no significant changes in individual and mean value of Na, K, Cl, BUN, creatinine, uric acid, fasting blood sugar, cholesterol, GOT, GPT studied before and after treatment except one case showing elevation of uric acid. No significant side effect was observed during trial except of 2 cases of transient diuretic effect.