Trend in Prevalence of Smoking and Motivation to Quit among Korean Adult Male Cancer Survivors over the Last 8 Years: The Korea National Health and Nutrition Examination Survey V–VII (2010–2017) / 가정의학회지

Background@#This study aimed to investigate trends in the prevalence of current smokers and motivation to quit among Korean male cancer survivors. @*Methods@#Out of 20,012 men who participated in the Korea National Health and Nutrition Examination Survey V (2010–2012), VI (2013–2015), and VII (2016–2017), 742 cancer survivors were included. A cancer survivor was defined as a person who concurred to the item, “The cancer has been diagnosed by a doctor” in the health questionnaire. Smoking status was classified as current, former, and never smokers. Regarding motivation to quit smoking, we defined those who had a willingness to quit within 6 months as the willing group. Logistic regression analysis was conducted to examine trends in the prevalence of current smokers and the proportion of the willing group among current smokers. @*Results@#Overall, 3.7% of Korean men who participated in the study were cancer survivors. Current smokers constituted 19.5%, 19.1%, and 15.3% of cancer survivors in phases V, VI, and VII respectively which did not show significant changes (P for trend=0.33). However, the proportion of current smokers in the non-cancer group was significantly reduced to 46.6%, 41.2%, and 38.9% in phases V, VI, and VII, respectively (P for trend <0.001). The proportion of those with a motivation to quit smoking did not show a significant trend in the cancer survivors (P for trend=0.964) and non-cancer group (P for trend=0.884). @*Conclusion@#Prevalence of current smokers and motivation to quit in Korean male cancer survivors did not show significant trends.

Trend in Prevalence of Smoking and Motivation to Quit among Korean Adult Male Cancer Survivors over the Last 8 Years: The Korea National Health and Nutrition Examination Survey V–VII (2010–2017) / 가정의학회지

Background@#This study aimed to investigate trends in the prevalence of current smokers and motivation to quit among Korean male cancer survivors. @*Methods@#Out of 20,012 men who participated in the Korea National Health and Nutrition Examination Survey V (2010–2012), VI (2013–2015), and VII (2016–2017), 742 cancer survivors were included. A cancer survivor was defined as a person who concurred to the item, “The cancer has been diagnosed by a doctor” in the health questionnaire. Smoking status was classified as current, former, and never smokers. Regarding motivation to quit smoking, we defined those who had a willingness to quit within 6 months as the willing group. Logistic regression analysis was conducted to examine trends in the prevalence of current smokers and the proportion of the willing group among current smokers. @*Results@#Overall, 3.7% of Korean men who participated in the study were cancer survivors. Current smokers constituted 19.5%, 19.1%, and 15.3% of cancer survivors in phases V, VI, and VII respectively which did not show significant changes (P for trend=0.33). However, the proportion of current smokers in the non-cancer group was significantly reduced to 46.6%, 41.2%, and 38.9% in phases V, VI, and VII, respectively (P for trend <0.001). The proportion of those with a motivation to quit smoking did not show a significant trend in the cancer survivors (P for trend=0.964) and non-cancer group (P for trend=0.884). @*Conclusion@#Prevalence of current smokers and motivation to quit in Korean male cancer survivors did not show significant trends.

Erratum: Authorship & Funding Acknowledgment Correction. The relationship of nutrition of rice and positive evaluation of the rice-based meal on the physical and emotional self-diagnosis and learning efficiency of the middle and highschool students in the Jeonju area / 한국영양학회지

The original version of this article contained errors in authorship and funding acknowledgment.

The relationship of nutrition of rice and positive evaluation of the rice-based meal on the physical and emotional self-diagnosis and learning efficiency of the middle and highschool students in the Jeonju area / 한국영양학회지

PURPOSE: This study examined the relationship of the nutrition of rice and the positive evaluation of the rice-based meal with the food consumption habits, physical and emotional health status, and learning efficacy of 601 middle and high school students in Jeonju area. METHODS: The participants were divided into two groups using cluster analysis in that the participants belonging to the upper groups had a center score of 46.86 (n = 348), while the people belonging to the lower group had a center score of 36.89 (n = 253). Statistical differences were tested for all the relationships between the physical and emotional healths symptoms and learning efficacy between the groups at the α = 0.05 level. RESULTS: Significant differences in the physical self-evaluated symptoms were observed in all five items in each cluster (p < 0.05). In the case of the emotional health status, nine out of 10 items showed significant differences between the groups. Similarly, significant differences in all five items in learning efficacy questionnaire were noted (p < 0.05). Positive attitudes of the parents toward having breakfast also showed significant differences among the groups. CONCLUSION: The nutrition of rice and a positive evaluation of the rice-based meals significantly affect the physical and emotional health status and learning efficacy of juveniles. These findings can be used as baseline information for promoting nutrition education, particularly rice-based breakfast.

Relationship between Perceived Health Status andPatient Satisfaction in Outpatient Settings - Korean National Health and Nutrition Examination Survey 2015 / 의료커뮤니케이션

BACKGROUND: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status.METHODS: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data.RESULTS: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347–2.338), 1.946 (1.356–2.793), 1.652 (1.218–2.240), and 1.665 (1.193–2.323) compared with the poor group.CONCLUSION: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.

Relationship between Dry Eye Syndrome and Frequency of Coffee Consumption in Korean Adults: Korea National Health and Nutrition Examination Survey V, 2010–2012 / 가정의학회지

BACKGROUND: Dry eye syndrome is a common health problem in the adult population. Many risk factors including age, sex, prior eye surgery, various chronic diseases, and lifestyle factors can affect its development. We have evaluated the risk of dry eye syndrome based on the frequency of coffee consumption among Korean adult population. METHODS: A total of 9,752 adults with age 19 years and older were randomly selected between 2010 and 2012. They have all participated in the National Health and Nutrition Examination Survey V of Korea. Dry eye syndrome was being diagnosed by the physicians at some points in the participant’s lifetime. The average daily coffee intake was divided into the following: less than 1 cup, 1 to 2 cups, and 3 cups or more. Various physio-environmental factors and medical conditions were used as correction variables to assess the risk of dry eye syndrome in relation to the frequency of coffee consumption. RESULTS: The prevalence of dry eye syndrome decreased to 9.2%, 8.8%, and 6.3% as coffee consumption increased from less than 1 cup to 1–2 cups and more than 3 cups, respectively. However, there was no significant relationship between the frequency of coffee consumption and the risk of dry eye syndrome after adjusting various risk factors. CONCLUSION: There is no relationship between the frequency of coffee consumption and risk of dry eye syndrome.

Relationship between Age at Menarche and Metabolic Syndrome in Premenopausal Women: Korea National Health and Nutrition Examination Survey 2013–2014 / 가정의학회지

BACKGROUND: Early menarche may be associated with increased risk of cardiovascular disease. The aim of this study was to evaluate the relationship between age at menarche and metabolic syndrome (MetS) in Korean premenopausal women. METHODS: We used nationally representative data from the Korea National Health and Nutrition Examination Survey from 2013 to 2014, and 3,023 premenopausal women aged 20–55 years were our subjects. We defined early menarche as age at first menstrual period less than 12 years. Multivariable logistic regression analysis was used to evaluate the relationship between age at menarche and MetS after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables. RESULTS: MetS was much more common in women aged 40–55 years than in women aged 20–39 years (4.1% vs. 15.1%). Compared with women who experienced menarche at age 12–15 years, the risk of MetS in the early menarche group was not higher in either age group, after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables (odds ratio [OR], 1.767; 95% confidence interval [CI], 0.718–4.351 in those aged 20–39 years; OR, 1.780; 95% CI, 0.775–4.085 in those aged 40–55 years). The risk of MetS in women with menarche at age ≥16 years was not higher than in women with menarche at age 12–15 years. CONCLUSION: Early or late menarche was not associated with an increased risk of MetS in premenopausal Korean women. Even before menopause, current age has a major influence on the development of MetS.

Molecular Targeting of ERKs/RSK2 Signaling Axis in Cancer Prevention

RSK2 is a downstream signaling protein of ERK1 and ERK2 and plays a key role in physiological homeostasis. For this reason, RSK2 is a highly conserved protein among the p90RSK family members. In its location in the signaling pathway, RSK2 is a kinase just upstream of transcription and epigenetic factors, and a few kinases involved in cell cycle regulation and protein synthesis. Moreover, activation of RSK2 by growth factors is directly involved in cell proliferation, anchorage-independent cell transformation and cancer development. Direct evidences regarding the etiological roles of RSK2 in cancer development in humans have been published by our research group illustrating that elevated total- and phospho-RSK2 protein levels mediated by ERK1 and ERK2 are higher in skin cancer tissues compared to normal skin tissues. Notably, it has been shown that RSK2 ectopic expression in JB6 Cl41 cells induces cell proliferation and anchorage-independent cell transformation. Importantly, knockdown of RSK2 suppresses Ras-mediated foci formation and anchorage-independent colony growth of cancer cells. Kaempferol is a one of the natural compounds showing selectivity in inhibiting RSK2 activity in epidermal growth factor-induced G1/S cell cycle transition and cell transformation. Thus, ERKs/RSK2 signaling axis is an important target signaling molecule in chemoprevention.

Urine Cotinine and Environmental Tobacco Exposure in Korean Adolescents / 가정의학회지

BACKGROUND: The aim of this study was to elucidate the relationship of environmental tobacco smoke (ETS) exposure and the urine cotinine concentrations in Korean adolescents. METHODS: The study population was 1st grade high school adolescents (n = 1467, girls 22.2%) recruited from four high schools, two from Seoul, one from Kangleung and one from Woolsan. We obtained information on active smoking and ETS exposure through self-reported questionnaire and urine cotinine concentrations. RESULTS: The prevalence of active smoking was 6.9% in boys and 0.9% in girls. Median urine cotinine concentrations were 19.5 microgram/L (range, 0-2341 microgram/L) among smokers, and 0 microgram/L (range, 0-1359 microgram/L) among nonsmokers. The positive rate of urine cotinine among nonsmokers exposed to ETS was 2.9%. Boys were exposed to ETS in the order of frequency in PC room (79.6%), home (39.4%), school (11.5%), and public places (5.9%); girls were exposed in the order of frequency in home (40.9%), PC room (33.2%), public places (28.0%), and school (15.2%). The frequency and duration of ETS exposure were significantly larger and longer in boys than in girls. Boys contacted friends who smoked more than girls did (32.6% vs. 17.1%). Parents; smoking status was similar both in boys and girls. Any information on ETS exposure did not differ according to the detectable urine cotinine among nonsmoking adolescents. CONCLUSION: Low positive rate of urine cotinine and no association of urine cotinine with various ETS exposure history reflect that urine cotinine may not be a good marker for ETS exposure in Korean adolescents.

The Relation of Overweight to Asthma and Other Allergic Diseases in High School Students in Korea / 가정의학회지

BACKGROUND: The worldwide prevalence of obesity and allergic diseases has increased. We aimed to explore the relation of overweight to asthma, atopic dermatitis, allergic rhinitis and conjunctivitis in a sample of Korean adolescents. METHODS: We investigated the prevalence of symptoms of asthma and other allergic diseases by using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The survey was conducted among 1,499 high school students in 3 regions of Korea. RESULTS: The lifetime prevalence of wheezing (21.2% vs. 15.7%, P = 0.04), the 12 months-prevalence of wheezing (4.5% vs. 2.0%, P = 0.04), exercise induced wheezing (13.8% vs. 9.3%, P = 0.04), treatment of asthma (3.3% vs. 1.1%, P = 0.01) and the prevalence of symptoms of allergic rhinitis (11.0% vs. 5.1%, P = 0.001) were signifi cantly higher in overweight boys than normal weight boys, but not in girls. However, there were no signifi cant differences of the prevalence of symptoms and past history of atopic dermatitis and allergic conjunctivitis between overweight and normal weight groups. In boys, overweight increased the risk of the lifetime prevalence of wheezing (OR 1.54, 95% CI: 1.05-2.24) and 12 months-prevalence of exercise induced wheezing (OR 1.64, 95% CI: 1.05-2.55) after adjusting for confounding variables. CONCLUSION: Overweight could be a risk factor for the development of symptoms of asthma and allergic rhinitis in adolescent boys, whereas it was not a signifi cant risk factor for allergic diseases in girls.

Overview of the national health screening program for infant and children / 소아과

The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child''s age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.

Introduction of National Health Screening Program for Infant and Children

No abstract available.

Children and Parental Factors Affecting Cholesterol Levels of First-grade Students in Elementary School in Gwacheon

BACKGROUND: Hypercholesterolemia is a risk factor of cardiovascular diseases and metabolic syndrome. Cholesterol level in childhood is related to the development of cardiovascular diseases in adulthood. This study aimed to investigate cholesterol levels of first grade students in elementary school, to analyze the relationship between the children's cholesterol levels and those of parents' and to evaluate the factors influencing children's cholesterol levels. METHODS: In 2004, a sample of 108 first-graders in elementary school in Gwacheon city and their 216 parents were included in this study. Height, weight, body mass index, waist and hip circumference and blood pressure were measured and bio-chemical data were obtained. The children's birth weight, eating habits, physical activity, occupation, educational background, married status, mean monthly income of each family were obtained by questionnaire. RESULTS: The correlation coefficient between children's cholesterol and fathers' cholesterol was 0.331 (P<0.001). The correlation coefficient between children's cholesterol and mothers' cholesterol was 0.364 (P<0.001). The mean total cholesterol level in children differed significantly according to mother's smoking status, mother's overeating due to stress and mother's diet restriction tendency for weight control. In multiple linear regression analysis of children's cholesterol as dependent variable, the explanation power (R(2)) of the model including children's sex, father's age and cholesterol levels, mother's age and cholesterol levels was 0.281. The explanation power (R(2)) of the other model including variables of the previous model and children's fruit consumption, parent's eating out tendency, mother's smoking status, mother's other behavior during mealtime, mother's overeating due to stress and mother's diet restriction tendency for weight control was 0.388. In final model, only the parent's cholesterol levels had significant effect on children's cholesterol levels. CONCLUSION: It was parent's cholesterol level that affected significantly on the children's cholesterol level.

Comparison of DEXA and CT for Truncal Obesity in Adult Women Related to Metabolic Complications

BACKGROUND: The metabolic risks associated with obesity are closely correlated with a central rather than a peripheral fat pattern. These complications of obesity have been attributed to increase in visceral adipose tissue. The aim of this study was to investigate whether the dual- energy X-ray absorptiometry (DEXA) method offers a good alternative to computed tomography (CT) for the prediction of visceral fat in the obese women in correlation of metabolic complication markers. METHODS: The design is a cross-sectional analysis. Total body fat and truncal fat amounts were measured by using DEXA, while total abdominal fat area was measured by CT, and divided into visceral abdominal fat area and subcutaneous fat area. Partial correlation after controlling for age and multiple regression analyses after adjusting for age and total percent body fat were performed to relate the metabolic variables to the CT and DEXA body composition variables. RESULTS: For serum uric acid, total abdominal fat area by CT had the largest R2 values (R2=0.259). For AST, ALT, total cholesterol and log triglyceride, visceral fat area had the largest R2 values (R2= 0.360, 0.407, 0.147, and 0.339), respectively, and for log insulin, truncal fat by DEXA had the largest R2 values (R2=0.275). CONCLUSION: Truncal fat amount measured by DEXA had a strong correlation with visceral fat area measured by CT. Truncal fat amount measured by DEXA and correlated significantly with visceral abdominal fat area measured by CT reflected most of the metabolic complication markers.

The Prevalence of Obesity and Obesity-related Metabolic Complications in Korean Adolescents

BACKGROUND: Obesity in adolescence is a serious health problem because it may proceed to adulthood, cause metabolic complications, and thereby increase mortality. The main purpose of this study was to investigate the prevalence of obesity and other metabolic complications related to obesity among Korean adolescents. METHODS: The subjects of the study were 3,615 adolescents recruited from 12 middle schools nationwide. We measured their height, weight, obesity indices, fasting blood glucose, serum total cholesterol, triglyceride, HDL- cholesterol, ALT, AST, and uric acid levels. The risk factors of obesity were assessed by self-administered questionnaires. RESULTS: Obesity was evident in 16.2% of the subjects (20.7% in boys, 11.0% in girls). Adolescent obesity was closely related to parental obesity (Odds Ratio 2.9, 95% CI (Confidence Interval) 1.7~2.5). Obese adolescents were at higher risk of elevated AST (OR 10.2, 95% CI, 5.2 ~19.9), elevated ALT (OR 12.9, 95% CI, 6.9~24.2), hypercholesterolemia (OR 1.5 95% CI, 1.2~1.8, P<0.05), hypertriglyceridemia (OR 4.0, 95% CI, 3.1~5.3), and hyperuricemia (OR 2.2, 95% CI, 1.7~3.0). More than 70% of obese adolescents had one or more metabolic complications related to obesity. CONCLUSION: Adolescent obesity was closely related to parental obesity and metabolic complications related to the obesity were common among both obese boys and girls.

Evaluation of School-based Obesity Prevention and Management Program in Korean Children

BACKGROUND: Childhood and adolescent obesity are major health concern impacting on short and long-term health. Prevention programs for obesity through school channel are essential. With the increasing prevalence of obesity and overweight among children and adolescence since 1990's, obesity prevention and management have been pursued in Korea. Schools, where students spend much of their daytime, are in a unique position to play a pivotal role in performing obesity prevention and management programs. The objective of this study was to assess the effectiveness of school-based interventions designed to prevent or manage obesity among elementary, middle, and high school students in Korea. METHODS: Electronic database were searched using the following key words; obesity, obesity prevention, obesity prevention program, child, adolescence, and effectiveness. In this systematic review, school-based programs were evaluated with the assessment items. RESULTS: Thirteen studies were included in the study. Most programs include at least one of the following components: dietary changes, physical activity, behavioral modifications, and parental participation. Studies that involved multidisciplinary measures including dietary education, increased physical activity, parental involvement and behavioral modification and studies focused on increased physical activity among subjects showed positive results. But the majority of studies were short-term and secondary prevention among children, not adolescents, not randomized, and without control. Few studies used validated questionnaires and process evaluation. CONCLUSION: The development and application of evidence-based and feasible strategies in support of communities and families to the school-centered obesity prevention program are needed in the near future.

Health and Exercise in Women

No abstract available.

The Effect of Job Stress in Jobholders on Propensity to Anxiety

BACKGROUND: In modern industrial society, the complexity and diversity of social structure has deeply influenced job stress, and thereby threatens mental health of jobholders more than ever. Therefore, the purpose of this study was to examine the effect of job stress in jobholders on propensity of anxiety. METHODS: Initially, 235 jobholders living in Cheonan, Asan or Seoul, from May to June 2003, were the subjects of this questionnaire. Only 233 jobholders were evaluated due to inadequate responses from two subjects. The questionnaire was made up of three contents: socio-demographic characteristic, Extended Karasek questionnaire for evaluation of job stress, and the Korean version of Goldberg anxiety scale for evaluation of anxiety. The data were analyzed by chi-square test and multiple logistic regression analysis. RESULTS: Univariate analysis of propensity to anxiety showed a statistical significance on age, monthly income and job characteristics. Moreover, in terms of multivariate analysis, in accordance with age, 40 to 49 (OR: 6.1), showed the highest odds ratio of propensity to anxiety, followed by 30 to 39 (OR: 5.2) and 10 to 29 (OR: 5.4). In job characteristics, high strain group (OR: 3.7) showed highest odds ratio, but neither low strain group nor active group revealed any statistical significance. In monthly income, there was no statistical significance. CONCLUSION: Job stress in jobholders and propensity to anxiety was positively associated; especially, the more stress jobholders got, the higher propensity to anxiety was.

Family Physician as a Counsellor Focused on Sexual and Family Problems: Cheonan Practice-Based Research Network Study

BACKGROUND: The primary concern of a family physician is the healthcare of patients and their families, with the patient's disease itself being secondary. Family physicians should make efforts to discuss personal issues with their patients. This study examined how many patients were counseled about their private problems, especially family or sexual issues in the private clinics of Cheonan. METHODS: The subjects were the patients who visited a practice-based network from April to June in 2003. The data were collected through simple questionnaire about sociodemographic features of patients and their family and sexual problems. RESULTS: Eighty eight patients were studied for a total of 107 cases that consisted of 67 cases of family problems (62%) and 40 cases of sexual matters (38%). The common issues about family problems were `the partners' (23 cases, 21%) and `the patients` children' (29 cases, 27 %). The most frequent sexual problems were 'sexually transmitted diseases' (13 cases, 32.5%), `impotence' (7 cases, 17.5%), 'loss of libido, and unsatisfaction' (6 cases, 15.0%). Most physicians were involved in family and sexual issues with medications, and simple counseling with reassurance. Simple counseling was given for 14 cases (21.0%) for family issues and 18 cases (44.0%) for sexual issues. The patients were treated with medications in 47 cases (70.0%) for sexual and 15 cases (38.0%) for family problems. CONCLUSION: The most common issue for family problems was their partners and for sexual problems was 'sexually transmitted diseases'. Most family physicians were involved with both simple counseling and medications.

The Survey of Family Medicine Clinical Clerkships in Medical Schools in Korea

BACKGROUND: New educational objectives and evaluation methods in Korean medical schools have been suggested recently to cope with health care related environmental changes. Current status of family medicine clinical clerkships in Korean medical schools is to be known before establishing standards. METHODS: Educational Committee of Korean Academy of Family Medicine surveyed the family medicine clerkship in Korean medical school (about educational environment, subjects and evaluation methods) using structured questionnaires by e-mail and Fax from February through March in 2004. RESULTS: Family medicine clinical clerkship was run by 25 of 41 medical schools (65.9%). Educational subject areas included communication skill, observation in hospital based ambulatory office, primary care and family medicine, medical recording, diagnosis and treatment of common problems, residential out-hospital ambulatory programs, presentation of hospital based ambulatory programs, procedure skill, lifelong heath management plan, and health promotion, in descending order. Faculties of family medicine were directly in charge of educational subjects. However, educational methods were mainly composed of lectures and indirect observation. It should be noted that concrete and precise evaluation methods in the family medicine clerkship program had been lacking due to insufficient and obscure evaluation strategies. CONCLUSION: Clerkship period, educational environment, and number of class were variable among medical schools in Korea. Educational format needs to be standardized in terms of common educational subjects such as communication skill education, patient education, and ambulatory care clerkship. More valid methods are to be introduced for family medicine clerkship evaluation.