The Effectiveness of Mental Health Problems Screening and Treatment Linkage in Children & Adolescents: Community Based Study Focused on ADHD and Depression

OBJECTIVES: This study evaluated the effectiveness of school-based mental health screening and treatment linkage programs, focusing on attention-deficit hyperactivity disorder (ADHD) and adolescent depression. METHODS: All 11,158 children and adolescents aged 8-14 years in Seoul received a school-based mental health screening, consisting of the Korean versions of the ADHD rating scale and the Child Behavior Checklist (CBCL), for ADHD, and the Center for Epidemiological Studies Depression Scale (CES-DS) and the Suicidal Ideation Questionnaire-Junior (SIQ-JR), for depression. The high-risk children's and adolescents' diagnoses were confirmed using the Diagnostic Interview Schedule for Children-IV (DISC-IV). Treatment linkage programs were managed by the Seoul Metropolitan Community Mental Health Center (Program 1), the Seoul Metropolitan Office of Education (Program 2), or the Dongjak District Office of Education (Program 3). We estimated and compared the referral rates of the three programs. RESULTS: Program 1 screened and referred 22.9% of ADHD youths to mental health services, Program 2, 68.8%, and Program 3, 40.0%. Program 1 screened and referred 22.8% of depressed youths to mental health services, Program 2, 53.8%, and Program 3, 88.9%. Key elements for successful screening and referral programs were an effective school/community mental health center/Office of Education network, the parents' financial support and perception of their child's mental health status as being problematic, and the teachers' active engagement. CONCLUSION: This is the first study investigating the effectiveness of school-based mental health screenings' linkage to treatment for primary and middle school students in Korea. An effective network for community mental health and improvements in parents' and teachers' perceptions regarding mental health are needed for more successful treatment linkage.

The Prevalence of Hematuria and Proteinuria in School Children in Seoul

BACKGROUND: Since 1998, mass urinary screening tests have been conducted in Korean school children. We analyzed the urinary screening test data gathered from the metropolitan city, Seoul, to identify the prevalence of persistent urine abnormalities. METHODS: The students were tested for hematuria and/or proteinuria using dipstick urinalysis. If the results were positive, the students were asked to visit a medical clinic to recheck urinalysis and in report their results. RESULTS: Among 1,337,210 students, who were screened with initial urinalysis, 10,871 students (proteinuria, 3,626 (0.27%); hematuria, 7,634 (0.57%); both, 389) were recommended to undergo second urinalysis in which 8,819 students (81.1%) did. Among them, 851 had persistent proteinuria and 2,618 had persistent hematuria. The results of the first urinalysis were scored based on the severity of hematuria and proteinuria from +1 to +4. Among all students 24.7% of the students who scored +1 and 40.4% who scored +3 proteinuria on the first test had persistent proteinuria, and 56.4% with both proteinuria and hematuria had persistent proteinuria on the second test. For hematuria, the more positive in the first test showed more prevalence of persistent hematuria. And 61.6% of students with both proteinuria and hematuia had persistent hematuria on the second test. CONCLUSION: The presence of both hematuria and proteinuria seemed to be a powerful predictor for persistent abnormal urine finding. And the more positive response in the first test was related to persistent abnormal finding. Therefore we should follow up closely for those students with positive findings.

Trend of Obesity in School Age Children in Seoul Over the Past 23 Years / 소아과

PURPOSE: The aim of this study was to evaluate the change in prevalence and the epidemiology of obesity in school age children of Seoul, Korea during the last 23 years with coherency and under the same standards. METHODS: We used the new 1998 standard weight for height to calculate obesity on the personal data from five years and produced a coefficient of correlation that could be applied to previous obesity prevalence results. RESULTS: From age six to 17, the average body mass index increased 5.7 in boys and 6.2 in girls. The prevalence of obesity according to age peaked around age 11 and age 13-14, and increased again at 16-17 in boys. In girls, there was a peak at the age of 10 and a second peak which was at age 16 in 1979, but the age of the second peak gradually came down to a younger age, to age 13, in 2002. Obesity in girls increased steadily after the second peak. In 1979 and 1981, there were many more underweight children than obese. In boys, obesity had risen to 11.0% by 1997 and rose abruptly to 17.9% by 2002 and in girls, to 9.0% by 1997 and 10.9% by 2002. Mild, moderate, and severe obesity also increased with the increase of obesity. CONCLUSION: As Korea became developed, obesity became more frequent than underweight. Obesity increased rapidly and the increase rate accelerated in boys, whereas though it increased, the increase rate slowly decreased in girls.

Current Issues and Perspectives on School Health Programs

The school health services target the students and teachers who attend the schools in their community. They provide many programs such as health assessment, medical service, environmental management and health education. The former two are mainly conducted by the primary care physicians in each community. In this article, the sentences in the School Health Act and the other laws governing the physician's roles in community school health programs are reviewed. In addition, the main issues on the recent attempts to reform the Act are discussed, and the most satisfying plan, 'primary care physician-centered health examination program', is suggested. As other health care programs, school health programs need more active and organized physician's participation.

The Prevalent Rates of Abnormal Serum Aminotransferase Levels and Total Cholesterol Levels among Adolescents with Obesity

PURPOSE: The purpose of this study was to look at prevalences of abnormal serum aminotransferase levels and abnormal serum total cholesterol levels among adolescents with obesity in Seoul area. METHODS: Body mass index[BMI(kg/m2)], serum aspartate aminotransferase(AST) alanine aminotransferase(ALT), and total cholesterol levels were measured in 26,876 adolescents(male : 13,287, female : 13,589) of first grade of high school in Seoul between the ages of 15 and 16 years, enrolled in a large health examination survey by Seoul School Health Center(SSHC) in 2001. Obesity was defined as BMI more than 95th percentile for age and sex and normal weight was defined as BMI between 25th percentile and 75th percentile for age and sex. Abnormal levels of AST, ALT and total cholesterol were defined as more than 95th percentile for age and sex. RESULTS: The BMI at 95th percentile was 28.7 in males and 26.9 in females. The prevalence of abnormal AST levels was higher in obesity group than in normal weight group. In males, those were 23.7% and 3.7%, respectively(P<0.01, x2-value : 529.2). In females, those were 11.8% and 4.9 %, respectively(P<0.01, x2-value : 56.3). The prevalence of abnormal ALT levels was significantly higher in the obesity group compared with the normal weight group. In males, those were 33.9% and 1.7%, respectively(P<0.01, chi2-value : 1,693.4). In females, those were 22.3% and 3.9%, repectively(P<0.01, x2-value : 397.6). The prevalence of abnormal total cholesterol levels was higher in the obesity group than in the normal weight group. In males, those were 16.8% and 3.5%, respectively(P<0.01, x2-value : 268.3). In females, those were 9.0% and 5.4%, respectively(P<0.01, x2- value : 14.2). CONCLUSIONS: This study revealed that the prevalences of abnormal AST, ALT and total cholesterol level were higher in the obese group than in the normal weight group.

Major health related problems among adolescents in Seoul area

BACKGROUND: Adolescence offers unique opportunities for investment in health and well-being. The purpose of this study was to examine the common physical symptoms and diseases and medical utilization rate and the prevalence of health behaviors among school-aged adolescents. METHODS: This study was carried in 1998. Subjects consisted of 3,771 adolescents (ages 10 to 18) who attended an elementary, middle, and high school in Seoul and 3,246 parents. Self-report questionnaire was administered to the students and their parents to measure self-reported physical and psycho\social problems, practice of health behavior, medical care utilization rate, and the most common diagnosis. RESULTS: 1) Academic performance was the most common psycho\social problem for adolescents and their parents. 2) The perceived health status was highest in middle school students, lowest in female high school students. 3) As adolescents went to higher grades, the medical institute and dental clinic utilization rate tended to be decreased, and oriental clinic utilization rate did not change. The most common diagnosis during the past year was dental caries. The next most common diagnosis was respiratory infection. Accidents (males), headache (females) were more common in high school than middle school. 4) The most frequently reported symptom was fatigue in middle and high school students. More than half of female high school students reported fatigue, dizziness, headache, dysmenorrhea, hypersomnia during the last month. 5) The higher their grade was, the less adolescents practiced health behaviors. 21.9% of males and 1.9% of female high school students were smokers. 34.5% of males and 13.3% of female high school students drank alcohol on a regular basis. The prevalence of obesity was 12.0% in males, 10.0% in female high school students. Male adolescents tended to deal with stress with leisure activities, female adolescents did by talking about their problems with related people. CONCLUSION: This overview of health associated issues among adolescents provided a unique view of differences in health care needs between younger and older teens and between male and female teens. These data have meaningful implications for health promotion program for adolescents.

Diagnostic Significance of the Urine-Stick Test in Middle and High School Children in Seoul

PURPOSE: This study was performed to assess the diagnostic significance of the urine-stick test in detecting Diabetes Mellitus (DM) and to assess the clinical characteristics of adolescent diabetes. MEHTODS: A total of 926,208 middle and high school children participated. The urine-stick test was performed and those who showed glycosuria and, further studies such as evaluations of plasma glucose, triglyceride, cholesterol and C-peptide level done. We compared the clinical characteristics between the diabetes group and non-diabetes group. RESULTS: Among 926,208 students, 1,020 (0.11%) showed glycosuria. Among the 1,020 glycosuria positive subjects, 339 (33.2%) had further laboratory tests. Two hundred and sixty-eight cases (79.1%) were normal, 52 cases (15.3%) were newly diagnosed as DM, 9 cases (2.7%) were already diagnosed DM, 10 cases (2.9%) had an impaired glucose tolerance. The 52 newly diagnosed DM cases, whose postprandial 2 hour glucose level was more than 200m/dL, showed different fasting glucose levels. Thirty cases (57.7%) had a level of more than 140mg/dL, 11 cases (21.1%) were between 110 and 140mg/dL and 11 cases (21.1%) were at a level of less than 110mg/dL. Polydipsia, polyuria and polyphagia were frequent symptoms exibited by the DM group while weight loss and fatigue showed no significant difference between the DM and non-diabetes groups. Six cases were type 1 DM and 44 cases were type 2 DM. Being female, having a family history of DM and a higher BMI and higher diastolic blood pressure were significant risk factors for DM. CONCLUSION: The positive rate of glycosuria by the urine-stick test was 0.11%. Among glycosuria positive subjects 15.3% were newly diagnosed as DM. For the high risk group, an annual urine-stick test and a postprandial blood glucose test should be performed and a systematic referral system is necessary.

Diagnostic Significance of the Urine-Stick Test in Middle and High School Children in Seoul

PURPOSE: This study was performed to assess the diagnostic significance of the urine-stick test in detecting Diabetes Mellitus (DM) and to assess the clinical characteristics of adolescent diabetes. MEHTODS: A total of 926,208 middle and high school children participated. The urine-stick test was performed and those who showed glycosuria and, further studies such as evaluations of plasma glucose, triglyceride, cholesterol and C-peptide level done. We compared the clinical characteristics between the diabetes group and non-diabetes group. RESULTS: Among 926,208 students, 1,020 (0.11%) showed glycosuria. Among the 1,020 glycosuria positive subjects, 339 (33.2%) had further laboratory tests. Two hundred and sixty-eight cases (79.1%) were normal, 52 cases (15.3%) were newly diagnosed as DM, 9 cases (2.7%) were already diagnosed DM, 10 cases (2.9%) had an impaired glucose tolerance. The 52 newly diagnosed DM cases, whose postprandial 2 hour glucose level was more than 200m/dL, showed different fasting glucose levels. Thirty cases (57.7%) had a level of more than 140mg/dL, 11 cases (21.1%) were between 110 and 140mg/dL and 11 cases (21.1%) were at a level of less than 110mg/dL. Polydipsia, polyuria and polyphagia were frequent symptoms exibited by the DM group while weight loss and fatigue showed no significant difference between the DM and non-diabetes groups. Six cases were type 1 DM and 44 cases were type 2 DM. Being female, having a family history of DM and a higher BMI and higher diastolic blood pressure were significant risk factors for DM. CONCLUSION: The positive rate of glycosuria by the urine-stick test was 0.11%. Among glycosuria positive subjects 15.3% were newly diagnosed as DM. For the high risk group, an annual urine-stick test and a postprandial blood glucose test should be performed and a systematic referral system is necessary.

FACES III in the Korean adolescents

BACKGROUND: This study was intended to look into the characteristics and problems when FACES III are used as tools to evaluate family function of adolescents. METHODS: From May to June 1996, self-reported questionnaires for FACES III were conducted on 2,430 middle school and high school students (males:1,190, females:1,240) in Seoul and Yangpyung, Kyunggi-Do. There were eight schools (four middle schools, four high schools) in Seoul and two schools (one middle school, one high school) in Yangpyung, Kyunggi-Do in this study. Also, educational level of parents, occupational status of parents, family types (extended/nuclear), number of family member and numbers of siblings were assessed. RESULTS: The mean values of adaptability were significantly higher in Seoul students, in females, and in nuclear families. The mean values were higher in single sibling than two or more and in parents with higher education. The mean values of cohesion were significantly higher in Seoul students, in middle school students and in family members of 5 and under. The mean values were higher in those without a sibling and in those with above college education. In stepwise regression analysis, educational level of parents, gender, area, occupational status of mother and grade were associated significantly with the mean values of adaptability and educational level of parents, grade and numbers of siblings were significantly associated with the mean values of cohesion. CONCLUSIONS: We consider that there are problems in deciding the cut-off point and in the questionnaires of survey when the FACES III is used as a tool for evaluating family function of adolescents. Trials of combining other tools of family function or consideration of lower concepts are needed in other to be applicable to the individual conversation and the clinical surroundings.

Lipid Profiles and Related Factors in Adolescent / 예방의학회지

OBJECTIVES: To assess the prevalence rate of dyslipidemia and the level of related factors in adolescents groups in Seoul and Yangpyong area. METHODS: Design; School based survey during May-Jun 1996 in Seoul and Yangpyong county. Subject; 2,453 boys and girls, aged 13 to 19 years; 1,137 Seoul and 1,316 Yangpyong county. Main Outcome Measures; Prevalence rates of raised serum total cholesterol, triglycerides, LDL-cholesterol, decreased HDL-cholesterol, obesity, and levels of energy intake and expenditure RESULTS: Energy intake and fat intake of boys were higher than those of girls and they were higher in Seoul. Energy expenditure per day of boys was bigger than that of girls too. Prevalence rate of obesity was higher in boys of Seoul(15.2%) and girls in Yangpyong county(14.0%). Serum lipid profiles(total cholesterol, triglycerides, LDL-cholesterol) were higher among girls and all prevalence rates of dyslipidemia were higher in boys in Seoul and in girls in Yangpyong county. Especially, girls(29.1%) in Yangpyong had raised serum cholesterol level(> or =170 mg/dl). In contrast, boys in Seoul had higher level of decreased HDL-cholesterol(46.8%) compared to Yangpyong(23.6%). The relationships between serum lipid profiles and relative weights and sex are highly significant. And the relationship between triglycerides and energy intake is significant(p=0.038). But, the associations between serum lipid profiles and energy expenditure had borderline significances. CONCLUSIONS: Hypercholesterolemia rates in girls were higher. Obesity prevalence rate was highest in boys of Seoul. Relative weight and sex are significantly related to lipid profiles. Therefore, Korea is in need of preventive strategies for different obesity and gender groups.

Weight control behaviors of obese adolescents

BACKGROUND: As childhood-onset obesity has been known to have a poor prognosis, and its prevalence is rapidly increasing, many children and adolescents are becoming concerned about obesity and try various weight control methods. This study assessed the experience and behaviors of weight control in obese adolescents. METHODS: A total of 732 among 840 obese students from 28 schools in Seoul metropolitan area were assessed with a self-administered questionnaire. RESULTS: Middle school students showed the highest trial rate of weight control. Elementary and high school girls showed significantly higher trial rates of weight control than boys(P<0.05). The methods more frequently used were physical exercise, and diet, drugs and other methods, and visits to obesity clinics in that order. Elementary school girls most frequently tried physical exercise while high school girls went on a diet most frequently. All groups of girls were dieting significantly more often than boys(P<0.05). High school girls were the most frequent users of drugs and other methods while elementary school boys and middle schoolgirls visited obesity clinics most frequently. Unhealthy weight control methods observed were monodiet(2.7%), fasting(1.9%), dieting pills(1.4%), and vomiting(0.1%). The mean number of weight control methods was decreased with increasing age. The possibility of overall weight control was significantly higher in girls, having higher weight dissatisfaction levels. The possibility of physical exercise was significantly higher in younger ages, having mother with a career and a family history of obesity. The possibility of dieting was significantly higher in girls, older ages, having higher obesity index. The possibility of using drugs and other methods was significantly higher if they had higher weight dissatisfaction levels and a family history of obesity. The possibility of visiting obesity clinics was significantly higher if they had higher obesity index. CONCLUSION: Although, exercise and diet were frequently chosen by obese adolescents for weight control, the munber unhealthy methods chosen were found to be higher and physical exercise decreased with increasing age. Therefore, an appropriate weight control program that is not detrimental to normal growth and development is called for in early adolescence.

Relationship between Adolescent Obesity and Socioeconomic Status of Parents: In Seoul, Yangpyong, and Yanbian Area / 예방의학회지

OBJECTIVES: Few studies have attempted to explain the association between socioeconomic status (SES) and obesity in Korea. Especially the studies on same race with different SES at same time are good for SES influence estimation. The present study highlights the influence of SES of parents on adolescent obesity. The subjects are the same race, but live in different areas, with different SES, Seoul and Yangpung in Korea, and Yanbian in China. METHODS: The cross-sectional study was conducted in Mar-Jun 1996. We carried out anthropometry, 24 hour-recall diet survey, self-reported questionnaire about sociodemographic characteristics and physical activity. For SES indicators, we used income and education of parents. RESULTS: The relationship between SES of parents, defined as educational status, and obesity in boys in Korea and China is direct, but not significant. The relationship is inverse and non-significant among Korean girls. However, for the Korean girls in severe obesity, the relationship is significant. For the Korean-Chinese girls, there is an inverse relationship between the education level and obesity but a direct relationship between the income level of parents and obesity. For the Korean adolescent, there are a direct association between the SES of parents and the nutrients factors such as energy, protein, and fat intake. The energy expenditure of adolescent has no relationship with SES of parents. CONCLUSION: Among boys, the higher the SES, the greater the risk of obese. Among girls in Korea and Korean-Chinese, on the other hand, the lower the educational status of parents, the greater the risk of obese.

Smoking, Alcohol and Other Drug Use in Korean Adolescents

BACKGROUND: The purpose of this study was to figure out the prevalence of smoking, alcohol and other drug abuse and the relationships among them. METHODS: In July 1996, a total of 4,438 school adolescents randomly sampled from 6 schools(2 middle schools, 2 general high schools, 2 vocational high schools) in Seoul were assessed with a self-completing questionnaire pertaining to smoking, alcohol and other drug (sedatives, stimulants, inhalants) use. RESULTS: The current smoking rate of the study subjects in the study was 17.1%(male : 27.5%, female : 8.3%) and the current alcohol drinking rate was 29.4%(male: 34.0%, female : 25.4%). The experience rate of sedatives and stimulants was 4.0%(male : 4.7%, female 4.4%) and 12.1%(male : 7.0%, female : 16.6%), respectively. The experience rate of glue, butane gas and other volatile solvents was 1.3%(male : 2.5%, female : 0.4%), 0.8%(male : 2.0%, female : 0.2%) and 1.0%(male : 1.4%, female 0.6%), respectively. Current alcohol drinking as we71 as smoking was increased with age, higher in males than females, higher in vocational high school students than general high school students. The experience rate of stimulants was higher in females than males but the experience rate of inhalants(glue, butane gas, organic solvents) was higher in males than females. The younger the age of the study subject, the earlier the starting age of smoking and alcohol drinking. Smoking, alcohol and other drug use status was highly associated with one another. CONCLUSIONS: The most commonly used drugs by the study subjects were alcohol, cigarettes, stimulants, sedatives and inhalants in this order. Higher experience rate was seen in vocational high school students than general high school students.

Psychosocial Aspects of Obse Adolescents

BACKGROUND: The prevalence of adolescent obesity is so rapidly increasing in Korea that there are concerns not only for increased risk of adult obesity in the future, but also for psychosocial problems in this period. This study is to find out the psychosocial correlates of adolescent obesity such as demographic characteristics, concerns about body image and weight, self-esteem, depression, and the locus of control for obesity. METHODS: A total of 963(obesity, 433 ; normal weight, 530) among 8,209 students from schools that underwent survey of physlcal examination in Seoul were assessed with a self-administered questionnaire. RESULTS: There were stastically significant differences between the obese group(OG) and the normal weight group(NWG) in family structure(p<0.05) and economic status(p<0.01). Adolescents in a extended family were more frequent in the OG(14.3%), than in the NWG( 9.4% ). Those in the high economic status were less frequent in the OG(15.3% ) than in the NWG (23.8% ), Although almost all obese adolescents considered that they were fat, normal weight students did not view themselves as they really were(p<0.001). That is, 57.5% of the NWG thought that they were either fat or thin instead. The majority of the OG was not satisfied with (86.4%) and was worried(88.0%) about their weight(p<0.001), and these aspects were more remarkable in women(p<0.001). The total self-esteem score in the OG was higher(p<0.001) than the NWG, and the depression score was lower in the OG than the NWG(p<0.001). Higher scores for powerful others and chance in the OG than those in NWG were shown(p<0.001). The psychosocial aspects which were highly associated with obesity were self-esteem in peers (odds ratio=1.547) and school(odds ratio=2.041), and powerful others(odds ratio=2.181) and chance(odds ratio=2.367) locus of control for obesity, and less probable characteristics were depression(odds ratio=0.723) and high economic status(odds ratio=0.498). CONCLUSIONS: Obese adolescents neither had low self-esteem nor were they depressive to the contrary of belief in the general public. Since they were not satisfied with and were worried about their body weight, however, there is a need to change our misconception of obese people who may risk unhealthy weight reduction. Further studies using various instruments and reinforcing internality for management of obesity would be needed to deeply understand the psychosocial correlates of obesity.

Development of an OPD-based childhood obesity control program and the effects of its utilization

BACKGROUND: Although childhood obesity is an increasing public health problem in our society and a number of regimens have been developed and distributed for the treatment of adult obesity, few studies have focused on therapeutic programs for obese children. The objective of this study was to deveIop and measure the effects of an OPD-based childhood obesity control program. METHOD: 'The OPD-based childhood obesity control program was developed by reviewing the preexisting literature and consulting specialists. It was applied to the 4-6th grade obese(obesity index >or=30% ) children. The effects of intervention were assessed by the changes in obesity-related behavior, caloric and nutrient intake and exercise amount. The effects in the OPD-based group (group I) were also compared with the school-based group (group II) and the no intervention group (group III). RESULTS: The OPD-based program was developed based on behavioral modification principles such as self monitoring, stimulus control, positive reinforcement, social support, cognitive change and behavioral contracts and contained diet and exercise therapy. The developed program was applied to 34 pairs(child and mother) in the treatment group of which 21 pairs completed the basic session and 17 pairs completed the additional follow up session. Significant changes, decreases, in obesity index were observed In the OPD-based group. No significant changes were found in the school-based group whereas increased degrees of obesity were found in the no intervention group. Obesity related behavior scores were significantly increased in both the OPD- and school-based groups. The children in both the OPD-based group showed significant decrease in dietary intake and increase in exercise amount. CONCLUSION: Although it was a short-term treatment result, the OPD-based program was more effective than the school-based program in childhood obesity control. We suggest that a control program of comparable intensity and individualization as ours is required, for effective childhood obesity control.

The effects of the adolescent smoking cessation program

BACKGROUND: Despite widespread recognition of the hazardous health effects of smoking, adolescent smoking continues to increase, emerging as a public health problem. However few studies have focused on smoking cessation programs for adolescent smokers. The purpose of this study was to measure the short-term effects of the adolescent smoking cessation program performed by the Seoul School Health Center. METHODS: Four hundred and twenty adolescent smokers referred from their schools from March to December of 1996 were assessed before and immediately after the program with a self-questionnaire. The data acquired from these 420 students was analyzed. RESULTS: Males were found to have a higher rate of daily smoking as compared with females. Middle school students had a earlier starting age than those of high school students. About 70% of the students had tried to stop smoking and about 1/3 had a high level of self-efficacy in stop smoking. More than 80% of the students were current alcohol drinkers and 10% ever had experience with other drugs. Many showed poor academic performance and low degree of satisfaction with their schools. More than 50% had experienced punishment at school Middle and high economic status were more common than low status, 73.3% had smokers in their families and 43.3% showed severe dysfunction in family APGA-R. Smoking cessation rate immediately after the program was 37.4%, highest in female high school students and lowest in male high school students Factors shown to be significantly associated with smoking cessation in males were school age, FTQ scores, presence of peer smokers, smoking and alcohol status, self-efficacy in stop smoking and degree of satisfaction with their schools. School age, presence of peer smakers, smoking and other drug use status, self-efficacy in stop smoking, academic performance, degree of satisfaction with their schools, experienoe of runaway from home, economic status and presence of smokers in their families were significant factors in females. Stepwise logistic regression showed that current alcohol users were less likely to succeed in smoking cessation and those with a higher level of self-efficacy in stop smoking were more likely to succeed in males. In females, high school students with higher economic status were more likely to succeed while those with smokers in their families or experience of runaway from home were less likely to succeed. CONCLUSIONS: To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of adolescent smokers. For more effectiveness, programs will need to comprehensively include the school, the family, peers, alcohol and other drug issues as well as smoking problem itself.

Body Mass Index, relative weight and Waist-hip ratio of school children and adolescents in Seoul

BACKGROUND: The purpose of this study is to obtain the accurate information on the obesity indices, such as body mass index(BMI), relative weight and waist-hip ratio(WHR) and to investigate their relationship in order to assess the childhood and adolescent obesity more appropriately. METHODS: In May, 1995, a total of 6943(male; 3469, female; 3474) students from primary, middle and high schools in Seoul were selected and each students height, weight, waist and hip circumference data were collected. RESULTS: The BMI increased with age in both sexes. From age 12 to 16, values of BMI 50th percentiles for females exceeded those for males. And the BMI 95th percentiles at the age of 13 to 14 years were higher for females than for males. The prevalence of obesity by relative weight was higher in males than in females(male ; 17.9%, female ; 13.1%). The WHR was higher in males than females in all age group and decreased with age in both sexes, showing more sharp reduction in females. Strong correlations were observed between the BMI and the relative weight, and the BMI and the relative weight correlated closely with WHR. The WHR was significanly higher in obese group' than in non-obese group. In the female obese group aged 6 to 11 years, no significant correlation was found between the relative weight and the WHR. CONCLUSIONS: There were significant relationships between the indices of obesity and body fat distribution. This study suggests that WHR as well as BMI and relative weight might be useful in assessing the childhood and adolescent obesity.

Pilot Study on Hepatitis B of 6- to 7-year-old School Children in Seoul / 한국역학회지

BACKGROUND: Recentry, the prevalence of HBsAg in children has been gradually decreased in Korea may be due to extensive vaccination. The object of this study is to identify the HbsAg positive rate in 6 to 7 year-old school children in Seoul and to outline the surveilance status of the HBsAg positive subjects. METHODS: We analyzed HBV mass screening results of 120,106 6 to 7-year-old school children in Seoul. For 188 HBsAg positive children who complied with the follow up visit, we tested HBeAg, LFT and interviewed their parents. We also compared the questionnaire results of HbsAg positive group with those of 694 random-sampled HBsAg negative controls. RESULTS: The overall HBsAg positive rate was 0.79%(0.81% in boys and 0.76% in girls). Children in poverty area showed significantly higher rate(1.04%) of HBsAg positivity than those in non-poverty area(0.77%). Among HbsAg positive children, 86.7% was also HBeAg positive and had higher ALT levels than those with negative HBeAg. More than 70% of parents of HBsAg positive children was not aware of their children's HBsAg status before the screening and 28.7% of mothers did not know their own HbsAg status. The complete vaccination rate of the HBsAg positive and HBsAg negative group were 75.5% and 77.4% respectively, which shows no significant difference. Having family history of HBV infection was significantly associated with HBsAg positive status(OR=32. 8). CONCLUSIONS: The HBsAg positive rate in 6- to 7-year-old school children has decreased in Korea compared to the data from previous studies. However in the aspects of public awareness and health care compliance, there are much room for quality improvement. Above all, more rigorous and continuous surveilance system is required for antenatal and postpartum care.

Correlation between High Blood Pressure and Lipid Profile in School Children

No abstract available.

Twelve-year Study on Body Mass Index Changes of Obese Adolescents / 예방의학회지

The purpose of this study is to observe the longitudinal changes in BMI (Body Mass Index) of obese and non-obese 3rd. grade high school students in Seoul for 12 years and to see the trends of overt weight gain in obese adolescents. The results are as follows; 1. The average annual increasing rates of body mass indices in male students were 1.14kg/m2 in obese group and 0.59 in non-obese group. In female students, the average annual increasing rates of body mass indices were 0.93kg/m2 in obese group and 0.53kg/m2 in non-obese group. 2. The change rate of BMI for 12 years was significantly higher in obese group than non-obese group. 3. Puberty had less influence on the change rate of BMI in obese group compared to non-obese group. 4. In obese group, 71.8% of the variance in BMI at 17 can be predicted by BMI at 16 years in male students. In female students 44.4% can be predicted by BMI at age 16. 5. Among the 17-year-old obese students, 58.8% of the males and 56.2% of females were found not to have been obese at 7 years of age. 6. Among the 17-year-old obese students, those who were obese at 7 years of age were found to have higher BMI at later ages than those who were in the non-obese group. Obese adolescents were more likely to be obese in their childhood than non-obese group. There was no optimal age for the significant weight gain and the increasing rate of BMI was constantly higher in obese group than in non-obese group. Due to the fact that child obesity in early age contributes to obesity in adolescence, close observation is advised on the other hand, a large proportion of obese adolescents can be preventable by early interventions, because about 50% of obese adolescents were not obese in early elementary school age.