National survey of awareness and training experience of automated external defibrillator

OBJECTIVE: Public concerns and awareness of automated external defibrillators (AEDs) are essential for improving the survival outcomes of out-of-hospital cardiac arrest (OHCA) in the community. On the other hand, the proportion of OHCA, in which AED is used in a prehospital setting, is very low in Korea. The aim of this study was to identify the barriers and training issues of AEDs. METHODS: A nationwide population-based survey was conducted to analyze the current public trends in AED awareness, training, and intention to use in 2017 (n=506). The barriers and training issues of AEDs were then documented. For trend analysis, previous tri-temporal surveys were obtained in 2007, 2011, and 2015. RESULTS: Public awareness of AEDs has increased: from 5.8% in 2007, to 30.6% in 2011, 82.6% in 2015, and 79.4% in 2017 (P<0.001). The training experience of AEDs has increased over time: from 0.5% in 2007 to 8.2% in 2011 and 33.2% in 2017. Thirty-two percent of respondents knew how and where to find the AEDs, but only 12.5% were able to certainly locate their public-access AED near their residency or work places. The reasons for being unwilling to use the AED included not knowing how to use (65.0%), fear of causing harm to the victim (21.3%), and legal liability (11.7%). CONCLUSION: Not knowing the location of AED and how to use it, and being unaware of the Good Samaritan Law were the major barriers to public access defibrillation. Further research is urgently needed if AEDs are to be increased and more lives saved.

Community mental health status six months after the Sewol ferry disaster in Ansan, Korea / 한국역학회지

OBJECTIVES: The disaster of the Sewol ferry that sank at sea off Korea's southern coast of the Yellow Sea on April 16, 2014 was a tragedy that brought grief and despair to the whole country. The aim of this study was to evaluate the mental health effects of this disaster on the community of Ansan, where most victims and survivors resided. METHODS: The self-administered questionnaire survey was conducted 4 to 6 months after the accident using the Korean Community Health Survey system, an annual nationwide cross-sectional survey. Subjects were 7,076 adults (≥19 years) living in two victimized communities in Ansan, four control communities from Gyeonggi-do, Jindo and Haenam near the accident site. Depression, stress, somatic symptoms, anxiety, and suicidal ideation were measured using the Center for Epidemiologic Studies-Depression Scale, Brief Encounter Psychosocial Instrument, Patient Health Questionnaire-15, and Generalized Anxiety Disorder 7-Item Scale, respectively. RESULTS: The depression rate among the respondents from Ansan was 11.8%, and 18.4% reported suicidal ideation. Prevalence of other psychiatric disturbances was also higher compared with the other areas. A multiple logistic regression analysis revealed significantly higher odds ratios (ORs) in depression (1.66; 95% confidence interval [CI], 1.36 to 2.04), stress (1.37; 95% CI, 1.10 to 1.71), somatic symptoms (1.31; 95% CI, 1.08 to 1.58), anxiety (1.82; 95% CI, 1.39 to 2.39), and suicidal ideation (1.33; 95% CI, 1.13 to 1.56) compared with Gyeonggi-do. In contrast, the accident areas of Jindo and Haenam showed the lowest prevalence and ORs. CONCLUSIONS: Residents in the victimized area of Ansan had a significantly higher prevalence of psychiatric disturbances than in the control communities.

National Survey of Training Methodology between Experience and Needs for Laypersons' Cardiopulmonary Resuscitation

PURPOSE: The purpose of this study was to perform a comparative analysis of training methodology between accessibility and needs for cardiopulmonary resuscitation (CPR) in the community. METHODS: This population-based nationwide study used a structured questionnaire via telephone survey in 2011-2012. The study was conducted by stratified cluster sampling to assess the impact of age, gender, and geographic regions (n=1,000). The contents of the questionnaire consisted of awareness, prior training status, and willing methodology of public CPR training. RESULTS: Thirty-eighty percent of respondents (n=381) had previously been taught CPR. Military service, education facility/ school, and workplace were 3 major resources of public CPR training among previously educated subjects (45%, 23%, and 9%, respectively). Seventy-two percent of trainees had been taught less than an hour and only 60% were trained using an individual manikin for CPR practice. Fifty-nine percent (n=593) had willingness to participate in CPR education and 40% of subjects wished to learn in a hospital or health care facility. Place of CPR training showed a major difference between previous experiences and willing groups in the community. Women and elders were more likely to learn CPR. Almost all respondents wanted short-duration learning (<1 hour), however, it was similar in the groups. CONCLUSION: In the scope of the public, training site showed a significant discrepancy between previous accessibility and needs of layperson. They prefer a highly accessible location and method with relatively short-practice programs.

A survey of patients with substance use disorders at government treatment facilities in The Bahamas / Estudio de pacientes con trastornos por uso de sustancias en centros gubernamentales de tratamiento en Las Bahamas

OBJECTIVE: To determine the sociodemographic information and characteristics of patients aged 18-60 years diagnosed with substance use disorders presenting to the three government treatment facilities. To determine the prevalence rates of alcohol, cannabis, cocaine and poly-substance use disorders in patients presenting to government treatment facilities. METHODS: The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition, text revision (DSM-IV-TR) Axis 1 disorders was the first instrument used to screen for drug abuse or dependence. Additional questionnaires included a sociodemographic questionnaire and the Survey of Addicted Patients in Treatment Centre Standardized Questionnaire. RESULTS: The number of participants interviewed in the study was 120 people; 89.2% were males and 10.8% were females. The mean age of all participants with substance use disorders was 36.22 (10.74) years and they were predominantly male (8 to 1). Males were mostly single, unemployed or casually employed, of middle school education and were residents of New Providence. Alcohol, cannabis and cocaine were the common drugs that were misused. Of cocaine users, 52 (82.5%) met the DSM-IV-TR criteria for dependence and of cannabis users, 20 (18.9%) met the DSM-IV-TR criteria for abuse. CONCLUSIONS: There is a need to conduct community surveys on school children, other adult populations eg in the wider community and on other island populations to determine the population rates of substance use disorders. Once the needs have been identified through research for the different islands and target groups, informed decisions can be made as to the allocation of financial and human resources.

OBJETIVO: Determinar la información sociodemográfica y las características de los pacientes en edades de 18-60 años diagnosticadas con trastornos por uso de sustancia, que acuden a los tres centros gubernamentales de tratamiento de la drogadicción. Determinar la tasa de prevalencia de los trastornos por uso de alcohol, cannabis, cocaína y polisustancias en los pacientes que acuden a los centros de tratamiento del gobierno. MÉTODOS: La Entrevista clínica estructurada para el diagnóstico y el Manual estadístico de trastornos mentales, cuarta edición, texto revisado (DSM-IV-TR), trastornos del eje 1, fue el primer instrumento utilizado para detectar el abuso o dependencia de drogas. Los cuestionarios adicionales incluyen un cuestionario sociodemográfico así como la llamada Encuesta de pacientes adictos en el cuestionario estandarizado de los centros de tratamiento. RESULTADOS: El número de participantes entrevistados en el estudio fue de 120 personas; 89.2% eran varones y 10,8% eran hembras. La edad promedio de todos los participantes con trastornos por uso de sustancias fue 36.22 (10,74) años y eran predominantemente masculinos (8 a 1). Los varones eran en su mayoría solteros, desempleados, o trabajadores eventuales, de nivel educacional medio, y residentes de Nueva Providencia. Alcohol, cannabis y cocaína fueron las comúnmente las sustancias del uso adictivo. De los consumidores de cocaína, 52 (82,5%) correspondían a los criterios del DSM-IV-TR con respecto a la dependencia, y de los consumidores de cannabis, 20 (18,9%) correspondían a los criterios de DSM-IV-TR en relación con el abuso de sustancias. CONCLUSIONES: Es necesario llevar a cabo encuestas comunitarias con niños en edad escolar, otras poblaciones adultas - por ejemplo en la comunidad en general y en otras poblaciones de la isla - para determinar las tasas poblacionales de trastornos por uso de sustancias. Una vez que las necesidades hayan sido identificadas mediante investigación de las diferentes islas y los grupos seleccionados como objetivos, pueden tomarse decisiones informadas en cuanto a la asignación de las finanzas y recursos humanos.

Application of a simple random sampling method on surveys at the community level / 中华流行病学杂志

Objective To study the feasibility of a simple random sampling on surveys at the community level and to evaluate the quality of samples under survey.Methods A simple random sample of households was taken,based on the electronic listings of community households from Gongshu and Xiacheng districts of Hangzhou city.One of the adults aged 18 to 64 years in the sampled households was identified with KISH method to finish a questionnaire survey.More than 500 people from the sample size was required in each district.Results Of 950 sampled households in Xiacheng district,511 (53.8%) finished the survey while 506 (36.7%) out of the 1380 sampled households in Gongshu district did.The proportions of non-response due to the following reasons as:none with eligible age in the households,relocation of the original household,mass relocation of the community,and errors in the household listings etc.were 38.3% and 43.5% respectively,in the two districts.Proportions attributed to non-response and refusal to response of sampled household or individual were 8.0% and 19.9% respectively.No statistical significant differences in age and gender were found between the surveyed samples and the population in the sampled households,or in gender between the populations in the sampled households and in Hangzhou city.However,the population in the sampled households showed a more aging population structure than the population in Hangzhou city.Conclusion In a geographically limited area,using a simple random sampling method to do the survey is feasible,based on the electronic listings of household.Enough time spent during the household visit guarantees the interviewers to get a representative sample of the sampling frame.There is an urgent need for the timeliness,completeness and accuracy of electronic household listings to be improved.

Evaluation of Measles Vaccine Effectiveness in a Community Outbreak / 예방의학회지

OBJECTIVE: From an analysis of a community outbreak of measles in Youngju, Gyeongbuk, in March 2000, the authors evaluated the effectiveness of the measles vaccination and its determinants to provide an epidemiologic basis for the establishment of a vaccination policy. METHODS: Information was collected regarding the vaccinations from the health records of four primary schools and through a questionnaire survey of the parents of students in two middle and two high schools (N=4638). Measles cases were surveyed from the patient list of each school and from case reports in the public health center. The attack rate and vaccine effectiveness of measles was evaluated by school; grade; frequency, region, and institution of vaccination. RESULTS: The attack rate of measles, 6.3% among the total subjects, was higher in middle school students (15.8%) than in primary (2.0%, p<0.05) and high school students (8.9%, p<0.05). The attack rate of the unvaccinated group was 4.6-fold higher than the vaccinated group in primary schools (p<0.05). Vaccine effectiveness was 83.2% among lower graders of primary schools, 34.0% among higher graders of primary schools, 26.1% in middle schools, and -7.0% in high schools. In multiple logistic regression analysis, grade in school (odds ratio, 0.77; 95% CI=0.67-0.87) and frequency of vaccination (odds ratio, 0.57; 95% CI=0.37-0.88) were significant predictors of the outcome. CONCLUSIONS: We concluded that the explosive outbreak of measles in this area resulted from both inadequate vaccination coverage and secondary failure of vaccination. There was no evidence of any effect of the cold chain system on the vaccine failure.