• Title/Summary/Keyword: Disease Preventive

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Introduction and Evaluation of Communicable Disease Surveillance in the Republic of Korea (전염병 감시 체계 소개 및 평가)

  • Park, Ok;Choi, Bo-Youl
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.259-264
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    • 2007
  • Effective communicable disease surveillance systems are the basis of the national disease prevention and control. Following the increase in emerging and re-emerging infectious diseases since late 1990s, the Korean government has strived to enhance surveillance and response system. Since 2000, sentinel surveillance, such as influenza sentinel surveillance, pediatric sentinel surveillance, school-based sentinel surveillance and ophthalmological sentinel surveillance, was introduced to improve the surveillance activities. Electronic reporting system was developed in 2000, enabling the establishment of national database of reported cases. Disweb, a portal for sharing communicable disease information with the public and health care workers, was developed. In general, the survey results on usefulness and attributes of the system, such as simplicity, flexibility, acceptability, sensitivity, timeliness, and representa-tiveness, received relatively high recognition. Compared to the number of paid cases of national health insurance, reported cases by national notifiable disease surveillance system, and various sentinel surveillance system, the result of the correlation analysis was high. According to the research project conducted by KCDC, the reporting rate of physicians in 2004 has also greatly improved, compared with that in 1990s. However, continuous efforts are needed to further improve the communicable disease surveillance system. Awareness of physicians on communicable disease surveillance system must be improved by conducting education and information campaigns on a continuous basis. We should also devise means for efficient use of various administrative data including cause of death statistics and health insurance. In addition, efficiency of the system must be improved by linking data from various surveillance system.

The Effects of Acupuncture on Crohn's Disease: a systematic review and meta-analysis

  • Joon Hyun Bae;Seo Young Kang;Si Eun You;Hye In Jeong;Soobin Jang;Kyeong Han Kim
    • Journal of Pharmacopuncture
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    • v.26 no.3
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    • pp.211-226
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    • 2023
  • Objectives: Crohn's disease is a chronic gastrointestinal disease that belongs to inflammatory bowel disease. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture for Crohn's disease. Methods: We searched 12 databases from the date of the establishment of each database up to May, 2023 for relevant RCTs. The risk of bias of each study was assessed independently by three reviewers. The level of evidence of meta-analysis was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Results: A total of 12 studies were included. The effective rate (odds ratio [OR] 3.23, 95% confidence interval [CI] 1.43, 7.30) for mild to moderate Crohn's disease patients showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. CDAI change (mean difference [MD] -74.15, 95% CI -93.28, -55.01) for mild to moderate Crohn's disease showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. Conclusion: Although acupuncture with moxibustion showed significant effects compared to sham-acupuncture with sham-moxibustion, the effect of acupuncture alone is inconclusive. Moreover, only the effect of acupuncture treatment on mild to moderate Crohn's disease patients was derived as a remarkable result. To confirm the effectiveness of acupuncture treatment for Crohn's disease, studies using only acupuncture for intervention or more RCTs targeting various Crohn's disease patients according to the CDAI are required.

The Health Status of Residents near Iksan Industrial Complex Based on Questionnaires (설문조사에 근거한 익산 산업단지 인근 주민의 건강수준조사)

  • Bang, Hyuk;Lee, Mee-Ri;Kim, Nam-Soo;Hwangbo, Young;Kim, Hwa-Sung;Lee, Sung-Soo;Kim, Geun-Bae;Lee, Bo-Eun;Yoon, Mi-Ra;Kim, Yong-Bae
    • Journal of Environmental Health Sciences
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    • v.46 no.1
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    • pp.35-44
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    • 2020
  • Objectives: The purpose of this study was to compare the health status of residents who were exposed to the Iksan industrial area in the living environment and those who were not exposed to such a source of industrial activity through a questionnaire survey designed to appraise the residents' health levels. Method: The authors conducted a health questionnaire survey of 1,012 residents around Iksan regarding their personal information, physician-diagnosed disease history, odors experienced, and more. Logistic regression was performed to identify the associations between hazardous chemical exposure and physician-diagnosed diseases. Result: Logistic regression shows significant differences in allergic rhinitis, cardiovascular disease, hypertension, dyslipidemia, liver disease, and osteoporosis. Odors were experienced by 88.0% of the survey group. The seasons were summer (71%) and spring (24.9%). Conclusion: For allergic rhinitis, cerebral cardiovascular disease, and hypertension, which were significantly higher in the case group than in the control group in the disease diagnosis and disease treatment history of physicians, it was difficult to completely eliminate the association with odor exposure in the Iksan Industrial Complex. It is considered that it has affected nearby residents. This study means that a correlation between chronic diseases has been found through regression analysis, and furthermore, this result can be used as a basis for sampling for secondary epidemiological surveys.

The Case-Control Study on the Risk Factors of Cerebrovascular Diseases and Coronary Heart Diseases (뇌혈관질환과 관상동맥성 심질환의 위험요인에 관한 환자-대조군 연구)

  • Park, Jog-Ku;Kim, Hun-Joo;Park, Keum-Soo;Lee, Sung-Su;Chang, Sei-Jin;Shin, Kye-Chul;Kwon, Sang-Ok;Ko, Sang-Baek;Lee, Eun-Kyoung
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.639-655
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    • 1996
  • Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of these diseases are mostly alike. But some risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group (RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of monarch, and prothrombin time. The factor whose level was higher in AMI than ill RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAM than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAM and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age, uric acid, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.

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Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018

  • Okui, Tasuku
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.3
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    • pp.198-204
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    • 2020
  • Objectives: This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis. Methods: We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases' mortality rates into age, period, and cohort effects. Results: The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later. Conclusions: The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

Hepatitis A Outbreak in a Facility for the Disabled, Gyeonggi Province, Korea: An Epidemiological Investigation

  • Chang, Yeonhwa;Kim, Chanhee;Kim, Nayoung;Kim, Joon Jai;Lee, Heeyoung
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.5
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    • pp.370-375
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    • 2021
  • Objectives: The number of cases of hepatitis A virus (HAV) infections has sharply increased in Korea, especially among young adults. In this study, an HAV outbreak in a facility for disabled people was investigated, and we found epidemiological differences both between 2 different generations and between generally abled and disabled groups. Methods: We analyzed the incubation period and attack rate of an HAV outbreak and investigated the prevalence of HAV antibodies among the staff and residents of a facility for the disabled. We performed a retrospective cohort study during the HAV outbreak, which lasted from February 8 to 25, 2019, including examinations of HAV antibody tests and post-exposure HAV vaccination for the staff or residents of the facility. Results: There were 9 confirmed cases in 2 staff members and 7 residents. Among 53 people (30 staff and 23 residents), except for the 9 confirmed cases and 1 staff member with a known history of HAV infection, HAV seroprevalence was seen in 16.7% of the staff under 40 years of age and 95.2% of those over 40 years of age, while the corresponding rates in the residents were 0.0% and 58.8%, respectively. Conclusions: This result implies that it is necessary to prioritize HAV vaccination for vulnerable groups and workers of residential care facilities.

Indoor Radon and Lung Cancer: Estimation of Attributable Risk, Disease Burden, and Effects of Mitigation

  • Kim, Si-Heon;Koh, Sang-Baek;Lee, Cheol-Min;Kim, Changsoo;Kang, Dae Ryong
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1123-1130
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    • 2018
  • Purpose: Exposure to indoor radon is associated with lung cancer. This study aimed to estimate the number of lung cancer deaths attributable to indoor radon exposure, its burden of disease, and the effects of radon mitigation in Korea in 2010. Materials and Methods: Lung cancer deaths due to indoor radon exposure were estimated using exposure-response relations reported in previous studies. Years of life lost (YLLs) were calculated to quantify disease burden in relation to premature deaths. Mitigation effects were examined under scenarios in which all homes with indoor radon concentrations above a specified level were remediated below the level. Results: The estimated number of lung cancer deaths attributable to indoor radon exposure ranged from 1946 to 3863, accounting for 12.5-24.7% of 15623 total lung cancer deaths in 2010. YLLs due to premature deaths were estimated at 43140-101855 years (90-212 years per 100000 population). If all homes with radon levels above $148Bq/m^3$ are effectively remediated, 502-732 lung cancer deaths and 10972-18479 YLLs could be prevented. Conclusion: These findings suggest that indoor radon exposure contributes considerably to lung cancer, and that reducing indoor radon concentration would be helpful for decreasing the disease burden from lung cancer deaths.

Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis

  • Lee, Hye-Ah;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.5
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    • pp.323-328
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    • 2012
  • Objectives: Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. Methods: We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. Results: All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. Conclusions: The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

The Validity and Reliability of a Screening Questionnaire for Parkinson's Disease in a Community

  • Kim, Jong-Hun;Cheong, Hae-Kwan;Lee, Chong-Sik;Yi, Sung-Eun;Park, Kun-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.1
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    • pp.9-17
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    • 2010
  • Objectives: Parkinson's disease is one of the most common neurodegenerative diseases in the elderly population. In order to estimate the prevalence of Parkinson's disease in the community, the application of a good screening tool is essential. We evaluated the validity and reliability of a Parkinson's disease screening questionnaire and propose an alternative measure to improve its validity for use in community surveys. Methods: We designed the study in a three-phase approach consisting of a screening questionnaire, neurologic examination, and confirmatory examination. A repeated survey was administered to patients with disease detected in the community and on 150 subjects. We examined internal consistency using Cronbach's alpha test, test-retest reliability using the kappa statistic, and validity using sensitivity, specificity, and ROC curves. Unadjusted odds ratios were utilized for the estimation of weights for each questionnaire item. Results: The Cronbach's alpha of the questionnaire was 0.708. The kappa statistic for test-retest reliability was good to generally fair in most of the items. When newly proposed weighting scores were used, the optimum cut-off value was 7/8. When cut-off value was 5/6 for surveying prevalence in a community, the sensitivity was 0.98, and the specificity was 0.61, with simultaneous improvement in reliability. Conclusions: We recommend 5/6 as the ideal cut-off value for the survey of PD prevalence in community. This questionnaire designed for the Korean community could help future epidemiologic studies of PD.