Factors Associated with Single-Use and Co-Use of Tobacco and Alcohol:A Multinomial Modeling Approach

Tobacco smoking and alcohol consumption are among the most important public health concerns not only in South Korea but also globally. This study identified the factors associated with single-use and co-use of tobacco and alcohol in Korean adults and provided more accurate estimates using a multinomial modeling approach. This study used the Korea Community Health Survey Data 2017, of which 205,336 respondents were selected as the sample for a multinomial logistic regression analysis. For the group that identified as only drinking monthly compared to the reference group, we found that the direction of the following factors was opposite to that of the results of the only currently smoking group: Age, marital status, educational level, monthly household income, occupation, obesity, self-rated health, hypertension, and hyperlipidemia. For the currently smoking and drinking monthly group relative to the reference group, the overall direction was a mix of the results of only currently smoking and only drinking monthly. These findings support the development of policies that consider the risk of smoking tobacco and consuming alcohol simultaneously

Sex Differences in Factors Associated with General Life Satisfaction among Occupationally Injured Workers in Korea:A Panel Analysis of the 2013-2017 Panel Study of Worker's Compensation Insurance

The majority of previous occupational studies focused on factors affecting life satisfaction among occupationally injured workers have been based on a cross-sectional design, not a sex-aggregated model. This study aimed to identify sex differences in factors related to life satisfaction among workers who experienced work-related injuries using nationally representative panel data from South Korea. Data from the first to fifth (2013-2017) waves of the Panel Study of Worker's Compensation Insurance were analyzed. Of 1514 respondents, those who participated in all five survey waves were included in the final study population. To assess the factors associated with general life satisfaction of the occupationally injured workers, a panel data analysis was conducted using generalized estimating equations. The impacts of education level, return to work, self-rated health, task performance, self-esteem, and self-efficacy were significant in both sexes. On the other hand, the influence of age, marital status, personal labor income, and National Basic Livelihood Act recipient status significantly varied by sex. There were sex differences in factors related to general life satisfaction among occupationally injured workers, highlighting the need for sex-specific intervention programs. Employers, healthcare providers, and other stakeholders need to pay attention to vulnerable groups and investigate the most appropriate financial support

Relationship between body image and weight status in east Asian countries:comparison between South Korea and Taiwan

Background: There are many studies examining the relationship between body image and weight status that compare Western and Asian countries. One limitation of these past studies was assuming that all Asian countries are a homogeneous group. To fill the gap in the literature, this study examined the relationship between body image and weight status between participants from two Asian countries. Methods: This study utilized data from the 2010 module of the East Asian Social Survey from South Korea (n = 1576) and Taiwan (n = 2199), which contained questions related to body image. Body image was originally measured using a five-point Likert-type question, which was collapsed into three categories for the analysis. Weight status was derived from body mass index scores, which were calculated using self-reported weight and height. A set of multinomial logistic regression analyses were used to investigate the relationship between body image and weight status, stratified by country. Results: A significant relationship between body image and weight status after controlling for relevant covariates was reaffirmed in this study in the South Korean and Taiwanese. Results indicated that the relationship between body image and weight status of the Taiwanese sample was similar to the relationship in the South Korean sample. However, the results from a further analysis showed that the strength of the relationship across the two Asian countries appeared to be different. Conclusions: The weight over-perception was more evident in South Korea than in Taiwan. Females were more vulnerable to societal pressures for thinness and the misperception of the ideal body than males. Interventions to improve distorted body image perception were needed in both countries

Engaging Patients with Heart Failure into the Design of Health System Interventions: Impact on Research Methods

Purpose: To engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. Design: A qualitative structured interview was conducted. Method: Eight patients from two rural hospitals participated in an interview prior to discharge. Results: Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Conclusion: Patient interviews validated that the intervention, methods and outcomes were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of patient centered outcome research is essential to guide the investigator approach to studies

Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan:a secondary analysis of cross-sectional survey data

OBJECTIVE: Untimely vaccination refers to receiving the given dose before (early) or after (delayed) the recommended time window. The purpose of this study was to assess the extent of timeliness of childhood vaccinations and examine the determinants of vaccination timeliness in Sindh province, Pakistan. DESIGN: Cross-sectional analysis of data from the 2013 and 2014 Maternal and Child Health Program Indicator Surveys. SETTING: Community-based maternal and child health surveys. PARTICIPANTS: Among 10 200 respondents of Maternal and Child Health Program Indicator Surveys, 1143 women who had a live birth in the 2 years preceding the survey were included. OUTCOMES: At the participants' home, an interviewer asked mothers to show their children's vaccination cards, which contained information regarding vaccinations. Children's vaccination status was categorised into timely or early/delayed compared with vaccination schedule. A logistic regression analysis using Firth's penalised likelihood was performed to identify factors associated with timeliness of vaccinations. RESULTS: 238 children (20.8% of children who received a full set of basic vaccinations) received all vaccinations on schedule among children who received a full set of basic vaccinations. The percentages of timely vaccinations ranged from 2.3% for second measles vaccination to 89.3% for bacillus Calmette-Guérin. Child's age and place of delivery were associated with timely vaccinations. Older child age and institutional delivery were associated with decreased timely vaccination rate. CONCLUSIONS: Home-based vaccination record is a key tool to improve the timeliness of vaccinations. The redesigned vaccination cards, the new electronic registries for vaccination card information and the vaccination tracking system to remind the second/third vaccination visits may be helpful to improve timely vaccinations for children under 2 years old

Body mass index and self-rated health in East Asian countries:Comparison among South Korea, China, Japan, and Taiwan

There have been conflicting findings regarding the relationship between body mass index (BMI) and self-rated health (SRH) worldwide. The purpose of this study was to examine the association between BMI and SRH by comparing its relationship in four East Asian countries: South Korea, China, Japan, and Taiwan. Using data from the East Asian Social Survey, the relationship between weight status and SRH status was investigated and compared between four countries, China, Japan, South Korea, and Taiwan. An ordinal logit regression model was estimated for each country, and the results were compared. We found that the relationship between weight status and SRH status differed across the four countries. In China, people who were overweight reported better SRH scores than those of normal weight, whereas in Japan, obese and severely obese people reported poor scores. In contrast, South Koreans who were underweight, obese, or severely obese reported poor ratings of health status than those of normal weight. In Taiwan, however, no differences in respondents' weight status were found across SRH scores. There were notable differences in the relationship between BMI and SRH status in four East Asian countries. Individual countries should consider these relationships when designing and implementing obesity intervention programs

Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan; A secondary analysis of cross- sectional survey data

Background Pakistan has a high burden of newborn mortality, which would be significantly preventable through appropriate routine immunization. The purpose of this study was to measure the basic timely childhood immunization coverage and to identify determinants of factors influencing childhood immunization coverage in Sindh, Pakistan. Methods Data from Maternal and Child Health Program Indicator Survey 2013-2014 which was conducted in Sindh province of Pakistan was used. Outcome measure was full coverage of the basic immunization schedule from child's vaccination card. The association of receiving basic immunization with demographic factors, socioeconomic status, mother and child health information sources, and perinatal care factors were tested by binary logistic regression. Results Among 2,253 children, 1,156 (51.3%) received age-based full basic immunization. The basic immunization rates were 69.1% for under five weeks old, 38.3% for six to nine weeks, 18.8% for 10-13 weeks, 44.0% for 14 weeks-eight months, 60.4% for nine to 11 months, and 59.1% for over one year. Child's age, number of living children, parents' education level, wealth, the source of mother and child health information, number of antenatal care, and assistance during delivery were associated with completing basic immunization. Conclusions The overall full basic immunization coverage in Pakistan was still low. Policy makers should identify children at risk of low immunization coverage and obstacles of receiving antenatal care, implement educational interventions targeting on less educated parents, and conduct mass immunization campaigns for timely and complete immunization

2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism

Primary aldosteronism (PA) is a common, yet underdiagnosed cause of secondary hypertension. It is characterized by an overproduction of aldosterone, leading to hypertension and/or hypokalemia. Despite affecting between 5.9% and 34% of patients with hypertension, PA is frequently missed due to a lack of clinical awareness and systematic screening, which can result in significant cardiovascular complications. To address this, medical societies have developed clinical practice guidelines to improve the management of hypertension and PA. The Korean Endocrine Society, drawing on a wealth of research, has formulated new guidelines for PA. A task force has been established to prepare PA guidelines, which encompass epidemiology, pathophysiology, clinical presentation, diagnosis, treatment, and follow-up care. The Korean clinical guidelines for PA aim to deliver an evidence-based protocol for PA diagnosis, treatment, and patient monitoring. These guidelines are anticipated to ease the burden of this potentially curable condition

End-of-life discussions as a component of advance care planning and their associations with care received near death

Background: Advance care planning (ACP) is an ongoing process of communication of end-of-life (EOL) preferences between patients, families, and health care professionals (HCPs). ACP includes having EOL discussions, durable power of attorney for health care (DPAHC), and living will (LW). Engagement in DPAHC and LW can lead to less aggressive treatments and more comfort care, but little is known about the effects of EOL discussions of patients’ preferences on their outcomes. Purposes: The purposes of this study were: 1) to examine patient characteristics influencing engagement in ACP; 2) to determine the effect of engagement in EOL discussions alone and the combined effect of EOL discussions with DPAHC and/or LW on EOL care; and 3) to examine the effect of EOL discussions and DPAHC on congruency between patients' preferences for care and care they received. Method(s): This study was a secondary data analysis using the Health and Retirement Study Exit Interviews of 6,001 decedents aged 50 years or older. Five different types of engagement in ACP were selected for this study. Sequential logistic regression and multivariable logistic regression were used. Results: Decedent characteristics significantly associated with engagement in ACP were different by the types of engagement. Engagement in EOL discussions only was not a predictor of receiving all possible care to prolong life but was a predictor of receiving comfort care. Engagement in all three types of ACP was the strongest predictor of receiving both all possible care to prolong life and comfort care. Among decedents who had a LW, there was a synergistic effect of engagement in EOL discussions and DPAHC on receiving care consistent with decedents' preferences for EOL care. Engaging in more types of ACP was associated with lower odds of receiving all possible care, higher odds of receiving comfort care, and higher odds of receiving care consistent with decedents’ preferences. Conclusions: Findings suggests that there was a synergistic effect of engagement in EOL discussions, DPAHC, and LW on receiving EOL care. HCPs should make more effort to communicate with patients and their families about their preferences at the EOL