Chun-Bae Kim

Erratum to: Does South Korea have hidden female smokers: discrepancies in smoking rates between self-reports and urinary cotinine level

Background Female smoking is perceived very negatively in East Asian countries such as South Korea, Japan, and China, as well as in Islamic countries. These countries’ self-reported surveys (SRs) tend to produce results that underestimate the number of smokers, owing to the social desirability response bias. The present study seeks to assess South Korea, Europe, and the Americas, by comparing data from SRs with those from urinary cotinine samples.

The Correlation of Different Cotinine Levels With Questionnaire Results A Comparative Study for Different Measurement Methods of the Adolescent Smoking Rate in Korea

This study compares the results of the Korea National Health and Nutrition Examination Survey (Self-Reported; KNHANEs [SR]) survey with urine-cotinine concentration (UCC) and the official index issued by the Korea Youth Risk Behavior Web-based Survey (KYRBS). We established standard cutoffs of 20 ng/mL, 30 ng/mL, 50 ng/mL, and 100 ng/mL to compare the results of UCC testing with those of self-reporting methods. The KYRBS demonstrated an overall current smoking rate of 12.25%, while the KNHANEs measured an overall rate of 9.63%. The UCC20 reported the highest current smoking rate at 25.6% overall. Methods that detected a lower prevalence of current smoking, in declining order, were the UCC30, UCC50, UCC100, online survey, and the KNHANEs (SR). The results of this study show that online surveys on smoking administered to adolescents have fewer false responses compared with the KNHANEs (SR). However, compared with UCC testing, online surveys still significantly underreport adolescent smoking rates.

Factors Influencing on Influenza Vaccination Coverage

The aim of this study was to investigate the factors influencing on influenza vaccination among socio-demographic characteristics and health behaviors. Data of 18,299 adults of age between 19 and 65 years who answered to the survey on National Health and Nutrition and influenza vaccination from 2007 to 2010 was used and analyzed. Overall influenza vaccination rate was 21.7%. Logistic regression analysis revealed that factors influencing on influenza vaccination were an increasing age, a residence in rural area, a high personal income, a low educational level, jobless women, experience of hospital visits, and morbidity of chronic illnesses. In conclusion, influenza vaccination rate in Korea is low and influenced by multiple socio-demographic factors and health behaviors. It is needed to seek a strategy to develop a vaccination program in consideration of factors associated with influenza vaccination.

Consequence of Indoor Air Pollution in Rural Area of Nepal: A Simplified Measurement Approach

People of developing countries especially from rural area are commonly exposed to high levels of household pollution for 3–7 h daily using biomass in their kitchen. Such biomass produces harmful smoke and makes indoor air pollution (IAP). Community-based cross-sectional study was performed to identify effects of IAP by simplified measurement approach in Sunsari District of Nepal. Representative samples of 157 housewives from household, involving more than 5 years in kitchen were included by cluster sampling. Data were analyzed by SPSS and logistic regression was applied for the statistical test. Most (87.3%) housewives used biomass as a cooking fuel. Tearing of eyes, difficulty in breathing, and productive cough were the main reported health problems and traditional mud stoves and use of unrefined biomass were statistically significant (p < 0.05) and more risk (AOR > 2) with health problems related to IAP. The treatment cost and episodes of acute respiratory infection was >2 folders higher in severe IAP than mild IAP. Simplified measurement approach could be helpful to measure IAP in rural area. Some effective intervention is suggested to reduce the severe level of IAP considering women and children.

Chhaupadi Culture and Reproductive Health of Women in Nepal

Different sociocultural barriers concerning women’s health are still prevalent. Chhaupadi culture in Nepal is that threat wherein menstruating women have to live outside of the home in a shed-like dwelling. Our study aims to determine the factors of reproductive health problems related to Chhaupadi. A cross-sectional study was performed with women of menstrual age (N = 672) in Kailali and Bardiya districts of Nepal. Data were collected with stratified sampling and analyzed using SPSS. Reproductive health problems were observed according to the World Health Organization reproductive health protocol. Regression analysis was performed to show the association between relevant variables. Results reveal that one fifth (21%) of households used Chhaupadi. Condition of livelihood, water facility, and access during menstruation and precisely the Chhaupadi stay was associated (P < .001) with the reproductive health problems of women. The study concludes that Chhaupadi is a major threat for women’s health. Further research on appropriate strategies against Chhaupadi and menstrual hygiene should be undertaken.

Factors Influencing Utilization of Medical Care Among Osteoarthritis Patients in Korea: Using 2005 Korean National Health and Nutrition Survey Data

OBJECTIVES The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. METHODS We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. RESULTS On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant difference between whether the medical utilization in men patients. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant difference between whether the medical utilization in women patients. CONCLUSIONS The patients who tend to receive less care are those suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.

Evaluation of Trained Teachers' Implementation of a Sex Education Curriculum.

Abstract This study evaluated the long-term implementation of the Understanding Sexuality (US) curriculum by teachers trained to use the curriculum. Cross-sectional written surveys were used to determine the extent to which teachers from 30 school corporations implemented US and factors related to this implementation. Although a majority of the schools (90.0 percent) and the teachers (66.7 percent) still utilize the US curriculum, many of the teachers failed to maintain implementation fidelity by modifying the lessons, using parts of the lessons, and integrating textbooks and other curricula into the module. The most important barriers to the implementation of US were insufficient time for sex education and the assignment of US trained teachers to other instructional areas. ANOVA and Mann-Whitney U tests revealed more favorable US perceptions and implementation practices among teachers who intended to attend a US reconvening workshop. Pearson product-moment correlation analyses revealed relationships betw...

The Components of Self-Perceived Health in the Kailali District of Nepal: A Cross-Sectional Survey

Self-perceived health is a health measure with well-established links with mortality, healthcare services utilization, and future health. Various components of self-perceived health have been identified in different populations. In this study, we aimed to investigate the components of self-perceived health in a Nepali population. This was a cross-sectional survey conducted in the Kailali district of Nepal in 2014. The sample was initially consisted of 309 households, representative of the population of one municipality and one village; however, 304 participants were included in the analyses. Information on socio-demographic characteristics, health condition, satisfaction with healthcare services, psychological factors, and health behaviors was extracted. Logistic regression analyses were carried out to identify putative components of self-perceived health. Among the 304 respondents, 244 (80.3%) and 60 (19.7%) perceived their health as good and poor, respectively. Middle age and lower satisfaction with healthcare services were associated with worse self-perceived health, accounting for 10.3% of variance. No regular exercise, drinking, smoking, and being unhappy were also related with worse self-perceived health, after adjustment for age and satisfaction level. In the final model, however, drinking status did not significantly contribute. Our findings support previous findings that individuals with positive health behaviors and psychological wellbeing are more likely to perceive their health better. This study may direct public health policies toward more targeted interventions.

Impact of Spiritual Behavior on Self-Reported Illness: A Cross-Sectional Study among Women in the Kailali District of Nepal

Background Different health behaviors influence health and illness. Spiritual well-being is one of the most important aspects of health promotion. The aim of this study was to identify the association between spiritual behavior in relation to meditation, worship, and physical exercise during yoga with self-reported disease/illness among women of the Kailali district of Nepal. Methods This was a cross-sectional study with 453 randomly selected women in the Kailali district of Nepal within 1 municipality and 4 village development committees (VDC) using cluster sampling. We used a semi-structured interview to collect the data for selected respondents. Socioeconomics, lifestyle, self-care, and spiritual behavior variables were independent variables, and self-reported illness in the past year was a dependent variable. Descriptive statistics, chi square, hierarchical logistic regression for odds ratio, and 95% CI were used when appropriate. Results Study results showed that 89% of participants were from the rural area, 29.3% were housewives, 51.4% had no formal education, 43.2% used tobacco, 42.1% did yoga, and 16.9% engaged in regular worship. Self-reported illness was associated with safe toilet-using behavior, tobacco use, junk food consumption, yoga and regular exercise, worship, and regular sleeping habits. Comparing odds ratios and 95% CIs, the women who had safe toilet behavior and did not use tobacco were 2.48 (1.98–7.98) and 2.86 (1.74–7.34) times less likely to be ill, respectively. Likewise, women who consumed junk food; did not regularly exercise, meditate, or worship; and had irregular sleeping habits were 1.65 (1.32–4.61), 2.81(1.91–5.62), 2.56 (2.01–4.88), 4.56 (3.91–8.26), and 2.45 (2.12–5.03) times more likely to become ill, respectively. Conclusion Our study concludes that spiritual behavior is effective for better health and low risk for disease occurrence. A spiritual health policy and separate curriculum for basic education and medical education should be promoted globally, and further research is recommended.

A Comparative Study on Outcome of Government and Co-Operative Community-Based Health Insurance in Nepal

Background There are different models for community-based health insurance (CBHI), and in Nepal, among them, the government and the local communities (co-ops) are responsible for operating the CBHI models that are in practice. Aims The aim of this study is to compare the outcomes in relation to benefit packages, population coverage, inclusiveness, healthcare utilization, and promptness of treatment for the two types of CBHI models in Nepal. Methods This study was an observational and interactive descriptive study using the concurrent mixed approach of data collection, framing, and compilation. Quantitative data were collected from records, and qualitative data were collected from key informants in all 12 CBHI groups. Unstructured questionnaires, observation checklists, and memo notepads were used for data collection. Descriptive statistics and the Mann–Whitney U test were used when appropriate. Ethically, written informed consent was obtained from the respondents who participated in the study, and they were told that they could withdraw from the study anytime. Results The study revealed the following: new enrolment did not increase in either group; however, the healthcare utilization rate did (Government 107% and co-ops 137%), while the benefit packages remained almost same for both groups. Overall, inclusiveness was higher for the government group. For the CBHI co-ops, enrollment among the religious minority and the discount negotiated with the hospitals for treatment were significantly higher, and the promptness in reaching a hospital was significantly faster (p < 0.05) than that in the government-operated CBHI. Conclusion Findings indicate that CBHI through co-ops would be a better model because of its lower costs and ability to enhance self-responsiveness and the overall health system. Health insurance coverage is the most important component to achieve universal health coverage.