Background
The influx of immigrants into Korea has increased in recent years, affecting Korean society and the healthcare system. This study analyzed the frequency of anxiety and depression in immigrants, which negatively affects their quality of life.
Methods
We analyzed data from a 2020 survey on the Health Rights of Migrants and the Improvement of the Medical Security System. Bivariate analyses and a multiple logistic regression model were used to identify the risk factors associated with the presence of anxiety or depression among immigrants.
Results
We included 746 immigrants, 55.9% of whom were female. The overall rate of anxiety or depression was 31.77%, with 38.3% in females, which was significantly higher than the 26.62% in males. The frequency of anxiety and depression was also strongly associated with certain immigrant groups, including immigrants of African or Western Asian origin (over 64%); those with student visas (60.53%); those who self-reported poor health (52%), physical or mental disabilities (69.23%), or chronic diseases (58.43%); and those facing difficulties accessing medical services (59.47%).
Conclusion
This study showed the frequency of feelings of anxiety or depression and associated risk factors among immigrants. These findings may have implications for policymakers in reducing the likelihood of developing anxiety or depression in the future and improving the quality of life of immigrants in Korea.

Background
Malnutrition is common among children under 5 years of age in Indonesia, with the rates varying between urban and rural areas. The minimum acceptable diet (MAD) assesses nutrient quality and quantity. This study aimed to identify the potential variables for MAD in 6–23-month-old children in both urban and rural Indonesia.
Methods
We used the data from the 2017 Indonesia Demographic and Health Survey to conduct this nationally representative study. A total of 4,688 children aged 6–23 months were included in the study. MAD was classified using the 2017 World Health Organization global nutrition monitoring framework. The determinants of MAD were analyzed using multiple logistic regression.
Results
Overall, 45% of children aged 6–23 months received the required MAD, with 47.4% receiving the MAD in urban areas and 35.7% in rural areas. Children’s age, fathers’ age, parents’ education level, mothers’ employment, and wealth index were strongly linked to MAD in both rural and urban homes. The factor specifically related to MAD in urban areas was mother living with her husband. For rural households, mothers’ involvement in decisionmaking and a minimum of four antenatal care (ANC) visits significantly increased the likelihood of their children’s MAD status.
Conclusion
MAD status was determined by increased child age, higher parent education, younger father, working mother, and higher wealth index in children aged 6–23 months in both urban and rural settings. Mothers living with a spouse determined the MAD status only in urban areas. More frequent ANC visits and mother participation in household decisions were other factors related to MAD status in rural areas.

Background
Adolescence is an essential stage of a child’s development, transitioning them into adulthood. During this time, they are vulnerable to various social issues, such as experimenting with alcohol, among others. Although alcohol consumption was proven to be detrimental to physical and cognitive development toward adulthood, and almost one in 10 Malaysian adolescents aged 13 years and above are current drinkers, studies concerning the driving factors are still scarce. This cross-sectional study aimed to determine alcohol use among 244 adolescents in Nabawan, Sabah.
Methods
This study assessed the associations between alcohol use and three potential factors: demographic, environmental, and psychological. Respondents who were selected through stratified proportionate random sampling answered a set of assessment tools.
Results
Results showed that 30.7% (95% confidence interval [CI], 24.91–36.48) of Nabawan adolescents use alcohol. Analysis revealed that older age adolescents 18 years and 19 years, respectively (adjusted odds ratio [aOR], 3.93; P=0.021; aOR, 5.38; P=0.003), having parents (aOR, 4.11; P=0.001) and peers (aOR, 11.57; P<0.001) who consume alcohol were significantly associated with alcohol use. Unexpectedly, good parental monitoring (aOR, 2.46; P=0.019) and discussing serious problems with parents (aOR, 3.86; P=0.001) were significantly associated with alcohol use.
Conclusion
Conclusively, policies on alcohol-related harm reduction and prevention should be developed, especially school-based programs, programs addressing family functioning, and parent-child communication, among others, should be further looked into. Future research on the school environment, adolescents’ drinking motives, and the development of practical adolescent-friendly alcohol screening tools are recommendations for improvements.

Background
Continuity of care in primary care settings is crucial for managing diabetes. We aimed to statistically define and analyze continuity factors associated with demographics, clinical workforce, and geographical relationships.
Methods
We used 2014–2015 National Health Insurance Service claims data from the Korean registry, with 39,096 eligible outpatient attendance. We applied multivariable logistic regression to analyze factors that may affect the continuity of care indices for each patient: the most frequent provider continuity index (MFPCI), modified-modified continuity index (MMCI), and continuity of care index (COCI).
Results
The mean continuity of care indices were 0.90, 0.96, and 0.85 for MFPCI, MMCI and COCI, respectively. Among patient factors, old age >80 years (MFPCI: odds ratio [OR], 0.81; 95% confidence interval [CI], 0.74–0.89; MMCI: OR, 0.84; 95% CI, 0.76–0.92; and COCI: OR, 0.81; 95% CI, 0.74–0.89) and mild disability were strongly associated with lower continuity of care. Another significant factor was the residential area: the farther the patients lived from their primary care clinic, the lower the continuity of diabetes care (MFPCI: OR, 0.74; 95% CI, 0.70–0.78; MMCI: OR, 0.70; 95% CI, 0.66–0.73; and COCI: OR, 0.74; 95% CI, 0.70–0.78).
Conclusion
The geographical proximity of patients’ residential areas and clinic locations showed the strongest correlation as a continuity factor. Further efforts are needed to improve continuity of care to address the geographical imbalance in diabetic care.

Citations

• Association of rurality and decreased continuity of care prior to a diagnosis of prediabetes
  Bobbie L. Johannes, Arch G. Mainous, Alex R. Chang, H. Lester Kirchner, G. Craig Wood, Christopher D. Still, Lisa Bailey‐Davis
  The Journal of Rural Health.2025;[Epub]     CrossRef
• Disease prevention measures applicable to primary healthcare clinics
  Jae-Heon Kang
  Journal of the Korean Medical Association.2024; 67(4): 226.     CrossRef
• Association between continuity of care and inappropriate prescribing in outpatient care in Germany: a cross-sectional analysis conducted as part of the LoChro trial
  Aline Pfefferle, Nadine Binder, Julia Sauer, Mario Sofroniou, Gloria Metzner, Erik Farin, Sebastian Voigt-Radloff, Andy Maun, Claudia Salm
  BMJ Open.2024; 14(7): e082245.     CrossRef
• COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country
  Abbasali Dehghani Tafti, Azadeh Fatehpanah, Ibrahim Salmani, Mohammad Amin Bahrami, Hossien Tavangar, Hossien Fallahzadeh, Ali Ahmadi Tehrani, Sajjad Bahariniya, Gholamreza Ahmadi Tehrani
  BMC Primary Care.2023;[Epub]     CrossRef
• Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis
  Boram Sim, Sunmi Kim, Eun Woo Nam
  BMC Public Health.2023;[Epub]     CrossRef
• The Impact of Continuity of Care on Health Indicators in Patients With Type 2 Diabetes Mellitus in Family Medicine Clinics in Riyadh
  Ghada Hussein, Aljoharah A Al Saud, Ahmad M Siddiqi, Abdallah Khasawinah, Ahmad Alenezi, Riham A Mohammed, Yaser A Alendijani
  Cureus.2023;[Epub]     CrossRef
• The Role of Continuity of Care in the Management of Chronic Disease
  Seung-Won Oh
  Korean Journal of Family Medicine.2022; 43(4): 207.     CrossRef

Background
The rising prevalence of alternative tobacco and nicotine products (ATNPs) use among adolescents is a global concern that has been attributed to the reemergence of preexisting alternative tobacco products and emergence of new ones in the market. This study examined ATNP use among late adolescents. The association between ATNP use and reasons for using them was explored.
Methods
This cross-sectional study conducted in 2016 involving 388 late adolescents from six government colleges in Kelantan, Malaysia, aged 18 to 19 years. They were requested to answer self-directed questionnaires with items on sociodemographic information and types of ATNP used. Other variables obtained include the environmental influence and reasons for using the products. Regression analyses between the dependent and independent variables were conducted using IBM SPSS ver. 20.0 (IBM Corp., Armonk, NY, USA).
Results
The prevalence of ATNP use among late adolescents was 14.4%. The male sex, cigarette smoking status, and peer use were significantly associated with ATNP use. Several reasons for use were not significantly associated with ATNP use: perception of ATNP being less harmful and less addictive compared with cigarettes, curiosity, less expensive than cigarettes, to aid smoking cessation, and pleasurable flavors and taste.
Conclusion
The prevalence of ATNP use among late adolescents studying in government colleges in Kelantan is significant. There is higher perception on ATNP being less harmful and addictive than the conventional cigarette among the users compared with non-users. Significant associations are seen for the male sex, peer use, and concurrent cigarette smoking.

Citations

• Prevalence and Associated Factors Related to Tobacco Consumption Among University Students in Malaysia
  Chui Yi Chow, Md Zobaer Hasan, Anton Abdulbasah Kamil
  Health Psychology Research.2024;[Epub]     CrossRef
• Factors Influencing the Use of Tobacco Among Youth in Low-Income, Lower-Middle-Income, and Upper-Middle-Income Countries: A Systematic Review
  Fahad Ali Mangrio, Penpaktr Uthis, Suwimon Rojnawee
  Journal of Research in Health Sciences.2024; 24(3): e00617.     CrossRef
• Prevalence and Associated Factors of E-Cigarette Use among Adolescents in Southeast Asia: A Systematic Review
  Miaw Yn Jane Ling, Ahmad Farid Nazmi Abdul Halim, Dzulfitree Ahmad, Norfazilah Ahmad, Nazarudin Safian, Azmawati Mohammed Nawi
  International Journal of Environmental Research and Public Health.2023; 20(5): 3883.     CrossRef
• Factors of e-cigarette use among Malaysian adolescents: A systematic review
  Vitalis Ronald Eden, Mohd Shahimi Mustapha, Saravanan Jaganathan, Hafiz Jaafar
  Journal of Health Science Research.2023; 9: 7.     CrossRef
• The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
  Cheol Min Lee
  Korean Journal of Family Medicine.2020; 41(5): 273.     CrossRef

Background
This study evaluated factors independently associated with electrocardiographic left ventricular hypertrophy (ECG-LVH) in subjects who were normotensive on clinical measurement and had no prior history of hypertension.
Methods
This cross-sectional study analyzed cases and controls in the Comprehensive Medical Examination Center of Hallym University Sacred Heart Hospital. Eligible case participants presented ECG-LVH according to the Sokolow-Lyon or Cornell criteria, were normotensive on clinical measurement, and had never received a diagnosis of hypertension. The control group comprised subjects with normal sinus rhythm who were normotensive on clinical measurement with no history of hypertension.
Results
A multiple logistic regression model showed male sex, age and systolic blood pressure to be positively related to the presence of ECG-LVH. A positive relation of smoking and regular exercise; an inverse relation of pulse rate to the presence of ECG-LVH were found only in men. An inverse relation of uric acid level was found only in women. Detailed analyses of relatively healthy and young men according to whether or not to exercise regularly showed that positive relations of age and systolic blood pressure; an inverse relation of obesity to the presence of ECG-LVH were apparent in the non-regular exercise group but not in the regular exercise group. In the regular exercise group, only pulse rate showed significant (inverse) association with the presence of ECG-LVH.
Conclusion
The varying risk factor profiles associated with ECG-LVH according to sex and the participation in regular exercise may help to elucidate the ECG-LVH in clinical normotensives with no prior history of hypertension.

Citations

• Prevalence, Performance and Predictors of Electrocardiographic Left Ventricular Hypertrophy in Male Black Athletes: A Retrospective Study
  Tochukwu F. Ilodibia, Clement O. Odigwe, Augustine N. Odili
  Indian Journal of Clinical Cardiology.2024; 5(1): 15.     CrossRef

Citations

• Associations between social jetlag trajectories and body mass index among young adults
  Chia-Shuan Chang, Ling-Yin Chang, Chi-Chen Wu, Hsing-Yi Chang
  SLEEP.2024;[Epub]     CrossRef
• Maternal pre-pregnancy body mass index and related factors: A cross-sectional analysis from the Japan Environment and Children’s Study
  Yasuaki Saijo, Eiji Yoshioka, Yukihiro Sato, Yuki Kunori, Tomoko Kanaya, Kentaro Nakanishi, Yasuhito Kato, Ken Nagaya, Satoru Takahashi, Yoshiya Ito, Hiroyoshi Iwata, Takeshi Yamaguchi, Chihiro Miyashita, Sachiko Itoh, Reiko Kishi, Malshani Lakshika Pathi
  PLOS ONE.2024; 19(6): e0304844.     CrossRef
• Association of duration of undernutrition with occurrence of tuberculosis
  Jiho Park, Ji Hyun Yoon, Hyun Kyun Ki, Yeonghee Eun, Kyungdo Han, Hyungjin Kim
  BMC Public Health.2022;[Epub]     CrossRef
• Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study
  Jelena Gudelj Rakić, Miloš Maksimović, Janko Janković, Hristina Vlajinac, Jelena Marinković
  Sao Paulo Medical Journal.2018; 136(4): 310.     CrossRef
• Pattern of Underweight and Overweight in Lagos Southwest Nigeria
  Ademolu Adegbenga Bolanle
  Journal of Applied Biotechnology & Bioengineering.2017;[Epub]     CrossRef
• Relationship between health behaviour and body mass index in the Serbian adult population: data from National Health Survey 2013
  Miloš Ž. Maksimović, Jelena M. Gudelj Rakić, Hristina D. Vlajinac, Nadja D. Vasiljević, Jelena M. Marinković
  International Journal of Public Health.2016; 61(1): 57.     CrossRef
• Association between built environment and moderate to vigorous physical activity in Korean adults: a multilevel analysis
  Jimee Kim, Hye-Young Lee, Eun Young Lee
  Journal of Public Health.2016; : fdw025.     CrossRef

Citations

• Impact of the Working Conditions on Health and Selected Job-related Diseases. An International Comparison
  Daniela Hrehova, Pavel Ziaran, T. Kliestik
  SHS Web of Conferences.2021; 92: 07025.     CrossRef
• Effect of work-related factors on the prevalence of peptic ulcer disease among Korean workers: a nationwide population-based study
  Youn I Choi, Jun-Won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim, Dong Kyun Park
  International Archives of Occupational and Environmental Health.2020; 93(8): 965.     CrossRef
• Seafarers' perceptions of job demand: A cross-sectional study
  Luisa Maria Roberta Tedesco, Pietro Ferrara, Lucia Stromillo, Antonio Arnese, Luciana Albano
  Archives of Environmental & Occupational Health.2018; 73(5): 278.     CrossRef
• Relationship between job stress and functional dyspepsia in display manufacturing sector workers: a cross-sectional study
  Younghyeon Nam, Soon-Chan Kwon, Yong-Jin Lee, Eun-Chul Jang, Seung-hwan Ahn
  Annals of Occupational and Environmental Medicine.2018;[Epub]     CrossRef
• The Effect of Probiotic Supplementation on Gastrointestinal Quality of Life
  JeJe Noval
  Journal of Nutritional Health & Food Engineering.2017;[Epub]     CrossRef
• Factors associated with the occurrence of functional dyspepsia and insomnia in shift-working nurses
  Hye-Sun Jung, Bokim Lee
  Work.2016; 54(1): 93.     CrossRef
• Population Health Concerns During the United States’ Great Recession
  Benjamin M. Althouse, Jon-Patrick Allem, Matthew A. Childers, Mark Dredze, John W. Ayers
  American Journal of Preventive Medicine.2014; 46(2): 166.     CrossRef
• Mental Health Levels and Incidence of Musculoskeletal Complaints among Speed Boat Crew Members
  Farzaneh Zigheimat, Abbas Ebadi, Fatemeh Rahmati Najarkolaei, Mohammad Malakoti, Farhad Kheiri Tootkaleh
  Trauma Monthly.2013; 17(4): 373.     CrossRef

Background
Many countries have been legally prescribing graphic health warning labels on cigarette package as a part of their national policy of smoking cessation. This study was designed to evaluate the effectiveness and appropriateness of graphic health warning labels of Canada, Singapore and European union, in Korean for smoking cessation. Methods: From February to July in 2005, we surveyed 110 people who were high school students and college students. After showing them the 64 graphic health warning labels (16 from Canada, 6 from Singapore and 42 from European union), the self recorded questionnaires were collected. Results: The effectiveness for smoking cessation was related to the arousal levels of visual effects and it had the same result for each country in which we researched. The high arousal loss-framed graphic health warning labels were more effective than the gain-framed low arousal ones. Conclusion: To quit smoking, it can be reasonably concluded that high and negative images of health that were shown on warning labels of cigarette packages were effective. Hereafter, it is recommended more useful and proper designs of graphic warning labels be developed and applied. (J Korean Acad Fam Med 2007;28:923-930)

Background
: Density patterns on mammography have been related to the risk factors for breast cancer in the western countries. High mammographic density appears to confer a 4-fold risk of breast cancer. While the proportion of high-density mammography is higher in Korean women than in Caucasian women, the incidence of breast cancer in Korean women is considerably lower. Therefore, we examined if the mammographic breast density pattern correlates with the risk factors for breast cancer in Korean women.

Methods : In a cross-sectional design, we recruited 1,758 pre- and post-menopause women without prior history of breast cancer and breast surgery who underwent screening mammogram and completed a self-administered questionnaire in 6 general hospitals. On the basis of ACR BI RADS breast composition, four density patterns were classified in caudocranial and mediolateral mammography by a designated radiologist in each hospital. Multiple linear logistic regression was used for statistical analyses.

Results : Inter-rater reliability between the initial report and the report made by another blinded radiologist was high (Pearson's co-efficient=0.81). Overall, the age, body mass index, family history of breast cancer, and duration of hormone replacement therapy correlated with the mammographic density patterns. In pre-menopausal women, the high body mass index and parity (=2) were associated with low mammographic density. In post- menopausal women, older age, high body mass index, negative family history of breast cancer, and duration of hormone replacement therapy were associated with low mammographic density.

Conclusion : Our data showed that the mammographic breast density patterns correlated with risk factors for breast cancer in Korean women. While the proportion of high-density mammography is higher in Korean women, the incidence of breast cancer is lower than in the western population. This maybe dependent on other unknown factors.

Background
: Many countries have been legally prescribing health warning messages on cigarette packages as a part of their national policy of smoking cessation. This study was designed to evaluate the effectiveness for smoking cessation of graphic health warning labels, and compare them with the existing health warning messages.

Methods : From February to December 2002, we surveyed 103 smokers who were college students of fine arts. After letfing them see the graphic health warning labels, the self recorded questionnaires were collected.

Results : The effectiveness for the smoking cessation of the existing health warning messages was evaluated low, despite its wide recognition. But there was no difference between the visual effect and the effectiveness for the smoking cessation of the graphic health warning labels. The graphic health warning labels were more effective for the smoking cessation than the existing health warning messages, and it was the same in the subgroup analysis such as sex, degree of recognition of disease, and non- smoking planning.

Conclusion : To quit smoking, it is reasonably concluded that the graphic health warning labels on cigarette packages was very effective. Hereafter, it is recommended more useful designs of graphic health warning labels be developed.

Background
: Electricardiographic variables such as changes in the ST-T segment, and increased QT interval have been found to predict the occurrence of myocardial ischemia, But disadvantages of most of these variables have poor reproducibility and require analysis of all ECG leads. If electrocardiographic T axis properly predicts myocardial ischemia, it can be used as a useful marker for diagnosing myocardial ischemia in primary practice.

Methods : We selected 147 persons, who visited the emergency room or an outpatient clinic because of chest pain, in whom coronary angiography was performed. We reviewed their medical records. Electrocardiographic T axis was classified as normal, borderline and abnormal T axis. We identified the relation between cardiovascular risk factors and electrocardiographic T axis, and also, the relation between ischemic electrocardiographic variables and T axis, We examined the relation between coronary angiographic results and electrocardiographic T axis.

Results : The sensitivity and specificity of electrocardiographic T axis was 26.7% and 86.9%, respectively. The positive predictive value and negative predictive value was 81.8% and 35.1%, respectively. The proportion of hypertension was 41.2% in normal T axis group, 65.5% in borderline T axis group, and 34.4% in abnormal T axis group, which was statistically significant(P=0.032). The relation between coronary angiographic results and electrocardiographic T axis was not statistically significant. The subjects with abnormal T axis were associated with ST depression (P=0.016).

Conclusion : The T axis abnormality was not useful for screening myocardial ischemia, but it was useful to rule out other diseases due to its high specificity.

Background
: Blood pressure is normally lower during night times than in day times. But in some people, this nocturnal blood pressure drop is decreased or absent. In essential hypertensives, absence of nocturnal blood pressure drop(the 'nondipping' pattern) has been associated with increased target organ damage and cardiovascular morbidity. Present study was intended to describe the proportion of 'nondippers' among untreated essential hypertensives in Korea and to investigate the influences of independent clinical factors on the nocturnal fall of blood pressure.

Methods : We studied 50 untreated Korean essential hypertensives who underwent 24-hour ambulatory blood pressure monitoring. Subjects with a nocturnal drop in systolic or diastolic blood pressure, or both, 10% were defined as 'dippers', the others as 'nondippers'. Their demographic and clinical characteristics were obtained through medical record and questionnaire. Above characteristics were considered to be independent variables and the dipping status, dependent.

Results : Thirty four percent of essential hypertensives were 'nondippers'. Nocturnal blood pressure drop decreased with reporting of family history of hypertension and higher 24-hour ambulatory mean blood pressure. Previous studies insisted on the influence of age on the dipping status, but in our study, age showed no impact on nocturnal blood pressure drop.

Conclusion : About one third of untreated subjects with essential hypertension were observed to be nondippers. Family history of hypertension and high 24-hour ambulatory mean blood pressure significantly decreased nocturnal blood pressure drop in our study. According to previous studies, above factors might work through affecting the normally decreased sympathetic activity during sleep time. Longitudinal studies of the influence of nondipping on the long term prognosis of hypertension and large scale studies to establish the factors influencing nocturnal blood pressure drop and their mechanisms are further needed.