OBJECTIVES: This study was conducted to analyze the current state and tendency of oral health inequality in 12-year-old Korean children by calculating the Gini coefficient from decayed, missing, or filled teeth (DMFT) data. METHODS: Ten-year trends were empirically estimated by calculating the Gini coefficient from the Lorenz curve plotted based on the DMFT data of 12-year-old children, obtained from the Korean National Oral Health Survey from 2000 to 2010. RESULTS: While the oral health improved in general, oral health inequalities increased with the decrease in the number of DMFT each year, and the DMFT-based Gini coefficient increased from 0.53 in 2000 to 0.61 in 2010. The increase in the number of decayed and missing teeth was strongly affected by the increase in oral health inequality. CONCLUSIONS: To resolve Korea's continually increasing oral health inequality, it is necessary to establish support measures for vulnerable populations and to develop and manage a surveillance system for continuous monitoring of oral health inequality in the future.
Child ; Humans ; Oral Health ; Socioeconomic Factors ; Tooth ; Vulnerable Populations

This study was performed to evaluate the existing pain assessment methods including the tools developed for use with nonverbal older adults with dementia, and to suggest recommendations to clinicians based on the evaluations. Computerized literature searches published after year 2000 using databases - Google scholar, RISS, KoreaMed, Medline, ScienceDirect, CINAHL - were done. Searching keywords were 'pain', 'pain assessment', and 'cognitive impairment/dementia'. The pain assessments for non-communicative dementia patients who are unable to self-report their pains are often made using the assessment tools relying on the observation of behavioral indicators or alternatively the strategy of surrogate reporting. While several tools in English version and only one in Korean are suggested for the pain assessments based on the observation of behavioral indicators, none are commonly used. In this review, we selectively evaluated those tools known to show relatively higher degree of validity and reliability for nonverbal older adults with dementia, namely, CNPI, DOLOPLUS 2, PACSLAC, PAINAD, and DS-DAT. It is hoped that the present review of selected tools for assessing pain in those vulnerable population and the general recommendations given be useful for clinicians in their palliative care practice. And future studies should focus on enriching the validation of the useful tools used to observe the nonverbal patient's behavioral indicators for pain in Korean.
Adult ; Dementia ; Humans ; Pain Measurement ; Palliative Care ; Vulnerable Populations

The seasonal influenza vaccine programs in many regions aimed to protect most vulnerable population, but current trivalent influenza vaccine does not provide sufficient effectiveness among people under high risk for severe outcome of the influenza. The vaccine herd effect (VHE) is the extra protection of non-immune high risk persons, with increase of immunity among vaccinated healthier persons which prevents circulation of influenza in the community. Accumulating evidences are supporting the immunization of extended population with regard to the VHE.
Humans ; Immunization ; Influenza Vaccines ; Influenza, Human* ; Seasons* ; Vulnerable Populations

Introduction: The coronavirus disease 2019 (COVID-19) is a respiratory disease caused by novel coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2. Its growing number of cases with a very limited number of studies in the country is quite alarming, especially to the vulnerable populations, such as pregnant women. Objective: To determine and compare the maternal and neonatal outcomes of COVID-19 positive versus negative parturient Materials and Methodology: This is a retrospective cohort study of 131 parturient in a tertiary hospital. Results: We analyzed a total of 131 patients, of whom 65 (49.6%) were COVID positive. At the time of testing, more than half were at their early term of pregnancy (64.89%) and at term (14.5%). Based on disease severity, 45 women (69.2%) exhibited mild disease, 39 were asymptomatic and 6 symptomatic, 19 (29.2%) moderate disease, and 1 (1.5%) severe disease. Among those symptomatic, the most common signs and symptoms were cough (33.85%), myalgia (10.77%), and a radiographic finding of localized or multilobar infiltrates (30.76%). Those who had laboratory examinations, the c-reactive protein (CRP) and D-dimer were found to be elevated. Based on maternal outcomes, there was a higher incidence of preterm birth (21.54%, P = 0.048) and longer length of hospital stay (P = 0.005) in the COVID-19-positive group. While the neonatal outcomes were similar in both groups, except for longer hospital stay, and delayed institution of breastfeeding among the COVID-19-positive group. Conclusion In this study, there was no evidence that the presence of COVID-19 infection during pregnancy causes increased morbidity and mortality in mothers and their neonates. Close surveillance should be done on this population, especially if detected before term, as these patients are predisposed to having preterm labor. Further research is needed to understand the true extent of the risks to improve the management of these special population.
COVID‑19 ; Pregnancy ; SARS-CoV-2 ; Pregnant Women ; Vulnerable Populations

PURPOSE: The purpose of this study was to develop a self triage application for rescue requests by disaster vulnerable populations. Literature was reviewed in order to define application trends and needs. METHODS: Development of the self triage application was conducted in six stages as a hybrid model (analysis, design, development, implementation, evaluation, modification) of the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model and Driscoll & Alexander model. Application system function and contents were tried with 6 experts and 4 people with hearing impairments. RESULTS: Expert assessment of the application for self triage showed that reliability at 5 points was the highest, followed by utility at 4.8 points. Scores for quickness and expressiveness were low at 4.6 and 4.2 points respectively. User acceptability assessment of the application was measured at 66.73 points. CONCLUSION: The results show that the application for self triage is helpful to disaster vulnerable populations by providing relief in disaster situations. It is expected that use of this application as a self rescue ability can be made available for disaster situations. However, it will be necessary to establish policies for communication strategies with rescuers and public relations to improve the access rate of disaster app service.
Disasters* ; Hearing ; Humans ; Mobile Applications ; Public Relations ; Triage* ; Vulnerable Populations*

PURPOSE: The purpose of this study was to investigate the relationships of social networks to health status among the urban low income elderly. METHOD: Using a sample of 598 elderly aged 65 years and higher, social networks, health status were measured by the Social Networks Scale (LSNS), Perceived Health Status, GDSSF-K, K-ADL respectively. The t-test, ANOVA and Tukey-test and Pearson's correlation analyses were performed using SPSS 18.0. RESULTS: 41% of subjects didn't contact with relatives at least once a month. 56% of subjects saw or heard less than monthly from relative with whom they have the most contact. 47% didn't have relatives who one can rely on private matters. Social networks among the low income elderly significantly differed by marital status, health insurance type, economic status, regular exercise, living with family. Social networks were significantly correlated with perceived health status (r=.201), cognitive function (r=-.154) and depressive symptoms (r=-.301). CONCLUSION: Poor social networks were found in urban low income elderly. Poorer social networks were related to worse health status and more depressive symptoms. Interventions targeting at increasing social networks are urgently needed for low income elderly.
Aged ; Depression ; Humans ; Insurance, Health ; Marital Status ; Vulnerable Populations

PURPOSE: The purpose of this study was to investigate the influences of job insecurity on job related depression and anxiety in large- and small-sized company employees. METHODS: Data of the third Korean Working Condition Survey in 2011 were used. Subjects were 2,050 large-sized company employees and 18,924 small-sized company workers. χ² test and multiple logistic regression using SAS 9.2 were conducted. RESULTS: Large- and small-sized company employees showed significant differences in terms of demographic, health-related, and job-related characteristics. From the bivariate analysis, gender, income, self-rated health, occupation, working hours per week, job-related stress, workplace violence, and job insecurity were significantly related to job-related depression/anxiety in large-sized company employees. From the multivariate analysis, higher income (AOR: 0.22, 95%CI: 0.07~0.71), better health perception (AOR: 0.05, 95%CL: 0.01~0.18), 40 or more working hours per week (AOR: 0.20, 95%CI: 0.05~0.79) showed lower risk for job-related depression/anxiety. From the bivariate and multivariate analysis, better health perception (AOR: 0.32, 95%CI: 0.20~0.53), higher job-related stress (AOR: 2.57, 95%CI: 1.68~3.93, workplace violence experience (AOR: 4.26; 95%CI: 2.88~6.30), and job insecurity experience (AOR: 1.90, 95%CI: 1.18~3.05) were significantly related to job-related depression/anxiety in small-sized company employees. CONCLUSION: Results of this study suggest that job insecurity experience was significantly related to job-related depression/anxiety in small-sized company employees but not in large-sized company employees. Therefore, small-sized company workers who have experienced feeling of job insecurity are vulnerable population in terms of job-related depression/anxiety.
Anxiety* ; Depression* ; Humans ; Logistic Models ; Multivariate Analysis ; Occupations ; Vulnerable Populations ; Workplace Violence

PURPOSE: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. METHODS: Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. RESULTS: Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. CONCLUSION: The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea.
Case Management* ; Cooperative Behavior ; Focus Groups ; Hospitalization* ; Humans ; Korea* ; Nursing ; Qualitative Research ; Vulnerable Populations

BACKGROUND: It is recognized that socioeconomic status (SES) has a significant impact on health and wellbeing; however, the effect of SES on suicide is contested. This study explored the effect of SES in suicide deaths and decomposed inequality into its determinants to calculate relative contributions. METHODS: Through a cross-sectional study, 546 suicide deaths and 6,818 suicide attempts from January 1, 2010 to December 31, 2014 in Ilam Province, Western Iran were explored. Inequality was measured by the absolute concentration index (ACI) and decomposed contributions were identified. All analyses were performed using STATA ver. 11.2 (Stata Corp., College Station, TX, USA). RESULTS: The overall ACI for suicide deaths was −0.352 (95% confidence interval, −0.389 to −0.301). According to the results, 9.8% of socioeconomic inequality in suicide deaths was due to addiction in attempters. ACI ranged from −0.34 to −0.03 in 2010–2014, showing that inequality in suicide deaths declined over time. CONCLUSION: Findings showed suicide deaths were distributed among the study population unequally, and our results confirmed a gap between advantaged and disadvantaged attempters in terms of death. Socioeconomic inequalities in suicide deaths tended to diminish over time, as suicide attempts progressed in Ilam Province.
Cross-Sectional Studies ; Humans ; Iran* ; Social Class ; Socioeconomic Factors* ; Suicide* ; Suicide, Attempted ; Vulnerable Populations

PURPOSE: The concept of respect is rooted in the core value of human relations, and interpersonal relationships with others. The notion of respect in these relationships is entrenched in the broader context of the processes of relationships between professionals and clients in general, along with the philosophical and ethical foundations of respect. Although nursing principles and values, such as autonomy and dignity have built their foundation of care on the concept of respect, these concepts (ie. autonomy and dignity) are still different from respect. Respect within health professional-client relationships, indicates that respect is a fundamental concept within nursing, permeating a number of other concepts that provide purposeful nursing care within the process of nurse-client relationships and respect has been discussed as an ethical and moral concept of care that addresses the values of human dignity in the nursing discipline, however research examining the client's perspectives of respect as an ethical principle of care, especially within Canada's diverse population is non-existent. There is limited research from the client's perspective addressing challenges communicating the concept of respect in relationships between health professionals and clients, specifically research directed at immigrant or the vulnerable population.
Delivery of Health Care ; Emigrants and Immigrants ; Ethnic Groups ; Foundations ; Health Occupations ; Humans ; Nursing Care ; Personhood ; Vulnerable Populations