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

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

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

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

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

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: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs. METHOD: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. RESULT: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. CONCLUSION: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.
*Community Health Nursing ; *Family Health ; *House Calls ; Humans ; *Needs Assessment ; Poverty ; *Vulnerable Populations

PURPOSE: This study was to develop and evaluate a health promotion program for women with osteoarthritis. METHODS: The research adopted the nonequivalent control group pretest-posttest design. The subjects were 34 in the experimental group and 34 in the control group sampled among vulnerable women aged over 40. The independent variable was the health promotion program, and the dependent variables were perceived health status, balance, K-WOMAC, depression, life satisfaction and health promoting behavior. The health promotion program was performed for 50minutes each session, twice a week and for 8 weeks. Data were collected from July 1 to September 11, 2010. RESULTS: The experimental group showed significant differences in perceived health status, balance, WOMAC pain, WOMAC difficulty of performing activity, depression, and health promoting behavior compared to the control group. There was no significant difference in WOMAC stiffness, waist, weight, and life-satisfaction. CONCLUSION: The results of this study suggest that the health promotion program can be applied in degenerative arthritis education to improve self-care.
Depression ; Education ; Female ; Health Promotion* ; Humans ; Osteoarthritis* ; Self Care ; Vulnerable Populations

Relying solely on measures of intellectual aptitude and academic performance in university admissions can be disadvantageous to underprivileged students. The Fiji School of Medicine primarily uses such measures to evaluate and select student applicants, and the introduction of supplementary assessments could provide better access for students from disadvantaged backgrounds. This study examined the need for supplementary assessments in the admission process, types of additional assessments needed, and stakeholders' views on a multi-entry multi-exit strategy currently in use at the Fiji School of Medicine. A survey of the key stakeholders was conducted in February and March 2012 using closed and open ended questionnaire. One hundred and twenty-two validated questionnaires were self-administered by key stakeholders from the College of Medicine, Nursing and Health Sciences (CMNHS) and Fiji Ministries of Education and Health, with a response rate of 61%. Returned questionnaires were analysed quantitatively and qualitatively. Sixty-five percent of respondents supported the introduction of supplementary assessments, 49% favoured admissions test, and 16% preferred assessing non-academic factors. Many respondents supported the School's multi-entry multi-exit strategy as a 'good policy' that provided 'flexibility' and opportunity for students, but should be better regulated. These findings demonstrate the need for supplementary assessments in the selection process and for continued support for the use of multi-entry multi-exit strategy at the school.
Aptitude ; Surveys and Questionnaires ; Delivery of Health Care ; Fiji ; Humans ; School Admission Criteria ; Vulnerable Populations