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

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

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

OBJECTIVES: Children are one of the most vulnerable populations to the impact of disasters. We aimed to examine children's mental health in the area affected by the Hebei Spirit oil spill accident on December 7, 2007. METHODS: A cross-sectional questionnaire survey was conducted using the Korean versions of the Children's Depression Inventory and State Anxiety Inventory for Children on 1,362 children attending elementary schools in the affected area. The information on distances between the nearest contaminated coastline to the child's residential house or attending school were obtained using a web-based map by inputting two address points. The symptom risks of depression and state anxiety were estimated by multiple logistic regression analyses adjusted for age, gender, and other covariates. RESULTS: Children with the closest distance (in the fourth quartile) to the school from the contaminated coastline showed a significantly higher symptom risk of depression compared to those with the farthest distance (first quartile)(odds ratio, 2.73; 95% confidence interval, 1.40-5.33), while there was no significant association between anxiety symptoms and distance. CONCLUSIONS: Children, a vulnerable population for mental health impact by the oil spill accident, should be included in mental health programs in the community along with their family as victims of the disaster.
Anxiety ; Child ; Depression ; Disasters ; Humans ; Logistic Models ; Mental Health* ; Petroleum Pollution* ; Vulnerable Populations ; Surveys and Questionnaires

PURPOSE: The purpose of the study was to understand low-income elders' experiences of community-based u-Health services. METHODS: Qualitative data were collected from 11 participants. All interviews were recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. RESULTS: Three themes and eight sub-themes emerged as a result of analysis. The three main themes were 'recovered confidence and health condition,' 'trial and error in change,' and 'hope.'The eight sub-themes were 'the burden and efforts to overcome it in using bio-signal device,' 'ambivalence due to changing lifestyle,' 'increase of care time, decrease of pressure', 'conflict under environmental constraints,' 'difficulty in prioritizing health management,' 'discouragement in handling new devices,' 'desire not to be a burden to their children-gradual fulfillment of learning needs,' and 'long for broadening coverage range of services.' CONCLUSION: The findings of this study demonstrate that low-income elders among the participants have different needs in using u-Health services. Therefore, health professionals need to give personalized education to deal with their conflicts and requirements, especially emotional and environmental support in order for them to successfully accept the u-Health services for self-care.
Aged ; Education ; Health Occupations ; Humans ; Learning ; Qualitative Research ; Self Care ; Telemedicine ; Vulnerable Populations

PURPOSE: The goal of this study was to find out factors influencing the health promotion behavior of low-income vulnerable 4th, 5th and 6th-grade elementary school students. The specific goals were: first, to find out difference in health knowledge, self-esteem and health promotion behavior according to general characteristics; second, to investigate the correlations among health knowledge, self-esteem and health promotion; and, third, to analyze factors influencing health promotion behavior. METHODS: The subjects of this study were 137 low-income vulnerable 4th, 5th and 6th-grade elementary school children who were participating after-school programs in Seoul. RESULTS: Statistically significant differences were observed in health knowledge, self-esteem and health promotion behavior between girls and boys. In the sub categories, differences were observed in personal hygiene and health responsibility, stress management and personal relationship. The correlation of health promotion behavior with self-esteem and health knowledge was statistically significant. Regression analysis revealed that the influencing factor is self-esteem with the other variables under control. CONCLUSION: Health promotion education requires low-income vulnerable elementary children to increase their self-esteem. We recommend that it should be one of the most effective ways to split boys and girls to educate them in disparate classrooms.
Child ; Education ; Female ; Fibrinogen ; Health Promotion* ; Humans ; Hygiene ; Seoul ; 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