Objectives: This study examined associations among social capital indicators (social participation and generalized trust) at the individual level and alcohol use, which was quantified using Alcohol Use Disorders Identification Test (AUDIT) scores. Methods: In total, there were 8800 participants in community health interviews, including 220 adults sampled systematically from a resident registration database of each of 40 sub-municipal administrative units of local (city or county) governments. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using polychotomous logistic regression. Results: The aORs for abstainers versus people with AUDIT scores of 0-7, based on 3 questions on generalized trust, in comparison to those with no positive responses, were 1.15 (95% CI, 0.99 to 1.34) for 1 positive response, 1.16 (95% CI, 0.98 to 1.37) for 2 positive responses; and 1.39 (95% CI, 1.20 to 1.61) for 3 positive responses. The aORs for abstainers versus people with AUDIT scores of 0-7, in comparison to participation in no organizations, were 0.61 (95% CI, 0.54 to 0.69) for participation only in informal organizations; 2.16 (95% CI, 1.57 to 2.99) for participation only in religious organizations; 2.41 (95% CI, 1.10 to 5.29) for participation only in volunteer organizations; and 0.65 (95% CI, 0.57 to 0.74) for participation in formal organizations. Participants in formal social organizations, regardless of their participation in informal organizations, were more likely to have AUDIT scores of 8-15 (aOR, 1.29; 95% CI, 1.04 to 1.60) or ≥16 (aOR, 1.65; 95% CI, 1.22 to 2.23) than to have scores of 0-7. Conclusions Our findings may have implications for health policy to reduce alcohol problems.

OBJECTIVES: The purpose of this study was to investigate the role of self-esteem as a moderator of the factors influencing suicidality among middle-schoolers. METHODS: Moderated multiple regression analysis was applied to assess the influence of happiness, depression, and hostility on suicidality and to determine the degree to which self-esteem served as a moderator of those relationships. Data were collected from 268 students at a middle school in Busan, Korea, using a self-administered structured questionnaire. RESULTS: Happiness, depression, and hostility had significant direct effects on suicidality. Self-esteem showed no direct effect, but had a significant moderating effect on the relationship between hostility and suicidal behavior. CONCLUSIONS: These results suggest that various interventions, such as counseling programs, should be designed to alleviate hostility and depression and to enhance happiness and self-esteem among early adolescents.
Adolescent ; Busan ; Counseling ; Depression ; Happiness ; Hostility ; Humans ; Korea

OBJECTIVES: The purpose of this study was to investigate the role of self-esteem as a moderator of the factors influencing suicidality among middle-schoolers. METHODS: Moderated multiple regression analysis was applied to assess the influence of happiness, depression, and hostility on suicidality and to determine the degree to which self-esteem served as a moderator of those relationships. Data were collected from 268 students at a middle school in Busan, Korea, using a self-administered structured questionnaire. RESULTS: Happiness, depression, and hostility had significant direct effects on suicidality. Self-esteem showed no direct effect, but had a significant moderating effect on the relationship between hostility and suicidal behavior. CONCLUSIONS These results suggest that various interventions, such as counseling programs, should be designed to alleviate hostility and depression and to enhance happiness and self-esteem among early adolescents.

OBJECTIVES: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. METHODS: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants’ frailty. RESULTS: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. CONCLUSIONS More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

BACKGROUND: The aim of this study was to investigate whether generalized trust and/or social participation at an individual level have negative associations with unmet healthcare needs. METHODS: Door-to-door interviews were conducted by trained interviewers to collect information. The 8,800 study participants included 220 adults sampled systematically using the resident registration database from 40 sub-municipal-level administrative units in Korea. Unmet healthcare needs were measured subjectively by the following question: “During the past 12 months, was there ever a time when you felt that you needed healthcare (excluding dental care) but did not receive it?” The responses were classified as either “yes” or “no.” RESULTS: The adjusted odds ratios (ORs) for unmet healthcare needs based on one positive response, two positive responses, and three positive responses to the three items of generalized trust compared to no positive responses were 0.92 (95% confidence interval [CI], 0.77–1.09), 0.90 (95% CI, 0.74–1.09), and 0.73 (95% CI, 0.61–0.87), respectively. The adjusted ORs for unmet healthcare needs based on social participation only in informal organizations, only in formal organizations, and in both informal and formal organizations compared to no social participation were 0.83 (95% CI, 0.71–0.98), 0.97 (95% CI, 0.77–1.21), and 0.97 (95% CI, 0.82–1.15), respectively. The covariates included in the multiple logistic regression were sociodemographic variables (gender, age, marital status, educational level, occupation, food security, and administrative unit), self-rated health, and perceived stress. CONCLUSION: Therefore, generalized trust and social participation in informal organizations can decrease the incidence of unmet healthcare needs.
Adult ; Delivery of Health Care* ; Food Supply ; Humans ; Incidence ; Korea ; Logistic Models ; Marital Status ; Mortality* ; Occupations ; Odds Ratio ; Power (Psychology) ; Social Capital ; Social Participation*

PURPOSE: Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and family caregivers preferences for family involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and family members agree on preferences. MATERIALS AND METHODS: A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forfamily involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment). RESULTS: Both patients and family caregivers preferred greater family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment. CONCLUSION: Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing family involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.
Aged ; Caregivers* ; Cognition Disorders ; Cognition* ; Decision Making* ; Humans ; Korea ; Patient Education as Topic

OBJECTIVES: This study investigated whether the impacts of orthodontic treatment of malocclusion on oral health-related quality of life and happiness are positive with middle and high school students. METHODS: Subjects were 157 orthodontic patients and 83 non-orthodontic in malocclusion patients. Questionnaires were collected with the self-administered method, and consisted of the general characteristics, self-esteem, social support appraisal scale(friends, family, teacher), Oral Impact on Daily Performance (OIDP) and oxford happiness questionnaire (OHQ). RESULTS: A physical factor was lower in the orthodontic treatment group (5.8±2.48) than in the non-orthodontic treatment group (7.7±2.10)(p<0.001), and OIDP was lower in the orthodontic treatment group (7.0±1.79) than in the non-orthodontic treatment group (7.8±1.80)(p=0.002). A feeling of happiness was higher in the orthodontic treatment group(4.6±0.81) than in the orthodontic treatment group (4.3±0.89) (p=0.009). As results of multiple regression analysis, OIDP was affected of orthodontic treatment(β=−0.0222, p=0.001) and OHP was affected of orthodontic treatment(β=0.087, p=0.030) and OIDP(β=0.116, p=0.003). CONCLUSIONS: Orthodontic treatment of malocclusion may positively affects happiness in teenager. Support policy for orthodontic treatment of malocclusion is necessary for adolescents.
Adolescent ; Happiness* ; Humans ; Malocclusion* ; Methods ; Quality of Life

PURPOSE: The purpose of this study is to investigate differences in organ-specific cancer incidence according to the region and population size in Korea. MATERIALS AND METHODS: We reviewed the data of the cancer registration program of Gyeongnam Regional Cancer Center between 2008 and 2011. Age-standardized rates of cancer incidence were analyzed according to population size of the region and administrative zone. RESULTS: Incidence of thyroid cancer has been increasing rapidly in both urban and rural areas. However, the thyroid cancer incidence was much lower in rural areas than in urban areas and megalopolis such as Seoul. Gastric cancer was relatively more common in rural areas, in megalopolis near the sea (Ulsan, Busan, and Incheon), and other southern provinces (Chungcheongnam-do, Gyeongsangbuk-do, and Gyeongsangnam-do). A detailed analysis in Gyeongsangnam-do revealed that rural areas have relatively low incidence of thyroid and colorectal cancer, and relatively high incidence of gastric and lung cancer compared to urban areas. CONCLUSION: This study suggests that there are some differences in cancer incidence by population size. Thyroid and colorectal cancer incidence was increasing, and gastric and lung cancer was slightly decreasing in urban areas, whereas gastric and lung cancer incidence still remains high in rural areas.
Busan ; Colorectal Neoplasms ; Epidemiology ; Gyeongsangbuk-do ; Gyeongsangnam-do ; Incidence* ; Korea* ; Lung Neoplasms ; Population Density ; Rural Population ; Seoul ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms ; Urbanization

OBJECTIVES: The objective of this study was to investigate the relationship between coronary artery calcification and risk factors of cardiovascular disease with multidetector computed tomography. METHODS: Data were collected from 5,899 males between 30 and 59 years old by interview, survey, physical examination, blood test, and multidetector computed tomography in the university hospital from January 2010 to December 2011. We confirmed the coronary artery calcium scores of subjects by multidetector computed tomography and identified risk factors of cardiovascular disorders. We investigated the relationship between coronary artery calcification and risk factors of cardiovascular disorders. RESULTS: Mean calcium score of the coronary arteries in 5,899 participants was 8.20, and 773 participants (13.1%) exhibited coronary artery calcification. The presence of coronary artery calcification was correlated to risk factors of cardiovascular disease (age, blood pressure, triglyceride, HDL cholesterol, LDL cholesterol, glucose, Apolipoprotein A-1, Apolipoprotein B, body mass index, waist circumference) and risk assessment tools of cardiovascular disorders. Significant predicted factors of coronary artery calcification had different patterns in each age group (30-39, 40-49, 50-59 years old). CONCLUSIONS: We confirmed the relationship between coronary artery calcification and either typical risk factors of cardiovascular disease or risk assessment tools of cardiovascular disease. In addition, we also observed that the pattern of these factors varied according to age. Therefore, age-related variation needs to be considered in management strategies to prevent cardiovascular disease.