• 한국간담췌외과학회지
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• 제28권2호
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• pp.144-154
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• 2024

Backgrounds/Aims: Socioeconomic determinants of health are incompletely characterized in cholangiocarcinoma (CCA). We assessed how socioeconomic status influences initial treatment decisions and survival outcomes in patients with CCA, additionally performing multiple sub-analyses based on anatomic location of the primary tumor. Methods: Observational study using the 2018 submission of the Surveillance, Epidemiology, and End Results (SEER)-18 Database. In total, 5,476 patients from 2004-2015 with a CCA were separated based on median household income (MHI) into low income (< 25th percentile of MHI) and high income (> 25th percentile of MHI) groups. Seventy-three percent of patients had complete follow up data, and were included in survival analyses. Survival and treatment outcomes were calculated using R-studio. Results: When all cases of CCA were included, the high-income group was more likely than the low-income to receive surgery, chemotherapy, and local tumor destruction modalities. Initial treatment modality based on income differed significantly between tumor locations. Patients of lower income had higher overall and cancer-specific mortality at 2 and 5 years. Non-cancer mortality was similar between the groups. Survival differences identified in the overall cohort were maintained in the intrahepatic CCA subgroup. No differences between income groups were noted in cancer-specific or overall mortality for perihilar tumors, with variable differences in the distal cohort. Conclusions: Lower income was associated with higher rates of cancer-specific mortality and lower rates of surgical resection in CCA. There were significant differences in treatment selection and outcomes between intrahepatic, perihilar, and distal tumors. Population-based strategies aimed at identifying possible etiologies for these disparities are paramount to improving patient outcomes.

• 대한치과기공학회지
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• 제38권1호
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• pp.23-36
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• 2016

Purpose: The purpose of this study is to suggest direction for dental technicians and management of dental laboratories to contribute to the improvement of oral health of citizens with high-quality dental prosthesis by researching operational status and management satisfaction of dental laboratories. Methods: In order to investigate operational status and management satisfaction of dental laboratories, this study conducted a questionnaire survey by mailing questionnaires to heads of dental laboratories designated as clinical training workshops of Department of Dental Technology of G University and a total of 158 questionnaires were used for analysis. Results: As for gender, males were 142 persons (89.9%) and females were 16 persons (10.1%). For location of the laboratories, number of laboratories in metropolitan cities was 94 (59.5%) while small and that in mid-sized cities was 64 (40.5%). As for the satisfaction with job, those who have managed dental laboratories for 23-30 years ($1.92{\pm}77$), transact with 7-12 dental clinics ($1.70{\pm}75$), had monthly income of 4-8 million won ($1.74{\pm}.80$) and had 8-10 employees ($2.33{\pm}.68$) were the highest in their satisfaction. As for satisfaction with management, those who have managed their business for 15-20 years ($2.86{\pm}.52$), transact with more than 20 dental clinics ($2.00{\pm}.04$), had monthly income of less than 4 million won ($2.00{\pm}.85$) and had less than 3 employees ($2.00{\pm}.62$) were the highest in their satisfaction. As for monthly income, those with less than 2 million won were 24 persons (15.2%), 2-4 million were 64 persons (40.5%), 4-6 million were 40 (25.3%), 6-8 million were 14 (8.9%) and over 8 million won were 16 persons (10.2%). As for number of employees, those with less than 3 employees were 32perosns (20.3%), 4-7 were 82 (51.9%), 8-10 were 26 (16.5%) and more than 11 were 10 persons (6.3%). As for severance payment, 84 persons practiced it according to Labor Standard Act (53.2%) and 34 practice it to a proper degree (21.5%) while 20 did not practice it at all (12.7%) and 20 persons did not respond to the question (12.7%). Conclusion: Although dental laboratories have rapidly expanded in number from 473 in 1986 to 2,400 in 2015, dental technician circles are facing difficulty in their management due to fierce competition and low profitability. Therefore, in order to improve this problem, it is necessary to readjust prices for dental prosthesis to realistic ones.

• Journal of Nutrition and Health
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• 제35권5호
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• pp.544-557
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• 2002

This study was performed to evaluate the quality of nutrient intakes of the hemodialysis patients (26 men and 23 women) according to the socioeconomic status by 3-day dietary recall in Daejeon city and Chungnam area, Korea. Mean age of the subjects was 50.7 yrs and BMI was 22.0 $\pm$ 0.4 kg/$m^2$. Education level was divided into two groups ($\leq$ 9 years： LE group, 9 years： HE group), and monthly family income level was divided into three groups (< 500,000 won: LI group, 500,000-1,499,999 won: MI group, $\geq$ 1,500,000 won : HI group). The data were analyzed by Student t-test and Oneway ANOVA using SPSS 9.0 version at p < 0.05 level. Intakes of energy, carbohydrates, cholesterol, potassium, thiamin and riboflavin were significantly higher in HE group than in LE group (p < 0.05). Intakes of all the nutrients except protein and phosphorus were less than Korean RDA, and INQs (Index of Nutritional Quality) of most nutrients were lower than 1.0 but cholesterol, phosphorus. thiamin and niacin being over 1.0 in HE group. MAR (Mean adequacy ratio) of all the nutrients (e.g., energy, protein, calcium, phosphorus, iron, vitamin A, vitamin C, thiamin, riboflavin and niacin) was significantly higher in HE group (0.61 $\pm$ 0.04) than in LE group (0.48 $\pm$ 0.03) at p = 0.036. Intakes of energy, protein (total, animal and plant), fat, cholesterol, potassium, calcium, phosphorus, iron, vitamin A, thiamin and riboflavin were also significantly higher in HI group than in LI and MI group (p < 0.05). Daily intakes of most nutrients were less than Korean RDA except protein ed phosphorus in HI poop, and INQs of thiamin, niacin and phosphorus were higher than 1.0, while those of calcium, iron, vitamin A and riboflavin were lower than 1.0. MAR of energy and 9 nutrients was significantly higher in HI group (0.70 $\pm$ 0.04) than in LI group (0. 56 0.04) and MI poop (0.47 $\pm$ 0.03) at p = 0.000. In conclusion, quality of nutrient intakes, especially energy and protein, was significantly influenced by socioeconomic status such as education and monthly income (p < 0.05). This result suggests that it would be very helpful to develop nutritional education programs considering hemodialysis patients' education levels, and to improve public supports (e.g., medical insurance system, low-rate lease system of dialysis equipments, etc.) focusing on the patients' family income levels f3r their better nutrition and health.

• 한국치위생학회지
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• 제15권1호
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• pp.39-46
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• 2015

Objectives: The purpose of the study is to investigate the cognition of dental caries prevention by the level of socioeconomic status based on Gallup survey in Korea. Methods: This study was done by Korean Gallup survey in October, 2010. A trained researcher carried out the computer aided telephone interview(CATI) using a structured questionnaire. This study was based on the latest population statistics of resident registration and whole country's phone data base. This survey included 869 selected Korean adults over 19 years old, and they were asked to answer a CATI. The questionnaire consisted of general characteristics of the subjects and socioeconomic factors including age, gender, education level, monthly income, and residential area. Cognition of dental caries prevention was measured by Likert 4 scale including 'much', 'a little', 'rarely', and 'never'. The attitude toward dental caries prevention consisted of daily tooth brushing frequency, experience of oral health education, regular dental checkup, chewing gums(xylitol), regular scaling, and use of oral care devices. Data were analyzed using SPSS 20.0 for frequency analysis, t-test, chi-square test, and one way ANOVA. Cronbach's alpha was 0.462 in oral health concern and attitude. Results: Mean of the frequencies of daily tooth brushing in men was 2.54 times and 2.78 in women. By the comparison to age group, 35-44 years old group had 2.82 times, 19-37 years old group had 2.72 times, and 45-64 years old group had 2.51 times. The level of education and monthly income was proportional to the tooth brushing frequency. Highly educated and higher monthly income group received regular dental checkup within a year and used the auxiliary oral health care devices. Conclusions: This study suggested the relationship between dental caries prevention and socioeconomic status. It is important to provide the low socioeconomic group with the better oral health promotion services in the future.

• 한국사회정책
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• 제24권2호
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• pp.157-179
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• 2017

우리 사회에서는 언론이나 젊은 세대를 중심으로"금수저-흙수저"로 구분되는 수저계급론이 크게 부각되고 있으며, 이를 통해 계층적 신분구조가 고착화되고 있다는 대중적 담론이 널리 확산되고 있다. 2000년대 말 이후 객관적인 소득분배구조의 일정한 개선이 이뤄짐에도 불구하고 국민들의 주관적 인식에 있어 오히려 계층이동/세습이나 사회공정성에 대해 부정적인 여론이 날로 확대되고 있다는 점이 주목된다. "기회불평등의 인식조사" 자료를 활용한 실증분석을 통해 사회경제적 기회불공평, 기회불평등의 심각성 그리고 노력성취에 대한 주관적 인식에 있어서 전반적으로 부정적 평가가 내려지고 있으며, 특히 주관적인 계층지위에 따라 그 부정적 평가의 정도가 높게 나타나고 있다. 사회경제적 성취기회 불공평, 기회불평등 심각성 그리고 노력성취의 주관적 인식에 대한 회귀분석을 통해서는 부모세대와 본인세대의 계층지위(-), 차별 불이익 경험(+), 연령(-), 대학 대학원의 고학력(+)이 일관되게 유의한 영향을 미치는 것으로 밝혀졌다. 부연하면, 15세 성장기(부모세대)와 조사시점의 주관적 계층지위가 낮을수록, 차별 불이익의 경험을 가질수록, 젊은 연령층일수록, 그리고 대학 이상의 고학력자일수록 우리 사회의 기회불평등에 대해 부정적이거나 비관적인 인식태도를 보이는 것으로 분석되었다. 아울러, 사회경제적 성취기회의 불공평과 기회불평등의 심각성에 대해서는 실업자 및 비정규직 또는 비경제활동이 높은 부정적 인식태도와 유의한 상관관계를 보이고 있으며, 기회불평등의 심각성과 노력성취에 대해 중위소득 가구 및 상위소득 가구가 부정적인 인식태도를 갖는 것으로 나타났다.

• 지역사회간호학회지
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• 제33권2호
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• pp.237-246
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• 2022

Purpose: The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. Methods: A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox's proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. Results: Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical=4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. Conclusion: In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.

• Clinical and Experimental Pediatrics
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• 제49권1호
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• pp.24-28
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• 2006

목 적 : 가정의 경제수준은 소아의 성장과 건강에 영향을 미칠 것으로 생각된다. 이에 저자들은 저소득층 소아들을 검진하여, 병을 발견하고 치료방향을 제시하며, 나아가 학교보건 정책 수립에 도움을 주고자 하였다. 방 법 : 2004년 6월부터 7월까지 서울의료원과 을지대학병원 소아과에서 서울, 경기 지역의 사회복지기관에서 운영하는 공부방을 이용하는 저소득층 가구의 초등학생 285명을 대상으로 하였다. 이들의 신체계측, 시력, 청력, 구강검사를 시행하고, 일반 혈액검사, 콜레스테롤, 간기능검사, B형간염항체, 소변검사 및 대변검사를 실시하였다. 결 과 : 신체계측상 동자초등학교 학생과 각 학년별로 비교해 보면 남학생의 경우 체중은 1, 2, 5학년에서 유의하게 적었으며, 신장은 1, 2, 4학년에서 유의하게 작았다. 여학생의 경우 체중은 4학년에서 유의하게 적었으며, 신장은 1, 4학년에서 유의하게 작았다. 2003년도 초 중등학생 신체검사 결과와 각 학년별로 비교해보면 체중의 평균치는 남아는 전 학년에서 0.1-5 kg, 여아는 5, 6학년을 제외하고 0.8-3.2 kg 적었다. 신장의 평균치는 남아는 1-4 cm, 여아는 0.4-4 cm 작았다. 비만의 빈도는 비만도 20% 이상을 기준으로 하였을 때 남아 16명(11.3%), 여아 15명(10.7%)이었고, BMI 95 백분위수 이상을 기준으로 하였을 때 남아가 15명(10.6%), 여아가 14명(10%)이었다. 시력검사상 0.7 미만인 경우는 20.22%로 2003년도 초 중등학생 신체검사 결과의 15.61% 보다 유의하게 높았고, 청력장애는 0.36%로 0.03%에 비해 유의하게 높았으며, 충치는 69.47%로 51.89%에 비해 유의하게 많았다. 이번 조사에서 새롭게 발견된 질환으로는 갑상선기능항진증, 백내장, 신경섬유종, 중증 아토피피부염, 심실중격 결손, 사시, 서혜부탈장 및 신경성난청이 있었다 결 론 : 저소득층 가구의 소아들의 신체계측상 신장은 국내 평균치보다 작았고, 체중은 저학년에서 국내 평균치보다 작았으며, 시력장애와 청력장애, 충치의 발생은 더 높게 나타났다. 또한 비교적 간단한 방법으로 치료될 수 있는 질환들이 새롭게 진단되기도 하였다. 이에 저자들은 저소득층 소아들에게 좀 더 체계적인 관심과 진료가 이루어져서 더 나은 건강상태를 유지하도록 도와야 할 것이라고 생각한다.

• 한국콘텐츠학회논문지
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• 제17권11호
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• pp.410-422
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• 2017

본 연구의 목적은 만성 폐쇄성 폐질환자(COPD)의 질병관련 지식, 질병태도, 삶의 질 세요인간의 상관관계를 규명하고자 시도되었다. 연구결과 질병관련 지식은 대상자의 교육과 월수입, 주관적 호흡곤란 정도(mMRC), 흡입형 기관지 확장제, 항생제 치료에 따라 유의한 차이가 있었고 질병태도는 월수입, mMRC에 따라 유의한 차이가 있었다. 또한 삶의 질은 연령, 결혼상태, 월수입, 입원상태, 입원경험, 산소사용, 동반질환, mMRC, 흡입형 스테로이드에 따라 유의한 차이가 있었다. 질병관련 지식과 삶의 질(r=-.438, p<.001), 질병태도와 삶의 질(r=.279, p=.001)은 유의한 상관관계가 있는 것으로 나타났다. 따라서 세 요인에 공통적으로 상관성을 보인 변수인 월수입과 mMRC를 파악하는 것이 중요하며, 임상에서 COPD환자의 상태평가시, 객관적 검사결과 뿐만 아니라 mMRC의 사정에 관심을 가지고, 저소득계층을 중심으로 질병관련 지식향상과 긍정적인 태도함량을 위한 다학제간 접근과, 헬스코칭 프로그램을 개발하는 것이 필요하다.

• Yonsei Medical Journal
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• 제59권9호
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• pp.1026-1033
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• 2018

Purpose: Consistent evidence indicates that cervical and breast cancer screening rates are low among socioeconomically deprived women. This study aimed to assess trends in cervical and breast cancer screening rates and to analyze socioeconomic inequalities among Korean women from 2005 to 2015. Materials and Methods: Data from the Korean National Cancer Screening Survey, an annual nationwide cross-sectional survey, were utilized. A total of 19910 women were finally included for analysis. Inequalities in education and household income status were estimated by slope index of inequality (SII) and relative index of inequality (RII), along with calculation of annual percent changes (APCs), to show trends in cancer screening rates. Results: Cervical and breast cancer screening rates increased from 54.8% in 2005 to 65.6% in 2015 and from 37.6% in 2005 to 61.2% in 2015, respectively. APCs in breast cancer screening rates were significant among women with higher levels of household income and education status. Inequalities by household income in cervical cancer screening uptake were observed with a pooled SII estimate of 10.6% (95% CI: 8.1 to 13.2) and RII of 1.4 (95% CI: 1.3 to 1.6). Income inequalities in breast cancer screening were shown to gradually increase over time with a pooled SII of 5.9% (95% CI: 2.9 to 9.0) and RII of 1.2 (95% CI: 0.9 to 1.3). Educational inequalities appeared to diminish over the study period for both cervical and breast cancer screening. Conclusion: Our study identified significant inequalities among socioeconomically deprived women in cervical and breast cancer screening in Korea. Especially, income-related inequalities were greater than education-related inequalities, and these were constant from 2005 to 2015 for both cervical and breast cancer screening.

• 가정과삶의질연구
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• 제4권1호
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• pp.49-69
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• 1986

This study aimed to fine out the rational quantity of kitchen utensils and appliances Questionnair was distributed to families of 469 of middle school students. I studied status of kitchen work centers, quantity and the kinds of kitchen utensils. The results were as follows. 1. the status of kitchen :1) The percentage of western style work centers was significantly higher than the average level of Seoul. 2) The length and the height of work centers were below standard. 3) Arrangement of work centers was relatively correct, however, the kinds of kitchen work centers were not fully equipped. 2. The quantity of kitchen utensils: The socio-economic status were the main factor of the quantity of kitchen utensils. Educational level, income level and floor space were strongly corrected to the quantity of kitchen utensils.