• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.19-24
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• 2021

Background/Objectives: The aim of this national population-based retrospective study was to analyze the status and treatment outcome in patients with hypopharyngeal cancer. Materials & Methods: Participants were included in the KNHIS national sample cohort who received a KNHIS health check-up in 2008 and 2009, and we followed these individuals until 2017. Patients were defined as having hypopharynx cancer if they had admissions records for hypopharynx cancer in their national health insurance data from 2010 to 2017. Results: The study cohort included 3,922 patients. According to our nationwide data, 3,533(90.1%) were male with a median age of 65.03±11.04 years at the time of diagnosis. Among parametric models for hypopharyngeal cancer prognosis, old age (Hazard ratio [HR]:1.92; 95% confidence interval[CI]:1.76-2.09), female (HR:0.77; 95% CI:0.66-0.89), and low socioeconomic status (HR:1.216; 95% CI:1.114-1.327) were significantly associated with survival. Compared with concurrent chemoradiotherapy, patients who received no treatment (HR, 1.88; 95% CI, 1.31-2.70), neoadjuvant chemotherapy followed by surgery (HR, 1.21; 95% CI, 1.04-1.41), and chemotherapy alone (HR, 1.16; 95% CI, 1.03-1.27) showed poor prognosis in hypopharyngeal cancer. Conclusion: Our data indicated that age, sex, and income were significant predictors of lifetime survival in patients with hypopharyngeal cancer. Treatment modalities were also associated with prognosis. The data have implications for treatment investigations and prevention strategies.

• Nutrition Research and Practice
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• v.18 no.4
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• pp.554-566
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• 2024

BACKGROUND/OBJECTIVES: Urban-rural inequities in health and mortality exist in Korea, a highly centralized developed country. The potential impact of multiple health-related lifestyle behaviors on mortality and difference between urban and rural areas is not fully understood. This study aimed to investigate the effect of high-risk health behaviors on all-cause mortality among residents living in urban and rural in Korea. SUBJECTS/METHODS: Cross-sectional analyses were conducted on 8,298 adults aged 40 yrs and older from the Korea National Health and Nutrition Examination Survey 2013-2015. High-risk behaviors were defined as having poor diet quality, current smoking, high-risk drinking, or insufficient physical activity. Mortality status was linked to the Cause of Death data followed up to December 31, 2019. The associations between all-cause mortality and high-risk behaviors were evaluated using Cox proportional hazard regression models adjusted for age, sex, education, income, and survey year. Population attributable fractions (PAFs) were calculated, and effect modification analysis was conducted. Participants were stratified by residential area (urban or rural). RESULTS: During the follow-up (median: 5.4 yrs), 313 deaths occurred. A higher proportion of rural residents than urban residents engaged in multiple high-risk behaviors (28.9% vs. 22.6%; P < 0.0001). As individual factors, a greater risk of mortality was associated with poor diet quality, current smoking, and inadequate physical activity, and these tendencies persisted in rural residents, especially for diet quality. Multiple high-risk behaviors were positively associated with a higher risk of mortality in Koreans living in urban and rural areas. PAF (95% confidence interval) was 18.5% (7.35-27.9%) and 29.8% (16.1-40.2%) in urban and rural residents, respectively. No additive or multiplicative effect of the region was observed. CONCLUSION: The higher prevalence of multiple high-risk lifestyle behaviors in rural residents may explain the higher mortality in rural areas compared to urban areas. Comprehensive public health policies to improve health-related behaviors in rural populations may be needed.

• Korean Journal of Social Welfare
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• v.61 no.4
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• pp.333-354
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• 2009

This study decomposes the gender differences on poverty to explain the causes of the poverty gap between male- and female-headed households. In order to do this, we start from examining the extent of the poverty gap between maleand female-headed families and then conduct decomposition of poverty differences by gender using the Oaxaca method. This paper uses the (Urban) Family Budget Survey data from 1982 to 2008 and measures poverty using 50% of the median income poverty line. Major findings of this study are as follows: First, in 2008, the coefficient effect explains 70% or more of the total gender-poverty gap. Second, the trend of gender-poverty gap in the period of 1982~2008 shows that the poverty gap by gender increased in the 1980s', decreased in the 1990s', and a re-increased in 2000s'. Third, comparing the decomposition results in 1982, 1989, 1999, 2008, we found that the share of characteristic effect of the total gender poverty gap has been increased gradually over time. It means the characteristics of the female-headed households have become worse than those of the male-headed households in urban working families. At the same time, the still large coefficient effect suggests that the problems such as the discrimination against matriarchs or the lack of social support for them still play important roles among urban working families in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7863-7867
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• 2014

Background: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia. Materials and Methods: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications. Results: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients. Conclusions: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.

• Parasites, Hosts and Diseases
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• v.53 no.5
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• pp.553-559
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• 2015

Research on micro-level assessment of the changes of socio-economic status following health interventions is very scarce. The use of household asset data to determine wealth indices is a common procedure for estimating socio-economic position in resource poor settings. In such settings information about income is usually lacking, and the collection of individual consumption or expenditure data would require in-depth interviews, posing a considerable risk of bias. In this study, we determined the socio-economic status of 213 households in a community population in an island in the north-western Tanzania before and 3 year after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention to control schistosomiasis and intestinal worm infections. We constructed a household 'wealth index' based housing construction features (e.g., type of roof, walls, and floor) and durable assets ownership (e.g., bicycle, radio, etc.). We employed principal components analysis and classified households into wealth quintiles. The study revealed that asset variables with positive factor scores were associated with higher socio-economic status, whereas asset variables with negative factor scores were associated with lower socio-economic status. Overall, households which were rated as the poorest and very poor were on the decrease, whereas those rated as poor, less poor, and the least poor were on the increase after PHAST intervention. This decrease/increase was significant. The median shifted from -0.4376677 to 0.5001073, and the mean from -0.2605787 (SD; 2.005688) to 0.2605787 (SD; 1.831199). The difference in socio-economic status of the people between the 2 phases was highly statistically significant (P<0.001). We argue that finding of this study should be treated with caution as there were other interventions to control schistosomiasis and intestinal worm infections which were running concurrently on Kome Island apart from PHAST intervention.

• Journal of Food Hygiene and Safety
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• v.35 no.6
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• pp.587-601
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• 2020

Exposure to hazardous substances occurs through multiple pathways. Aggregated risk assessment, which includes all potential exposure pathways to a single toxicant, is necessary to prevent exposure to harmful substances. We aimed to estimate cadmium and lead exposure through various media, such as food, water, air, smoking, cosmetics, and female hygiene products. This study covered 10,733 subjects from the Seventh Korea National Health and Nutrition Examination Survey(2016, 2017). Dietary exposure was estimated using 24-hour recall data. For water and inhalational exposure, regional variations were considered. Water was classified as tap, bottled, and public water. Inhalational exposure was estimated using the '2014 Time Use Survey' based on daily lifestyle and social status. The frequency and volume of cosmetic usage were randomly approximated by sex and age. Post-menarcheal and premenopausal women were assumed to use feminine hygiene products. Non-carcinogenic aggregated risks were estimated using the Aggregate Risk Index from EPAs and the Total Exposure Hazard Index from Korean government guidelines. For carcinogenic risk assessment, excessive cancer risk was estimated. Ingestion, especially food, was the major route for both cadmium and lead exposure. Smoking was also associated with high cadmium exposure. Exposure to lead from cosmetics was remarkable but not critical. In aggregate risk assessments, median cadmium and lead exposure did not exceed the reference value. Sex, age, smoking status, and income affected exposure levels, unlike to regional variations.

• Journal of the Korean Institute of Landscape Architecture
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• v.39 no.1
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• pp.46-55
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• 2011

The importance of forests and plants are appreciated by all of us, but it is often overlooked because we are surrounded by it. The arboretum is one of facilities which provide users with education on the environment, knowledge about plants, and recreation, playing a role as a nature school by exhibiting and collecting plants of various ecosystems. Anyone can enjoy fresh air, a pleasant environment, and knowledge about a wide variety of plants on the condition that they aactually visit it and pay the entrance fee. However, it has not been measured whether the expense which users pay to enjoy an arboretum is a true value of arboretums. The environment that arboretums offer is extra-market goods, or public goods. A variety of ideas and methods to measure the value of public goods have been researched among economists, statisticians, and mathematicians. The Contingent Valuation Method(CVM) is most widely used a s an assessment method on environment goods and adopted as an estimation method for compensation for restoration of the environment by the American Supreme Court. The purpose of this study is to suggest a current monetary value correspondingent to the value of arboretums by applying the CVM. The survey suggested that when an arboretum provides a high educational value and when the respondents have a higher income, it is more likely that they would be willing to pay for entrance into the arboretum. The quantified value in monetary terms for the environmental value of Gyeongnam Arboretum is WTP mean \15,648; WTP median \13,648; and WTP truncated \15,449 per visitor. In annual terms, the amounts are calculated at WTP mean \8,408,265,024; WTP median \7,333,589,024; and WTP truncated \8,301,334,762. These quantified amounts can be thought to represent the value of conservation of arboretums and awaken users to the precious value of nature. Also, they are helpful to let the general public have proper knowledge about and recognize the value of arboretums and forests.