• Journal of Preventive Medicine and Public Health
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• v.52 no.6
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• pp.355-365
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• 2019

Objectives: In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly. Methods: The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification. Results: A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91). Conclusions: We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.

• Safety and Health at Work
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• v.12 no.3
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• pp.311-316
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• 2021

Background: The present study investigated the association between two domains of physical activity (occupational physical activity [OPA] and leisure-time physical activity [LTPA]) and sleep duration. Methods: We investigated 3,421 paid workers from the Korea National Health and Nutrition Examination Survey, 2014-2015. Sleep duration was categorized into three categories (short for less than 5 h, optimal for 5-9 h, and long for more than 9 h). OPA and LTPA were defined in terms of answers to relevant questions. Odds ratios were calculated for sleep duration according to each physical activity domain using multinomial logistic regression models. Results: There were 464 subjects (13.6%) who showed short sleep duration, and 169 subjects (4.9%) who showed long sleep duration. Prevalence of OPA and LTPA was higher in male workers than in female workers (for OPA: 3.67% and 1.76%, respectively, p = 0.0108; for LTPA: 16.14% and 6.07%, respectively, p < 0.0001). The odds ratio of OPA for long sleep duration in female workers was 3.35 (95% confidence interval, 1.37-8.21). Otherwise, LTPA was not associated with sleep duration in female paid workers, nor both physical activity domains in male paid workers. Conclusion: Female paid workers with work-related physical activity were at risk of oversleeping. These findings also suggested that physical activity has distinct associations with sleep duration according to the physical activity domains and sex.

• Health Policy and Management
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• v.29 no.2
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• pp.228-236
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• 2019

Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

• Fire Science and Engineering
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• v.33 no.2
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• pp.139-144
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• 2019

The increase in the elderly population also increased the damage and deaths of the elderly drivers. However, studies on the severity and severity of the elderly driver are not actively conducted and the factors are unknown. In this study, I tried to find out the factors affecting the damage and severity of the elderly driver in the frontal collision and to utilize them additionally in the severity classification. Collision Deformation Classification (CDC) Code was used to check the extent of damage to the vehicle. Abbreviated Injury Scale (AIS) was used to determine the injury parts and severity of injury, and the Injury Severity Score (ISS) to confirm the severity of the patient. The odds ratios of severe injury patients were found to be 7.381 in the subjects with 5 or more deformation extent and the ${\beta}$ value of the deformation extent was 0.453 in the analysis of the severity by linear regression analysis. Therefore, the degree of deformation extent of 5 or more can be suggested as a criterion that can be used additionally to the severity classification in the elderly driver.

• Journal of Environmental Health Sciences
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• v.44 no.6
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• pp.608-617
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• 2018

Objectives: The purpose of this study was to analyze related factors in relation to usage of illicit substances for Korean adolescents. Methods: This was a cross-sectional study, which used data from the Twelfth Korean Youth Risk Behavior Web-based Survey (KYRBWS). A total of 65,528 students in 2016 were included in this study. Chi-square test and logistic regression analysis were used for analyzing related factors using illicit substances. Results: Overall, 553 (0.8%) students responded as having ever used illicit substances during their lifetime and 133 (0.2%) students responded as current illicit substance users. It was found that electronic cigarette (EC) use, conventional cigarette smoking, second hand smoking, sad/despair mood, and economic status were significantly associated factors with usage of illicit substances. Comparing 'current EC users' with 'never EC users', the adjusted odds ratios (OR) was 7.76 (95% confidence interval (CI): 5.56-10.82) for life-time use of illicit substances, and 18.74 (95% CI: 8.01-43.87) for current use of illicit substances among adolescents. Additionally, comparing 'students who ever were exposed to second hand smoking during the past week', with 'students who never were exposed to second hand smoking', the adjusted OR was 2.60 (95% CI: 2.13-3.17) for life-time use of illicit substances, and 2.85 (95% CI: 1.68-4.83) for current use of illicit substances among adolescents. Conclusions: Based on the results, electronic cigarette use, second hand smoking, conventional cigarette smoking, sad/despair mood, and economic status were significantly associated with increased odds of substance experience and current substance use. Therefore, the results of this study can provide a useful evidence about adolescent behaviors in predicting substance use.

• Safety and Health at Work
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• v.10 no.2
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• pp.141-150
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• 2019

Background: Evidence on associations between occupational diesel exhaust and gasoline exposure and colorectal cancer is limited. We aimed to assess the effect of workplace exposure to diesel exhaust and gasoline on the risk of colorectal cancer. Methods: This case-control study included 181,709 colon cancer and 109,227 rectal cancer cases diagnosed between 1961 and 2005 in Finland, Iceland, Norway, and Sweden. Cases and controls were identified from the Nordic Occupational Cancer Study cohort and matched for country, birth year, and sex. Diesel exhaust and gasoline exposure values were assigned by country-specific job-exposure matrices. Odds ratios and 95% confidence intervals were calculated by using conditional logistic regression models. The results were adjusted for physical strain at work and occupational exposure to benzene, formaldehyde, ionizing radiation, chlorinated hydrocarbons, chromium, and wood dust. Results: Diesel exhaust exposure was associated with a small increase in the risk of rectal cancer (odds ratio - 1.05, 95% confidence interval 1.02-1.08). Gasoline exposure was not associated with colorectal cancer risk. Conclusion: This study showed a small risk increase for rectal cancer after workplace diesel exhaust exposure. However, this finding could be due to chance, given the limitations of the study.

• Korean Journal of Community Nutrition
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• v.26 no.5
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• pp.363-381
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• 2021

Objectives: This study examined the Korean elderly's dietary intake status, subjective health-related perception and chronic disease prevalence among age groups. Associations of dietary quality with subjective health-related perception and chronic diseases were also examined. Methods: Based on data from the 7th National Health and Nutrition Examination Survey, a total of 3,231 elderly were selected and categorized into 4 age groups of '65 ~ 69', '70 ~ 74', '75 ~ 79' and 'over 80'. Nutrient intakes, proportions of those with insufficient nutrient intakes, Korean Healthy Eating Index (KHEI), some subjective health-related perceptions and prevalence of major chronic diseases were compared according to the age groups. Differences in the subjective health-related perceptions and odds ratios of the chronic diseases according to the quartile levels of KHEI within the same age group were analyzed. Results: With the increase of age, several nutrient intakes (P < 0.001) and KHEI scores significantly decreased (P < 0.01). In women, activity restriction increased (P < 0.05), and EQ-5D score decreased with age (P < 0.001). Prevalence of hypertension (P < 0.0001), hypercholesterolemia (P < 0.05) and anemia (P < 0.01) significantly increased, while hypertriglyceridemia (P < 0.01) significantly decreased only in men. Obesity prevalence decreased, while underweight prevalence increased (P < 0.05). Subjective health status, EQ-5D score and PHQ-9 score significantly improved as KHEI score increased in certain age groups of women (P < 0.05). Odds ratio of hypercholesterolemia significantly increased with the increase of KHEI score in 65 ~ 69-year-old women. However, hypertension and anemia significantly decreased with the increase of KHEI score in 75 ~ 79-year-old women (P < 0.05). Conclusions: The study findings suggest that nutrition management and policy for the Korean elderly need to apply a segmented age standard that can better reflect their dynamic characteristics.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.409-416
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• 2020

Objectives: The goal of this retrospective study was to determine the significance and impact of several factors on the alveolar cleft bone grafting procedure. Materials and Methods: The medical records were reviewed. In addition, x-rays were checked. The size of every cleft was measured in this retrospective study. The analyzed factors included sex, age, type of cleft, size of the cleft, and the type of flap used in surgery. The patients were characterized into group A (no complications, Bergland scale 1 or 2), group B (complications or Bergland scale 3), or group C (failure cases). Statistical analysis was performed with a P-value set at 0.05. Results: There were 32 cases in group A, 26 in group B, and 9 in group C. Multinomial logistic regression showed an association between the type of the cleft and the size of the cleft, with the presence of complications, or achieving type 3 on the Bergland scale, with odds ratios of 5.118 and 6.000, respectively. The type of cleft was related to failure with an odds ratio of 4.833. Given a small sample, statistical analysis could not be performed to evaluate the relationship between the size of the cleft and group C. Age, sex, and the type of the flap were not significant factors. Conclusion: The cleft size of more than 10 mm and bilateral clefts were listed regarding their effect on the procedure. Clinicians should not overlook these factors. In addition, patients must be informed of any risks that are present.

• Journal of Korean Academy of Nursing
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• v.51 no.3
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• pp.380-389
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• 2021

Purpose: This study aimed to understand the relationship between cigarette and electronic cigarette (e-cigarette) use and sleep health among Korean adolescents. Methods: Using the 14th Korea Youth Risk Behavior Survey, we included 52,928 adolescents who responded to sleep satisfaction and sleep duration. Participants were classified into four groups: non-users, cigarette-only users, e-cigarette-only users, and dual users of both products. To examine the associations between cigarette and e-cigarette use and sleep health, data were analyzed using complex samples cross tabulation and complex samples logistic regression. Results: Of the four groups, dual users reported the lowest level of sleep satisfaction and sleep duration; 57.0% and 86.9% of dual users were not satisfied with their sleep and have insufficient sleep duration, respectively. The proportion of students who were not satisfied with their sleep was higher among cigarette-only users compared to e-cigarette-only users (52.7% vs. 45.8%), but the two groups reported similar rates of insufficient sleep duration (84.2% vs. 84.3%). Compared to non-users, cigarette-only users, e-cigarette-only users, and dual users were more likely to not be satisfied with sleep (odds ratios [ORs] were 1.49, 1.36, and 1.75, respectively) and had significantly higher odds of experiencing insufficient sleep duration (ORs were 1.85, 2.06, and 2.34, respectively). Conclusion: E-cigarette-only use and dual use as well as cigarette-only use were associated with poor sleep health. Therefore, to improve adolescent sleep health, health professionals should provide sleep intervention strategies considering the association between smoking and sleep health.

• Journal of Korean Dental Hygiene Science
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• v.4 no.1
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• pp.39-51
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• 2021

Background: Limited information is available regarding the associations of various nutrients and periodontitis in Korea. Furthermore, these associations have been controversial in previous studies. Therefore, the present study aimed to evaluate the associations between several nutrients and periodontitis. Methods: Pooled data from the 2007~2010 and 2012 Korea National Health and Nutrition Examination Surveys (KNHANES) were used for the present study. Periodontitis was defined using the World Health Organization (WHO) Community Periodontal Index. All participants completed the Food Frequency Questionnaire (FFQ), which was analyzed using CAN-Pro 4.0. Vitamins A, B₁, B₂, and C, iron, phosphorus, calcium, and protein were selected for analysis. Multiple logistic regression analyses were used to estimate the odds ratios (ORs) for periodontitis. Results: Lower intake of phosphorus (adjusted odds ratio [AOR] = 1.86), calcium (AOR = 1.25), and protein (AOR = 1.52) were associated with periodontitis in males, and lower intake of vitamins A (AOR = 1.32), B1 (AOR = 1.21), B2 (AOR = 1.24), and C (AOR = 1.21), iron (AOR = 1.25), phosphorus (AOR = 1.33), and protein (AOR = 1.27) showed significant relationships with periodontitis in females. In the sociodemographic, somatic, and health behavior-adjusted models, lower phosphorus (AOR = 2.68) and protein (AOR = 1.68) intake in younger males, and lower vitamin A intake (AOR = 1.37) in middle-aged females were significantly associated with periodontitis. Conclusions: The results of the present study demonstrated a significant association between periodontitis and nutrient intake. To avoid an insufficient nutrient supply for a patient with periodontal disease, the patient's diet should be closely monitored.