Objective:To examine the association of depression with oral health behaviors and oral health status in a large nationwide sample of Korean adults. Methods: This study included 6,139 participants aged 19 years or older who participated in the fifth Korean National Health and Nutrition Examination Survey. Binary and polychotomous logistic regression analyses were used to estimate adjusted odds ratios (AORs) and 95 percent confidence intervals (CIs). Results: Participants with lifetime depression (self-report of past or present depression) brushed their teeth less frequently (AOR = 1.30, 95 percent CI 1.03-1.65) and were more likely not to receive treatment when experiencing dental problems (AOR = 1.43, 95 percent CI 1.23-1.66) than those without lifetime depression after adjusting for sociodemographic factors, gender, and age. After adjusting for significant oral health behaviors, current smoking status, and sociodemographic factors, participants with lifetime depression had poorer oral health status than those without this disorder: uncomfortable mastication (AOR = 1.25, 95 percent CI 1.05-1.50), toothache (AOR = 1.18, 95 percent CI 1.01-1.39), temporomandibular joint symptoms (AOR = 1.41, 95 percent CI 1.08-1.85), and maxillary periodontal bleeding (AOR = 1.29, 95 percent CI 1.03-1.61 for the right side; AOR = 1.40, 95 percent CI 1.13-1.74 for the left side). Conclusion: Depression was significantly associated with oral health status, even after adjusting for the impact of oral health behaviors in Korean adults. Thus, our findings suggest the necessity of further investigation to detect underlying mechanisms in the relationship between depression and oral health that are not mediated by oral health behavior.

Background: Despite the presence of a strong association between influenza infection and stroke, whether influenza vaccination reduces the risk of stroke is yet a matter of controversy. We conducted a meta-analysis to determine whether influenza vaccination protects against stroke. Methods: We searched PubMed, EMBASE, and the Cochrane Library from database inception date to November 18, 2016, without language restrictions, to identify studies investigating the effect of influenza vaccination on subsequent risk of stroke. We conducted a meta-analysis to quantify the risk of stroke in overall and subgroup analyses and calculated a pooled OR for developing stroke with a 95% CI. Publication bias was assessed by Begg's rank correlation test. Results: Eleven studies fulfilled our inclusion criteria. In a random-effects model, vaccinated individuals had a decreased risk of stroke compared with unvaccinated individuals (OR 0.82; 95% CI 0.75-0.91; p < 0.001). The relationship between influenza vaccination and stroke risk remained robust in subgroup analyses. The significant effect of influenza vaccination was associated with ascertainment of vaccination status and stage of prevention. Conclusion: Vaccination against influenza is associated with a lower risk of stroke. Well-designed prospective studies are needed to provide stronger evidence of the protective effect of influenza vaccination against stroke.

PurposeTo reduce lung cancer mortality, lung cancer screening was recommended using low-dose computed tomography (LDCT) to high-risk population. A protocol for multicenter lung cancer screening pilot project was developed to evaluate the effectiveness and feasibility of lung cancer screening to implement National Cancer Screening Program in Korea.Materials and MethodsMultidisciplinary expert committee was comprised to develop a standardized protocol for Korean Lung Cancer Screening Project (K-LUCAS). K-LUCAS is a population-based single arm trial that targets high-risk population aged 55-74 years with at least 30 pack-year smoking history. LDCT results are reported by Lung-RADS suggested by American Radiology Society. Network-based system using computer-aided detection program is prepared to assist reducing diagnostic errors. Smoking cessation counselling is provided to all currently smoking participants. A small pilot test was conducted to check the feasibility and compliance of the protocols for K-LUCAS.ResultsIn pilot test, 256 were participated. The average age of participants was 63.2 years and only three participants (1.2%) were female. The participants had a smoking history of 40.5 pack-year on average and 53.9% were current smokers. Among them, 86.3% had willing to participate in lung cancer screening again. The average willingness to quit smoking among current smokers was 12.7% higher than before screening. In Lung-RADS reports, 10 (3.9%) were grade 3 and nine (3.5%) were grade 4. One participant was diagnosed as lung cancer.ConclusionThe protocol developed by this study is assessed to be feasible to perform K-LUCAS in multicenter nationwide scale.

BackgroundRecently there has been a growing interest in healthcare quality control in Korea. We examined the association between patient factors and quality indicators of diabetic care among Korean adults with diabetes.MethodsWe obtained a sample of 335 adults aged 20 or older diagnosed with diabetes from the 2005 Korean National Health and Nutrition Examination Survey. Patient factors were divided into two categories: socioeconomic position and health-related factors. Quality indicators for diabetes care were defined as receiving preventive care services for diabetes complications (e.g., fundus examination, microalbuminuria examination, diabetes education) and diabetes-related clinical outcomes (e.g., HbA1c, blood pressure, LDL-cholesterol). We performed multiple logistic regression analyses for each quality indicator.ResultsWe found that people with lower education levels or shorter duration of diabetes illness were less likely to receive preventive care services for diabetes complications. Women or people with longer duration of diabetes were less likely to reach the glycemic target. Obese diabetic patients were less likely to accomplish adequate control of blood pressure and LDL-cholesterol.ConclusionsSeveral factors of patients with diabetes, such as education level, duration of illness, gender, and obesity grade are associated with the quality of diabetes care. These findings can help inform policy makers about subpopulations at risk in developing a public health strategy in the future.

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