• Title/Summary/Keyword: 취약성 평가

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Effects of Visiting Prehabilitation Program against Functional Decline in the Frail Elderly: A Prospective Randomized Community Trial (허약노인을 위한 방문재활 프로그램의 장애발생예방 효과에 대한 연구)

  • Kim, Chang-O;Lee, Heeyeon;Ho, Seung Hee;Park, Hyunsuk;Park, Chulwoo
    • 한국노년학
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    • v.30 no.4
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    • pp.1293-1309
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    • 2010
  • This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.

The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program (현행 영유아 및 소아청소년 건강검진제도의 평가 및 대안)

  • Eun, Baik-Lin;Moon, Jin Soo;Eun, So-Hee;Lee, Hea Kyoung;Shin, Son Moon;Seong, In Kyung;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.300-306
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    • 2010
  • Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.

Health and nutrition intake status of the Korean elderly according to their food security level: data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018 (식품안정성 수준에 따른 한국노인의 건강상태와 영양섭취현황: 제7기 (2016-2018) 국민건강영양조사 자료 활용)

  • Maeng, Ahreum;Lee, Jeehyun;Yoon, Eunju
    • Journal of Nutrition and Health
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    • v.54 no.2
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    • pp.179-198
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    • 2021
  • Purpose: This study examined general characteristics, health status, accessibility to medical services, health-related quality of life, dietary behavior, and energy and nutrient intakes of the elderly at different levels of food security utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Methods: The elderly subjects (1,721 males and 2,271 females) were divided into 3 groups (secure, mildly insecure, moderately/severely insecure) according to their food security levels. Health and nutrient status was determined using energy intake, nutrient density, the prevalence of insufficient nutrient intake, dietary behavior, and health status. Results: The elderly with food insecurities had a lower self-evaluated health status and a higher prevalence of physician-diagnosed chronic diseases such as arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis for males, and hypertension, stroke, arthritis, and osteoarthritis for females. The associated financial burden was the major reason for not accessing medical services in the food insecure group. Furthermore, the food insecure group had a higher risk of impaired health-related quality of life compared to the secure group. The proportion of subjects with an energy intake below the estimated energy requirement was higher in the food insecure group and a significantly higher prevalence of insufficient intake was observed for all the nutrients (proteins, vitamin A, vitamin B1, vitamin B2, niacin, vitamin C, calcium, and iron) assessed in this study compared to the food secure group. Conclusion: This study suggests that food insecurity poses a challenge to the health and nutritional status of the elderly population in Korea and needs proper management. It would be helpful to develop food and nutrition assistance programs to ensure the food stability of the elderly population and assure quality to address gaps in their nutrient intake.

Spatial problems of Korea -A delphi survey- (國土管理의 方向定立을 위한 國土診斷 -專門家 集團의 問題意識을 中心으로-)

  • Kim, Inn;Yu, Woo-Ik;Huh, Woo-Kung;Park, Young-Han;Park, Sam-Ock;Yu, Keun-bae;Choi, Byung-Seon
    • Journal of the Korean Geographical Society
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    • v.29 no.1
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    • pp.16-38
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    • 1994
  • The spatial structure of Korea has been changed drastically during the second half of this century. The events such as the Korean War and the resultant division of the Korean Peninsular into two Koreas, rapid industrialization and urbanization are the major causes among others for the spatial changes of the nation. The changes in turn have spawned a number of spatial problems. It is time, we argue, to diagnose how much the nation is now ill-structured, and to discuss of which directions the long-term spatial management be reoriented. A delphi survey was conducted during the early 1993 to fulfill such research needs. Questionnaires were distributed among geographers, planners, and high governmental officials throughout the nation. These 'experts of spatial problems' were requested to evaluate the past spatial policies and strategies, and to identify spatial and environmental problems at the national, regional and local levels. The survey included questions with regard to the spatial problems in North Korea too. A complementary literature survey in the fields of spatial sciences was accomplished as well in order to identify the major research interests and issues with regard to the nations's spatial structure. The delphi survey results indicatee that the present spatial structure: in relation to consumption, housing and economic activities is satisfactory in overall, while rather poor in terms of education, leisure and community activities. Most of the experts consider infrastructural improvements are urgent in the areas of roads, waste disposal facilitles, railroads, harbors, water supply and drainage systems. The over-concentration of economic, social and political function in the Seoul Metropolitan Region is perceived to be the most serious spatial problem in Korea. The long-term solutions suggested are strategies toward a more balanced regional development as well as toward a cleaner environment. The concensus among the experts for the short-term solution is the redistribution of population and industries from the Seoul Metropolitan Region to the intermediate and small cities. The land use policies and concurrent large-scale infrastructural projects are evaluated largely pertinent and desirable in general. It is, however, suggested that development projects be conducted in a more harmonious way with environment. The survey respondents suggest that the present environmental management policies should be reexamined critically. With regard to regional and local problems, transportation and pollutions are thought to be most serious in the Seoul Metropolitan Region, while employment opportunities, and information, education and health care services are most deprived in small cities and rural areas. The majority of the experts consider a city size of 250, 000-500, 000 population is desirable to live within. Respondents beileve that North Korea's physical environment is still not aggravated much whereas its infrastructural provisions are largely pool. The co-authors of this research figure a "environmentaly sound and spatially balanced Korean Penninsular" as the ideal type of spatial structure in Korea. The basic guidelines toward this ideal prototype are suggested: the recovery of spetial integrity, progressive restructuring of the nation, land uses geared to public welfare rather than private interests, and eco-humanistic approach in spatial policies.

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A Study for the Certified Security Certification in Private Security Industry in Korea (민간경비 자격제도에 관한 연구)

  • Ahn, Hwang-Kwon
    • Korean Security Journal
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    • no.11
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    • pp.159-181
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    • 2006
  • This study is concerned on Why The Certified Security certification is needed and How to control the security quality to get better service to the clients. Theses days are required The Certified Certificate in all the industry. And in this point of view, the certified certificate is a kind of confirmation by an authority to the person who has how much special knowledge and practice in a certain field. Moreover, in the functionalism society the certified certificate system would be very positive effect to the related industry and society as official measurement by an authority. The security is freedom from fear and anxiety. Which means the security can not be operated in isolation from citizen's safe-living expectation, and which is also dealing with valuable human being's life. For getting the better purpose the security industry employees should have more organized special training and education. As my understanding the certified certificate exam system is the confirmation by an authority, the certified certificate is only neutral evidence to get the confidence and credit from the clients. In this point of view the core point is How to control The Certified Certificate by a credied authority.

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Relationships between obesity, blood and urinary compositions, and dietary habits and depressed mood in Koreans at the age of 40, a life transition period (만 40세 생애전환기 건강진단 수검자의 우울기분과 영양 생활습관 및 건강특성과의 관련성)

  • Chu, Ji Eun;Lee, Ji Min;Cho, Han-Ik;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.46 no.3
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    • pp.261-275
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    • 2013
  • This study was designed to investigate the relationships of depressed mood with obesity, blood and urinary compositions, and dietary habits in Koreans at the age of 40, a critical transition to the middle adulthood stage. A total of 27,684 people who have taken the Life Transition Period Health Examination at the Korea Association of Health Promotion in 2011 were divided into two groups; the depressed mood group (DG) and the non-depressed group (NG) according to results of the primary questionnaire for mental health. The results were analyzed using the health examination criteria of the National Health Insurance Corporation. Women and medicaid recipients showed higher incidence of depressed mood than men and health insurance subscribers. People with underweight in BMI or abdominal obesity showed correlation with depressed mood, while there was no significant relationship with metabolic syndrome. Regarding blood and urinary compositions, DG was related to a higher level of hemoglobin and lower levels of HDL-cholesterol and triglyceride, although the relationships diminished after adjustment for other confounder effects. According to dietary habits, more people in DG were categorized as a group for "Needs Much Improvement", and the odds ratio of the depressed mood showed a significant increase. Significant difference regarding the frequency of food items such as milk products, animal proteins, Kimchi, and fruits was observed between DG and NG. In addition, a higher portion of subjects in DG did not consume regular meals and various kinds of food. In conclusion, the depressed mood of 40 year-old adults was significantly related to underweight, higher waist measurement, and undesirable dietary habits. Results of our study can be applicable as a basic resource for development of effective nutrition counseling and education programs for improvement of mental health promotion during the critical transition to the middle adulthood stage.

ASSOCIATION STUDY OF ATTENTION-DEFICIT/HYPERACTIVITY DISORDER(ADHD) AND THE DOPAMINE TRANSPORTER(DAT1) GENE - CASE CONTROL DESIGN STUDY - (주의력결핍과잉행동 장애와 도파민 운반체 유전자간 연합연구 - 환자-대조군 디자인 연구 -)

  • Kim Boong-Nyun;Cho Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.199-210
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    • 2005
  • Objective : Attention deficit hyperactivity disorder(ADHD) affects $5-10\%$ of children in Korea, with more boys and girls being diagnosed. Despite seriousness of ADHD, little is known about its causes. From the current genetic epidemiologic studies, ADHD is known as a heritable disorder. Till now, however, there have been very few genetic studies about ADHD in Korea. The aim of the this study is to examine the association between dopamine transporter gone type 1 and ADHD using case-control design in Korean ADHD probands and normal controls. Materials and Method : Child Psychiatric Genetic research team in Seoul National University Hospital, Clinical Research Institute recruited the ADHD probands using clinical interview/observation, diverse rating scales, and neuropsychological tests. For eliminating phenocopy or ADHD, diagnosis of ADHD was based upon clinical data, psychometric data, and parent/teacher reports. Total 85 ADHD-probands were recruited as final study subjects and independent 100 normal adults participated in this study as control group. For all the ADHD probands, and controls, the 3'-UTR-VNTR polymorphism of DAT1 was analyzed. Based on the DAT1 allele and genotype informations, Chi-square test based on case-control design was performed. Results : As for genetic study, total of 85 probands and 100 controls were included for the genetic analysis. Four different alleles, 350bp (7repeat), 440bp (9repeat), 480bp (10repeat) and 520bp (11repeat) were found in DAT1 gene of study subjects. In case-control analysis, ADHD probands and parents have significantly more 9 repeat allele and 9/10 genotype. Also, The probands with 9repeat allele have more commission errors in ADS. Conclusion : The positive association between ADHD and DAT1 gene was replicated in this report like other previous results for caucasian children and Korean children with ADHD. There are ongoing studies on other candidate genes such as DRD4 and DRD5 and it would be required to explore the association of these candidate genes in Korean children with ADHD. These ongoing genetic research will contribute to the understanding of heterogenous genetic and environmental etiologies of ADHD phenotype, which will lead to the development of more comprehensive treatment and preventive interventions for ADHD.

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Evaluation of Characteristics of Re-liquefaction Resistance in Saturated Sand Deposits Using 1-g Shaking Table Test (1-g 진동대시험을 이용한 포화된 모래지반의 재액상화 강도 특성 평가)

  • Ha Ik-Soo;Kim Myoung-Mo
    • Journal of the Korean Geotechnical Society
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    • v.21 no.4
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    • pp.65-70
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    • 2005
  • Many case histories of re-liquefaction phenomena seem to support the idea that sand deposits, if they once have been liquefied, could be reliquefied again by a subsequent earthquake even though the earthquake is smaller than the previous one. The magnitude of the strains induced in the initial liquefaction has a significant influence on the resistance of the sample to re-liquefaction. The deposits undergoing liquefaction experience large shear strain during liquefaction. And this previous strain changes the microstructure into highly anisotropic structure such as columnlike structure and connected voids. This type of anisotropy is so unstable that it can reduce re-liquefaction resistance. It is blown that the extent of anisotropic structural change depends on the gradation characteristics of ground. The purpose of this study is to estimate the correlation between the gradation characteristics of the sand and the ratio of re-liquefaction resistance to liquefaction resistance. In this study, 1-g shaking table tests were carried out on five different kinds of sands. During the tests the values of excess pore pressure at various depths and surface settlements were measured. Re-liquefaction resistances were not affected by the initial void ratio and the effective confining pressures, and the deposits of all test sands which had once been liquefied were reliquefied in the cyclic loading number below 1 to 1.5. The ratio of re-liquefaction resistance to liquefaction resistance linearly decreased as $D_{10}/C_u$ increased, and was constant as about 0.2 above the value of $D_{10}/C_u$, 0.15 mm.

The Comparison of Stress Responses, Anger Expression and Alexithymia between Chronic Gastritis and Gastric Ulcer Patients (만성위염 환자들과 위궤양 환자들 간의 스트레스반응, 분노표현 및 감정표현불능증의 비교)

  • Koh, Kyung-Bong;Oh, Seung-Jun;Lee, Sung-Hee;Lee, Sang-In;Chung, Jae-Bock
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.30-37
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    • 2004
  • The objective of this study was to make a comparison between chronic superficial gastritis and gastric ulcer patients regarding stress responses, anger expression and alexithymia. The subjects included 100 patients with chronic superficial gastritis and 40 patients with gastric ulcer confirmed by gastroscopy. Stress responses were measured by the Stress Response Inventory(SRI) and anxiety, depression, somatization and hostility subscales of the Symptom Checklist-90-revised(SCL-90-R). Anger expression and anger suppression were assessed by the Anger Expression Scale. The level of alexithymia was assessed by the Toronto Alexithymia Scale(TAS). Multiple regression analysis showed that the patients with chronic gastritis scored significantly higher on tension subscale and somatization subscale of the SRI, and anxiety subscale of the SCL-90-R than those with gastric ulcer. However, no significant differences were found in the score of anger expression and anger suppression subscales and total score of TAS between the two groups. In chronic gastritis patients, women scored significantly higher on somatization subscale of the SRI than men, whereas in gastric ulcer patients, men scored significantly higher on somatization subscale of the SRI than women. These results suggest that chronic gastritis patients are more likely to have higher level of stress responses and higher susceptibility to stress than gastric ulcer patients. In addition, in chronic gastritis patients, women are more likely to somatize than men, but in gastric ulcer patients, men are more likely to somatize than women. However, there were no differences between the two groups in anger expression, anger suppression and alexithymia.

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The assessment of Seoul City school sheriff system and developmental expansion plan - Around the righteousness proof of the security industry law application - (서울시 학교보안관 제도의 평가와 발전적 확대방안 - 경비업법 적용의 당위성 논증을 중심으로 -)

  • Lee, Sang-Hun
    • Korean Security Journal
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    • no.29
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    • pp.163-191
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    • 2011
  • Recently, the problems in school violence did not stop on the crime between the members at the school and which developed into the invasion crime of the school caused by outsiders. The school is no more the safety zone from the crime. Particularly, in the case of the elementary school, because there are nearly no people who oppose to the outside attacker and can control this, it is the place where it is vulnerable to the invasion crime. The Metropolis of Seoul implements the School Sheriff system within the jurisdiction bureau, in the public elementary school. However, actually the School Sheriff business is being managed, never applying a rule in the Security Industry Law with the main content, that is the Security Industry Law application is excluded. Because the jurisdiction on the contract of Seoul City and operating company are run, the various issues is caused. First, since it is not being considered as a security business, the commercial liability insurance for security company has no chance to applicate when the operation company and the School Sheriff have related damage generation. So the security for the indemnification of loss of the victim is weak. Second, The task of the School Sheriff is ruled just by in the individual contracts. But it is insufficient with this thing. The related duties are required some supplement like a general rule application including the obligation of the guard in the security industry law. Third, the education of the School Sheriff needs to connect with the educational programme in the security industry law. The related professional education specially needed for the prevention of school violence ought to be reserved compensation. Forth, the citizens still demand the strengthening of police patrol for the surroundings of a school in spite of the result of Seoul City's public survey. Therefore, the active relation of cooperation with the police needs to be supported legally and institutionally with the Security Industry Law application. Fifthly, the success of the School Sheriff business can be more guaranteed with the supervision of the legal and institutional device like a the Security Industry Law application or police and all sorts of administrative execution's and etc.

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