• Journal of Family Resource Management and Policy Review
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• v.16 no.4
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• pp.23-44
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• 2012

The purpose of this study is to examine the preference for living with adult children of the baby-boomer generation and the elderly based on independent variables such as demographic characteristics, the values of their children and the consciousness for supporting their parents. The National Survey of Korean Families was done by the Ministry of Equality and Family in 2010. Respondents were 664 baby boomers and 628 elderly, and the results are as follows. First, the baby boomers rely heavily on their spouse, whereas the elderly rely heavily on their children. While both groups desire to live with their spouse in their later years, and the elderly rely the most on their children, they are reluctant to live together. This result shows that the elderly have high expectations for financial and emotional support from their children, but in reality, the elderly have lower expectations for living together and they prefer to live alone or with their spouse. Second, the boomers, who for the most part live in big cities, have comparatively high average monthly income and jobs and own a house, consider filial obligation as their own responsibility and yet tend to live independently. The boomers, who have a relatively high education level, consider living with aged parents as the children's obligation and consider their children as the most reliable people in their lives, and thus have high expectations to live together with their children. Third, the elderly, with a spouse, who consider having raised children to be their happiness, while considering providing financial support for the aging parents to be the children's responsibility, at the same time accept that the obligation of support lies on themselves, the government or the society, and thus have lower expectations of living with their children in later years. The elderly, now living with their family, with generous financial plans for their aging years and considering the children's success as their own success, have higher expectations of living together with their children.

• Clinical and Experimental Pediatrics
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• v.53 no.10
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• pp.872-879
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• 2010

Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.251-262
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• 2022

Purpose: Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs. Methods: A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study's primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates. Results: Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6-98%; I²=0) and 93.9% (95% CI, 82.6-98%; I²=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7-92.9%; I²=0) and 92.3% (95% CI, 87.4-95.4%; I²=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3-11.4%; I²=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1-17.1%; I²=0). Conclusion: Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.

• 한국노년학
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• v.25 no.2
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• pp.35-52
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• 2005

This study attempts to develop the scale of 'Successful Aging' for Korean elderly. It follows fives: (1)developing 105 items based on the literature reviews, (2)performing the 1st survey to confirm and reduce items, (3)verifying the content validity through the professional group and the elderly focused group, (4)performing the 2nd survey to explore the factors of 'Successful Aging' and (5)performing the 3rd survey to identify the construct validity and concurrent validity. The scale constructs four factors with 30 items. The four factors are confirmed : (1)self efficacy, (2)satisfaction with adult children's success, (3)couple life like companion, (4)self control. The reliability of this scale is 0.94 and the relationship between the items and each factor are statistically significant by the confirmatory factor analysis. Thus, the content validity is verified. Also the correlation with the successful aging and the life satisfaction is 0.69 and then the concurrent validity is verified. This 'Successful Aging Scale' for Korean elderly will contribute to use as the socio-metrics at the welfare practice for aging.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.437-443
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• 2014

The JCVSD (Japan Cardiovascular Surgery Database) was organized in 2000 to improve the quality of cardiovascular surgery in Japan. Web-based data harvesting on adult cardiac surgery was started (Japan Adult Cardiovascular Surgery Database, JACVSD) in 2001, and on congenital heart surgery (Japan Congenital Cardiovascular Surgery Database, JCCVSD) in 2008. Both databases grew to become national databases by the end of 2013. This was influenced by the success of the Society for Thoracic Surgeons' National Database, which contains comparable input items. In 2011, the Japanese Board of Cardiovascular Surgery announced that the JACVSD and JCCVSD data are to be used for board certification, which improved the quality of the first paperless and web-based board certification review undertaken in 2013. These changes led to a further step. In 2011, the National Clinical Database (NCD) was organized to investigate the feasibility of clinical databases in other medical fields, especially surgery. In the NCD, the board certification system of the Japan Surgical Society, the basic association of surgery was set as the first level in the hierarchy of specialties, and nine associations and six board certification systems were set at the second level as subspecialties. The NCD grew rapidly, and now covers 95% of total surgical procedures. The participating associations will release or have released risk models, and studies that use 'big data' from these databases have been published. The national databases have contributed to evidence-based medicine, to the accountability of medical professionals, and to quality assessment and quality improvement of surgery in Japan.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.51-59
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• 2007

Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.