• Journal of Digital Convergence
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• v.19 no.4
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• pp.467-475
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• 2021

Purpose: When a patient with acute deterioration occurs in a ward, the decision to transfer to intensive care unit (ICU) is critical to improve the patient's outcomes. However, when available ICU resources limited, it is difficult to determine which of the deteriorating ward patients to transfer to the ICU. Therefore the purpose of this study was to identify risk factors in predicting deteriorating ward patients transferred to intensive care unit (ICU). Methods: We reviewed retrospectively clinical data of 2,945 deteriorating ward patients who referred medical emergency team. Data were analyzed with multivariate logistic regression. Results: The solid cancer that diagnosed at hospitalization (odds ratio[OR] 0.39; 95% confidence interval [CI] 0.32-0.47), when the cause of deterioration was respiratory problem (1.51; 95% CI 1.17-1.95), high MEWS (1.22; 1.17-1.28) and SpO2/FiO2 score (2.41; 2.23-2.60) were predictive of ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.

• Journal of the Korean Regional Science Association
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• v.37 no.1
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• pp.29-44
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• 2021

Particulate matter(PM) is one of the leading causes of lung cancer. Recognizing its considerable risk to human health, people change their behaviors when a concentration level of PM is high. The impact of particulate matter on urban activities may vary depending on the lasting days of PM and PM matter alerts. In addition, the level of averting behavior may vary depending on the types and physical characteristics of urban activities and the degree of vulnerability to PM among people. Although the way people respond to PM may vary depending on these various factors, previous research evidence on this is very insufficient. Therefore, this study multilaterally analyzed the impact of PM on the urban activities in Jongno-gu, one of the CBD areas of Seoul. For this, we linked SKT's mobile phone signal data to land use data to extract the daily number of active people by urban activity types and ages. According to multiple regression analysis, the averting behavior varies depending on the type of urban activity, the physical characteristics of the place of activity(inside and outdoor), the lasting days of PM, PM alerts and the age of people. The results of this study can be used as basic data to policy makers who establish policies for adapting to air pollution policies by providing various effects of PM on the urban activities.

• Journal of Digital Convergence
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• v.18 no.12
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• pp.279-284
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• 2020

In January 2020, COVID19 plunged the whole planet into a pandemic. This has caused great economic losses and is causing social confusion. COVID19 has a superior infection rate among people with underlying disease such as heart disease, high blood pressure, diabetes, stroke, depression, and cancer. In addition, it was studied that patients with underlying disease had a higher fatality rate than those without underlying disease. In this study, the presence or absence of underlying disease was classified using EEG data. The data used to classify the presence or absence of underlying disease was EEG data provided by Data Science lab, consisting of 33 features and 69 samples. Z-score was used for data pretreatment. Classification was performed using the neural network NEWFM and ZNN engine. As a result of the classification of the presence or absence of the underlying disease, the experimental results were 77.945 for NEWFM and 76.4% for ZNN. Through this study, it is expected that EEG data can be measured, the presence or absence of an underlying disease is classified, and those with a high infection rate can be prevented from COVID19. Based on this, there is a need for research that can subdivide underlying disease in the future and research on the effects of each underlying disease on infectious disease.

• Journal of the Korea Convergence Society
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• v.12 no.11
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• pp.359-369
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• 2021

In this study, a complex sample logistic regression analysis was performed to identify the factors affecting the activity restriction of 2,701 normal elderly and chronically ill elderly aged 65 and over using raw data from the 8th period of the National Health and Nutrition Examination Survey. It was found that the elderly with chronic disease felt more restricted in their activities than the normal elderly. Activity limiting factors in stroke and hypertension patients are subjective health status, economic level, stress perception, and moderate-intensity work and leisure. The factors limiting activity in patients with heart disease were subjective health status and economic level, and factors limiting activity in patients with joint disease were subjective health status and high-intensity work and leisure. Activity limiting factors for lung disease patients are education level, high intensity work and leisure, and endocrine system activity limiting factors include subjective health status, stress perception, high intensity work and leisure, and activity limiting factors for cancer patients. is subjective health status, stress perception, moderate-intensity work and high-intensity leisure. Rehabilitation programs and policy support are needed for the continuous participation of the elderly with chronic diseases.

• Journal of Environmental Health Sciences
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• v.49 no.4
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• pp.218-227
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• 2023

Background: Since 2019, the Ministry of Environment has implemented a seasonal fine dust management system from December to March, targeting high PM_2.5 levels with the aim of reducing PM_2.5 concentrations and protecting public health. The focus of improving the seasonal management system lies in the atmospheric PM_2.5 levels. Considering the primary goal of protecting public health, it is necessary to analyze the policy effects from an exposure perspective rather than a concentration-based approach. Objectives: This study aims to quantitatively assess the improvement of indoor PM_2.5 levels and the health impacts of the seasonal management system by comparing the periods before and during its implementation in residential environments. Methods: PM_2.5 concentrations within residential environments in a metropolitan area were measured using an optical particle counter (IAQ-C7, K-weather, Ltd, Korea) at one-minute intervals during the pre-implementation period (November 21~25, 2022) and during the implementation period (December 19~23, 2022). Based on the measured PM_2.5 concentrations, a quantitative evaluation of cancer and mortality risks was conducted according to age and gender. Results: The results of comparing indoor and outdoor PM_2.5 concentrations before and during the implementation of the seasonal management system showed a decrease of approximately 56.6% and 47.9%, respectively. Health risk assessments revealed that both the safety-limit-based and safety-target-based Hazard Quotients (HQ) exceeded the threshold of 0.1 for children under 19 years of age, both before and after the implementation. The mortality risk decreased by approximately 47.9% after the implementation, with children aged 0-9 showing the highest mortality risk at 0.9%. Conclusions: The findings of this study confirmed the positive health impacts of the seasonal management system across all age groups, particularly children under 19 who are more vulnerable to fine dust exposure.

• Journal of agricultural medicine and community health
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• v.48 no.2
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• pp.81-90
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• 2023

Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid dis- ease(β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipi- demia(β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions: Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

• Asian Journal of Atmospheric Environment
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• v.8 no.1
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• pp.35-47
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• 2014

The purpose of the study is to evaluate the pollution level (gaseous and particle phase) in the public facilities for the PAHs, non-regulated materials, forecast the risk level by the health risk assessment (HRA) and propose the guideline level. PAH assessments through sampling of particulate matter of diameter < 2.5 ${\mu}m$ ($PM_{2.5}$). The user and worker exposure scenario for the PAHs consists of 24-hour exposure scenario (WIES) assuming the worst case and the normal exposure scenario (MIES) based on the survey. This study investigated 20 PAH substances selected out of 32 substances known to be carcinogenic or potentially carcinogenic. The risk assessment applies major toxic equivalency factor (TEF) proposed from existing studies and estaimates individual Excess Cancer Risk (ECR). The study assesses the fine dusts ($PM_{2.5}$) and the exposure levels of the gaseous and particle PAH materials for 6 spots in each 8 facility, e.g. underground subway stations, child-care facilities, elderly care facilities, super market, indoor parking lot, terminal waiting room, internet caf$\acute{e}$ (PC-rooms), movie theater. For internet caf$\acute{e}$ (PC-rooms) in particular, that marks the highest $PM_{2.5}$ concentration and the average concentration of 10 spots (2 spots for each cafe) is 73.3 ${\mu}g/m^3$ (range: 6.8-185.2 ${\mu}g/m^3$). The high level of $PM_{2.5}$ seen in internet cafes was likely due to indoor smoking in most cases. For the gaseous PAHs, the detection frequency for 4-5 rings shows high and the elements with 6 rings shows low frequency. For the particle PAHs, the detection frequency for 2-3 rings shows low and the elements with 6 rings show high frequency. As a result, it is investigated that the most important PAHs are the naphthalene, acenaphthene and phenanthrene from the study of Kim et al. (2013) and this annual study. The health risk assessment demonstrates that each facility shows the level of $10^{-6}-10^{-4}$. Considering standards and local source of pollution levels, it is judged that the management standard of the benzo (a)pyrene, one of the PAHs, shall be managed with the range of 0.5-1.2 $ng/m^3$. Smoking and ventilation were considered as the most important PAHs exposure associated with public facility $PM_{2.5}$. This study only estimated for inhalation health risk of PAHs and focused on the associated cancer risk, while multiple measurements would be necessary for public health and policy.

• Journal of Hospice and Palliative Care
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• v.22 no.3
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• pp.105-116
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• 2019

Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

• KDI Journal of Economic Policy
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• v.31 no.1
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• pp.139-167
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• 2009

A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.233-243
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• 2000

Purpose : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Material : Thirty-two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow-up period was 29 months, Twenty-seven patients (84.4$\%$) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional iymphatics with shrinking field technique. Ail patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on primary or gross tumor lesion. Thirteen patients had Induction chemotherapy with cisplatln and 5-fluorouracil (1-3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6$\%$): stage II, 10/32 (31.3$\%$); stage III, 8/32 (25$\%$): stage IV, 9/32 (28.1$\%$). Results :The 5-year overall survival rate of the whole series (32 patients) was 51.7$\%$. The overall survival rate at 5-years was 80$\%$ in stage I, 66.7$\%$ in stage II, 42.9$\%$ in stage III, 25$\%$ in stage IV (p=0.0958). The S-year local control rates after radiotherapy were as fellows: stage I, 100$\%$; stage II, 60$\%$ stage III, 62.5$\%$; stage IV, 44.4$\%$ (p=0.233). Overall vocal preservation rates was 65.6$\%$, 100% In stage I, 70% in stage II, 62.5$\%$ In stage III, 44.4$\%$ in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotllerapy, emergent tracheostomy was done. Four patients were died from distant metastsis, . three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor ( p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.002). Conclusion : The role of radiotherapy treatment of supraglottic carcinoma is to important factor on survival and to preserve the laryngeal function. Based on our data and other studies, early and moderately advanced supragiottic carcinomas could be successfully treated with either consewative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is Inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.