• Title/Summary/Keyword: Disability

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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.

Does Sarcopenic Obesity Affect Physical Function and Physical Fitness of Korean Older Women? (근위축비만이 국내 여성고령자의 신체기능과 체력에 미치는 영향)

  • Hong, Seung-youn
    • 한국노년학
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    • v.30 no.3
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    • pp.831-842
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    • 2010
  • BACKGROUND: Sarcopenic obesity(SO), a condition of the reduction in muscle mass paired with an increased fat mass has been paid attention because of its association with disability in later life. A few evidence, however, has reported the association with these factors. PURPOSE: To explore the association among SO, physical function and fitness in older women. METHOD: 257 older women(age of 74) were recruited from Y city and 7 physical functions and 4 fitness tests were measured. Participants were classified into one of four groups based on their body fat and muscle mass: Normal group (GR-A), high fat(GR-B), sarcopenia(GR-C), and sarcopenic obese(GR-D). GLMand LSD-test were conducted with SPSS 12.0. RESULTS: Chair stand, arm-curl, back-scratch, 2-min steps of GR-A was higher than GR-C and GR-D(p<.05). One-leg stand of GR-A was higher than GR-D(p<.01) and of GR-C was higher than GR-D(p<.01).8ft-TUG of GR-D was lower than GR-A(p<.01). Grip strength, knee extension of GR-A was higher than that of GR-C and GR-D(p<.01) and knee flexion of GR-A was also higher than that of GR-C and GR-D(p<.01). CONCLUSION: Based on our findings, we conclude that SO is significantly associated with lower physical function and fitness in older Korean women, which alarm the risk of frailty induced by SO.

Research on the Need Assessment Tool for the Korean Elderly at Home Focused on their Desires Based (한국 재가노인의 욕구중심 사정도구 개발에 관한 연구)

  • Kirn, Young sook;Jung, Kook in;Park, So rah
    • 한국노년학
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    • v.27 no.2
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    • pp.459-472
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    • 2007
  • This research has its purpose of developing a tool to assess the needs of the Korean elderly at home population and to provide adequate services by evaluating their physical, psychological, and socio-environmental aspects. This developed tool is composed of two hundred questions and has the advantage of combined physical, psychological and social environmental situation assessment of the elderly at home. The tool also contains not only the objective view of the professionals, but also the subjective appeals of the elderly at home population so that it can reflect their substantial desires. The assessment tool was developed over 21 months from July, 2004 to March, 2006 and this period can be divided into three different stages. In the first stage, collecting of questions for the desire-focused assessment of the elderly by literature investigation and researching foreign source materials was carried out, and this ultimately developed assessment tool was applied to the long-term care insurance pilot project in the second stage. In this process, we revised some insufficiencies of this tool after we applied to elderly of 250 from the pilot project and other 200 elderly from this research team. For the last stage, the tool was completed by using inquiries of the focused group and the group of professionals to ensure its reliability and validity. In the process of developing the tool, the total of 200 questions under 13 subcategories was selected. The 13 subcategories are basic information, subjective appeals, information of the main helper, use of services, house environment, condition of health, condition of rehabilitation, daily living(ADL, IADL, defecation, assistance), social maintenance, behavioral disability, medical health, living habits, and strength. This tool is on the purpose to assess thoroughly the desires that the elderly at home population has and to provide the best service they need.

A Study of Psychometric Function Curve for Korean Standard Monosyllabic Word Lists for Preschoolers (KS-MWL-P) (한국표준 학령전기용 단음절어표 (Korean Standard Monosyllabic Word Lists for Preschoolers, KS-MWL-P)의 심리음향기능곡선 연구)

  • Shin, Hyun-Wook;Kim, Jin-Sook
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.6
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    • pp.534-541
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    • 2009
  • Word recognition test (WRT) for the children can be useful for diagnosing the degree of communication disability, prescribing hearing instruments, planning aural rehabilitation and speech therapy, and determination of site of lesions. The Korean standard monosyllabic word lists for preschoolers (KS-MWL-P) were developed considering the criteria given by the literatures. However, the authors of KS-MWL-P suggested more children should be included to verify homogeneity of the lists using psychometric function curve since only 8 children participated in the developing process. The purpose of this study was to explore the homogeneity of KS-MWL-P for supplementing the limitations of the lists employing psychometric analysis. To 23 preschoolers who have normal-hearing, 100 monosyllabic KS-MWL-P words were examined with the pictures. Psychometric function curve with linear slopes of 20% and 80%'s correct rates through accounting recognition scores of each monosyllabic word at variable intensities from -10 to 40 dBHL was obtained and analyzed. As a result, s-shaped psychometric function curve was presented with increasing correct rate depending on intensity and showed no statistical significant differences among each word and list. The congruous graph shapes among lists also indicated good homogeneity and the list 1,2,3,4's average slopes were 4.48, 3.86, 4.65, 4.50. It was verified that the homogeneity was suitable because the analysis of variance showed no statistical significance among lists (p>0.05). However, KS-MWL-P's order of slope according to the order of the number of items, $1{\sim}10$, $1{\sim}20$, $1{\sim}25$ showed no difference with the p-value of 0.93, 0.59, 0.91, 0.70 for the lists 1,2,3, and 4, respectively. Although KS-MWL-P was assumed that the lower-numbered items were easy for testing younger ages, this study's results could not agree with the author's conclusion. Considering this matter, rearranging of the number of items should be performed according to the analysis of slope suggested by this study for testing younger children with easier items. Other than this, in conclusion, KS-MWL-P was proved to be useful for clinical and rehabilitative evaluating and training tools for preschoolers.

Fusion of the Guardianship System and Mental Health Law Based on Mental Capacity - Focusing on the Enactment and the Application of the Mental Capacity Act (Northern Ireland) 2016 - (의사능력에 기반한 후견제도와 정신건강복지법의 융합 - 북아일랜드 정신능력법[Mental Capacity Act (Northern Ireland) 2016]의 제정 과정과 그 의의를 중심으로 -)

  • Kihoon You
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.155-206
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    • 2023
  • When a person with diminished mental capacity refuses necessary medical care, normative judgments about when paternalistic intervention can be justified come into question. A typical example is involuntary hospitalization for people with mental disabilities, traditionally governed by mental health law. However, Korean civil law reform in 2011 introduced a new form of involuntary hospitalization through guardianship legislation, leading to a dualized system to involuntary hospitalization. Consequently, a conflict has arisen between the 'best interest and surrogate decision-making' paradigm of civil law and the 'social defense and preventive detention' paradigm of mental health law. Many countries have criticized this dualized system as not only inefficient but also unfair. Moreover, the requirement for the presence of 'mental illness' for involuntary hospitalization under mental health law has faced criticism for unfairly discriminating against people with mental disabilities. In response, attempts have been made to integrate guardianship legislation and mental health law based on mental capacity. This study examines the legislative process and framework of the Mental Capacity Act (Northern Ireland) 2016, which reorganized the mental health care system by fusing guardianship legislation with mental health law based on mental capacity. By analyzing the case of Northern Ireland, which has grappled with conflicts between guardianship legislation and mental health law since the 1990s and recently proposed mental capacity as a single, non-discriminatory standard, we aimed to offer insights for the Korean guardianship and mental health systems.

Development of a complex failure prediction system using Hierarchical Attention Network (Hierarchical Attention Network를 이용한 복합 장애 발생 예측 시스템 개발)

  • Park, Youngchan;An, Sangjun;Kim, Mintae;Kim, Wooju
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.127-148
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    • 2020
  • The data center is a physical environment facility for accommodating computer systems and related components, and is an essential foundation technology for next-generation core industries such as big data, smart factories, wearables, and smart homes. In particular, with the growth of cloud computing, the proportional expansion of the data center infrastructure is inevitable. Monitoring the health of these data center facilities is a way to maintain and manage the system and prevent failure. If a failure occurs in some elements of the facility, it may affect not only the relevant equipment but also other connected equipment, and may cause enormous damage. In particular, IT facilities are irregular due to interdependence and it is difficult to know the cause. In the previous study predicting failure in data center, failure was predicted by looking at a single server as a single state without assuming that the devices were mixed. Therefore, in this study, data center failures were classified into failures occurring inside the server (Outage A) and failures occurring outside the server (Outage B), and focused on analyzing complex failures occurring within the server. Server external failures include power, cooling, user errors, etc. Since such failures can be prevented in the early stages of data center facility construction, various solutions are being developed. On the other hand, the cause of the failure occurring in the server is difficult to determine, and adequate prevention has not yet been achieved. In particular, this is the reason why server failures do not occur singularly, cause other server failures, or receive something that causes failures from other servers. In other words, while the existing studies assumed that it was a single server that did not affect the servers and analyzed the failure, in this study, the failure occurred on the assumption that it had an effect between servers. In order to define the complex failure situation in the data center, failure history data for each equipment existing in the data center was used. There are four major failures considered in this study: Network Node Down, Server Down, Windows Activation Services Down, and Database Management System Service Down. The failures that occur for each device are sorted in chronological order, and when a failure occurs in a specific equipment, if a failure occurs in a specific equipment within 5 minutes from the time of occurrence, it is defined that the failure occurs simultaneously. After configuring the sequence for the devices that have failed at the same time, 5 devices that frequently occur simultaneously within the configured sequence were selected, and the case where the selected devices failed at the same time was confirmed through visualization. Since the server resource information collected for failure analysis is in units of time series and has flow, we used Long Short-term Memory (LSTM), a deep learning algorithm that can predict the next state through the previous state. In addition, unlike a single server, the Hierarchical Attention Network deep learning model structure was used in consideration of the fact that the level of multiple failures for each server is different. This algorithm is a method of increasing the prediction accuracy by giving weight to the server as the impact on the failure increases. The study began with defining the type of failure and selecting the analysis target. In the first experiment, the same collected data was assumed as a single server state and a multiple server state, and compared and analyzed. The second experiment improved the prediction accuracy in the case of a complex server by optimizing each server threshold. In the first experiment, which assumed each of a single server and multiple servers, in the case of a single server, it was predicted that three of the five servers did not have a failure even though the actual failure occurred. However, assuming multiple servers, all five servers were predicted to have failed. As a result of the experiment, the hypothesis that there is an effect between servers is proven. As a result of this study, it was confirmed that the prediction performance was superior when the multiple servers were assumed than when the single server was assumed. In particular, applying the Hierarchical Attention Network algorithm, assuming that the effects of each server will be different, played a role in improving the analysis effect. In addition, by applying a different threshold for each server, the prediction accuracy could be improved. This study showed that failures that are difficult to determine the cause can be predicted through historical data, and a model that can predict failures occurring in servers in data centers is presented. It is expected that the occurrence of disability can be prevented in advance using the results of this study.