• 생명과학회지
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• 제33권12호
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• pp.1046-1051
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• 2023

본 연구의 목적은 개인의 흡연여부와 다양한 사회경제적 변수 간 영향관계가 성별과 장애여부에 따라 구분된 하위집단에서 차별적으로 나타나는지를 확인하는데 있다. 특히 본 연구는 일반인의 흡연 여부가 아니라 장애인을 대상으로 흡연의 여부가 장애인의 건강에 미치는 영향을 분석한 연구로 연구의 의의가 있다고 볼 수 있다. 본 연구에서는 장애인의 흡연율과 흡연 요인을 분석하는데 목적이 있다. WHO에 따르면 담배로 인한 사망자는 매년 600만명에 이른다. 담배는 심혈관질환, 폐질환, 암 등 비전염성질환과 조기 사망에 매우 강한 인과관계를 갖는 것으로 알려져 있다. UN이 제시한 지속가능 발전목표(Sustainable Development Goals, 이하 SDGs)는 건강한 삶의 보장과 모든 세대의 복지 증진(Ensure healthy lives and promote well-being for all at all ages)을 위해 WHO의 담배규제기본협약(Framework Convention on Tobacco Control)을 이행할 것을 요구하고 있다. 이것은 흡연의 모든 과정에서 발생하는 다양한 위협요인이 흡연자뿐만 아니라 경제, 사회, 환경 등 다양한 영역에서 다차원적으로 작용하는 위협하기 때문이다. 본 연구목적의 달성을 위해 본 연구는 2013년 국민건강영양조사를 활용하여 흡연과 선행연구에서 확인된 흡연 영향요인 간 인과관계를 확인하였다. 본 연구를 위하여 특히 성별과 장애여부에 따라 구분된 4개의 하위집단을 독립적 모형으로 하여 분석하였으며 흡연여부를 종속변수로 하는 로지스틱회귀분석을 활용하였다. 본 연구 분석결과 독립변수의 영향력 여부는 성별과 장애유무에 따라 구분된 각 집단별로 뚜렷한 차이를 나타내는 것이 확인되었다. 상대적으로 비장애집단에서 독립변수의 영향이 유의한 반면 장애집단에서는 유의성이 상실되는 경향을 보였으며 이 같은 경향은 특히 장애여성집단에서 더욱 명백하게 확인되었다. 분석결과를 기반으로 장애집단의 특성을 고려하지 않은 기존의 선행연구가 가진 설명의 한계를 확인하였으며 장애의 물리적·심리적 특수성을 충분히 고려한 연구모형을 통해 흡연과의 상관관계를 재분석해야 함을 함의로 제시하였다. 추후 장애인의 건강한 삶의 질을 개선하기 위하여 건강증진 영향들을 분석한 이후 건강증진에 기여할 수 있는 대표적인 변인들을 고려하여 적용하는 다양한 연구들이 수행되어져야 할 것으로 여겨진다.

• Journal of Preventive Medicine and Public Health
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• 제39권6호
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• pp.511-519
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• 2006

Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

• 대한지역사회작업치료학회지
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• 제11권1호
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• pp.23-43
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• 2021

목적 : 본 연구의 목적은 작업치료사가 전문역량을 강화하기 위한 수단으로 보수교육을 잘 활용할 수 있도록 전문가 의견을 수렴하여 체계적인 교육운영 플랫폼을 마련하는 것이었다. 연구방법 : 2019년과 2020년에 시행한 공통영역, 노인치매, 지역사회, 신체재활, 발달장애 영역의 보수교육 강좌에 대하여 전문가 23명을 대상으로 델파이 연구를 시행하였다. 1차 델파이에서는 해당 강좌의 전문 보수교육으로서의 적합성 여부와 적절한 교육 수준에 대하여 조사하였다. 2차 델파이에서는 내용타당도를 검증하였고 최종 플랫폼을 도출하였다. 결과 : 최종적으로 공통영역은 87항목, 노인치매는 53항목, 지역사회는 66항목, 신체재활은 66항목, 발달장애는 85항목을 도출하였다. 주요 내용은 작업치료사들에게 필요한 전문지식, 다양한 분야에서의 역할과 임상에서 많이 겪는 어려움에 대한 해결, 미래를 준비하는 주제 등이 있었다. 결론 : 본 연구는 기초연구로서 전문적 작업치료사 양성을 위한 교육운영 플랫폼을 제시한데 의미가 있다. 추후 연구를 통하여 작업치료사들이 전문역량을 효율적으로 강화할 수 있는 최적의 교육운영 플랫폼이 개발되기를 기대한다.

• 해양환경안전학회지
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• 제24권4호
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• pp.389-397
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• 2018

오늘날 현대적 국가는 UN 장애인의 권리에 관한 협약을 비준하여 장애인이 차별받지 않는 환경을 조성하고 있다. 세계해사기구에서 1996년에 노인 및 장애인의 요구에 부응하기 위한 여객선의 설계 및 운영에 관한 권고안을 제시하였다. 우리나라에서는 교통약자의 이동편의 증진법이 시행되어 선박, 차량, 항공기, 철도 및 여객시설에 장애인편의시설이 신속하게 설치되고 있다. 하지만 해상교통환경은 안전에 관한 관심에 비하여 장애인에 대한 배려가 부족한 편이다. 본 연구에서는 현장 조사와 문헌조사를 통해 우리나라에서 장애인에 대한 해상교통환경을 개선하는 기초적 연구를 실시하였다. 연구결과 연안여객운송의 상당부분을 담당하는 유선과 도선 및 소규모 항구는 관련 법규의 적용이 제외되어 있었다. 또한 선박과 터미널에 장애인 교통편의시설의 설치율이 낮을 뿐만 아니라 낙후된 장비를 고려하고 있었다. 따라서 법령의 보완과 향상된 장애인 교통편의 시설을 신속하게 구축하여 인류보편적 가치인 장애인에 대한 인권을 보호해야 한다.

• 가정간호학회지
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• 제24권1호
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• pp.69-78
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• 2017

Purpose: The purpose of this study was to identify the frequency and duration of primary health practitioners' work, and their job satisfaction, and to confirm differences in work and job satisfaction by type of primary health care post. Methods: Work frequency, duration of work, and job satisfaction were estimated by 371 primary health practitioners. Chi-square test and t-test were used to identify the differences in working patterns and job satisfaction by type of primary health care post. Results: Primary health practitioners were found to spend more time working with the elderly population than with students, pregnant women, children, people with disabilities, and multicultural families. Those in costal areas were more concerned with students than those working inland. In the latter group of practitioners, more time was spent working with patients with chronic diseases, pregnant women, women, children, multicultural families, and mental health clients. Also, the job satisfaction of inland primary health practitioners was significantly higher than that of costal practitioners. Conclusion: It is necessary to identify the characteristics of primary health practitioners' work, focusing on changes in the medical service environment. Furthermore, it is necessary to provide job training according to type of primary health care post, as practitioners' approaches should differ between posts.

• The Journal of Korean Physical Therapy
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• 제15권1호
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• pp.61-81
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• 2003

There can be little dissension that the ultimate goal of all physical therapy interventions with the elderly is to restore or maintain the highest level of function possible for the individual. Whenever physical therapists take on this challenge, they assist elders in maintaining their identities as competent adults. Advancing age is associated with profound changes in body composition, including increased fat mass, decreased fat-free mass(particularly muscle), decreased total body water and decreased bone density. Along with these changes in body compositions, and perhaps as a direct result of them, elderly people have lower energy needs, reduced strength and functional capacity and a greatly increased risk for such diseases as noninsulin-dependent diabetes mellitus and osteoporosis. Resistance training is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density. In the past couple of decades, many studies have examined the effects of Resistance training on risk factors for age-related diseases or disabilities. We have explored the positive and negative aspects of older adults' participation in resistance training programs. The benefits to older adults are reported to be increased strength, endurance, muscle capacity, and flexibility; more energy; and improved self-image and confidence. The negative aspects include some pain or stiffness and other nonspecific problems. The positive and negative aspects of resistance training are therefore very similar to those in younger populations. Scientific investigations over the past 10 years have demonstrated that resistance training can be safely and successfully implemented in older populations. Even the frail and very sick elderly can benefit and improve their quality of life. Proper design and progression of a resistance training program for older adults is vital to optimal benefits from resistance exercise. The results of data provided by this research on resistance training for health shows that there is enough existing evidence to conclude that resistance training, particularly when incorporated into a comprehensive fitness program, can offer substantial health benefits which can be obtained by persons of all ages. These benefits, including improvements in functional capacity, translate into an improved quality of life.

• 산업융합연구
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• 제22권2호
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• pp.105-117
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• 2024

본 연구는 65세 이상 음주노인을 대상으로 이들의 사회적 활동과 음주량이 시간의 흐름에 따라 어떠한 변화패턴을 갖는지 그리고 사회활동이 음주노인의 음주량에 어떤 영향을 미치는지를 확인하기 위한 종단연구이다. 주요 분석결과를 살펴보면 다음과 같다. 첫째, 시간이 지나면서 음주노인의 사회활동과 음주량은 감소하는 양상이 나타났으나 이는 통계적으로 유의하지 않았다. 그러나 사회활동과 음주량의 변화율에 대한 개인차가 존재하는 것으로 나타나 이러한 개인차가 구체적으로 어떠한 요인에 의해 변화하는가를 이후 조건적 모형에서 구체적으로 확인하였다. 조건적 모형의 분석결과를 살펴보면 우선 사회활동의 경우 초기 사회활동 정도가 높을수록, 연령이 많을수록, 여자보다는 남자노인이 초기 음주량이 낮은 것으로 나타났다. 다음으로 음주량의 경우 건강상태가 좋을수록, 여자노인보다는 남자노인이, 비흡연자보다는 흡연자가, 장애가 있는 노인보다는 없는 노인이 이후 음주량이 큰 폭으로 감소하는 것으로 나타났다. 이상의 분석결과를 바탕으로 국내 음주노인의 사회활동을 촉진하고 음주를 감소시키기 위한 제언을 제시하였다.

• 로봇학회논문지
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• 제3권1호
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• pp.23-32
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• 2008

This paper presents a task planning system for a steward robot, which has been developed as an interactive intermediate agent between an end-user and a complex smart home environment called the ISH (Intelligent Sweet Home) at KAIST (Korea Advanced Institute of Science and Technology). The ISH is a large-scale robotic environment with various assistive robots and home appliances for independent living of the elderly and the people with disabilities. In particular, as an approach for achieving human-friendly human-robot interaction, we aim at 'simplification of task commands' by the user. In this sense, a task planning system has been proposed to generate a sequence of actions effectively for coordinating subtasks of the target subsystems from the given high-level task command. Basically, the task planning is performed under the framework of STRIPS (Stanford Research Institute Problem Solver) representation and the split planning method. In addition, we applied a state-partitioning technique to the backward split planning method to reduce computational time. By analyzing the obtained graph, the planning system decomposes an original planning problem into several independent sub-problems, and then, the planning system generates a proper sequence of actions. To show the effectiveness of the proposed system, we deal with a scenario of a planning problem in the ISH.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.120-126
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• 2018

Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 'distal humerus fracture' and 'hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion ($107.6^{\circ}$ flexion-extension, $157.5^{\circ}$ for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.