• Korean Journal of Culture and Social Issue
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• v.15 no.3
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• pp.399-429
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• 2009

The purpose of this research examines the factors that influence happiness among Korean adolescents by focusing on psychological resource (as measured by self-efficacy), relational resource (as measured by social support) and financial resource (as measured by family's monthly income). In addition, the influence of academic achievement on happiness is examined. To examine the influence of socio-economic status and family's monthly income, adolescents living in three different districts in Seoul (from working to middle to upper class districts) were randomly selected and interviewed in their home. A total of 190 elementary school, middle school, high school and university students (male=83, female=107) completed the resiliency of efficacy scale developed by Bandura (1995) and emotional support and happiness scale developed by the present researchers, in addition to background information. The results of the path analysis are as follows. First, the most important predictor of happiness among Korean adolescents is relational resources. In other words, emotional support received from significant others was most predictive of happiness; more than 60 times the effect of family's monthly income, three times the effect of academic achievement, and two times the effect of resiliency of efficacy. The second most important factor that predicted the happiness of Korean adolescents was psychological resource (i.e., resiliency of efficacy), which had 30 times the effect of family's monthly income. In addition resiliency of efficacy played a mediating role between emotional support on one hand and happiness on the other. Third, those respondents who had higher academic achievement reported higher levels of happiness, which had 20 times the effect of family's monthly income. Fourth, family monthly income did not predict happiness among Korean adolescents. Fifth, socio-economic status and school level did not have direct influence on happiness but had mediating influence through their influence on emotional support. In other words, those respondents with higher socio-economic status and elementary school students were more likely to receive social support from significant others, which in turn increased their happiness. These results indicate that the most important predictor of happiness among Korean adolescents is emotional support, followed by resiliency of effic acy and academic achievement, indicating that those adolescents from wealthy families are not necessarily happier.

• Economic and Environmental Geology
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• v.57 no.2
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• pp.233-241
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• 2024

This study was conducted to investigate the geological distribution characteristics of fluorine in rocks, which can be a major resource of forest aggregates in Korea. Samples of forest aggregates were collected from 224 sites in 22 cities and counties for this study. The national background concentration was 344 mg/kg, which was significantly lower than the average fluorine concentration of crustal, which was 625 mg/kg, and slightly higher than the average fluorine concentration of world soil, which was 321 mg/kg. In terms of region and tectonic structure, fluorine concentrations were investigated to be highest in Gyeonggi-do(394 mg/kg) and Gyeonggi massif(396 mg/kg), respectively. The concentration distribution by the origin of the parent rock was in the order of metamorphic rock(362 mg/kg) > sedimentary rock(354 mg/kg) > igneous rock(328 mg/kg), and the concentration distribution by geologic ages was the highest in the Paleozoic at 394 mg/kg. The concentration distribution by rock types was in the order of diorite(515 mg/kg) > gneisses(377 mg/kg) > schists(344 mg/kg) > phyllite(306 mg/kg) > granites(305 mg/kg) > quartz porphyry(298 mg/kg). Consequently, it is speculated that gneisses and schists, Precambrian metamorphic rocks in the Gyeonggi massif that forms the crust of Gyeonggi-do, contain high fluorine concentrations.

• Health Policy and Management
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• v.34 no.1
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• pp.48-58
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• 2024

Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Health Policy and Management
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• v.34 no.2
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• pp.141-155
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• 2024

Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.129-139
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• 2023

Background: The elderly population aged 65 or older in Korea is expected to continue to increase to 18.4% in 2023, and to enter a super-aged society at 20.6% in 2025. In clinical practice, the elderly discrimination of dental hygienists may experience difficulties during dental hygiene treatment due to an increase in the number of elderly patients due to aging, which can lead to maladjustment to work and turnover, so education on the understanding of the elderly is essential for students in the Department of Dentistry, who are prospective dental hygienists. Accordingly, a study was conducted to prepare for a super-aged society by studying the relationship between elderly discrimination and the knowledge and attitudes of the elderly, and to change the curriculum of universities and develop programs related to the elderly. Method: 204 students enrolled in the Department of Dentistry in D area were analyzed using the SPSS/WIN 25.0 program. The subject's geriatric discrimination, knowledge about the elderly, and attitude toward the elderly were calculated as the mean and standard deviation. T-test and one-way ANOVA were performed to verify the difference in geriatric discrimination according to the general characteristics of the subject, with a Scheffe' test applied for post-hoc analysis. Correlation analysis was conducted on the subject's geriatric discrimination, knowledge about the elderly, and attitudes toward the elderly. Results: Geriatrics scored 2.03±0.36 out of 4. Knowledge about the elderly was categorized as follows: physical domain 0.57±0.15; social domain 0.36±0.17; and psychological domain 0.35±0.20. The attitude toward the elderly was 3.86±0.27. Knowledge of the elderly averaged 11.27±3.30 points out of 25. The question with the highest percentage of correct answers to knowledge about the elderly was 'physical strength tends to decrease with age', which was 93.1%. The attitude toward the elderly according to the general characteristics of the study subjects showed significant differences in gender (p=0.040), age (p=0.026), and life experience with grandparents (p=0.001). The elderly discrimination of the study subjects showed a negative correlation in both attitude and knowledge toward the elderly, and among the elderly discrimination, there was a high positive correlation with regard to emotional avoidance (r=.892, p<0.001). Conclusion: College students are the leading players in caring for the elderly and are directly affected by aging social problems. Therefore, it is considered necessary to apply various programs in the state, society, and educational institutions to avoid negative prejudices that lead to positive thinking and discrimination against the elderly.

• Journal of Preventive Medicine and Public Health
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• v.6 no.1
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• pp.51-63
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• 1973

This paper illustrate residual hearing and socio-medical background on the hearing impaired children, 207 comming to Deaf School. attached to Hankuk Social Work College, Taegu, Korea. The survey was performed through interview with their parents and testing by diagnostic audio-meter (TRIO, AS 105 type) at soundproof room from March 10, to November 28, 1973. The results obtained were as follows. 1) The attendance rate of the compulsory primary school was markedly lower tendency in female than male according to directly proportional to prevalence rate of deafness among them. If was showed the deeper gap in the more superior school (middle and high school). 2) Who entered at the suitable age to each school (six years old to primary school, 12 years to middle and 15 years to high) was 11.3%. And who were enrolled in school age to each school (6-11 years for primary. 12-14 years for middle and 15-17 years for high) was 45.9% (43.7% in male, 50.0% in female). 3) As causative disease, congenital case, were 23.6% included of 13.5% of heredity and 10.1% of troubles during pregnancy; the total acquired cases were 47.9%, it was classified as 11.6% of convulsion from any other diseases, 7.7% of measles, 7.7% of other febrile diseases, 3.4% of drug (the most of streptomycin) intoxication, 2.4% of meningitis, 1.5% of epidemic encephalitis and 31.3% of other diseases; and unknown cases were 28.5%. 4) 31.4% of who included congenital cases lost their hearing within six months old, 11.6% in 6-11 months. 9.7% in 1-2 years old and 14.0% in 2-3years old. Consequently we obtained that the most cases 90.0% were lost their hearing within 3 years after birth. 5) According to qualities of hearing leases the most of cases were perceptive, 197(97.5%), only two cases were conductive, and eight cases were mixed. 6) The status of residual hearing according to average grade of hearing loss. $B(=\frac{a+2b+c}{4}$ as table 13) were as follows. Two cases were normal (one was mute and another was severe speach disorder). Ten cases, moderate. Moderately severe cases were 40 (19.3%). Severe cases, 38(18.4%). Scale out, profound cases, 48 (23.3%). And impossible testing cases because that were infantile or had some mental disorder were 69 (33.3%). 7) The using rate of hearing aides was only 12.0%. Among them who had some more residual hearing and could showed hearing effect with hearing aide have used more many proportionary but who were difficult to expect that effect were rare.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.329-334
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• 2008

Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.29-38
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• 2008

Purpose: The aim of this study was to investigate the feasibility of 3 ' -[F-18]fluoro-3 ' -deoxythymidine positron emission tomography(FLT-PET) for the detection of locally advanced breast cancer and to compare the degree of FLT and 2' -deoxy-2 ' -[F-18]fluoro-d-glucose(FDG) uptake in primary tumor, lymph nodes and other normal organs. Material & Methods: The study subjects consisted of 22 female patients (mean age; $42{\pm}6$ years) with biopsy-confirmed infiltrating ductal carcinoma between Aug 2005 and Nov 2006. We performed conventional imaging workup, FDG-PET and FLT PET/CT. Average tumor size measured by MRI was $7.2{\pm}3.4$ cm. With visual analysis, Tumor and Lymph node uptakes of FLT and FDG were determined by calculation of standardized uptake value (SUV) and tumor to background (TB) ratio. We compared FLT tumor uptake with FDG tumor uptake. We also investigated the correlation between FLT tumor uptake and FDG tumor uptake and the concordant rate with lymph node uptakes of FLT and FDG. FLT and FDG uptakes of bone marrow and liver were measured to compare the biodistribution of each other. Results: All tumor lesions were visually detected in both FLT-PET and FDG-PET. There was no significant correlation between maximal tumor size by MRI and SUVmax of FLT-PET or FDG-PET (p>0.05). SUVmax and $$SUV_{75} (average SUV within volume of interest using 75% isocontour) of FLT-PET were significantly lower than those of FDG-PET in primary tumor (SUVmax; $6.3{\pm}5.2\;vs\;8.3{\pm}4.9$, p=0.02 /$SUV_{75};\;5.3{\pm}4.3\;vs\;6.9{\pm}4.2$, p=0.02). There is significant moderate correlation between uptake of FLT and FDG in primary tumor (SUVmax; rho=0.450, p=0.04 / SUV75; rho=0.472, p=0.03). But, TB ratio of FLT-PET was higher than that of FDG-PET($11.7{\pm}7.7\;vs\;6.3{\pm}3.8$, p=0.001). The concordant rate between FLT and FDG uptake of lymph node was reasonably good (33/34). The FLT SUVs of liver and bone marrow were $4.2{\pm}1.2\;and\;8.3{\pm}4.9$. The FDG SUVs of liver and bone marrow were $1.8{\pm}0.4\;and\;1.6{\pm}0.4$. Conclusion: The uptakes of FLT were lower than those of FDG, but all patients of this study revealed good FLT uptakes of tumor and lymph node. Because FLT-PET revealed high TB ratio and concordant rate with lymph node uptakes of FDG-PET, FLT-PET could be a useful diagnostic tool in locally advanced breast cancer. But, physiological uptake and individual variation of FLT in bone marrow and liver will limit the diagnosis of bone and liver metastases.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.69-84
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• 1997

Background : Although the overall prognosis of patients with lung cancer is poor, highly effective treatment exists for the small subset of patients with early lung cancer(carcinoma in situ/micro- invasive cancer). But very few patients have benefit from them because these lesions are difficult to detect and localize with conventional white-light bronchoscopy. To overcome this problem, a Lung Imaging Fluorescence Endoscopic device(LIFE) was developed to detect and clearly delineate the exact location and extent of premalignant and early lung cancer lesions using differences in tissue autofluorescence. Purpose : The purpose of this study was to determine the difference of sensitivity and specificity in detecting dysplasia and carcinoma between fluorescence imaging and conventional white light bronchoscopy. Material and Methods : 35 patients (16 with abnormal chest X-ray, 2 with positive sputum study, 2 with undiagnosed pleural effusion, 15 with respiratory symptom) have been examined by LIFE imaging system. After a white light bronchoscopy, the patients were submitted to fluorescence bronchoscopy and the findings of both examinations have been classified in 3 categories(class I, II, III). From of all class n and III sites, 79 biopsy specimens have been collected for histologic examination: a comparison between histologic results and white light or fluorescence bronchoscopy has been performed for assessing sensitivity and specificity of the two methods. Results : 1) Total 79 sires in 35 patients were examined. Histology demonstrated 8 normal mucosa, 21 hyperplasia, 23 dysplasia, and 27 microinvasive and invasive carcinoma. 2) The sensitivity of white light or fluorescence bronchoscopy in detecting dysplasia was 60.9% and 82.6%, respectively. 3) The results of this study showed 70.3 % sensitivity for microinvasive or invasive carcinoma with LIFE system, versus 100% sensitivity for white light in 27 cases of carcinoma. The false negative study of LIFE system was 8 cases(3 adenocarcinoma and 5 small cell carcinoma), which were infiltrated in submucosal area and had normal epithelium. Conclusion : To improve the ability 10 diagnose and stage more accurately, fluorescence imaging may become an important adjunct to conventional bronchoscopic examination because of its high detection rate of premalignant and malignant epithelial lesion. But. it has limitation to detect in submucosal infiltrating carcinoma.