Falls among Community Dwelling Elderly People: Prevalence and Associated Factors (일부 농촌지역 노인들의 낙상발생과 관련된 요인)
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- Journal of agricultural medicine and community health
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- v.29 no.2
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- pp.223-235
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- 2004
Objectives: This study was to evaluate the actual condition of falls among community-dwelling elderly people and its related factors to prepare for the establishment of comprehensive prevention programs of senior population. Methods: The study subjects included 460 home residents over 65 years in a district of Chungnam Province and interviews were given to all of them, asking about experiences of falls and their related factors. The analysis of study results came to the following conclusions. Results: The rate of falls among total subjects was 35.5%. With the percentage by age and sex, over 70's and female were significantly higher than male(p=0.000) and under 69 (p=0.008). The groups with poor visual acuity and hearing ability had higher rate of falls than the normal groups based on their health status. In terms of place they experienced falls, out-door occurrence accounted for 53.4% of total falls, which was higher 46.6% of in-door. By season when falls are experienced, "winter" showed the greatest rate, and by time of the day, evening had the highest rate. By causes of falls, "Slippery ground"accounted for 30.5% and "Tumbled over" 23.5% of total falls, respectively, showing the major role of environmental causes for falls. For individual factors, "Irritability" and "Carelessness" occupied 11.3%, 10.8% of total falls, respectively. The Odds Ratios for falls in women was 2.19 times higher than in men, and those in 70's are 2.01 times higher than in 60's, and those with abnormal BMI was 3.68 times higher than in normal groups, and those with perceived symptoms was 1.94 times higher than those without. Conclusions: It is suggested that more consideration should be directed toward taking comprehensive and systematic prevention measures ranging from setting-up the injury-protective environments to allowing senior citizens to have competence in ADL activity as well as proper general health conditions, considering the higher rate of falls for elderly persons in a rural part of this country than that of western countries and the greater proportion of falls which can be ascribed to environmental factors.
This study aims to develop of contents for the activities of daily living training - Korean version that reflexes the domestic situation and can be applied to clinical practice. For contents development, a Delphi survey was conducted with 13 experts. In the first Delphi survey, 133 items of activities of daily living training are derived based on previous studies, and then the extracted items are asked to group of experts, and the derived items are answered for actual domestic clinical application. In the second survey, 118 items were added by excluding items with a low content validity ratio (CVR) including the results of the first survey, and adding items that can be derived from other opinions. In the 3rd survey, while presenting the 2nd Delphi survey items as they are, it provides an opportunity to change their opinions by presenting their 2nd response and the 2nd average score of other expert panels, and adding appropriateness and importance together. The data were analyzed to obtain the mean, standard deviation, interquartile range, CVR, convergence, and consensus. Finally, a total of 69 items were selected and 49 items were excluded so that 105 items for CVR 0.54 or higher, 111 items for convergence degree 0.50 or lower, and 70 items for continuity degree 0.75 or higher. Sexual activity, care of others, care of pets, and child rearing are difficult to apply socially and culturally, driving and community mobility cannot be performed within the clinical room, and home establishment and management may have different roles depending on gender, and religious spiritual activities and expression are so personal. For these reasons, these items were found to have low importance or suitability. This study can be usefully used as an indicator on the activities of daily living training - Korean version in clinic or community setting.
This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However,
News articles are the most suitable medium for examining the events occurring at home and abroad. Especially, as the development of information and communication technology has brought various kinds of online news media, the news about the events occurring in society has increased greatly. So automatically summarizing key events from massive amounts of news data will help users to look at many of the events at a glance. In addition, if we build and provide an event network based on the relevance of events, it will be able to greatly help the reader in understanding the current events. In this study, we propose a method for extracting event networks from large news text data. To this end, we first collected Korean political and social articles from March 2016 to March 2017, and integrated the synonyms by leaving only meaningful words through preprocessing using NPMI and Word2Vec. Latent Dirichlet allocation (LDA) topic modeling was used to calculate the subject distribution by date and to find the peak of the subject distribution and to detect the event. A total of 32 topics were extracted from the topic modeling, and the point of occurrence of the event was deduced by looking at the point at which each subject distribution surged. As a result, a total of 85 events were detected, but the final 16 events were filtered and presented using the Gaussian smoothing technique. We also calculated the relevance score between events detected to construct the event network. Using the cosine coefficient between the co-occurred events, we calculated the relevance between the events and connected the events to construct the event network. Finally, we set up the event network by setting each event to each vertex and the relevance score between events to the vertices connecting the vertices. The event network constructed in our methods helped us to sort out major events in the political and social fields in Korea that occurred in the last one year in chronological order and at the same time identify which events are related to certain events. Our approach differs from existing event detection methods in that LDA topic modeling makes it possible to easily analyze large amounts of data and to identify the relevance of events that were difficult to detect in existing event detection. We applied various text mining techniques and Word2vec technique in the text preprocessing to improve the accuracy of the extraction of proper nouns and synthetic nouns, which have been difficult in analyzing existing Korean texts, can be found. In this study, the detection and network configuration techniques of the event have the following advantages in practical application. First, LDA topic modeling, which is unsupervised learning, can easily analyze subject and topic words and distribution from huge amount of data. Also, by using the date information of the collected news articles, it is possible to express the distribution by topic in a time series. Second, we can find out the connection of events in the form of present and summarized form by calculating relevance score and constructing event network by using simultaneous occurrence of topics that are difficult to grasp in existing event detection. It can be seen from the fact that the inter-event relevance-based event network proposed in this study was actually constructed in order of occurrence time. It is also possible to identify what happened as a starting point for a series of events through the event network. The limitation of this study is that the characteristics of LDA topic modeling have different results according to the initial parameters and the number of subjects, and the subject and event name of the analysis result should be given by the subjective judgment of the researcher. Also, since each topic is assumed to be exclusive and independent, it does not take into account the relevance between themes. Subsequent studies need to calculate the relevance between events that are not covered in this study or those that belong to the same subject.
Consumers differ in the way they make a purchase. An audio mania would willingly make a bold, yet serious, decision to buy a top-of-the-line home theater system, while he is not interested in replacing his two-decade-old shabby car. On the contrary, an automobile enthusiast wouldn't mind spending forty thousand dollars to buy a new Jaguar convertible, yet cares little about his junky component system. It is product involvement that helps us explain such differences among individuals in the purchase style. Product involvement refers to the extent to which a product is perceived to be important to a consumer (Zaichkowsky, 2001). Product involvement is an important factor that strongly influences consumer's purchase decision-making process, and thus has been of prime interest to consumer behavior researchers. Furthermore, researchers found that involvement is closely related to perceived risk (Dholakia, 2001). While abundant research exists addressing how product involvement relates to overall perceived risk, little attention has been paid to the relationship between involvement and different types of perceived risk in an electronic commerce setting. Given that perceived risk can be a substantial barrier to the online purchase (Jarvenpaa, 2000), research addressing such an issue will offer useful implications on what specific types of perceived risk an online firm should focus on mitigating if it is to increase sales to a fullest potential. Meanwhile, past research has focused on such consumer responses as information search and dissemination as a consequence of involvement, neglecting other behavioral responses like online merchant selection. For one example, will a consumer seriously considering the purchase of a pricey Guzzi bag perceive a great degree of risk associated with online buying and therefore choose to buy it from a digital storefront rather than from an online marketplace to mitigate risk? Will a consumer require greater trust on the part of the online merchant when the perceived risk of online buying is rather high? We intend to find answers to these research questions through an empirical study. This paper explores the impact of enduring product involvement and perceived risks on required trust level, and further on online merchant choice. For the purpose of the research, five types or components of perceived risk are taken into consideration, including financial, performance, delivery, psychological, and social risks. A research model has been built around the constructs under consideration, and 12 hypotheses have been developed based on the research model to examine the relationships between enduring involvement and five components of perceived risk, between five components of perceived risk and required trust level, between enduring involvement and required trust level, and finally between required trust level and preference toward an e-tailer. To attain our research objectives, we conducted an empirical analysis consisting of two phases of data collection: a pilot test and main survey. The pilot test was conducted using 25 college students to ensure that the questionnaire items are clear and straightforward. Then the main survey was conducted using 295 college students at a major university for nine days between December 13, 2010 and December 21, 2010. The measures employed to test the model included eight constructs: (1) enduring involvement, (2) financial risk, (3) performance risk, (4) delivery risk, (5) psychological risk, (6) social risk, (7) required trust level, (8) preference toward an e-tailer. The statistical package, SPSS 17.0, was used to test the internal consistency among the items within the individual measures. Based on the Cronbach's
Previous studies have shown that the most important factor affecting customer loyalty in the service industry is service quality. However, on the subject of whether service quality has a direct or indirect effect on customer loyalty, scholars' views apparently vary. Some studies suggest that service quality has a direct and fundamental influence on customer loyalty (Bai and Liu, 2002). However, others have shown that service quality not only directly affects customer loyalty, it also has an indirect impact on customer loyalty by influencing customer satisfaction and perceived value (Cronin, Brady, and Hult, 2000). Currently, there are few domestic articles that specifically address the relationship between service quality and customer loyalty in the mobile communication industry. Moreover, research has studied customer loyalty as a whole variable, rather than breaking it down further into multiple dimensions. Based on this analysis, this paper summarizes previous study results, establishes an effect mechanism model among service quality, customer satisfaction, and customer loyalty in the mobile communication industry, and presents a statistical test on model assumptions by using customer investigation data from Heilongjiang Mobile Company. It provides theoretical guidance for mobile service management based on the discussion of the hypothesis test results. For data collection, the sample comprised mobile users in Harbin city, and the survey was taken by random sampling. Out of a total of 300 questionnaires, 276 (92.9%) were recovered. After excluding invalid questionnaires, 249 remained, for an effective rate of 82.6 percent for the study. Cronbach's