• Clinical and Experimental Pediatrics
• /
• v.64 no.9
• /
• pp.480-488
• /
• 2021

Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study established the National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008) based on data from a nationwide population-based health screening program and data on healthcare utilization for children. Methods: The NICKs-2008 study consisted of the Korean National Health Insurance System (NHIS) and the National Health Screening Program for Infants and Children (NHSPIC) databases comprising children born in 2008 (n=469,248) and 2009 (n=448,459) in the Republic of Korea. The NHIS database contains data on age, sex, residential area, income, healthcare utilization (International Classification of Diseases10 codes, procedure codes, and drug classification codes), and healthcare providers. The NHSPIC consists of 7 screening rounds. These screening sessions comprised physical examination, developmental screening (rounds 2-7), a general health questionnaire, and age-specific anticipatory guidance. Results: During the 10-year follow-up, 2,718 children (0.3%) died, including more boys than girls (hazard ratio, 1.145; P<0.001). A total of 848,048 children participated in at least 1 of the 7 rounds of the NHSPIC, while 96,046 participated in all 7 screening programs. A total of 823 infants (0.1%) weighed less than 1,000 g, 3,177 (0.4%) weighed 1,000-1,499 g, 37,166 (4.4%) weighed 1,500-2,499 g, 773,081 (91.4%) weighed 2,500-4,000 g, and 32,016 (5.1%) weighed over 4,000 g. There were 23,404 premature babies (5.5%) in 2008 compared to 23,368 (5.6%) in 2009. The developmental screening test indicated appropriate development in 95%-98% of children, follow-up requirements for 1%-4% of children, and recommendations for further evaluation for 1% of children. Conclusion: The NICKs-2008, which integrates data from the NHIS and NHSPIC databases, can be used to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors.

• 한국노년학
• /
• v.38 no.2
• /
• pp.351-364
• /
• 2018

The purpose of this study is to learn about the decision factors affecting utilization of elderly welfare center of the elderly living in Gimpo city. The reason of the study is that the elderly welfare center as a provider of general welfare services could not only thinking about the state policy but also need to consider about the inherent role and function of the elderly. Especially for these elders living in rural areas, although the number of elderly welfare centers of the whole country has greatly increased in last 10 years, the effect and function of the facility are almost the same and they are still lack of leisure activities. This issue become a serious problem nowadays. For the above reasons, this article conducts a social survey of 360 elderly people over the age of 65 who lives in the Gimpo city which is a rural-urban type city. The research method is to examine the relationship between the predisposing factors, enabling factors and need factors of Andersen's behavior model with binary logistic regression analysis and the decision tree analysis. The result of binary logistic regression shows the most of factors of Andersen's model is significant. The factors of age, gender, education level in predisposing factors; monthly income in enabling factors and the reserve for old life, the preparation of economic activity for old life in need factors are significant. Then the result of decision tree analysis shows the interaction between factors; when the education level in predisposing factors is higher, the possibility of using of elderly welfare center becomes bigger. Also as the level of healthy promoting preparation in the need factors gets lower, the possibility of using of elderly welfare center still becomes bigger. Although differences were found in the interpretation of the results of regression analysis and decision tree analysis, the results of this study can still provide support for the necessity of elderly welfare centers providing integrated welfare services.

• International Area Studies Review
• /
• v.22 no.4
• /
• pp.3-18
• /
• 2018

In this study, I examined capital market shock reaction effects of 29 OECD countries with the past 24 years sample period consisting of daily stock market return using T-GARCH model focused on volatility feedback hypothesis. US daily stock market return is used as a unique independent variable in this model in consideration of its characteristics of biggest market share and as an origin country of Global Financial Crisis. As a result, France, Finland, and Mexico in order are shown to be the strongest countries in the aspect of return spillovers from US. Canada, Mexico, and France are shown to be the highest countries in the aspect of explanatory power of model. The degrees of shock reaction are proved to be higher in order in Germany, Chile, Switzerland, and Denmark and those of downside shock reaction are seen higher in order in Greece, Great Britain, Australia, and Japan. Canada and Mexico belonging to NAFTA are shown to be higher in the return spillover from US and in the model explanatory power, but they are shown to be lower in the impact of shock reaction, suggesting that regional distance effect or gravity theory cannot be applied to financial spillovers any longer. In the analysis of subsample period of Global Financial Crisis, north American three countries do not show any consistent results as in the full sample period but shock reaction in the European countries are shown to record stronger, suggesting that shocks from US in the Crisis Times are transferred mainly to European region.

• 한국노년학
• /
• v.38 no.2
• /
• pp.291-308
• /
• 2018

The purpose of this study is to analyze the factors influencing financial preparedness for retirement of the middle-aged North Korean defectors (resettling in South Korea) using concepts of 'financial literacy' and 'financial inclusion'. Those questioned were 100 North Korean defectors of 40-60 years-old residing in Seoul and Gyeonggi-do Province selected by convenience sampling, one of the non-probability sampling. Path analysis is used as a main analysis method. The results of the study show a direct effect in which increased financial literacy resulted in better financial preparedness for retirement among middle-aged North Korean defectors at a statistically significant level. In addition, by boost-trapping method, financial inclusion has its mediating effect on the relationship between financial literacy and financial preparedness for retirement. However, this study shows that influence of financial literacy on financial preparedness for retirement is different across economic statues. The mediating effect of financial inclusion on the relationship between financial literacy and financial preparedness is statistically significant only for the low-income group. Meanwhile, for the above average income group, financial literacy has a direct effect on the financial preparedness after retirement at a statistically significant level. Based on these results, this study suggests practical and policy implementation such as necessity of customized financial education suited to their economic status, development of financial instruments for retirement, introduction of financial social workers to prepare stable old age of North Korean defectors.

• 한국노년학
• /
• v.38 no.3
• /
• pp.395-408
• /
• 2018

The purpose of this study is to investigate the effects of staffs' general characteristics and institutional characteristics on the staff members' recognition of the level of ethical management in the elderly welfare institutions and to provide basic materials for raising standard of ethical management in the elderly welfare institutions. For this purpose, we conducted a questionnaire survey using structured self-filling-type questionnaires for 245 staffs of elderly welfare institutions in Seoul and Gyeonggi-do. This study sets general characteristics of staffs and institutional characteristics as the independent variables and the staff members' recognition of the level of ethical management as the dependent variable. The variables are investigated through the descriptive statistics such as frequency, percentage and average analysis, and the difference of effect on the staff members' recognition of ethical management in the elderly welfare institutions by each independent variable was analysed by t-test, ANOVA and multiple regression analysis. The results of the study shows that in terms of general characteristics of staffs, the higher male to female ratio and the higher educational level; and in institutional characteristics, the less experience in basic ethics education and the better ethical working environment of the institution are the positive factors for that the staff members estimate the level of ethical management of their workplace high. Based on these results, for making staff members recognize the level of ethical management in the elderly welfare institutions higher, we should create actual atmosphere of the ethical working environment in the institution and implement not formal but step-by-step intensive ethics education that make employees can apply it in the real situations. In conclusion, this study gives the practical suggestions for improving the staff members' recognition of ethical management level in the practice field of elderly welfare on the fast-changing trends including downsizing and privatization.

• Tuberculosis and Respiratory Diseases
• /
• v.82 no.3
• /
• pp.242-250
• /
• 2019

Background: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results: A total of 156 patients treated with NIV were enrolled (mean age, $71.9{\pm}11.6years$). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion: AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.

• BMB Reports
• /
• v.52 no.7
• /
• pp.463-468
• /
• 2019

Autosomal dominant polycystic kidney disease (ADPKD), one of the most common human monogenic diseases (frequency of 1/1000-1/400), is characterized by numerous fluid-filled renal cysts (RCs). Inactivation of the PKD1 or PKD2 gene by germline and somatic mutations is necessary for cyst formation in ADPKD. To mechanistically understand cyst formation and growth, we isolated RCs from Korean patients with ADPKD and immortalized them with human telomerase reverse transcriptase (hTERT). Three hTERT-immortalized RC cell lines were characterized as proximal epithelial cells with germline and somatic PKD1 mutations. Thus, we first established hTERT-immortalized proximal cyst cells with somatic PKD1 mutations. Through transcriptome sequencing and Gene Ontology (GO) analysis, we found that upregulated genes were related to cell division and that downregulated genes were related to cell differentiation. We wondered whether the upregulated gene for the chemokine CXCL12 is related to the mTOR signaling pathway in cyst growth in ADPKD. CXCL12 mRNA expression and secretion were increased in RC cell lines. We then examined CXCL12 levels in RC fluids from patients with ADPKD and found increased CXCL12 levels. The CXCL12 receptor CXC chemokine receptor 4 (CXCR4) was upregulated, and the mTOR signaling pathway, which is downstream of the CXCL12/CXCR4 axis, was activated in ADPKD kidney tissue. To confirm activation of the mTOR signaling pathway by CXCL12 via CXCR4, we treated the RC cell lines with recombinant CXCL12 and the CXCR4 antagonist AMD3100; CXCL12 induced the mTOR signaling pathway, but the CXCR4 antagonist AMD3100 blocked the mTOR signaling pathway. Taken together, these results suggest that enhanced CXCL12 in RC fluids activates the mTOR signaling pathway via CXCR4 in ADPKD cyst growth.

• 재활복지
• /
• v.20 no.4
• /
• pp.31-54
• /
• 2016

The purpose of this study is to explore the improvement method of the emergency safety system as a social protection scheme for the elderly living alone with severe disabilities. The study was conducted by randomly choosing three regions in the metropolitan area (Jongno-gu, Seoul), the small-medium city (Yongin-si, Gyeonggi-do) and the rural area (Geochang-gun, Gyeongsangnam-do) among 17 cities and counties nationwide. The study method is based on the interview form of the structured questionnaires with city officials, county officials, and center operators. According to the results of the interview analysis, it was recognized that there was a need for an emergency safety system for the elderly living alone with severe disabilities. In spite of this necessity, there were problems about publicity for the discovery of victims of the blind spot in welfare, about inconvenience due to frequent malfunctions of the emergency equipment, about insufficient awareness of the security of the emergency officials and about supply and demand of manpower for 24-hour monitoring service. In order to improve the effective operation of the emergency safety system, it was the most urgent issue to formulate the legislation for responding to the crisis management of the vulnerable. A suggestion of this study is to build a safety system in which one-stop service is provided for the realization of compact welfare through the establishment of a MOU for linkage with community organizations, the full inspection of emergency equipment to solve safety equipment malfunction problems and the manpower supplement for 24-hour monitoring.

• International Area Studies Review
• /
• v.20 no.2
• /
• pp.3-23
• /
• 2016

In this study, we used actual proof analysis, based on SVAR model according to economy theory, to observe the impact of actual and financial market of Korea, Japan, and China that have adopted quantitative easing export based strategy of growth, an unconventional monetary policy of the U.S. As a result of estimation, it appears that real effective exchange rate rise shock of Korea, Japan, and China against U.S. dollar has a negative influence on current account and index of industrial product, which are real economy. It can be implied that the result is driven from the fact that strong home currency of Korea, Japan, and China decreases price competitiveness of exports, causing negative influence on real economy. The real effective exchange rate shock against U.S. dollar appeared to decrease national bond rate of Korea and Japan, while increasing that of China. In instances of Korea and Japan, it is implied that national bond rate decreases as foreigner investment funds flow in, considering foreign-exchange profit through advanced financial market with high opening extent. On the other hand, because there are strong regulation on opening extent of Chinese financial markets, the influence seems to be greater for domestic policy, rather than a foreign influence. Lastly, Korea showed a more dramatic variable reaction to exchange rate shock compared to Japan or China. It is implied from the result that Korea is relatively more susceptible and fragile in regards of international status of economic size and currency.

• Tuberculosis and Respiratory Diseases
• /
• v.82 no.3
• /
• pp.251-260
• /
• 2019

Background: Beyond its current function as a rescue therapy in acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) may be applied in ARDS patients with less severe hypoxemia to facilitate lung protective ventilation. The purpose of this study was to evaluate the efficacy of extended ECMO use in ARDS patients. Methods: This study reviewed 223 adult patients who had been admitted to the intensive care units of 11 hospitals in Korea and subsequently treated using ECMO. Among them, the 62 who required ECMO for ARDS were analyzed. The patients were divided into two groups according to pre-ECMO arterial blood gas: an extended group (n=14) and a conventional group (n=48). Results: Baseline characteristics were not different between the groups. The median arterial carbon dioxide tension/fraction of inspired oxygen ($FiO_2$) ratio was higher (97 vs. 61, p<0.001) while the median $FiO_2$ was lower (0.8 vs. 1.0, p<0.001) in the extended compared to the conventional group. The 60-day mortality was 21% in the extended group and 54% in the conventional group (p=0.03). Multivariate analysis indicated that the extended use of ECMO was independently associated with reduced 60-day mortality (odds ratio, 0.10; 95% confidence interval, 0.02-0.64; p=0.02). Lower median peak inspiratory pressure and median dynamic driving pressure were observed in the extended group 24 hours after ECMO support. Conclusion: Extended indications of ECMO implementation coupled with protective ventilator settings may improve the clinical outcome of patients with ARDS.