• Research in Vestibular Science
• /
• 제17권4호
• /
• pp.152-159
• /
• 2018

Objectives: The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of our study was to address the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis. Methods: The unidimensionality, scale targeting, separation reliability, item difficulty (severity), and response category utility of the KDHI were statistically assessed based on the Andrich rating scale model. The utilities of the orderedresponse categories of the 3-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability (PSR), which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits. Results: Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the 3-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (items 1 and 2) for Rasch model. Conclusions: The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified parts for possible amendments in order to further improve the linear metric scale.

• 대한간호학회지
• /
• 제30권3호
• /
• pp.776-790
• /
• 2000

Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups：33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

• 한국습지학회지
• /
• 제19권3호
• /
• pp.345-352
• /
• 2017

지구온난화에 의해 지구의 평균 기온은 1880년 이후로 약 $0.85^{\circ}C$ 상승하였다. 이는 수문현상에 영향을 미치며 이로 인해 전 세계는 홍수 및 가뭄과 같은 자연재해에 어려움을 겪고 있다. 따라서 미래의 안정적인 물 공급을 위한 수자원 계획 수립을 위해 특히 물 부족 측면에서 기후의 불확실성을 고려한 물 수요의 정확한 예측이 필요하다. 이를 위해 본 연구에서는 한국의 안성천 유역을 대상으로 기후변화를 고려하여 미래 물수지 및 물 부족량을 평가하였다. RCP 8.5 기후변화 시나리오를 이용하여 미래 강수량을 모의하였고, 준분포 강우-유출 모형인 SLURP 모형을 통해 유출량을 추정하였다. K-WEAP 모형을 통해 안성천 유역 소유역의 물수지 분석을 위한 시나리오 및 네트워크를 구축하였다. 또한 1965-2011년간 과거 자료로부터 계산된 용수이용량(생활, 공업, 농업용수)을 활용한 선형예측함수식을 통해 장래 물 수요 추정량을 산정하였다. 물 수지 분석 결과, 인구 증가, 급격한 도시화 및 지구온난화에 의한 기후변화로 인해 생활 및 공업용수 이용량은 증가하고, 반면 농업용수 이용량은 점차적으로 감소할 것으로 확인되었다. 전체적으로 안성천유역에서 미래 물 부족 문제가 심각해질 것으로 나타났다. 이에 유역 내 물 부족 문제를 해결하기 위한 사례연구로서 광역상수도 확충 및 제한급수의 두 가지 대안을 제시하였다.

• Journal of Ecology and Environment
• /
• 제38권2호
• /
• pp.241-247
• /
• 2015

A participatory approach of local stakeholders is important to create a balance between nature protection and the sustainable use of natural resources in a nature reserve and its vicinity area. The zoning and management policy of biosphere reserves (BRs) is a good example of this idea, especially for island reserves. Yakushima was inscribed as a World Natural Heritage (WH) in 1993. Almost all of its residents did not remember that Yakushima was a BR. In addition, Yakushima has some problems in nature reserve management. Overabundance of the deer population is a critical threat to both agriculture and natural vegetation in the world heritage site. There are too many tourists visiting the WH site and Nagata-hama beach. The beach is a Ramsar site and one of the most important spawning grounds of sea turtles in the north Pacific. Now, residents and the municipality have decided to reactivate the Yakushima BR. Although the Ministry of the Environment of Japan has an initiative to manage the WH and the Ramsar site, the BR is managed by the municipality and local stakeholders. Local activities of both nature conservation and the sustainable use of natural resources are encouraged in the BR site. The islanders willingly included all areas of the island into the BR site. Scientists who have participated in the Society of Yakushimaology have played a significant role to build trust between local stakeholders and to seek feasible policies on the nature reserves. The concept of the "Yakushima Environmental Culture Village" is a good model for the extension plan of the Yakushima and Kuchinoerabujima BRs.

• 분석과 대안
• /
• 제7권2호
• /
• pp.35-77
• /
• 2023

This study aims to solve the entangled loop between demographic transition (DT) and economic growth by analyzing cross-country data. We undertake a national-level group analysis to verify the compressed transition of demographic variables over time. Assuming that the LA (latecomer advantage) on DT over time exists, we verify that the DT of the latecomer is compressed by providing a formal proof of LA on DT over income. As a DT has the double-kinked functions of income, we check them in multiple aspects: early maturation, leftward threshold, and steeper descent under a contour map and econometric methods. We find that the developing countries (the latecomer) have speedy DT (CDT, compressed DT) as well as speedy income such that DT of the latecomers starts at lower levels of income, lasts for a shorter period, and finishes at the earlier stage of economic development compared to that of developed countries (the early mover). To check the balance of DT, we classify countries into four groups of DT---balanced, slow, unilateral, and rapid transition countries. We identify that the main causes of rapid transition are due to the strong family planning programs of the government. Finally, we check the effect of latecomer's CDT on economic growth inversely: we undertake the simulation of the CDT effect on economic growth and the aging process for the latecomer. A worrying result is that the CDT of the latecomer shows a sharp upturn of the working-age population, followed by a sharp downturn in a short period. Compared to early-mover countries, the latecomer countries cannot buy more time to accommodate the workable population for the period of demographic bonus and prepare their aging societies for demographic onus. Thus, we conclude that CDT is not necessarily advantageous to developing countries. These outcomes of the latecomer's CDT can be re-interpreted as follows. Developing countries need power sources to pump up economic development, such as the following production factors: labor, physical and financial capital, and economic systems. As for labor, the properties of early maturation and leftward thresholds on DTs of the latecomer mean that demographic movement occurs at an unusually early stage of economic development; this is similar to a plane that leaks fuel before or just before take-off, with the result that it no longer flies higher or farther. What is worse, the property of steeper descent represents the falling speed of a plane so that it cannot be sustained at higher levels, and then plummets to all-time lows.

• 한국방재안전학회논문집
• /
• 제16권4호
• /
• pp.75-84
• /
• 2023

대다수의 개발도상국은 물수급 계획을 위한 수문 자료 부재로 장기유출량 산정이 불가능하며, 물 분배 의사결정을 진행하는데 합리적인 물수급 계획을 수립하기가 어려운 상황이다. 연구대상지역인 인도네시아 반둥지역은 급격한 도시화 및 인구집중으로 심각한 상수부족 상황이며 물수지 예측 방안이 구축되어 있지 않아 상수도 보급률이 약 20% 정도 수준이다. 이에 본 연구에서는 개발도상국에서의 물수지 예측접근방안을 제시하기 위해 MODSIM(Modified SIMYLD) 네트워크 모형 활용한 이수안전도 및 용수공급 가능량을 분석하였다. MODSIM 모형의 적정성을 검토하기 위해 비유량법을 적용하여 Pataruman 관측소의 19개년(2002~2020년) 유출량 자료를 기준으로 장기유출량을 산정하고 물수지 분석을 수행하였다. 분석결과 기존 월별 최적운영곡선과 일치하는 것을 확인할 수 있었다. 발전소의 발전용량을 분석한 결과 0.30~0.50% 정도 차이가 났으며, Pataruman 지점 이수안전도는 Q95% 유량 기준 1.64%, Q355 유량 기준 0.47% 높게 나타났다. 기존 저수지 최적운영곡선과 비교한 운영효율이 1% 내외로 유사하게 계측되어, 이를 통해 MODSIM 네트워크 모형을 이용한 용수공급 평가 가능성과 용수공급시설의 필요성을 확인할 수 있었다.

• 대한간호학회지
• /
• 제11권2호
• /
• pp.5-8
• /
• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Journal of Microbiology and Biotechnology
• /
• 제27권6호
• /
• pp.1071-1077
• /
• 2017

A rise in the occurrence of allergic diseases is attributed to the dysregulated balance of type 1/type 2 immunity, where type 2 T-helper (Th2) cells predominate over type 1 T-helper (Th1) cells, leading to an abnormally increased production of IgE in response to unharmful antigens. Kimchi, a traditional Korean fermented food, is a rich source of beneficial lactic acid bacteria. In this study, we investigated the ability of Enterococcus faecium FC-K derived from kimchi to induce type I immunity in the presence of Th2 polarizing conditions in vitro and in vivo. Stimulation of mouse peritoneal macrophages with E. faecium FC-K induced the production of tumor necrosis factor alpha, interleukin (IL)-6, and IL-12. Under the in vitro Th2 conditions in which splenic T cells were activated in the presence of IL-4, E. faecium FC-K enhanced the ability of T cells to produce interferon $(IFN)-{\gamma}$. Using the ovalbumin (OVA)-induced allergy model, male BALB/c mice receiving E. faecium FC-K reduced the serum level of total IgE, but not that of OVA-specific IgE. Furthermore, the population of activated splenic B cells during OVA immunization was decreased in E. faecium FC-K-treated mice, accounting for a reduction of total IgE in the serum. Restimulating splenocytes from OVA-immunized mice with OVA ex vivo resulted in an increased production of $IFN-{\gamma}$, with no effect on IL-4, in E. faecium FC-K-treated mice. These observations provide the evidence that E. faecium FC-K can be a beneficial probiotic strain that can modulate the Th2-mediated pathologic response.

• Korean Chemical Engineering Research
• /
• 제43권2호
• /
• pp.286-293
• /
• 2005

기체 수송층 흡수탑과 기포 유동층 재생탑으로 구성된 $CO_2$ 회수 공정에 대한 해석의 첫 단계로 이 공정에서 고체 순환특성을 해석하였다. 흡수제 고체 입자에 대한 입도별 물질수지를 해석하여 공정의 흐름에서 고체 흐름량과 입도 분포를 결정하였다. 실험실 규모 공정(흡수탑: 직경 25 mm, 높이 6 m; 재생탑: 직경 0.1 m, 높이 1.2 m)에서 고체순환특성을 모사하였다. 흡수탑의 입도분포는 재생탑의 입도분포와 거의 같았다. 흡수탑에서 유속과 정체층 높이가 증가함에 따라서 고체순환량과 새 흡수제 주입량은 증가하였다. 반면에 흡수탑 내 입자의 평균입경은 감소하였다. 흡수탑사이클론의 절단입도가 증가함에 따라서 고체순환속도는 감소하였으며, 새 흡수제 주입속도와 흡수탑 내 입자의 평균 입경은 증가하였다. 흡수제 입자의 마모계수가 증가함에 따라서 고체순환속도는 증가하고, 새 흡수제 주입속도는 증가하며, 흡수탑 내 입자의 평균입경은 감소하였다.

• Experimental and Molecular Medicine
• /
• 제50권12호
• /
• pp.12.1-12.14
• /
• 2018

Osteoporosis develops with high prevalence in both postmenopausal women and hypogonadal men. Osteoporosis results in significant morbidity, but no cure has been established. Mesenchymal stem cells (MSCs) critically contribute to bone homeostasis and possess potent immunomodulatory/anti-inflammatory capability. Here, we investigated the therapeutic efficacy of using an infusion of MSCs to treat sex hormone-deficient bone loss and its underlying mechanisms. In particular, we compared the impacts of MSC cytotherapy in the two genders with the aim of examining potential gender differences. Using the gonadectomy (GNX) model, we confirmed that the osteoporotic phenotypes were substantially consistent between female and male mice. Importantly, systemic MSC transplantation (MSCT) not only rescued trabecular bone loss in GNX mice but also restored cortical bone mass and bone quality. Unexpectedly, no differences were detected between the genders. Furthermore, MSCT demonstrated an equal efficiency in rectifying the bone remodeling balance in both genders of GNX animals, as proven by the comparable recovery of bone formation and parallel normalization of bone resorption. Mechanistically, using green fluorescent protein (GFP)-based cell-tracing, we demonstrated rapid engraftment but poor inhabitation of donor MSCs in the GNX recipient bone marrow of each gender. Alternatively, MSCT uniformly reduced the $CD3^+T$-cell population and suppressed the serum levels of inflammatory cytokines in reversing female and male GNX osteoporosis, which was attributed to the ability of the MSC to induce T-cell apoptosis. Immunosuppression in the microenvironment eventually led to functional recovery of endogenous MSCs, which resulted in restored osteogenesis and normalized behavior to modulate osteoclastogenesis. Collectively, these data revealed recipient sexually monomorphic responses to MSC therapy in gonadal steroid deficiency-induced osteoporosis via immunosuppression/anti-inflammation and resident stem cell recovery.