• The Journal of KAIRB
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• v.5 no.1
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• pp.21-32
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• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• Health Policy and Management
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• v.31 no.4
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• pp.462-471
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• 2021

Background: The purpose of this study was to identify the association between participation in social activities and mortality rates for those aged 45 aged and older in Korea. Methods: In this study, the 1st to 6th Korea Longitude Study of Aging was used to analyze 10,217 people excluding missing values among middle and old age groups aged 45 or older. The scope of social activities was classified into "religious gatherings," "religious gatherings," "leisure/cultural/sports-related organizations," and "clubs/hometowns/religious associations," and analyzed using a chi-square test and Cox proportional risk model. Results: In the case of non-participating groups in religious activities, the mortality rate was 1.24 times higher (hazard ratio [HR], 1.24; p=0.000) than those of the participating group. The non-participating group of social gatherings had a 1.27 times higher mortality rate (HR, 1.27; p<0.0001) than the participating group. In addition, the mortality rate of non-participating groups related to leisure/cultural/sports was 1.79 times higher (HR, 1.79; p=0.000). The mortality rate of the group that did not participate in the alumni association/festival/folklore society was 1.51 times higher than that of the participating group (HR, 1.51; p<0.0001). As a result of correcting the control variable to analyze the relationship between the number of participants in social activities and the mortality rate, the mortality rate of the group participating in one or less social activities was 2.26 times higher (HR, 2.26; p<0.0001) compared to the four or more social activity participating groups, and the mortality rate of the 1-3 social activities was 1.64 times higher (HR, 1.64; p<0.0001). Conclusion: As a result of the study, it was found that participation in social activities of the middle-aged and elderly groups was effective in reducing mortality, and in particular, it was found that there was a strong relationship with mortality in less than one social activity group. Therefore, it is intended to provide an academic basis for lowering the mortality rate of the group in line with the continuous improvement of domestic social activity participation conditions, and through this, this study can be expected to serve as a policy and institutional basis for lowering the mortality rate of the group.

• Journal of Advanced Navigation Technology
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• v.26 no.3
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• pp.172-178
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• 2022

In this paper, water meter AMR(automatic meter reading), one of the core technologies of smart water grid, using LoRa IoT network is studied. The main content of the research is to develop the network system and show the test results that one PC server receives the readings of water meters from multiple households through LoRa communication and stores them in the database, and at the same time sends the data to the web server database through internet. The system also allows users to monitor the meter readings using their smartphones. The hardware and firmware of the main board of the digital water meter are developed. For a PC server program, MDMS(meter data management system) is developed using Visual C#. The app program running on the user's smartphone is also developed using Android Studio. By connecting each developed parts, the total network system is mounted on a flow test bench in the laboratory and tested. For the fields test, 5 places around the university are selected and the transmission distances are tested. The test result show that the developed system can be applied into the real field. The developed system can be expanded to various social safety nets such as monitoring the living alone or elderly with dementia.

• Journal of Practical Engineering Education
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• v.15 no.3
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• pp.751-759
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• 2023

In the era of global aging and the retirement of baby boomers, the response is very intensive and dynamic. As baby boomers actually retire, the terms for middle-aged people have been diversified into middle-aged, midle-elderly, and the new middle, which are also evident in the training process. In line with the timing, the government and academia are also making efforts to advance the development of training courses for middle-aged, along with organizing terms for middle-aged. From this point of view, this study aims to analyze the performance of the three-year training courses (2018-2020) for the new middle at Korea Polytechnics and suggest the direction of development of the new middle training course. As a result of the study, the three-year performance of the Shin middle-aged training course gradually increased, but the completion rate and employment rate gradually decreased, indicating that countermeasures were needed. In addition, campus performance in the metropolitan area was higher than that in the non-capital area, so a plan for this deviation was needed. In addition, the need for the integrated operation of the existing 'middle-aged' and 'the new middle' courses operated by Korea Polytechnics was suggested, and measures to specialize in the new middle-aged were proposed.

• Journal of Environmental Health Sciences
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• v.49 no.6
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• pp.362-371
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• 2023

Background: PM_2.5 pollution has been a persistent problem in South Korea, with concentrations consistently exceeding World Health Organization (WHO) guidelines. The aging of the population in the country further exacerbates the health impacts of PM_2.5 since older adults are more susceptible to the adverse effects of air pollution. Objectives: This study aims to evaluate how the health impact (premature death) due to long-term exposure to PM_2.5 in South Korea could change in the future according to the trend of change in the country's population structure. Methods: The study employs a relative risk function, which accounts for age-specific relative risks, to assess the changes in premature deaths by age and region at the average annual PM_2.5 concentration for 2022 and at PM_2.5 concentration improvement levels. Premature deaths were estimated using the Global Exposure Mortality Model (GEMM). Results: The findings indicate that the increase in premature deaths resulting from the projected population structure changes up to 2050 would significantly outweigh the health benefits (reduction in premature deaths) compared to 2012. This is primarily attributed to the rising number of premature deaths among the elderly due to population aging. Furthermore, the study suggests that the effectiveness of the current domestic PM_2.5 standard would be halved by 2050 due to the increasing impact of population aging on PM_2.5-related mortality. Conclusions: The study highlights the importance of considering trends in population structure when evaluating the health benefits of air pollution reduction measures. By comparing and evaluating the health benefits in reflection of changes in population structure to the predicted PM_2.5 concentration improvements at the provincial level, a more comprehensive assessment of regional air quality management strategies can be achieved.

• Health Policy and Management
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• v.32 no.4
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• pp.347-355
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• 2022

Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals. Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020. Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities. Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• Toxicological Research
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• v.17
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• pp.47-57
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• 2001

Alzheimer's disease (AD) is the most common cause of dementia in the elderly, and its pathology is characterized by the presence of numerous numbers of senile plaques and neurofibrillary tangles. Several genetic and transgenic studies have indicated that excess amount of $\beta$-amyloid protein (A$\beta$) is produced by mutations of $\beta$TEX>$\beta$-amyloid precursor protein and causes learning impairment. Moreover, $A\beta$ has a toxic effect on cultured nerve cells. To prepare AD model animals, we have examined continuous (2 weeks) infusion of $A\beta$ into the cerebral ventricle of rats. Continuous infusion of $A\beta$ induces learning impairment in water maze and passive avoidance tasks, and decreases choline acetyltransferase activity in the frontal cortex and hippocampus. Immunohistochemical analysis revealed diffuse depositions of $A\beta$ in the cerebral cortex and hippocampus around the ventricle. Furthermore, the nicotine-evoked release of acetylcholine and dopamine in the frontal cortex/hippocampus and striatum, respectively, is decreased in the $A\beta$-infused group. Perfusion of nicotine (50 $\mu\textrm{M}$) reduced the amplitude of electrically evoked population spikes in the CA1 pyramidal cells of the control group, but not in those of the $A\beta$-infused group, suggesting the impairment of nicotinic signaling in the $A\beta$-infused group. In fact, Kd, but not Bmax, values for ［$^3H$］ cytisine binding in the hippocampus significantly increased in the $A\beta$-infused rats. suggesting the decrease in affinity of nicotinic acetylcholine receptors. Long-term potentiation (LTP) induced by tetanic stimulations in CA1 pyramidal cells, which is thought to be an essential mechanism underlying learning and memory, was readily observed in the control group, whereas it was impaired in the $A\beta$-infused group. Taken together, these results suggest that $A\beta$ infusion impairs the signal transduction mechanisms via nicotinic acetylcholine receptors. This dysfunction may be responsible, at least in part, for the impairment of LTP induction and may lead to learning and memory impairment. We also found the reduction of glutathione- and Mn-superoxide dismutase-like immunoreactivity in the brains of $A\beta$-infused rats. Administration of antioxidants or nootropics alleviated learning and memory impairment induced by $A\beta$ infusion. We believe that investigation of currently available transgenic and non-transgenic animal models for AD will help to clarify the pathogenic mechanisms and allow assessment of new therapeutic strategies.

• Journal of Life Science
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• v.22 no.5
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• pp.613-620
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• 2012

To evaluate the effects of sleep habits on the powers of beta waves and the sensory motor rhythm of the electroencephalogram (EEG), female college student subjects were divided into four groups, according to their sleep habits, as follows: GSHG (Good Sleep Habit Group), CSHG (Common Sleep Habit Group: late bedtime), CSDG (Cognitive Sleep Disorder-Delayed Sleep Phase Syndrome Group), and NSDG (Non-cognitive Sleep Disorder-Delayed Sleep Phase Syndrome Group). Brain function was stimulated by reading a book for 3 min in the morning (9~12 am) and the EEG was measured. According to the results, the powers of the beta waves and sensory motor rhythm were not different during the resting period among the four groups. However, during the reading stimulation period, the powers of beta waves and the sensory motor rhythm in the GSHG were significantly greater than in the other groups ($p$ <0.05). Beta powers during stimulation also increased in all brain areas in the GSHG ($p$ <0.05). Interestingly, these were decreased in the frontal and temporal lobes in the CSHG by the reading stimulation ($p$ <0.05). On the other hand, sensory motor rhythm, which represents focusing efficacy, only improved in the GSHG. These results indicate that the brain's focusing function during the reading stimulation was not properly operating in the morning in the female college students who had a delayed bedtime and bad sleep habits.

• Korean Journal of Construction Engineering and Management
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• v.20 no.6
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• pp.57-65
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• 2019

If aging apartments are left unimproved through remodeling, the city will be eventually slum. As the government recognizes remodeling as an alternative to reconstruction, the law has been revised mainly to increase the housing area, increase the number of house and allow the vertical extension for making remodeling costs. However, the remodeling is still not activated yet in the market. Therefore, this study analyzes the decision factors of apartment remodeling in Seoul metropolitan area based on Heckman two-stage analysis considering sampling error. Research findings indicate that the decision for remodeling is determined by the characteristics of the household, housing, and time-lapse variables. And also the number of household members, net assets, housing satisfaction, the 11-20, 21-30, and more than 30 years of building are identified as the significant variables as a result of remodeling choice probability analysis. It is noteworthy that the significant variables from then remodeling cost analysis are net assets, area, more than 30 years of building, and unit housing price. It is also notable that the policy, which extend the housing area to cover remodeling cost, are not actually effective to activate the remodeling, and the age in the case of elderly people in Seoul and Gyeonggi-do who are expected to have high net assets and income is not significant variables. This study is expected to provide more objective and reliable implication to the policy makers, the home owner and the investors on the decision making process related to the remodeling project.