• Title/Summary/Keyword: Vulnerable Elderly People

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The Effects of National Health Insurance Denture Coverage Policies for the Elderly on the Unmet Dental Needs of the Edentulous Elderly

  • Ahn, Eunsuk;Hwang, Ji-Min;Han, Ji-Hyoung
    • Journal of dental hygiene science
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    • v.18 no.3
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    • pp.182-187
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    • 2018
  • As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.

Effects of the Forest Healing Program on Depression, Cognition, and the Autonomic Nervous System in the Elderly with Cognitive Decline

  • Lim, Young-suwn;Kim, Jaeuk;Khil, Taegyu;Yi, Jiyune;Kim, Dong-jun
    • Journal of People, Plants, and Environment
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    • v.24 no.1
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    • pp.107-117
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    • 2021
  • Background and objective: The purpose of this study is to investigate the effect of a forest healing program in terms of depression, neuropsychological and physiological benefits for the elderly. Methods: For this purpose, we developed a forest therapy program for the elderly who are vulnerable to dementia and conducted a total of 11 sessions of forest therapy activities in a forest once a week. We measured the changes in depression, resting-state Electroencephalography(EEG) and heart rate variability (HRV) before and after the program. There were 60 subjects aged over 65 yesrs old. 30 subjects participated in the forest therapy program, and the other were in the control group. The Geriatric Depression Scale was used to measure the level of depression, neuroNicle FX2 (Laxtha, Korea) was used to measure the resting-state EEG, and photoplethymogram (ubpulse T1, Laxtha, Korea) was used to measure the HRV. Results: The results showed that the depression index of the experimental group improved with statistical significance after the program (experiment group = 3.267 decrease of the mean). In the EEG measurement, the alpha-peak frequency at rest (experimental group = 0.227 Hz increase of the mean) was improved (mean increase = 0.23 in the experimental group, p < .05). The high frequency of HRV, which represents the parasympathetic nerve activity of the body's autonomous response, was also significantly improved (mean increase = 0.396 in the experimental group, p < .05). Conclusion: The results suggest that the forest therapy program can reduce the cognitive, psychological and physical risk factors of dementia for the elderly at risk of cognitive decline. Therefore, forest therapy activities may be suitable for the prevention of dementia in the elderly.

Clustering Analysis of Walking Characteristics of Elderly People for Use in Pedestrian Facilities Design (보행시설 설계시 활용을 위한 고령자 보행특성 군집화 연구)

  • ROH, Chang-Gyun;PARK, Bum jin;MOON, Byungsup
    • Journal of Korean Society of Transportation
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    • v.34 no.5
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    • pp.409-420
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    • 2016
  • Korea is expected to enter 'Super Aged Society' in 2026. However, as walking is the very basic human right of mobility, securing safe and convenient moving of elderly people comprising the majority of transportation vulnerable is thought to be the most basic welfare, which can be easily neglected. From this perspectives, this study provides the walking characteristics of elderly people to be used in design of pedestrian facilities. The analysis of the measurements using Motion Analysis Systems shows that all walking factors of elderly people is 75% level of the younger group. Elderly group shows slower movement, reduced shoulder movement and increased ankle movement compared to the others. Also, foots are risen less and ground repulsive force is increased. Cluster analysis shows that the group of the elderly shows high variability inside the group, and 2 or 3 clusters can be formed with factors of Walking, Balance and Muscles. These walking characteristics can be used in designing pedestrian road, slope and step height of roadway facilities.

A Study on the Methodology of Extracting the vulnerable districts of the Aged Welfare Using Artificial Intelligence and Geospatial Information (인공지능과 국토정보를 활용한 노인복지 취약지구 추출방법에 관한 연구)

  • Park, Jiman;Cho, Duyeong;Lee, Sangseon;Lee, Minseob;Nam, Hansik;Yang, Hyerim
    • Journal of Cadastre & Land InformatiX
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    • v.48 no.1
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    • pp.169-186
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    • 2018
  • The social influence of the elderly population will accelerate in a rapidly aging society. The purpose of this study is to establish a methodology for extracting vulnerable districts of the welfare of the aged through machine learning(ML), artificial neural network(ANN) and geospatial analysis. In order to establish the direction of analysis, this progressed after an interview with volunteers who over 65-year old people, public officer and the manager of the aged welfare facility. The indicators are the geographic distance capacity, elderly welfare enjoyment, officially assessed land price and mobile communication based on old people activities where 500 m vector areal unit within 15 minutes in Yongin-city, Gyeonggi-do. As a result, the prediction accuracy of 83.2% in the support vector machine(SVM) of ML using the RBF kernel algorithm was obtained in simulation. Furthermore, the correlation result(0.63) was derived from ANN using backpropagation algorithm. A geographically weighted regression(GWR) was also performed to analyze spatial autocorrelation within variables. As a result of this analysis, the coefficient of determination was 70.1%, which showed good explanatory power. Moran's I and Getis-Ord Gi coefficients are analyzed to investigate spatially outlier as well as distribution patterns. This study can be used to solve the welfare imbalance of the aged considering the local conditions of the government recently.

An Ethical Consideration on the Standard Operating Procedure Operation Status and the Ethical Review of the Vulnerable Research Subjects of Institutional Review Board, a Medical Institution in Korea (우리나라 의료기관 Institutional Review Board의 취약한 연구 대상자 관련 표준운영지침서 운영 현황과 윤리적 고찰)

  • Eun Hwa Byun;Byung In Choe
    • 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.

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A Study on the Road Facilities Use Characteristics of the Transportation Vulnerable by AHP Analysis (AHP분석을 통한 교통약자의 도로시설 이용특성에 관한 연구)

  • KIM, Min Je;LEE, Young Woo
    • Journal of Korean Society of Transportation
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    • v.33 no.3
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    • pp.276-283
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    • 2015
  • Pedestrians have been exposed to dangerous traffic environments, in which walking spaces in a city decrease without improved facilities even though cars increase. Such poor walking environments are deadly dangerous to the vulnerable as well as the non-vulnerable. This study analyzed the road facilities use characteristics according to a type of vulnerability in order to improve traffic safety and walking environment for vulnerable pedestrians. This study surveyed the vulnerable in terms of issues that they encountered on existing walkways and conducted the analytic hierarchy process (AHP), which took all quantitative and qualitative variables into account. The results of Level-3 analysis were showed that the elderly and the disabled were partially similar; both felt most inconvenient at enter-exit sections, steep walkway and bad paved walkway. Unlike those results, people with children and/or infants answered that overpass or underpass walkways without lifting facilities were most inconvenient walking environments.

Fall Risk in Low-Income Elderly People in One Urban Area (도시 빈곤 노인의 낙상발생 위험요인에 관한 연구)

  • Choi, Kyung-Won;Lee, In-Sook
    • Journal of Korean Academy of Nursing
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    • v.40 no.4
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    • pp.589-598
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    • 2010
  • Purpose: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. Methods: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Results: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression. Conclusion: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

The determinants of purchasing private health insurance among middle-aged and elderly Korean adults (중.고령자의 민간의료보험 가입 여부의 결정 요인)

  • Yoo, Ki-Bong;Cho, Woo-Hyun;Lee, Min-Jee;Kwon, Jeoung-A;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.17 no.3
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    • pp.23-36
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    • 2012
  • Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

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Combined Impacts of Physical Activity and Exercise on Depression in Elderly People (규칙적인 신체활동과 운동중재가 노인의 우울증에 미치는 영향분석)

  • Jeong-Yoon Oh;Jeong-Ok Yang;Yi-Sub Kwak
    • Journal of Life Science
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    • v.34 no.3
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    • pp.208-213
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    • 2024
  • Depression is one of the greatest health concerns in the world. Symptoms include emotion disorders, loss of appetite, reduction in interest, and insomnia. The prevalence of depression is increasing rapidly around the world and in South Korea. Elderly people are vulnerable to depression, resulting in serious socioeconomic problems. Depression in the elderly can cause sleep disorders, cognitive impairment, memory impairment, and many other diseases. Additionally, depression can cause frailty, which is associated with increased falls, chronic diseases, and mortality. Therefore, this study empirically analyzed sleep disorders in relation to depression, the link between exercise and the hippocampus in mitigating depression, and physical activity and exercise in the management of depression for successful aging.

The Life Experiences of the Deaf Elderly (농아노인의 생활 경험)

  • Park, Ina;Hwang, YoungHee;Kim, Hanho
    • 한국노년학
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    • v.36 no.3
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    • pp.525-540
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    • 2016
  • The purpose of this study was to investigate what kind of experiences the deaf elderly would have in the course of life. It also aimed to promote the understanding of their living difficulties and culture among people with normal hearing and provide basic data to help them live with others as members of the community. Phenomenological qualitative research was conducted as part of the methodology. The subjects include seven deaf old people. Based on the results of in-depth interview and analysis, the life experiences of the deaf elderly were categorized into "unforgettable wounds," "life in the community," "life with the family," "marriage of the deaf elderly", and "living by adjusting to reality." First, the subcategories of "unforgettable wounds" include "receiving no treatment for fever," "damage by the Korean War," "alienation from the family," and "people's cold eyes." It turned out that the deaf elderly had led a life, suffering from the heart wounds that they could not forget. Second, the subcategories of "life in the community" include "inconvenience in life," "disadvantages in life," and "severed life." The deaf elderly were not only subjected to inconvenience and disadvantages in life, but also suffered loneliness, being cut off from the community. Third, the subcategories of "life with the family" include "not communicating with children," "being abandoned again," "being used by the family," "being lonely even with the family," and "wishing to live independently from the family." The deaf elderly were not supported by their families and were abandoned or used by them, leading a solitary life. Fourth, the subcategories of "marriage of the deaf elderly" include"send as a surrogate mother," "frequent remarriage and divorce," "lean on as a married couple." Deaf elderly form their own culture of the marriage and lean on each other. Finally, the subcategories of "living by adjusting to reality" include "getting help from neighbors," "behaving oneself right in life," "learning Hangul," "living by working," "living freely," "living by missing," and "controlling the impulse to end life," "resorting to religion." The deaf elderly made the most alienated and vulnerable group with no access to benefits due to their limitations as a linguistic and social minority, but they made efforts to form their own culture and adjust to reality for themselves. Based on those findings, the study made the following proposals: first, there is a need for practical approaches to heal the ineffaceable wounds in the hearts of deaf elderly. Second, there is a need for policies to help them experience no inconvenience and disadvantages as members of community and communicate with people with normal hearing. Third, there should be practical approaches to enable them to get recognition and support from their families and share love with them. Finally, there should be practical policy approaches to help people with normal hearing understand the culture of deaf elderly and assist the deaf elderly to receive supports from the community and live with others within the community.