• 한국노년학
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• v.32 no.4
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• pp.993-1011
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• 2012

The purpose of this study is to investigate the factors associated with the incidence and the transition of disability among Korean older adults. Samples consist of 1,454(42.7%) men and 2,032(58.3%) women aged 65 and over who participated in the 1st and 2nd wave of the Korea Longitudinal Study of Aging: KLOSA. To estimate the level of disability, ADL and IADL disability indexes are used. As the results, major risk factors for ADL/IADL disability incidence include injury, vision problem, cognitive function, depression, health behavior, socioeconomic characteristics and age. Among the normal older adults, the odds ratio of having dementia symptoms at 2nd wave(2008) are 2.0 times greater for the older adults who have less cognitive function than those who don't have at 1st wave(2006). Among the older adults with chronic diseases, the odds ratio of having disability at 2nd wave are 1.8 times greater for the older persons who have depression than those who don't have at 1st wave. Secondly, concerning the predictors affecting the disability transition among the disabled older adults at 1st wave, the likelihood of remaining at the same level or deteriorating the level of IADL disability, as compared with improving the level, is associated with having less instrumental support or being older. These results indicate that it is necessary to prefer multilevel intervention in order not only to prevent the incidence of disability, but also to prolong the deterioration of disability in the older adults.

• Biomedical Science Letters
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• v.25 no.3
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• pp.218-226
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• 2019

In old age, measures to cope with the natural phenomenon of aging and various diseases of the elderly due to the deterioration of physical function are also a challenge for this society. While interest in systematic health is increasing, it is true that awareness and interest in oral-related diseases is relatively lacking. This study aims to present basic data necessary to improve the quality of life for senior citizens aged 65 or older by improving the oral dryness caused by systemic health. By research method, improve oral dryness caused by whole-body health with the elderly over 65 and promote their oral health, inducing the increase of the salivary flow rate through oral health care education, oral exercise, and salivary gland massage. First, on the DMSQ according to the general characteristics of the elderly, the recognition of the whole body and oral health status, independent sample t-test and One-way ANOVA were conducted. Second, on changes in the salivary flow rate and saliva pH according to the general characteristics of the elderly, recognition of oral and whole-body health status, and whole-body health, paired samples t-test was conducted. Studies have shown that salivary gland flow increased significantly after oral exercise and salivary gland massage, the salivary flow rate significantly increased. In all variables of the recognition of the oral health status, the salivary flow rate increased after oral exercise and salivary gland massage, and in the whole-body health, regardless of hypertension, diabetes, cardiovascular disorders, and osteoporosis, the salivary flow rate increased after oral exercise and salivary gland massage, and the salivary flow rate increased after oral exercise and salivary gland massage if the subjects responded that they did not have thyroid abnormality, anemia, abnormalities of breathing, hypotension, gastrointestinal disturbance, or kidney diseases. As a comprehensive analysis of this study, many felt oral dryness when they had a problem with the whole-body health, and many felt oral dryness when they had a problem with oral health cognition. After applying oral exercise and salivary gland massage as intervention methods in the oral health care for the elderly, the salivary flow rate significantly increased, and it is judged that the methods were very effective for controlling oral dryness. Furthermore, it is judged that the factors affecting oral health, whole-body health, and oral dryness would be identified, which would be helpful for the promotion of whole-body health and oral health. It is judged that continuous research would be needed so that measures for the application of the oral care program and system for the elderly would be prepared in the future.

• Korean Journal of Social Welfare Studies
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• v.44 no.2
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• pp.327-358
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• 2013

This study aimed to analyze the trajectories of cognitive function and functional disability, and to identify the impacts of socio-demographic factors on the two variables. Based on the assumption that there are differences according to the progress of cognitive impairment, it focused on examining the differences in trajectories of cognitive function and functional disability between two groups: dementia conversion group and dementia non-conversion group among cognitively normal older adults. This study was conducted based on the data from a 3-wave panel study of a sample of 966 Yeoncheon elderly cohort aged 65 and over between 1997 and 2003. Latent growth curve model and multi-group structural equation modeling were used to examine the hypothesis. Results revealed that dementia conversion group exhibited faster rate of cognitive decline as well as lower initial cognitive level. Difference between two groups was not significant in the initial level of functional disability, yet dementia conversion group showed greater degree of deterioration in the functional disability over time than dementia non-conversion group did. In terms of the influence of socio-demographic factors on cognitive function and functional disability, the cognitive decline was more drastic in the female group, whereas functional decline was more apparent for the male group. The level of education in early life had a strong impact on the cognitive function in later life. Based on these findings, practical implication for high risk groups in cognitive function and functional disability were discussed.

• Journal of dental hygiene science
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• v.13 no.1
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• pp.62-70
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• 2013

The aim of this study was to analyze factors related to xerostomia in adults aged 30 years and over. The data were analyzed using the t-test, one-way ANOVA and multiple linear regression analysis in the SPSS version 12.0 program. The results were as follow. 1. The respondents who were older than 51 years old, unemployed and had less than 3 million won of average monthly income were more aware of xerostomia (p<0.05). 2. The respondents who answered poor and moderate for their general and oral health and the group with duplicate medication and comorbidity were more aware of xerostomia (p<0.05). 3. The respondents that had problems in chewing, communication, ordinary activities and complained of pain discomfort and suffered from anxiety depression were more aware of xerostomia (p<0.001). 4. The respondents that answered frequent dryness on their skin, eyes, lips, and nasal mucosa were more aware of xerostomia (p<0.001). 5. Xerostomia showed highest correlation with quality of life ($\beta$=0.436) followed by the number of medications ($\beta$=0.239), sense of entire body dryness ($\beta$=0.200), feeling of hopelessness ($\beta$=0.160) and number of oral mucosa disease symptoms ($\beta$=0.099) (p<0.05). According to the results of the study, xerostomia may cause deterioration in quality of life. Thus, it is advised to improve the patient management system among dental professions to prevent various complications caused by xerostomia and conduct regular health education on the cause and management method of xerostomia.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.31-39
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• 2016

Purpose: The aim of this study was to investigate the prognostic factors for Pneumocystis jirovecii pneumonia (PCP) and to evaluate the influence of PCP prophylaxis in pediatric patients. Methods: From January 2002 to April 2015, patients aged <18 years with a diagnosis of confirmed PCP at our institute were reviewed retrospectively. Clinical characteristics and outcomes were compared according to the groups with or without PCP prophylaxis. Risk factors associated with PCP-related death were analyzed by logistic regression analysis. Results: During study period, a total of 24 patients were diagnosed with PCP by immunofluorescence assay and/or PCR. The median age of the patients was 5 years (range, 3 months-18 years) and 23 (96%) had immunocompromised conditions including hematologic disorders with or without hematopoietic stem cell transplantation (n=15), solid organ transplantation (n=4), and primary immune deficiency (n=4). Most common presenting symptoms were tachypnea and cough (92%, each). At the time of diagnosis, 79% (19/24) and 25% (6/24) suffered from respiratory failure and multi-organ dysfunction syndrome (MODS), respectively. Mechanical ventilation was required in 8 (33%) patients and 5 (21%) patients died of PCP. Multivariate analysis showed that MODS at initial presentation was an indicator of poor prognosis (OR, 17.1 [95% CI 1.13-257.67]; P=0.04). Compared to the patients without PCP prophylaxis, the frequency of MODS at diagnosis, need for mechanical ventilation and length of hospital days were significantly less common in the children who received PCP prophylaxis. Conclusions: MODS at presentation was a significant predictor for poor outcome and PCP prophylaxis could alleviate the clinical courses of pediatric PCP. Prospective study will be mandatory to determine the risk factors for development and deterioration of PCP in children.

• Proceedings of the Korean Journal of Food and Nutrition Conference
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• 2001.12a
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• pp.39-74
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• 2001

The endeavors enhancing the grain quality of high-yielding japonica rice were steadily continued during 1980s∼1990s along with the self-sufficiency of rice production and the increasing demands of high-quality rices. During this time, considerably great, progress and success was obtained in development of high-quality japonica cultivars and qualify evaluation techniques including the elucidation of interrelationship between the physicochemical properties of rice grain and the physical or palatability components of cooked rice. In 1990s, some high-quality japonica rice caltivars and special rices adaptable for food processing such as large kernel, chalky endosperm aromatic and colored rices were developed and its objective preference and utility was also examined by a palatability meter, rapid-visco analyzer and texture analyzer. The water uptake rate and the maximum water absorption ratio showed significantly negative correlations with the K/Mg ratio and alkali digestion value(ADV) of milled rice. The rice materials showing the higher amount of hot water absorption exhibited the larger volume expansion of cooked rice. The harder rices with lower moisture content revealed the higher rate of water uptake at twenty minutes after soaking and the higher ratio of maximum water uptake under the room temperature condition. These water uptake characteristics were not associated with the protein and amylose contents of milled rice and the palatability of cooked rice. The water/rice ratio (in w/w basis) for optimum cooking was averaged to 1.52 in dry milled rices (12% wet basis) with varietal range from 1.45 to 1.61 and the expansion ratio of milled rice after proper boiling was average to 2.63(in v/v basis). The major physicochemical components of rice grain associated with the palatability of cooked rice were examined using japonica rice materials showing narrow varietal variation in grain size and shape, alkali digestibility, gel consistency, amylose and protein contents, but considerable difference in appearance and torture of cooked rice. The glossiness or gross palatability score of cooked rice were closely associated with the peak. hot paste and consistency viscosities of viscogram with year difference. The high-quality rice variety “Ilpumbyeo” showed less portion of amylose on the outer layer of milled rice grain and less and slower change in iodine blue value of extracted paste during twenty minutes of boiling. This highly palatable rice also exhibited very fine net structure in outer layer and fine-spongy and well-swollen shape of gelatinized starch granules in inner layer and core of cooked rice kernel compared with the poor palatable rice through image of scanning electronic mcroscope. Gross sensory score of cooked rice could be estimated by multiple linear regression formula, deduced from relationship between rice quality components mentioned above and eating quality of cooked rice, with high Probability of determination. The ${\alpha}$ -amylose-iodine method was adopted for checking the varietal difference in retrogradation of cooked rice. The rice cultivars revealing the relatively slow retrogradation in aged cooked rice were Ilpumbyeo, Chucheongbyeo, Sasanishiki, Jinbubyeo and Koshihikari. A Tongil-type rice, Taebaegbyeo, and a japonica cultivar, Seomjinbyeo, shelved the relatively fast deterioration of cooked rice. Generally, the better rice cultivars in eating quality of cooked rice showed less retrogiadation and much sponginess in cooled cooked rice. Also, the rice varieties exhibiting less retrogradation in cooled cooked rice revealed higher hot viscosity and lower cool viscosity of rice flour in amylogram. The sponginess of cooled cooked rice was closely associated with magnesium content and volume expansion of cooked rice. The hardness-changed ratio of cooked rice by cooling was negatively correlated with solids amount extracted during boiling and volume expansion of cooked rice. The major physicochemical properties of rice grain closely related to the palatability of cooked rice may be directly or indirectly associated with the retrogradation characteristics of cooked rice. The softer gel consistency and lower amylose content in milled rice revealed the higher ratio of popped rice and larger bulk density of popping. The stronger hardness of rice grain showed relatively higher ratio of popping and the more chalky or less translucent rice exhibited the lower ratio of intact popped brown rice. The potassium and magnesium contents of milled rice were negatively associated with gross score of noodle making mixed with wheat flour in half and the better rice for noodle making revealed relatively less amount of solid extraction during boiling. The more volume expansion of batters for making brown rice bread resulted the better loaf formation and more springiness in rice bread. The higher protein rices produced relatively the more moist white rice bread. The springiness of rice bread was also significantly correlated with high amylose content and hard gel consistency. The completely chalky and large gram rices showed better suitability for fermentation and brewing. Our breeding efforts on rice quality improvement for the future should focus on enhancement of palatability of cooked rice and marketing qualify as well as the diversification in morphological and physicochemical characteristics of rice grain for various value-added rice food processings.

• Health Policy and Management
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• v.34 no.3
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• pp.334-346
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• 2024

Background: Research on the link between subjective health and unmet healthcare needs is limited. This study examines whether experiences of subjective healthcare needs and unmet needs are related to subjective health in South Korea, where the rate of poor subjective health is notably high. Methods: This analysis utilized data from the Korea Health Panel (2014-2018), incorporating 68,930 observations from 16,535 adults aged 19 or older. The dependent variable, subjective health, was dichotomized into poor (bad or very bad) and non-poor (fair, good, or very good) categories. The primary variables of interest were the experiences of subjective healthcare needs and unmet needs, while control variables included 14 socio-demographic, health, and functional characteristics. The study employed population proportion analysis and multivariable two-level binary logistic regression analysis for each gender, accounting for the complex sampling design. Results: In 2018, the rate of reporting poor health was 8.7% (95% confidence interval [CI], 8.0%-9.5%) for men and 14.7% (95% CI, 13.8%-15.6%) for women. For both genders, compared to individuals whose healthcare needs were met, those without healthcare needs were less likely to report poor subjective health (adjusted odds ratio [AOR], 0.58; 95% CI, 0.39-0.86 for men; AOR, 0.59; 95% CI, 0.37-0.93 for women). Conversely, individuals whose healthcare needs were not met were more likely to report poor subjective health (AOR, 2.31; 95% CI, 2.01-2.65 for men; AOR, 2.19; 95% CI, 1.98-2.43 for women). A policy simulation indicated that reducing the experience of subjective healthcare needs would be approximately 5 times more effective in reducing poor subjective health than a policy focused on reducing the experience of unmet needs. Conclusion: South Korea must make significant efforts to reduce the deterioration of subjective health and promote appropriate healthcare utilization. To achieve this, a set of policies is recommended to address subjective healthcare needs. These policies should include (1) prompting individuals to proactively manage their own health, (2) providing primary healthcare similar to that in advanced countries, (3) ensuring the healthcare delivery system operates effectively, (4) decentralizing the healthcare management system, and (5) reducing the likelihood of people being misled into thinking they have a healthcare need.

• KDI Journal of Economic Policy
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• v.12 no.3
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• pp.27-45
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• 1990

Two opposing views prevail regarding the economic impact of rural out-migration on the rural areas of origin. The optimistic neoclassical view argues that rapid rural out-migration is not detrimental to the income and welfare of the rural areas of origin, whereas Lipton (1980) argues the opposite. We developed our own alternative model for rural to urban migration, appropriate for rapidly developing economies such as Korea's. This model, which adopts international trade theories of nontraded goods and Dutch Disease to rural to urban migration issues, argues that rural to urban migration is caused mainly by two factors: first, the unprofitability of farming, and second, the decrease in demand for rural nontraded goods and the increase in demand for urban nontraded goods. The unprofitability of farming is caused by the increase in rural wages, which is induced by increasing urban wages in booming urban manufacturing sectors, and by the fact that the cost increases in farming cannot be shifted to consumers, because farm prices are fixed worldwide and because the income demand elasticity for farm products is very low. The demand for nontraded goods decreases in rural and increases in urban areas because population density and income in urban areas increase sharply, while those in rural areas decrease sharply, due to rapid rural to urban migration. Given that the market structure for nontraded goods-namely, service sectors including educational and health facilities-is mostly in monopolistically competitive, and that the demand for nontraded goods comes only from local sources, the urban service sector enjoys economies of scale, and can thus offer services at cheaper prices and in greater variety, whereas the rural service sector cannot enjoy the advantages offered by scale economies. Our view concerning the economic impact of rural to urban migration on rural areas of origin agrees with Lipton's pessimistic view that rural out-migration is detrimental to the income and welfare of rural areas. However, our reasons for the reduction of rural income are different from those in Lipton's model. Lipton argued that rural income and welfare deteriorate mainly because of a shortage of human capital, younger workers and talent resulting from selective rural out-migration. Instead, we believe that rural income declines, first, because a rapid rural-urban migration creates a further shortage of farm labor supplies and increases rural wages, and thus reduces further the profitability of farming and, second, because a rapid rural-urban migration causes a further decline of the rural service sectors. Empirical tests of our major hypotheses using Korean census data from 1966, 1970, 1975, 1980 and 1985 support our own model much more than the neoclassical or Lipton's models. A kun (county) with a large out-migration had a smaller proportion of younger working aged people in the population, and a smaller proportion of highly educated workers. But the productivity of farm workers, measured in terms of fall crops (rice) purchased by the government per farmer or per hectare of irrigated land, did not decline despite the loss of these youths and of human capital. The kun having had a large out-migration had a larger proportion of the population in the farm sector and a smaller proportion in the service sector. The kun having had a large out-migration also had a lower income measured in terms of the proportion of households receiving welfare payments or the amount of provincial taxes paid per household. The lower incomes of these kuns might explain why the kuns that experienced a large out-migration had difficulty in mechanizing farming. Our policy suggestions based on the tests of the currently prevailing hypotheses are as follows: 1) The main cause of farming difficulties is not a lack of human capital, but the in­crease in production costs due to rural wage increases combined with depressed farm output prices. Therefore, a more effective way of helping farm economies is by increasing farm output prices. However, we are not sure whether an increase in farm output prices is desirable in terms of efficiency. 2) It might be worthwhile to attempt to increase the size of farmland holdings per farm household so that the mechanization of farming can be achieved more easily. 3) A kun with large out-migration suffers a deterioration in income and welfare. Therefore, the government should provide a form of subsidization similar to the adjustment assistance provided for international trade. This assistance should not be related to the level of farm output. Otherwise, there is a possibility that we might encourage farm production which would not be profitable in the absence of subsidies. 4) Government intervention in agricultural research and its dissemination, and large-scale social overhead projects in rural areas, carried out by the Korean government, might be desirable from both efficiency and equity points of view. Government interventions in research are justified because of the problems associated with the appropriation of knowledge, and government actions on large-scale projects are justified because they required collective action.

• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.752-759
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• 2000

Background : Many studies have shown that pulmonary function differs widely among race, age and geographical residency. By virtue of the improvement of nutrition and environment, the elderly population in Korea is markedly increasing and so are the ages of patients complaining respiratory symptoms. However, we do not have our own data on the pulmonary functional reserve of elderly persons in Korea. We evaluate the deterioration of pulmonary functional reserve and standardize the predictive values of pulmonary function in the elderly population. Method : Pulmonary function tests were conducted in 100 men and 100 women over the age of 65. We analyzed changes of FVC and $FEV_1$ according to age and height by linear regression. We compared our new multiple linear regression equation with other equations currently used in Korea. Results : In men, the mean age was $71.5{\pm}5.2$(mean${\pm}$SD) years and the mean height was $163.6{\pm}6.2$cm. The mean FVC was $3.42{\pm}0.49{\ell}$ and the mean $FEV_1, $2.72{\pm}v$. In women, the mean age was $72.0{\pm}5.1$ years and the mean height was $149.1{\pm}5.9$cm. The mean FVC was $2.22{\pm}0.42{\ell}$ and the mean $FEV_1$ $1.83{\pm}0.34{\ell}$. Multiple linear regression equation using age and height as an independent factors was as follows : FVC(${\ell}$)=1.857-0.0356$\times$age(year)+0.02517$\times$height(cm) (p<0.01, $R^2$=0.279), $FEV_1(${\ell}$)=1.340-0.02698$\times$age(year)+0.02021$\times$height(cm) (p<0.01, $R^2$=0.255) in men, FVC(${\ell}$) =-0.09765-0.03332$\times$age(year)+0.03164$\times$height(cm) (p<0.01, $R^2$=0.435), $FEV_1(${\ell}$)=-0.l69-0.02469$\times$age(year)+0.02539$\times$height(cm) (p<0.01, $R^2$=0.41) in women. Conclusion : We established prediction regressions for pulmonary functional tests in the elderly Korean population. We also confirmed that currently adopted equations do not exactly anticipate the expected pulmonary functional reserve in the aged person over 65 years old. We suggest that our new equations from this study should be applied to interpret the pulmonary function tests in the elderly population in Korea.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.47
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• pp.15-32
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• 2002

The endeavors enhancing the grain quality of high-yielding japonica rice were steadily continued during 1980s-1990s along with the self-sufficiency of rice production and the increasing demands of high-quality rices. During this time, considerably great progress and success was obtained in development of high-quality japonica cultivars and quality evaluation techniques including the elucidation of interrelationship between the physicochemical properties of rice grain and the physical or palatability components of cooked rice. In 1990s, some high-quality japonica rice cultivars and special rices adaptable for food processing such as large kernel, chalky endosperm, aromatic and colored rices were developed and its objective preference and utility was also examined by a palatability meter, rapid-visco analyzer and texture analyzer, Recently, new special rices such as extremely low-amylose dull or opaque non-glutinous endosperm mutants were developed. Also, a high-lysine rice variety was developed for higher nutritional utility. The water uptake rate and the maximum water absorption ratio showed significantly negative correlations with the K/Mg ratio and alkali digestion value(ADV) of milled rice. The rice materials showing the higher amount of hot water absorption exhibited the larger volume expansion of cooked rice. The harder rices with lower moisture content revealed the higher rate of water uptake at twenty minutes after soaking and the higher ratio of maximum water uptake under the room temperature condition. These water uptake characteristics were not associated with the protein and amylose contents of milled rice and the palatability of cooked rice. The water/rice ratio (in w/w basis) for optimum cooking was averaged to 1.52 in dry milled rices (12% wet basis) with varietal range from 1.45 to 1.61 and the expansion ratio of milled rice after proper boiling was average to 2.63(in v/v basis). The major physicochemical components of rice grain associated with the palatability of cooked rice were examined using japonica rice materials showing narrow varietal variation in grain size and shape, alkali digestibility, gel consistency, amylose and protein contents, but considerable difference in appearance and texture of cooked rice. The glossiness or gross palatability score of cooked rice were closely associated with the peak, hot paste and consistency viscosities of viscosities with year difference. The high-quality rice variety "IIpumbyeo" showed less portion of amylose on the outer layer of milled rice grain and less and slower change in iodine blue value of extracted paste during twenty minutes of boiling. This highly palatable rice also exhibited very fine net structure in outer layer and fine-spongy and well-swollen shape of gelatinized starch granules in inner layer and core of cooked rice kernel compared with the poor palatable rice through image of scanning electronic microscope. Gross sensory score of cooked rice could be estimated by multiple linear regression formula, deduced from relationship between rice quality components mentioned above and eating quality of cooked rice, with high probability of determination. The $\alpha$-amylose-iodine method was adopted for checking the varietal difference in retrogradation of cooked rice. The rice cultivars revealing the relatively slow retrogradation in aged cooked rice were IIpumbyeo, Chucheongyeo, Sasanishiki, Jinbubyeo and Koshihikari. A Tonsil-type rice, Taebaegbyeo, and a japonica cultivar, Seomjinbyeo, showed the relatively fast deterioration of cooked rice. Generally, the better rice cultivars in eating quality of cooked rice showed less retrogradation and much sponginess in cooled cooked rice. Also, the rice varieties exhibiting less retrogradation in cooled cooked rice revealed higher hot viscosity and lower cool viscosity of rice flour in amylogram. The sponginess of cooled cooked rice was closely associated with magnesium content and volume expansion of cooked rice. The hardness-changed ratio of cooked rice by cooling was negatively correlated with solids amount extracted during boiling and volume expansion of cooked rice. The major physicochemical properties of rice grain closely related to the palatability of cooked rice may be directly or indirectly associated with the retrogradation characteristics of cooked rice. The softer gel consistency and lower amylose content in milled rice revealed the higher ratio of popped rice and larger bulk density of popping. The stronger hardness of rice grain showed relatively higher ratio of popping and the more chalky or less translucent rice exhibited the lower ratio of intact popped brown rice. The potassium and magnesium contents of milled rice were negatively associated with gross score of noodle making mixed with wheat flour in half and the better rice for noodle making revealed relatively less amount of solid extraction during boiling. The more volume expansion of batters for making brown rice bread resulted the better loaf formation and more springiness in rice breed. The higher protein rices produced relatively the more moist white rice bread. The springiness of rice bread was also significantly correlated with high amylose content and hard gel consistency. The completely chalky and large grain rices showed better suitability far fermentation and brewing. The glutinous rice were classified into nine different varietal groups based on various physicochemical and structural characteristics of endosperm. There was some close associations among these grain properties and large varietal difference in suitability to various traditional food processing. Our breeding efforts on improvement of rice quality for high palatability and processing utility or value-adding products in the future should focus on not only continuous enhancement of marketing and eating qualities but also the diversification in morphological, physicochemical and nutritional characteristics of rice grain suitable for processing various value-added rice foods.ice foods.