• Journal of Hospice and Palliative Care
• /
• v.5 no.2
• /
• pp.111-124
• /
• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

• Proceeding of Spring/Autumn Annual Conference of KHA
• /
• 2011.04a
• /
• pp.65-68
• /
• 2011

The average increase in life expectancy obtained as a gift of modern science cannot hold itself responsible for extended life's happiness. It admits of no argument that the necessity of social preparation for minimizing bad health and longevity of unhappiness to aged people who are in the state of these continuous growth. Recently, because of an aging trend, targeting on elderly housing expected continuous increased demand in housing market, this study is to comprehend it's characteristic and offer implications. For the characteristic of elderly housing, firstly it needs scientific analysis of related theory and analysis of statistical data. Also this study aims to look through and suggest an alternative included the special matters of Korean society with advanced foreign country's analysis of an alternative. And judging from economic characteristics of elderly housing to be presented as an important factor, choices of housing according to economic level are anticipated to show different forms. In future, to supply elderly housing, therefore, the introduction of the concept of housing providing various opportunity of choice is necessary. If studies proceed through expanded alternative, it is judged to be able to draw more varied results in elderly housing. Also, if going along with political dimension study, it is expected to offer more specific and effective solutions of the problem of elderly housing.

• Clinical and Experimental Pediatrics
• /
• v.54 no.11
• /
• pp.429-435
• /
• 2011

Although Korean population has been growing steadily during the past four decades, the nation is rapidly becoming an aging society because of its declining birth rate combined with an increasing life expectancy. In addition, Korea has one of the lowest fertility rates in the world due to fewer married couples, advanced maternal age, and falling birth rate. The prevalence of low birth weight infants and multiple births has been increased compared with the decrease in the birth rate. Moreover, the number of congenital anomalies is expected to increase due to the advanced maternal age. In addition, the number of interracial children is expected to increase due to the rise in the number of international marriages. However, the maternal education level is high, single-mother birth rate is low, and the gender imbalance has lessened. The number of overweight babies has been decreased, as more pregnant women are receiving adequate prenatal care. Compared to the Asian average birth weight, the average birth weight is the highest in Asia. Moreover, the rate of low birth weight infants is low, and infant mortality is similarly low across Asia. Using birth data from Statistics Korea and studies of birth outcomes in Korea and abroad, this study aimed to assess the changes in maternal and infant characteristics associated with birth outcomes during the past four decades and identify necessary information infrastructures to study countermeasures the decrease in birth rate and increase in low birth weight infants in Korea.

• Journal of Korean Public Health Nursing
• /
• v.31 no.3
• /
• pp.492-504
• /
• 2017

Purpose: This study aims to investigate the effect of employment of elderly over 65 years on elderly depression using the "Nation Elderly Survey 2014". Methods: The subjects were 10,451 elderly aged 65 or older who were selected from 16 cities and provinces via multilevel stratified sampling method. In an effort to represent well the nation's elderly population, composite sample analysis method was used for the study, and a hierarchical logistic regression analysis was performed to identify those factors affecting the depression among the elderly population. Results: The factors affecting the depression were education level, household income, Perceived health status, smoking, drinking, physical activity, body mass index and employment status. It was found that the unemployed persons were 1.68 times more likely to be depressed than those who remain employed. Conclusion: Where the average life expectancy is getting longer and the poverty rate of elderly is high, employment activities of the elderly are of great significance in terms of ensuring economic stability as well as in lowering medical expenses through reduction of depression. Therefore, it is necessary to increase the employment rates of the elderly for economic, social and healthcare perspectives.

• Journal of Community Nutrition
• /
• v.4 no.1
• /
• pp.51-58
• /
• 2002

Eating behavior change as a result of nutrition education interventions as secondary prevention strategies can contribute to an increase in life expectancy and better health for older adults in the United States (U.S.). Many of the chronic conditions prevalent in older adults are modifiable by dietary changes, including heart disease, diabetes mellitus, hypertension, obesity and osteoporosis. Important demographic observations in the U.S. including the projected large increase in number of older adults by 2030 have implications for nutrition education focus and services. A comprehensive review of nutrition education interventions for older adults in the U.S. published in 1995 identified elements from adult education theories that contribute to the effectiveness of nutrition education. These elements have been the focus of more recent studies with older adults providing additional evidence for relationships between concepts from commonly used behavior change theories and dietary patterns or change. In the U.S, an important program contributing to nutritional adequacy of the diet for older adults is the Elderly Nutrition Program which provides resources for congregate dining and includes a mandatory nutrition education component. Nutrition education is also provided through clinic based programs, and print and broadcast media. Application of the Transtheoretical Model has shown that the level of interest or motivation to comply with dietary guidance may be greater for some older adults due to an increasing burden of chronic disease and poorer quality of life, while others may not feel a need to change lifestyle habits.

• Health Policy and Management
• /
• v.26 no.4
• /
• pp.352-358
• /
• 2016

Summary measures of population health (SMPHs) have been used to estimate the burden of diseases. Among various type of SMPHs, disability adjusted life year (DALY) and healthy life expectancy (HALE) have been calculated in the global and national burden of disease studies. In order to calculate DALY and HALE, disability weight is an essential element. Disability weights quantify the level of disability for health states or diseases and have values between 0 (full health) to 1 (being dead). In this study, we reviewed the main disability weights studies and determined their meaning and limitations. Furthermore, we provided the whole process of typical disability weight study and reviewed key issues as follows: health state or disease description development, panel composition, valuation method, validation of disability weight, cross-cultural variability in health state or disease, and so on. The results from this study will be helpful to conduct future disability weight studies for adapting disability weights and developing new methodologies.

• Korea Journal of Hospital Management
• /
• v.15 no.2
• /
• pp.15-26
• /
• 2010

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.

• The Journal of Asian Finance, Economics and Business
• /
• v.7 no.11
• /
• pp.421-428
• /
• 2020

The study investigates the causal factors affecting mobile banking services acceptance by customers in Thailand. This study employs quantitative research methodology and non-probability sampling to draw 400 mobile banking users from the population who are the mobile banking users of commercial banks in Thailand. The online questionnaires were used as a research tool to collect data with the Cronbach's alpha coefficient as 0.931. By using the structural equation model to analyze data, the results have shown that service quality, perceived usefulness, perceived ease-of-use, safety in use, and social factors influenced mobile banking services acceptance by customers in Thailand.By checking the harmony with the statistics χ² = 108.618, df. = 86, χ²/df. = 1.263, p-value = .050, CMIN/DF =1.263, GFI = .989, AGFI=.962, TLI= .962, CFI = .976, RMSEA = .037,along with testing the weight factor. In conclusion, the research model was found to be harmonious with the empirical data at the significance level 0.05. The findings of this study suggest that the commercial banks should apply this research to understand the acceptance behavior of mobile banking users, also to determining marketing strategies, identifying opportunities and creating a competitive advantage for their services in the future.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.17 no.1
• /
• pp.15-22
• /
• 2011

Nowadays, a proportion of healthcare service for the elderly has been improved due to the factors, such as a prolonged life expectancy, a growth of aging population and a change of member of family. For these factors, it is necessary for the elderly to receive treatment for multidisciplinary diseases, associated with psychological care of sociological concept. It is quite difficult in an acute-care hospital to accommodate the elderly patient because of the fact that an acute-care hospital is required to maintain a high level of medical care and technical standard. That is why specialized medical service is needed for the elderly. In the case of Germany, they are at the stage of the change from large scale facilities to specialized facilities applying the integrated concept. This paper addresses the medical environmental factor and distinction of medical facilities for the elderly through survey and analysis relating to all change in Germany. Therefore, it aims to suggest a fundamental resource for architectural planning and network of medical facilities for the elderly.

• Advances in concrete construction
• /
• v.4 no.2
• /
• pp.89-105
• /
• 2016

The post - fire investigation is conducted on a fire-affected reinforced concrete shear wall building to ascertain the level of its strength degradation due to the fire incident. Fire incident took place in a three-storey building made of reinforced concrete shear wall and roof with operating floors made of steel beams and chequered plates. The usage of the building is to handle explosives. Elevated temperature during the fire is estimated to be $350^{\circ}C$ based on visual inspection. Destructive (core extraction) and non-destructive (rebound hammer and ultrasonic pulse velocity) tests are conducted to evaluate the concrete strength. X-ray diffraction (XRD) and Field Emission Scanning Electron Microscopy (FESEM) are used for analyzing micro structural changes of the concrete due to fire. Tests are conducted for concrete walls and roof slab on both burnt and unburnt locations. The analysis of test results reveals no significant degradation of the building after the fire which signifies that the structure can be used with full expectancy of performance for the remaining service life. This document can be used as a reference for future forensic investigations of similar fire affected concrete structures.