• 한국환경보건학회지
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• 제39권1호
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• pp.19-31
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• 2013

Objectives: Elevated temperatures during summer months have been reported since the early 20th century to be associated with increased daily mortality. However, future death impacts of high temperatures resulting from climate change could be variously estimated in consideration of the future changes in historical temperature-mortality relationships, mortality, and population. This study examined the future death burden of high temperatures resulting from climate change in Seoul over the period of 2001-2040. Methods: We calculated yearly death burden attributable to high temperatures stemming from climate change in Seoul from 2001-2040. These future death burdens from high temperature were computed by multiplying relative risk, temperature, mortality, and population at any future point. To incorporate adaptation, we assumed future changes in temperature-mortality relationships (i.e. threshold temperatures and slopes), which were estimated as short-term temperature effects using a Poisson regression model. Results: The results show that climate change will lead to a substantial increase in summer high temperature-related death burden in the future, even considering adaptation by the population group. The yearly death burden attributable to elevated temperatures ranged from approximately 0.7 deaths per 100,000 people in 2001-2010 to about 1.5 deaths per 100,000 people in Seoul in 2036-2040. Conclusions: This study suggests that adaptation strategies and communication regarding future health risks stemming from climate change are necessary for the public and for the political leadership of South Korea.

• 한국환경보건학회지
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• 제38권6호
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• pp.460-471
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• 2012

Objectives: Due to global warming resulting from climate change, there has been increasing interest in the relationship between temperature and mortality. These temperature-related deaths depend on diverse conditions related to a given place and person, as well as on time. This study examined changes in the impact of high temperatures on death in summer, using the effect and burden of elevated temperatures on deaths in Seoul and Daegu. Methods: A Poisson regression model was used to estimate short-term temperature effects on mortality. Temperature-related risks were divided into three time periods of equal length (1996-2000, 2001-2005, and 2006-2010). In addition, in order to compare the impact of high temperatures on deaths, this study calculated the proportion of attributable deaths to population, which simultaneously considers the threshold and the slope above the threshold. Results: The effect and burden of high temperatures on deaths is high in Daegu. However, the impact (i.e. the effect and burden) of elevated summer temperatures on deaths has declined over the past 15 years. Sensitivity analyses using alternative thresholds show the robustness of these findings. Conclusion: This study suggests that the attributable burden of high temperatures on deaths to be more plausible than relative risk or threshold for comparing the health impact of high temperatures across populations. Moreover, these results contain important implications for the development or the adjustment of present and future strategies and policies for controlling the temperature-related health burden on populations.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.519-528
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• 2009

결핵은 아직도 전세계적으로 소아에서 높은 유병률과 사망률을 보이는 질환이다. 아쉽게도 결핵에 대한 새로운 진단법, 치료법, 예방법에 대한 과학적 혹은 임상 연구는 주로 성인에 초점을 맞추어 왔으며 소아 결핵은 상대적으로 등한시되어 왔다. 그러나 특히 소아 결핵은 감염 후 중한 질환으로 진행되기 쉬우며 이는 사망을 초래하기도 한다. 또한 소아청소년기의 잠복결핵 감염은 후일 결핵균의 재활성으로 인하여 미래의 감염원으로 작용한다. 따라서 미래의 결핵 발생을 줄이기 위해서는 잠복결핵 감염에 대한 특징, 진단, 치료에 대해 이해하는 것이 매우 중요한다. 그러나 우리나라의 국가 결핵관리정책에는 이러한 개념들이 완전히 적용되지 않았으므로, 가능한 빨리 포함되고 시행되어져야 한다.

• 한국가족복지학
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• 제56호
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• pp.251-277
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• 2017

이 연구는 최근 탈시설화에 대한 논의가 증가하는 상황에서, 장애자녀를 둔 부모의 시설입소 의향에 대한 미래계획을 탐색하고 이를 통해 시설입소를 예방하는 방안을 논의하고자 한 것이다. 이를 위해 독립변인은 장애자녀, 가족, 사회요인으로 구성하였으며, 종속변인으로서 미래계획은주거지 및 보호자로 구분하여 그 영향을 살펴보았다. 첫째, 장애인의 부모사후 '미래 주거지 계획'에서는 장애인의 의사소통수행능력이 높을수록 미래의 주거지로서 시설입소를 선택할 의향이낮아졌으며, 가족의 긍정성이 높고 양육부담이 낮을수록 부모사후 시설입소 의향이 낮아지는 것으로 나타났다. 둘째, 장애인의 부모 사후 '미래 보호자계획' 또한 장애인의 의사소통수행능력이높을수록, 가족의 긍정성이 높을수록 부모 사후 시설입소에 대한 의향이 낮아지는 것으로 분석되었다. 이를 통해, 장애자녀의 의사소통능력과 가족의 긍정성이 부모사후 시설입소를 결정하는데중요한 요인으로 나타나서, 시설입소를 예방하기 위해서는 이에 대한 지원방안 마련이 필요함을알 수 있었다. 다만, 본 연구에서 사회 요인은 부모 사후 미래계획에 대한 유의도가 낮은 것으로나타났으나, 변수구성 등의 한계로 후속연구의 필요성을 제기하였다. 이러한 결과를 통해 이 연구는 부모 사후, 장애자녀의 주거지 및 보호자에 대한 미래계획의 중요성과 시설입소예방을 위한사회복지적 함의를 논의하고 있다.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.211-219
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• 2020

Objectives: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. Methods: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Results: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Conclusions: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1295-1301
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• 2015

Background: Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. Materials and Methods: The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. Results: In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Conclusions: Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

• 지역사회간호학회지
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• 제23권2호
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• pp.127-133
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• 2012

Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.

• Journal of Gastric Cancer
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• 제24권1호
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• pp.29-56
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• 2024

In recent years, remarkable progress has been made in the molecular profiling of gastric cancer. This progress has led to the development of various molecular classifications to uncover subtype-specific dependencies that can be targeted for therapeutic interventions. Human epidermal growth factor receptor 2 (HER2) is a crucial biomarker for advanced gastric cancer. The recent promising results of novel approaches, including combination therapies or newer potent agents such as antibody-drug conjugates, have once again brought attention to anti-HER2 targeted treatments. In HER2-negative diseases, the combination of cytotoxic chemotherapy and programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors has become the established standard of care in first-line settings. In the context of gastric cancer, potential biomarkers such as PD-L1 expression, Epstein-Barr virus, microsatellite instability, and tumor mutational burden are being considered for immunotherapy. Recently, promising results have been reported in studies on anti-Claudin18.2 and fibroblast growth factor receptor 2 treatments. Currently, many ongoing trials are aimed at identifying potential targets using novel approaches. Further investigations will be conducted to enhance the progress of these therapies, addressing challenges such as primary and acquired resistance, tumor heterogeneity, and clonal evolution. We believe that these efforts will improve patient prognoses. Herein, we discuss the current evidence of potential targets for systemic treatment, clinical considerations, and future perspectives.

• 한국사회복지학
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• 제43권
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• pp.106-130
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• 2000

When parents as primary care takers to the mentally disabled adult are no longer taking care of their care-needed offsprings because of their own death or illness, instead themselves. who take care of their offsprings with the mental disability? Therefore, 'permanency planning' is very important for reduction of parents' care burden and social integration of mentally disabled adults. Accordingly, this study aims to find out factors which are related to permanency planning for adults with the mentally disability For the purpose of the study, 192 parents of the adult with the mental illness and mental retardation were conducted a survey regarding type of permanency planning, and its related factors including social functioning level of the mentally disabled, care burden, parents' self-perception of being aged, help from offspring without mental disability, social support, and financial ability. Furthermore, this study examined correlation between these factors and residential planning. Results obtained by the study were as follows: 1) 51% of the parents are having a plan for institution and most parents want other family member to take care for financial planning for their mentally disabled offsprings. 2) As a result of multiple regression for finding out factors which affect parents' permanency planning, social functioning level of the mentally disabled, parents' self-perception of being aged, help from offspring without mental disability, social support, and financial ability were statistically significant influenced factors, which has 23.3% of explanatory power. 3) As a result of step-wise multiple regression, financial ability, parents' self-perception of being aged, and help from offspring without mental disability were the most powerful influenced factors for permanency planning. 4) In case of having a plan for residential types-which are institution and community living-, parents who have a plan for the mentally disabled offsprings' future residence as community living than institution have the offsprings with more social functioning and also have more help from offspring without mental disability. Therefore, this study concluded that welfare policy for mental health and the handicapped which secure various types of community living facilities and income security is strongly needed. At the same time, mental health profession is needed to have more active interest and intervention for permanency planning for their adult clients and parents.

• 호스피스학술지
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• 제8권1호
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• pp.1-12
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• 2008

목적: 한국과 중국 간호대학생의 죽음의식을 조사하여 죽음교육과정설계에 간호대학생의 특성을 고려한 내용이 반영되도록 기여하고 간호교육 및 임상간호의 질적 향상에 도움이 되는 자료를 제공하고자 하였다. 방법: 본 연구는 2007년 3월19일부터 3월23일 사이에 한국 E대학교 간호대학생 248명과 중국 Y대학교 간호대학생 244명 총 492명을 대상으로 하였으며 측정도구는 Thorson과 Powell(1988)의 죽음의식도구를 박석춘(1992)이 번안하여 사용했던 도구를 이용하였다. 수집된 자료는 SPSS(12.0)통계 프로그램을 이용하여 전산처리 하였으며, 실수, 백분율, 평균, 표준편차는 기술통계 방법을 사용하고, Cronbach Alpha Coefficient, 요인분석, t-test, ANOVA 및 회귀분석 등을 통하여 분석하였다. 결과: 1. 한국 간호대학생은 반수이상(58.5%)이 종교가 있는데 비해 중국 간호대학생은 거의 종교를 가지고 있지 않았다(93.9%). 죽음경험이 한국 간호대학생(66.9%)보다는 중국 간호대학생이 많았다(76.6%). 사후세계유형에서 한국 간호대학생은 '사람이 죽으면 천국이나 지옥중의 한곳으로 간다'고 생각하는 경우가 제일 많았고(27.3%), '사람이 죽으면 어떻게 될 것인지 통 모르겠다'가 2위로 나타났다(22.9%). 중국 간호대학생은 '사람이 죽으면 어떻게 될 것인지 통 모르겠다'가 제일 많고(30.3%), '사람이 죽으면 그것으로 끝이고 사후세계는 존재하지 않는다'가 그 다음으로 많았다(29.5%). 2. 죽음의식은 한국 간호대학생이 평균 2.36점, 중국 간호대학생이 평균 2.50점으로 죽음에 대한 염려, 불안, 두려움이 중간수준이었으며 중국 간호대학생이 한국 간호대학생보다 높았다(t=3.51,p=.000). 3. 한국 간호대학생의 죽음의식은 연령(t=3.20, p=.002), 종교(t=2.56, p=.011), 사후세계(F=4.64, p=.000)에 대한 태도에 따라 유의한 차이가 나타났으며, 죽음의식에 대한 기여도는 사후세계변수가 수량화범위 0.735(p=.000)로 나타났다. 중국 간호대학생의 죽음의식은 모든 변수에서 유의한 차이가 없는 것으로 나타났다. 결론: 본 연구의 결과, 내세에 대한 믿음을 가지고 있는 대상자의 죽음의식이 제일 긍정적이므로 영적간호의 필요성이 강조된다. 한편 중국 간호대학생은 한국 간호대학생보다 죽음을 더 의식하고 죽음에 대한 염려, 불안, 두려움이 더 높게 나타났으므로 간호교육과정의 비교검토를 통해 한국의 죽음교육내용을 참고하고 중국의 정치, 문화와 사회제도에 알맞은 죽음교육을 해야 된다고 하겠다. 죽음의식은 사후세계에 대한 태도가 가장 크게 영향을 미치고 있으므로 이에 대한 지속적인 연구와 교육 및 실무에 적용을 제언한다.