• 한국임상약학회지
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• 제28권3호
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• pp.174-180
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• 2018

Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

• 대한족부족관절학회지
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• 제10권1호
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• pp.71-75
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• 2006

Purpose: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular tongue type fracture of calcaneus, especially in elderly patient or patients with underlying disease including diabetes mellitus. Materials and Methods: Seven cases with intra-articular tongue type fracture of calcaneus, from November 2003 to February 2005, were reviewed. There were 6 males and 1 female with 65 years old mean age (range: $61{\sim}71$ years old). The average follow-up period was 16 months (range: $10{\sim}25$ months). Two Steinmann pins were used for closed reduction. After closed reduction was done like Essex-Lopresti's method, two Acutrak screws were inserted. The third Acutrak screw was inserted at the sustentaculum tali away from sinus tarsi to fix the primary fracture line. The patients were evaluated with Salama scale, the extent of recovery of Bohler angle, state of subtalar joint. Results: Clinical results according Salama scale were excellent in 5 cases, and good in 2 cases. Average preoperative Bohler angle was $13^{\circ}$ (range: $12{\sim}15^{\circ}$). Average postoperative Bohler angle was 31o (range: $23^{\circ}-40^{\circ}$). There were no soft tissue complications. There were two mild subtalar arthritis. Conclusions: We think that percutaneous Acutrak screw fixation is a good option for tongue type fracture of calcaneus in elderly patient or patients with underlying disease including diabetes mellitus.

• 한국융합학회논문지
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• 제11권2호
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• pp.69-73
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• 2020

본 연구는 65세 이상 노인 중 당뇨병 진단을 받은 자를 대상으로 당뇨병과 구강건강과의 관련성 및 구강관리 실태를 분석하여 당뇨 환자를 위한 구강제품개발에 필요한 기초자료를 마련하고자 하였다. D시의 노인복지관을 방문한 당뇨병 진단을 받은 65세 이상 노인 8명을 연구대상자로 하여 4명을 한 그룹으로 하고 그룹 당 약 40분의 면담을 진행하였다. 연구결과 '당뇨와 구강건강', '구강 내 불편감', '구강관리방법', '치과방문', '구강관리를 위한 요구'의 5개의 핵심 주제가 도출되었다. 연구대상자의 대부분이 당뇨와 구강건강의 관련성에 대하여는 처음 들어본다고 대답하였고, 구강건강관리는 하루 3~4회 치약을 사용하여 잇솔질을 하고, 치과방문은 구강에 문제가 생겼을 때만 방문한다고 대답하였다. 구강관리에 필요하다고 생각하는 부분은 당뇨환자 맞춤 구강관리교육과 치약 등 다양한 관리제품들이 개발되었으면 좋을 것 같다고 대답하였다. 본 연구결과를 볼 때 향후 노인 당뇨 환자의 맞춤형 구강건강관리 프로그램개발 및 구강제품개발이 필요할 것으로 생각된다.

• 기본간호학회지
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• 제16권4호
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• pp.481-489
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• 2009

Purpose: The purpose of this study was to identify health promoting lifestyle patterns (HPLP) and health perception (HP), and related factors, in elderly people using welfare service centers. Methods: Three hundred elders were interviewed using a structured questionnaire through convenience sampling at two welfare centers. Data were analyzed using the SPSS WIN 12.0 program. Results: Most of the elders had some kind of diseases, such as hypertension, diabetes, or osteoarthritis. The mean HPLP score was 2.53, and significant differences were found according to the elders' general characteristics. The sub-domain nutrition had the highest mean score, and stress management and exercise, the lowest. The mean HP score was 3.38, and significant differences were found according to education level and number of underlying diseases. HPLP showed a correlation with HP. Conclusion: The results indicate that elders have poor practices in stress management and exercise reflecting need for community based stress management programs for welfare service centers elderly clients.

• 한국인공지능학회지
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• 제12권3호
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• pp.25-31
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• 2024

The purpose of this study is to develop a sophisticated web-based artificial intelligence chatbot system designed to provide personalized dietary service for diabetic patients. According to a 2022 study, the prevalence of diabetes among individuals over 30 years old was 15.6% in 2020, identifying it as a significant societal issue with an increasing patient population. This study uses generative AI algorithms to tailor dietary recommendations for the elderly and various social classes, contributing to the maintenance of healthy eating habits and disease prevention. Through meticulous fine-tuning, the learning loss of the AI model was significantly reduced, nearing zero, demonstrating the chatbot's potential to offer precise dietary suggestions based on calorie intake and seasonal variations. As this technology adapts to diverse health conditions, ongoing research is crucial to enhance the accessibility of dietary information for the elderly, thereby promoting healthy eating practices and supporting disease prevention.

• 한국직업건강간호학회지
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• 제26권4호
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• pp.247-260
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• 2017

Purpose: The purpose of this study was to investigate the individual and working environment-related factors affecting hypertension among middle-aged and elderly self-employed workers in South Korea. Methods: This was a secondary data analysis of data from the Korean Longitudinal Study of Aging (KLoSA). The study sample included 1,319 middle-aged and elderly self-employed workers who were diagnosed without hypertension and older than 45 years at Wave 1 of the KLoSA. Data were analyzed using descriptive statistics and Cox proportional hazards regression analysis using SPSS 20.0. Results: About 20% of the middle-aged and elderly self-employed workers were diagnosed with hypertension within about 8 years from the baseline. the significant predictors of hypertension among the participants were age, diabetes mellitus, body mass index, frequency of health examinations, working hours per week, the presence of regular day off, and the type of job. Conclusion: Middle-aged and elderly self-employed workers are vulnerable to work-related health problems. In order to prevent hypertension among self-employed workers, it is necessary to improve the work environment-related factors as well as individual life styles.

• 한국식품영양학회지
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• 제27권5호
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• pp.872-880
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• 2014

본 연구의 조사대상자인 경기 북부(의정부, 양주, 동두천)에 거주하는 노인을 성별을 기준으로 구분하여 노인의 급식 서비스 이용 현황 및 만족도를 조사하였다. 일반적 특성을 보면, 평균 연령은 76.7세이며, 남성과 여성이 각각 35.7, 64.3%, 배우자 사별은 남자노인은 46.9%, 여자노인은 85.0%로 나타났다. 학력은 중학교졸 이하가 전체의 88.1%로 대다수를 차지하였고, 과거 직업은 대부분 무직(33.6%)이거나 자영업(13.4%)에 종사하였다. 남자노인과 여자노인 각각 78.1, 79.2%로 비교적 자유로운 일상 활동이 가능하였고, 건강정보 출처는 남자노인과 여자노인 각각 건강전문가(49.0, 45.7%), 대중매체(34.4, 33.5%)의 순이었고, 건강정보 출처 신뢰도 역시 남자노인과 여자노인 각각 건강전문가(65.6, 59.8%), 대중매체(19.5, 20.8%)의 순이었다. 운동 횟수는 남자노인은 '1주일에 1~2회'(43.8%), '매일'(21.9%)의 순이었으나, 여자노인은 '거의 하지 않는다'가 63.0%로 가장 많다고 응답하여 성별에 따른 차이를 보였다. 노인들이 현재 앓고 있는 질환은 남자노인은 '고혈압'(27.1%), '당뇨병'(21.9%), '뇌졸중'(19.8%)의 순이었고, 여자노인은 '고혈압'(32.4%), '당뇨병'(24.9%), '관절염'(15.0%)의 순으로 응답하였다. 급식서비스를 이용하는 이유로는 남자노인은 '혼자 차려먹기 귀찮아서'(28.1%), '친구를 만날 수 있어서'(25.0%), '경제적인 이유'(14.6%)의 순이었으나, 여자노인은 '경제적인 이유'(25.4%), '친구를 만날 수 있어서'(23.1%), '혼자 차려먹기 귀찮아서'(23.1%)의 순으로 응답하였다. 노인의 복지시설 급식서비스의 시행을 알게 된 경위는 남자노인과 여자노인 각각 전체의 36.5, 68.8%가 '집 가까이 있어서' 자연스럽게 알게 되었고, 30.2, 8.7%가 '가족의 소개로 알게 되었다고 응답하였으며, 남자노인과 여자노인의 65.6, 43.4%가 질환별 급식서비스가 '필요하다'고 응답하였다. 남자노인과 여자노인 각각 전체의 56.3, 72.3%, 52.1, 86.7%, 53.1, 89.6%가 급식의 맛, 위생 상태, 온도가 '만족한다'고 응답하여, 특히 여자노인의 만족도가 남자보인보다 훨씬 더 높다는 것을 알 수 있었다. 복지 시설 만족도는 남자노인과 여자노인 각각 전체의 78.1, 69.9%가 '만족한다'고 응답하였고, 이들 중 만족한다고 응답한 노인들을 대상으로 조사한 만족 이유로는 남자노인과 여자노인 각각 '식사를 제공하여서'(28.0, 37.2%), '노인들과 어울려 노는 것이 좋아서'(20.0, 22.3%), '시설이 좋아서'(18.7, 18.2%)의 순으로 응답하였다. 시설종사자 만족도는 '기타 및 무응답'이 남자노인과 여자노인 각각 49.3, 67.8%이었으며, 남자노인은 '시설 행정직원'(13.3%), '간호사'(9.3%), 여자노인은 '간호사'(12.4%), '시설 행정직원'(8.3%)의 순으로 응답하였다. 이상과 같은 결과들을 토대로 복지 관련 시설을 이용하는 노인들의 급식 및 복지서비스의 향상을 위한 기초자료로 제공 및 활용하고, 향후 경기 북부 실버산업의 활성화를 도모하고자 하였다.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.455-464
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• 2020

Objectives: The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals. Methods: This study used online data on Korean national law to gather information on individual local governments' regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources. Results: The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48). Conclusions: The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

• 대한영양사협회학술지
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• 제28권4호
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• pp.247-266
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• 2022

This study examines the sociodemographic and anthropometric data, health-related and dietary habits, and nutrient intakes according to depression levels in men and women aged over 65 years. A total of 2,938 subjects were analyzed from the 2016~2018 Korean National Health and Examination Survey. Statistical analyses for complex samples were applied using the SPSS software package. Based on the health questionnaire-9, the subjects were applied into two groups. The percentage of depression in women was significantly higher than in men (P<0.001). The factors associated with men's depression were marital status (P<0.05), household income (P<0.001), occupation (P<0.01), and body mass index (P<0.01). Women's depression was found to be significantly associated with household income (P<0.001), education level (P<0.01), basic living allowance (P<0.001), and body weight status (P<0.01). Perceived health status, stress level, quality of life, not feeling very well for the last two weeks, and activity restriction (P<0.001, respectively) were significant health-related habits associated with depression in both sexes. Diabetes (P<0.05) amongst men and hypertriglyceridemia (P<0.01) in women were significant factors associated with depression. Frequency of meals and eating meals together were significant dietary habits associated with depression by sex. Significant associations between improper nutrient intake and depression were also derived for both sexes; 7 nutrients were identified in men and 10 in women. Our results indicate that different factors are associated with depression in the elderly based on sex. Hence, sex-based health promotion programs are required to prevent the onset of depression among the elderly.

• 한국지역사회생활과학회지
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• 제17권3호
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• pp.159-174
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• 2006

The purpose of this study is to provide information searching for health promotion, nutrition improvement, and health care of the impaired elderly by ADL(Activity of Daily Living) and IADL(Instrumental Activity of Daily Living). The subjects were divided into the Assistant Needed Group and No Assistant Needed Group for living in line with the responses of ADL(10 items like dressing, washing, move etc.) and IADL(10 items like housekeeping, using transportation, shopping, Phone call etc.). Survey was made for health behavior, health risk habit, dietary management status and diet intake by 24 hr-recall and questionnaire method. 242 subjects were collected in 12 cities or Gun districts in Gyeonggi Province, S. Korea. Survey was carried out by regional home extension workers using interview method. Statistical analyses were made using SAS (Version 8.1). Chi-Square Tests and General Linear Models. The subjects of impaired ADL elderly was 26.5% and it composed 30% of the total male and 22.2% of the total female. The demographic status of the impaired ADL elderly showed no difference from that of the normal elders, elementary school educated (73.4%), with spouse (43.8%) or with adult children(37.5%), using monthly living cost of 500-1,000 thousand won(35.9%). Mean age was 74.05 years compared to 72.25 years of normal elders. However, there was no significant difference from the normal and impaired ADL group, regular exercise(60.0%), with walking (90.0%), no-smoke(54.7%) and no-drink(48.4%). Kind of disease was not different from the one in impaired and normal group, with cardiovascular disease(32.3%), with diabetes mellitus(8.1%), joint lumbago neuralgia(32.3%) and osteoporosis(9.7%). Gastrointestinal complaints of the impaired ADL group were nausea(57.8%), chronic indigestion (23.4%), constipation (14,0%) and vomiting(3.7%). Sleeping time required for the impaired was longer than that for the normal group by 10hours(4.7%) or 8-10hours(20.3%), which consisted 1.7% and 16.6% respectively. Nutrient intake of the impaired ADL group was low compared to normal range elders: Energy(1260kca1), Protein(52.75g). There was gender difference in nutrient intake; the male impaired group showed no significant difference from the normal group but it was significantly lower in female impaired group. These results suggest that low quality of life and low economic status of the impaired ADL elderly require congregate meal in village hall to cover the lack of side dishe variety. And nutrition education program including community assistance would be required for the impaired ADL elderly together with the sufficient food and exercise practice. By operating nutrition education program, the impaired ADL elderly would maintain more enhanced quality of life and ameliorate the ADL capability.