• Health Policy and Management
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• v.34 no.1
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• pp.26-37
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• 2024

Background: The purpose of this study was to compare and analyze the differences in charges and length of stay per case between spine specialty hospitals and non-specialty hospitals, and to identify the factors that influenced them. Methods: This study used claims data from the Health Insurance Review and Assessment Service, including inpatient visits from January 2021 to December 2022. The healthcare facility status data was used to identify the characteristics of study hospitals. Multilevel analysis was conducted to identify factors associated with the charges and Poisson regression analysis was conducted to analyze the length of stay between spine specialty hospitals and non-specialty hospitals. There were 32,015 cases of spine specialty hospitals and 17,555 cases of non-specialty hospitals. Results: For four of five common spinal surgeries, specialty hospitals shaped longer length of stay than those of non-specialty hospitals. Multilevel and Poisson regression analysis revealed that regardless of the type of surgery, higher age and higher Charlson comorbidity index scores were significantly associated with an increase in both the charges per case and length of stay (p<0.05). However, when hospitals were located in metropolitan areas, there was a significant decrease (p<0.05). Conclusion: This study found that specialty hospital had higher inpatient charges and loner length of stay contrary to the previous study results. Further studies will be needed to find which contribute to the differences.

• The Journal of Korean Academy of Sensory Integration
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• v.22 no.1
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• pp.54-68
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• 2024

Purpose : This study aimed to explore the clinical experiences of occupational therapists who have transitioned from adult to child occupational therapy to provide a basis for developing programs to facilitate rapid clinical adjustment for transitioning occupational therapists. Method : Telephone interviews and Colaizzi's phenomenological research method were employed. The interviewees were six occupational therapists with at least three years of clinical experience who had transitioned from hospital-based adult occupational therapy to sensory integration-focused children's occupational therapy. The interviews were recorded, transcribed, and analyzed with the participants' consent. Results : The analysis of the interview transcripts yielded 3 categories, 7 themes, and 17 meanings. The three categories were the challenges facing transitioning occupational therapists in clinical practice, the strengths gained from their post-transition clinical experiences, and the facilitators needed before the transition to ensure quick clinical adjustment. Conclusion : Training and institutional arrangements must be in place to ensure that adult occupational therapists transitioning to sensory integration-focused child occupational therapy can quickly adapt clinically and professionally to their new environments.

• Journal of Food Hygiene and Safety
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• v.39 no.3
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• pp.231-238
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• 2024

Vibrio parahaemolyticus is a major seafood-borne pathogen commonly detected in marine environments. In Korea, V. parahaemolyticus-induced foodborne illnesses account for 7.5% of bacterial pathogen-related food poisonings. Moreover, the amount of antimicrobial agents used in aquatic cultures is continuously increasing. In this study, we isolated V. parahaemolyticus from seafood samples and performed antimicrobial susceptibility tests using the microbroth dilution method. Furthermore, using whole-genome sequencing, we identified antimicrobial resistance genes, virulence genes, and sequence types (STs). We could isolate V. parahaemolyticus from 47 (59.5%) of the 79 seafood samples we purchased from retail markets in Seoul and Chungcheong provinces. Antimicrobial susceptibility tests revealed that 2 and all of the 47 isolates were ampicillin-resistant (4.3%) and susceptible to all tested antimicrobial agents (100%), respectively. The genotype analysis revealed that all isolates carried beta-lactam-, tetracycline-, and chloramphenicol-associated antimicrobial resistance genes. However, we could detect fosfomycin resistance only in one isolate. Concerning the virulence genes, we detected T3SS1 and T3SS2-associated genes in all and one isolate, respectively. However, we could not detect the tdh and trh genes. Of the 47 isolates, 17 belonged to 15 different STs, including ST 658 with 3 isolates. The rest 30 isolates were identified as 25 new STs. The results of this study support the need for operating a continuous monitoring system to prevent foodborne illnesses and the spread of antimicrobial resistance genes in V. parahaemolyticus.

• Science of Emotion and Sensibility
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• v.22 no.1
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• pp.23-34
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• 2019

The U-Healthcare era has evolved with the development of the Internet of things (IoT) in the early stages of being connected as a society. Already, many changes such as increased well-being and the extension of human life are becoming evident across cultures. Korea entered the growing group of aging societies in 2017, and its silver industry is expected to grow rapidly by adopting the IoT of a super-connected society. In particular, the senior shift phenomenon has resulted in increased interest in the promotion of the health and well-being of the emergent silver generation which, unlike the existing silver generation, is highly active and wields great economic power. This study conducted in-depth interviews to investigate the characteristics of the new silver generation, and to develop the design for a wearable serious game that intends to boost the interest of the elderly in exercise and fitness activities according to their personalized physical training regimes as prescribed by the U-Hospital service. The usage scenario of this wearable serious game for the 'U-silver generation' is derived from social necessity. Medical professionals can utilize this technology to conduct health examinations and to monitor the rehabilitation of senior patients. The elderly can also use this tool to request checkups or to interface with their healthcare providers. The wearable serious game is further aimed at mitigating concerns about the deterioration of the physical functions of the silver generation by applying personalized exercise prescriptions. The present investigation revealed that it is necessary to merge the on / off line community activities to meet the silver generation's daily needs for connection and friendship. Further, the sustainability of the serious game must be enhanced through the inculcation of a sense of accomplishment as a player rises through the levels of the game. The proposed wearable serious game is designed specifically for the silver generation that is inexperienced in using digital devices: simple game rules are applied to a familiar interface grounded on the gourmet travels preferred by the target players to increase usability.

• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.75-93
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• 2021

Objective : The aim of this study was to identify subgroups of older adults with respect to their lifestyle patterns and examine the characteristics of each subgroup in order to provide a basic evidence for improving the health and quality of life. Methods : This cross-sectional study was conducted in South Korea. Community-dwelling older adults (n=184) above the age of 65 years were surveyed from April 2019 to May 2019. This study used latent profile analysis to examine the subgroups. Chi-squared (χ²) and multinomial logistic regression measures were then used to analyze individual characteristics and influencing factors. Results : The pattern of physical activity which is one of the lifestyle domains in elderly was categorized into three types: 'passive exercise type (31.1%)', 'low intensity exercise type (54.5%)', and 'balanced exercise type(14.5%)'. Activity participation was divided into three patterns: 'inactive type (12%)', 'self-management type (61%)', and 'balanced activity participation type (27%)'. In terms of nutrition, there were only two groups: 'overall malnutrition type (13.5%)' and 'balanced nutrition type (86.5%)'. Furthermore, as a result of the multinomial logistic regression analysis to understand the effects of lifestyle types on the health and quality of life of the elderly, it was confirmed that the health and quality of life were higher in those following an active and balanced lifestyle. In addition, gender, education level and residential area were analyzed as predictive factors. Conclusion : The health and quality of life of the elderly can be improved when they have balanced lifestyle. Therefore, an empirical and policy intervention strategy should be developed and implemented to enhance the health and quality of life of the elderly.

• Therapeutic Science for Rehabilitation
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• v.12 no.4
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• pp.81-96
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• 2023

Objective : This study aimed to examine the association between the structural and functional aspects of social networks and health-promoting behaviors in community-dwelling older adults. Methods : Social networks based on structural and functional aspects and health-promoting behaviors by lifestyle were measured in 226 community-dwelling adults aged 65 years and over. To analyze the collected data, an independent t-test, one-way ANOVA, Pearson's correlation analysis, and hierarchical regression were performed. Results : The network size was the highest in the friend network, and the frequency of contact and social support was the highest in the non-living family network. Health-promoting behaviors were highest for activities of daily living and lowest for productive and social activities. All subfactors of social networks showed significant positive correlations with health-promoting behaviors. Hierarchical regression showed social support from neighbors as the variable with a significant effect on health-promoting behaviors; gender and depression were also influencing factors, and this model showed 37% explanatory power. Conclusion : To promote healthy behaviors of older adultsin the community, the development of health promotion programs and related policies considering social networks centering on social support from neighbors is required.

• Journal of Nutrition and Health
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• v.56 no.6
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• pp.629-640
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• 2023

Purpose: Non-alcoholic fatty liver disease (NAFLD) is characterized by the accumulation of fat in the liver which is not a result of excessive alcohol consumption. Its global prevalence was estimated to be approximately 32% in the years 1994-2019. More than half of obese individuals and patients with diabetes are reported to have NAFLD as a comorbidity. This study aimed to investigate the impact of the autumn olive (Elaeagnus umbellata Thunb.) berry on insulin resistance and steatosis in rats fed a high-fructose diet. Methods: Six-week-old Wistar rats were divided into four groups. The control group received a diet consisting of 65% corn starch, while the fructose and experimental groups were fed a diet comprising 65% fructose (FRU) and an FRU diet containing 0.5% (low-dose autumn olive berry group; LAO) or 1.0% (high-dose autumn olive berry group; HAO) ethanol extract of autumn olive berry, respectively, for 10 weeks. Results: The HAO group exhibited significantly lower blood glucose levels compared to the fructose-fed group. Both the LAO and HAO groups showed a substantial reduction in serum insulin levels and insulin resistance when compared to the fructose-fed group. The consumption of LAO and HAO significantly ameliorated dyslipidemia and reduced the levels of triglycerides in the liver compared to the fructose-fed group. Additionally, the consumption of HAO resulted in lower serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities compared to the fructose group. The hepatic expression of the sterol regulatory element-binding protein-1c (SREBP-1c) and carbohydrate-responsive element-binding protein (ChREBP) was significantly reduced in the LAO and HAO groups compared to the fructose group. Conclusion: Autumn olive berries improved steatosis by ameliorating insulin resistance and down-regulating the lipogenesis proteins in rats fed on high fructose diet.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.2
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• pp.69-83
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• 2023

Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.

• Therapeutic Science for Rehabilitation
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• v.13 no.1
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• pp.35-47
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• 2024

Objective : This study aimed to investigate the association between lifestyle factors and risk of frailty and depressive symptoms among older South Korean adults. Methods : This study included 10,072 individuals aged 65 or older from the 2017 National Survey of Older Koreans, a cohort of community-dwelling older South Koreans. The following lifestyle factors were assessed: physical activity, nutrition management (NM), and leisure/social activity participation (AP). Frailty was measured using the frail scale and depressive symptoms were measured using the Geriatric Depression Scale. Logistic regression analyses were performed to determine the odds ratios. Results : All lifestyle factors were associated with the risk of frailty and depressive symptoms in the study population. Regular exercise (≥3 times/wk, odds ratio [OR] = 0.59, 95% confidence interval [95% CI] = 0.52~0.91; OR = 0.66, 95% CI = 0.59~0.75), active NM (OR = 0.86, 95% CI = 0.80~0.91; OR = 0.81, 95% CI = 0.76~0.86), leisure AP (OR = 0.79, 95% CI = 0.74~0.84; OR = 0.71, 95% CI = 0.66~0.77) and social AP (OR = 0.92, 95% CI = 0.88~0.96; OR = 0.82, 95% CI = 0.78~0.87) were correlated with lower odds ratios of frailty and depressive symptoms. Conclusion : Adopting a healthier lifestyle characterized by regular exercise, balanced nutrition, and active engagement in various activities can effectively reduce the risk of frailty and depressive symptoms among the older population. Ultimately, this study emphasized the essential role of lifestyle choices in promoting the physical and mental well-being of older adults.

• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.