• 농촌의학ㆍ지역보건
• /
• 제16권2호
• /
• pp.179-194
• /
• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• Transactions on Electrical and Electronic Materials
• /
• 제18권5호
• /
• pp.298-302
• /
• 2017

With an increasing aging population and improved standards of living, more attention has been paid to health. Although walking exercise is known as an aerobic exercise, it imposes repeated and continuous impacts on the joints of the lower extremities. Therefore, when overweight gives a burden to the lower extremity or there is a joint disease, exercise limit occurs. The articular cartilage, weakened with age, also makes it difficult for the elderly to perform walking exercises. Accordingly, this study conducted a comparative analysis between regular walking using only the lower extremity and Nordic walking, which has been known as stable. For analysis, electromyography (EMG) was performed and the ground reaction force of the upper and lower extremities were measured in the same exercise. Integrated EMG (iEMG) revealed that the upper extremity muscles were more active in Nordic walking than in regular walking, where lower extremity muscles were relatively more inactive. In addition, when EMG measurements were performed at each measurement point during walking exercise, the pattern was different. Nevertheless, the result was the same as in iEMG. The load that occurs in each exercise was measured using the ground reaction force system. As a result, Nordic walking had a lower load than regular walking. Therefore, it was found that Nordic walking minimized the load on the lower extremities owing to the effect of whole-body exercise and was a safer and more efficient exercise method.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제16권1호
• /
• pp.55-63
• /
• 2010

The study was initially designed to look into the soon-to-be senior citizens' preferences for the life after retirement in aging society. Its outcomes are to be contributed to grading up the quality of housing culture through examining the expected changes of housing types in the future. The increasing number of the soon-to-be senior citizens becomes leading subjects in information, culture and consumption areas. Therefore it is significant to present a model of housing types for those citizens by analyzing their preferred residence after retirement. To complete those objectives, a set of questionnaires concerning sex, age, district, education and income of those subjects in 40's-50's, who are expected to be more than 20 percent of national population by 2030, were collected and analyzed to find out their preferences over housing types, residential welfare facilities, and co-housing. The results show that the preferences over the residential welfare facilities and co-housing for those who are able to move for themselves are low, while the preferences over single-unit houses in the suburbs within 2 hours from a city are very high. Preferences for apartments in the urban areas are high for those with high income and education. In contrast preferences for life in their hometowns are high for those whose income and education are relatively low. Most of those with some difficulties in moving for themselves want to get help with welfare facilities for the elderly people. And the preferences of those who want to receive help from assistants are different from those preferring to get help from their offsprings, which tells a need for further study of the convertible housing types according to their family members.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권10호
• /
• pp.6085-6088
• /
• 2013

Prostate specidic antigen (PSA) and digital rectal examination (DRE) are the known predictive factors for positive prostate biopsies differing according to the age, region and race. There have been only very limited studies about the impact of PSA on histological findings at prostate biopsy in Turkey. The aim of this study was to evaluate the impact of PSA and clinical stage on histologic findings of prostate biopsy in men older than 75 years of age as a first study in the Turkish population. A total of 1,645 consecutive prostate biopsies were included, with 194 men aged 75 or older. Cancer was identified in 104 patients (53.6%). Of the 104 positive biopsies, Gleason scores were less than 7 in 53 (49%) patients, 7 or greater in 51 (51%) patients. Positive prostate biopsies were significantly correlated with advanced age (p=0.0001), abnormal DRE (p=0.0001) and raised PSA (p=0.0001). The prostate volume was significantly correlated with advanced age especially in prostate cancer patients over 75 years, compared with those under 75 (p=0.0001). These results are useful for counseling men older than 75 years for prostate cancer detection. However, PCa screening decisions are currently based on urologist judgment and detection of latent asymptomatic disease is an important concern regarding costs, overdiagnosis, overtreatment and quality of life (QOL) for men aged 75 years and older. Healthy old patients with a long life expectancy need to be carefully evaluated for eligibility for PCa screening.

• 대한의생명과학회지
• /
• 제21권1호
• /
• pp.1-8
• /
• 2015

Alzheimer's disease is a common form of dementia occurring among the elderly population and can be identified by symptoms such as cognition impairments, memory loss and neuronal dysfunction. Alzheimer's disease was found to be caused by the deposition of $\beta$-amyloid plaques and neurofibrillary tangles. In addition, mutation in the APP (Amyloid precursor protein), Presenilin 1 (PSEN1) and Presenilin 2 (PSEN2) genes were also found to contribute to Alzheimer's disease. Since the potential conformational diagnosis of Alzheimer's disease requires histopathological tests on brain through autopsy, potential early diagnosis still remains challenging. In recent years, several researches have proposed the use of biomarkers for early diagnosis. In cerebrospinal fluid (CSF), $\beta$-amyloid(1-42), phosphorylated-tau and total tau were suggested to be effective biomarkers for Alzheimer's disease diagnosis. However, a single biomarker might not be sufficient for potential diagnosis of Alzheimer's disease. Thus, the use of RNA interference (RNAi) through microRNAs (miRNAs) has been proposed by several researchers for simultaneous analysis of several biomarkers using microarray technology. These miRNA based biomarkers can be analysed from both blood and CSF, but miRNAs from blood are advantageous over CSF as they are non-invasive and simple for collection. Moreover, the RNAi based therapeutics by siRNA (short interference RNA) or shRNA (short hairpin RNA) have also been proposed to be effective in the treatment of Alzheimer's disease. This review describes the promising application of RNAi technology in therapeutics and as a biomarker for both Alzheimer's disease diagnosis and treatment.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권4호
• /
• pp.2265-2270
• /
• 2016

Background: Chronic myeloid leukemia (CML) is one of the most frequent hematopoietic malignancies in the elderly population; however, knowledge is limited regarding the genetic factors associated with increased risk for CML. Polymorphisms affecting microRNA (miRNA) biogenesis or mRNA:miRNA interactions are important risk factors in the development of different types of cancer. Thus, we carried out a case-control study to test the association with CML susceptibility of gene variants located in the miRNA machinery genes AGO1 (rs636832) and GEMIN4 (rs2740348), as well as in the miRNA binding sites of the genes BRCA1 (rs799917) and KRAS (rs61764370). Materials and Methods: We determined the genotype of 781 Mexican-Mestizo individuals (469 healthy subjects and 312 CML cases) for the four polymorphisms using TaqMan probes to test the association with CML susceptibility. Results: We found a borderline association of the minor homozygote genotype of the KRAS_rs61764370 polymorphism with an increased risk for CML susceptibility (P = 0.06). After gender stratification, this association was significant only for women (odds ratio [OR] = 13.41, P = 0.04). The distribution of the allelic and genotypic frequencies of the four studied SNPs was neither associated with advanced phases of CML nor treatment response. Conclusions: To the best of our knowledge, this study is the first to show a significant association of the KRAS_rs61764370 SNP with CML. To further determine such an association of with CML susceptibility, our results must be replicated in different ethnic groups.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권4호
• /
• pp.1833-1835
• /
• 2016

Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권4호
• /
• pp.1409-1413
• /
• 2015

Background: According to increase in elderly populations, and change in lifestyle and cancer-causing behavior, the global burden of cancer is increasing. For prevention and control of disease, knowledge of population statistics of cancers and their trends is essential. This study aimed to investigate the epidemiology and trends of cancer in the province of Kerman: southeast of Iran. Materials and Methods: This analytical and cross-sectional study was carried out based on cancer registry data at the Disease Management Center of the Health Ministry from 2004 to 2009 in the province of Kerman in Iran. Common cancers were defined as the number of reported cases and standardized incidence rates. To compute the annual percentage change (APC), joinpoint 4.1.1.1 software was applied. Results: Of 10,595 registered cases, 45.3% (4802 cases) were in women and 56.7% (5,793 cases) occurred in men. The standardized incidence rates for both females and males were increasing during the six years studied. The most common cancers in both sexes during six years of studied were skin (13.4%), breast (9.35%), bladder (7.8%), stomach (7.45%), leukemia (7.05%), colorectal(5.57%), lung(4.92%), trachea(3.51%) and prostate(2.48%). Conclusions: Our findings revealed that the cancer incidence is demonstrating increasing trends in both sexes in the province of Kerman. This may be because of changes in lifestyle, increasing exposure to risk factors for cancer and increase of life expectancy. If this is the case, increasing public awareness of cancer risk factors is a high priority, together with introduction of large-scale screening techniques.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권10호
• /
• pp.5053-5056
• /
• 2012

Background: Bladder cancer is one the most common malignancies of the genitourinary tract. The present study aimed to assess the epidemiology, of bladder cancer in Mazandaran, a large province in northern Iran as high-incidence cancer area, during a 2-year period. Methods: The data for this study were obtained from the population-based cancer registry of the Vice-Chancellory for Health Affairs of Mazandaran University of Medical Sciences and Mazandaran hospitals between March 1, 2010 and March 1, 2011. Demographic data, including sex, age, residency and symptoms were investigated through careful review of medical records. Using a questionnaire protocol, several variables were assessed for these cases such as smoking, history of opium, vegetable consumption habits, and history of other cancers. Results: A total of 112 cases were analyzed, 98 (87.5%) in men and 14 (12.5%) in women (mean age of $68.0{\pm}14.6$ years). Urban and rural residence were 60.7% and 39.3%. Tobacco and opium use were found in 45.5% and 21.4% of patients, respectively. Approximately 60% consumed vegetables an average of fewer than one time per day. Hematuria was the first symptom in these cases which were mainly diagnosed as having bladder cancer by ultrasonography. Conclusion: The results showed that bladder cancer tends to be found in the elderly and the male to female ratio is high. Macroscopic hematuria is a very important symptom for indicating probably urothelial tumor that should be followed up patients with transabdominal ultrasonography as a routine modality.

• 한국멀티미디어학회논문지
• /
• 제13권1호
• /
• pp.143-152
• /
• 2010

생활수준의 향상과 더불어 의료 기술의 발달로 우리나라도 2018년에는 노인인구가 전체의 14%이상이 고령화 사회로 진입할 것으로 예상되고 있으며, 실버세대가 생산과 소비의 주체로서 경제적으로 차지하는 비율도 증가할 것이다. 실버세대들은 신체적 노화로 지각능력, 학습능력, 운동능력이 상대적으로 낮으므로, 신체적?정신적 기능 유지, 여가 시간 활용과 함께 기능성 운동을 지속적으로 제공할 수 있는 게임 콘텐츠 개발의 중요성이 강조되고 있다. 본 논문에서는 실버세대의 여가 활용과 건강을 유지할 수 있는 하체 운동 효과를 갖는 게임 콘텐츠를 개발하기 위한 방법을 제안한다. 제안 방법은 실버세대의 인지능력, 신체 활동 능력에 맞는 기능적 디자인 요소와 개별적인 특성에 따른 맞춤형 게임 진행 방법, 그리고 실버세대들이 사용하기 쉬운 체감형 인터페이스를 통해 실버세대에게 게임으로서의 재미와 함께 지속적인 신체 활동에 도움이 될 수 있을 것이다.