• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.218-222
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• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• Communications for Statistical Applications and Methods
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• v.17 no.5
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• pp.689-696
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• 2010

Interval-censored data are commonly found in studies of diseases that progress without symptoms, which require clinical evaluation for detection. Several techniques have been suggested with independent assumption. However, the assumption will not be valid if observations come from clusters. Furthermore, when the cluster size relates to response variables, commonly used methods can bring biased results. For example, in a study on lymphatic filariasis, a parasitic disease where worms make several nests in the infected person's lymphatic vessels and reside until adulthood, the response variable of interest is the nest-extinction times. Since the extinction times of nests are checked by repeated ultrasound examinations, exact extinction times are not observed. Instead, data are composed of two examination points: the last examination time with living worms and the first examination time with dead worms. Furthermore, as Williamson et al. (2008) pointed out, larger nests show a tendency for low clearance rates. This association has been denoted as an informative cluster size. To analyze the relationship between the numbers of nests and interval-censored nest-extinction times, this study proposes a joint model for the relationship between cluster size and clustered interval-censored failure data.

• Nutrition Research and Practice
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• v.14 no.4
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• pp.352-364
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• 2020

BACKGROUND/OBJECTIVES: Given the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008-2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken. RESULTS: The sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points (P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003-3.254, P < 0.05). CONCLUSIONS: This study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.

• The KIPS Transactions:PartC
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• v.12C no.7 s.103
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• pp.999-1006
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• 2005

The Secure OS is an operating system which adds security functions to the existing operating system, in order to secure a system from sorority problems originated from inherent frailty of applications or operating systems. With the existing Secure Oses for it is difficult to set an effective security policy securing personal resources in a multi-user environment system. To solve this problem in this paper we present two Techniques to secure user data efficiently in the RBAC-based Secure OS for a multi-user environment. Firstly we utilizes object's owner information in addition to object's filename. Secondly we make use of meta symbol('$\ast$'), which is able to describe multiple access targets. In addition this paper gives some examples to show advantages from these techniques. And these features are implemented in an solaris-based Secure OS called Secusys.

• Korean Journal of Social Welfare
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• v.63 no.4
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• pp.83-107
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• 2011

This study examines the duration dependence in the exit rate from National Basic Livelihood Protection Program(NBLP). If the length of time on welfare is negatively correlated with the exit rate after controlling for 'unobserved heterogeneity', the observed declining exit rates would provide evidence of true duration dependence. Data are drawn from Korean Welfare Panel study 2005~2008. A variety of discrete-time hazard models are estimated, including parametric/nonparametric hazard model, gamma frailty hazard model/mass point technique model. It is found that welfare dynamics in Korea does not show strong evidence of duration dependence after controlling for unobserved heterogeneity. All the models estimated show that this finding is quite robust. The observed declining exit rate is largely due to differences in the unobservable characteristics of recipients. Thus, the detrimental effect of the welfare on the preference and attitude among recipients is not likely to be strengthened as time on welfare increases.

• Architectural research
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• v.13 no.3
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• pp.31-40
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• 2011

Profit-keeping behaviors naturally occur in the market to satisfy consumers, and the logic behind it lies in the economies of scale. On the flip side, some commodities transacted in the market are not available or can not be easily acquired unless the demand is high enough. Under this proposition, some consumers rise and find their own solution to meet the services at a reasonable cost or at an adequate level. The commonly adopted way is to establish a cooperative, and it stirs purchasing power by pooling resources and further bargains price and service quality. As a consumer cooperative, housing cooperatives notably found in rural towns enable the elderly to continue independent living. This study is to take a closer look at residential life of the rural elderly in housing cooperatives. Utilizing in-depth focus group interviews with 40 residents in four housing cooperatives, this qualitative research draws main factors affecting the decision to move in, residential assessment, and strengths and weakness of living in a housing cooperative. The primary factor influencing the moving decision is to continue to independent living in a familiar community, and the bottom line is planning ahead. Frailty and bereavement are found to be the leading occasions for them to move. The participants are satisfied with the independent living arrangement, and particularly, cited such features as safety and security, elderly-friendly design, common spaces, freedom, social activities and efficient living. Also, it is stated that some cooperative natures such as control over the property and giving a voice on management render positive impacts on the satisfaction with communal living. In spite of all the benefits and strengths, participants face with a public notion that an independent living arrangement like a housing cooperative has never done before in rural towns, so that most people recognize it as part of dependent living arrangements like nursing home.

• Journal of Haehwa Medicine
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• v.19 no.2
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• pp.13-24
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• 2011

The medical profession has the problem of lack of bioethics, due to the expansion of capitalism and mannerism after modernization. Therefore, the need of education of bioethics is increasing, however, the cramming system of education is insufficient for promoting personal morals. So the author studied ancient and present bioethics and searched for the cause of current bioethics absence and the method of overcoming it. Especially, studying the vocational features of oriental medical doctor as profession and the problems of education of bioethics in oriental medical college, the author searched for the directions of educations of bioethics. The conclusions are as follows. The current medical profession have ethical problems because of social moral hazard, evils of capitalism, change of doctor-patient relationship due to expansion of consumerism, limitation of autonomy due to commercialize of hospitals, decrease of knowledge monopolism of professionals, moral indifference and frailty, and a missdeed preference. The education of bioethics needs "Rest's 4 components" but the current education of bioethics in oriental medicine college lacks of time and is composed of the cramming system of education. So it needs various types of education system. Morals are subjective and discretionary personal character. Therefore, informational education is insufficient for enhancing morals and complex education for various personal attainments (various social indirect experience, philosophical speculation, mental serenity) is needed. It has to be done on the basis of educational method by experience not lecture, long term expectation, and basic understanding of bioethics.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.3
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• pp.211-217
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• 2013

The purpose of this study is to report the effect of oriental medical treatments with exercise therapy on the frail elderly patient with gait disturbance and cognitive decline. The frail elderly patient with gait disturbance and cognitive decline was treated by oriental medical treatments combined with exercise therapy during 3 months. The improvement of clinical symptom was evaluated by Manual Muscle Test (MMT), Passive Range Of Motion (PROM), Mini Mental State Examination-Korea (MMSE-K). After 3 months, all of both lower extremity Manual Muscle Test (MMT) improved to Grade 4. Both knee extension Passive Range Of Motion (PROM) and Mini Mental State Examination-Korea (MMSE-K) also increased from -30/-30 to 0/-5, from 7 to 25 respectively. It could be suggested that oriental medical treatments with exercise therapy were effective on the frail elderly patient with gait disturbance and cognitive decline. And further research is encouraged to confirm the effectiveness of this treatment with a larger number of patients.

• The Journal of Korean Physical Therapy
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• v.24 no.4
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• pp.253-261
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• 2012

Purpose: In this study, the following experiment was conducted to see how to apply the sprinter pattern in proprioceptive neuromuscular facilitation (PNF) and functional weight bearing exercise affected balance capabilities and weight bearing among chronic stroke patients. Methods: The subjects included 27 subjects who had been diagnosed with hemiplegia due to stroke. A total of 12 sessions was held, 3 sessions a week over 4 weeks, were provided to the groups. The control group received general rehabilitation program, and the experimental group performed sprinter pattern in PNF or functional weight bearing exercise. The weight bearing capability and static balance capability test was implemented by using Good-Balance System and Frailty and Injuries Cooperative Studies of Intervention Techniques, while the dynamic balance capability test was carried out by using Four Square Step Test and Timed "Up and Go". Results: The paretic/nonparetic side weight bearing by application of each exercise showed that there were no significant differences in variation among each groups on before exercise, after exercise, 2 weeks after exercise. Static balance test by application of each exercise showed that there were significant differences after exercise and 2 weeks after exercise. Dynamic balance test by application of each exercise showed that there were significant differences after exercise and 2 weeks after exercise. Conclusion: To put the results together, the application of sprinter pattern and functional weight bearing exercise was effective in improving static and dynamic balance capabilities. Therefore, these exercises are helpful to improve balance in patients with stroke.

• PNF and Movement
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• v.7 no.1
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• pp.9-16
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• 2009

Purpose : The aim of this study was to determine the effect of proprioceptive neuromuscular facilitation(PNF) on balance ability in poststroke hemiparetic subjects. Methods : The subjects of this study were 12 patients with hemiplegia who volunteered to participate in the experiment which was carried out over the course of 4 weeks. The Proprioceptive Neuromuscular Facilitation is applied to group with three positions (sidelying, half-standing, modified plantigrade). The tests between before and after the intervention were measured by FSST (Four Square Step Test), FICSIT-4 (Frailty and Injuries: Cooperative Studies of Intervention Techniques), BBS(Berg Balance Scale). The data were analyzed using paired t-test and Wilcoxon signed rank test to determine the statistical significance. Results : The results of this study were summarized as follows: 1. After intervention, the score of BBS and FICSIT-4 significantly were increased compared with before intervention. 2. After intervention, the time of FSST were reduced significantly compared with before intervention. Conclusions : According to above results, Proprioceptive Neuromuscular Facilitation improved with balance ability of patients with hemiplegia. This study provided basic data for effects Proprioceptive Neuromuscular Facilitation on balance ability. In conclusion, Proprioceptive Neuromuscular Facilitation with other interventions is effective way to improve balance ability of patients with hemiplegia.