• Title/Summary/Keyword: Risk Adjustment

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Age Effects on Center of Mass during Obstacle Crossing (장애물 보행 시 노화에 따른 신체질량중심의 변화)

  • Son, Nam-Kuk;Kim, Hyeong-Dong
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.1
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    • pp.93-99
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    • 2014
  • PURPOSE: The purpose of this study was to compare three dimensional displacement and peak velocity of the center of mass (COM) during obstacle crossing in young and older adults. METHODS: 10 young adults (6 males/4 females, $24.6{\pm}1.9$ years, age range: 22.0-26.9) and 10 older adults (1 male/9 females, $76.9{\pm}5.1$ years, age range: 65.2-81.2) participated in the study. Both groups crossed an obstacle, which is 10% of leg length, and COM was measured using motion analysis system. Independent t-test was used to find significant differences between two groups. RESULTS: The older adults showed significantly greater and faster COM displacement and peak velocity in mediolateral (M-L) direction as compared with young adults (p<.01 and p<.001 respectively). However, the young adults showed significantly greater and faster COM displacement and peak velocity in anteroposterior (A-P) direction as compared with older adults (p<.05 and p<.001 respectively). Furthermore, the young adults showed faster peak velocity of COM in vertical direction as compared with older adults (p<.001). However, no significant difference was found in the COM displacement in vertical direction between two groups. CONCLUSION: Greater and faster COM displacement and peak velocity in M-L direction in older adults were due to compensatory adjustment for appropriate contact on base of support of swing limb. Thus, the motion of the COM in M-L direction may be a crucial factor to identify risk of falls in older adults.

Association between Mental Health with Oral Health Behaviors in Korean Adolescents (우리나라 청소년의 정신건강이 구강보건행태에 미치는 영향)

  • Lee, Won-Jeong;Jung, Tae-Eun;Park, Jin-Kyung;Sim, Sang Hyo
    • The Journal of Korean Society for School & Community Health Education
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    • v.18 no.1
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    • pp.13-29
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    • 2017
  • Objectives: The purpose of the study was to investigate the effect of stress, depressive mood and suicide ideation with oral health behavior in Korean adolescents. Methods: The subjects were 57,904 adolescents who were selected from the web-based survey of the 10th(2014) Korean Youth Risk Behavior of Korean Center for Disease Control. Data were analyzed by SPSS 18.0. A web-based self-reported questionnaire was completed by 72,060 middle and high school students. The subjects consisted of 28,269 man students(48.8%) and 29,635 women students(51.2%) from 500 middle schools and 400 high schools. Results: Multiple logistic regression analysis after adjustment to demographic characteristics and stress, depressive mood and suicide ideation by man and women of middle, high school students the subjects whose have had different oral health behaviors. low level of stress, do not think about suicide ideation, they were increased their oral brushing frequency of yesterday($$3{\geq_-}$$) with brushing after lunch(p<0.05). alternatively subjects whose do not have depressive mood, they were decreased their oral health behaviors(p<0.05). Conclusions: According to gender by middle and high school students are mental health of the youth, which has direct and indirect effects on physical health, is closely associated with their oral health according to oral health behaviors.

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Characteristics of Healthcare REITs' Performance and Operation, and their Use for Activating the Silver Industries in Korea (헬스케어 REITs의 성과 및 운영 특성과 국내 실버산업에의 활용 방안)

  • Park, Won-Seok
    • Journal of the Economic Geographical Society of Korea
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    • v.14 no.2
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    • pp.157-175
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    • 2011
  • This paper aims to analyze the characteristics of healthcare REITs' performance and operation, and to examine their use for activating the silver industries in Korea. The results of this study are as follows. First, according to the results of analyzing healthcare REITs' performance, healthcare REITs outperformed average REITs and extended investment proportion compared to total REITs after 2007. This outperforming came from not only rapid growth of silver industries, but also REITs strategy using the structure of sale-and-leaseback and triple-net lease. Second, healthcare REITs use selection and concentration strategy in terms of asset sector, but use portfolio diversification strategy in terms of investment region. Third, according to the analysis results, healthcare REITs are to be useful for activating the silver industries in Korea. In this context, major implications are presented to use healthcare REITs effectively.

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An Association Between Air Pollution and the Prevalence of Allergic Rhinitis in the Ulsan Metropolitan Region (울산지역 대기오염과 알레르기 비염 유병률과의 관계)

  • Oh, In-Bo;Lee, Ji-Ho;Sim, Chang-Sun;Kim, Yang-Ho;Yoo, Cheol-In
    • Journal of Environmental Health Sciences
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    • v.36 no.6
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    • pp.465-471
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    • 2010
  • This study aims to investigate the relationship between air pollution exposure and the prevalence of allergic rhinitis in a young population in the Ulsan metropolitan region (UMR). Data on physician-diagnosed allergic rhinitis (past 12 months) in 1,449 infants and children aged 1-18 years who lived within 1.5 or 2 km of air quality monitoring sites were collected in a cross-sectional health interview survey conducted between January-February 2006 in the UMR. Comparisons of the spatial distribution of the prevalence rates for allergic rhinitis and annual average pollutant concentrations over the region showed that a relatively high prevalence rate occurred around the coastal industrial area, with high PM10 concentrations. A linear correlation analysis demonstrated a positive correlation relationship between them (R = 0.680, p = 0.04). Multiple linear regression analysis revealed that the combined effect of the PM10 and $SO_2$ variables accounts for approximately 81% of the variance (R-square: 0.81) in the prevalence rate. From the multiple logistic regression analysis after adjustment by age, sex, and air-pollutant factors, the PM10 and $SO_2$ which were mainly from industrialrelated emissions were found to be significantly associated with an increased risk of allergic rhinitis (aOR: 1.76, 95% CI: 1.15-2.70 for PM10 ; aOR: 1.63, 95% CI: 1.12-2.35 for SO2).

Blood Lead Concentration and Hypertension in Korean Adults Aged 40 and Over According to KNHANES IV (2008) (40세 이상의 한국성인의 혈중 납 농도와 고혈압 - 2008년 국민건강영양조사를 바탕으로 -)

  • Kim, Sun-Young;Lee, Duk-Hee
    • Journal of Environmental Health Sciences
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    • v.37 no.6
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    • pp.418-428
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    • 2011
  • Objectives: The purpose of this study was to examine the cross-sectional relationship between low blood lead levels and increasing blood pressure among Korean adults using a nationally representative sample of the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. Methods: A total of 918 subjects aged 40 and older and not currently being treated for hypertension participated in this study. Information about age, gender, smoking status, alcohol consumption, education level, and the use of anti-hypertensive medication was collected. The blood pressure was defined as the mean of the second and the third measurements after three time measurements. Lead levels were determined by an analysis of blood samples. Multiple linear and logistic regression analyses were implemented after adjusting for covariates including age, gender, educational level, smoking status, alcohol consumption, and BMI. Results: This study showed that the average differences in systolic and diastolic blood pressure comparing the lowest to highest quintile of blood lead were 4.33 mmHg (95% CI, 0.66-8.00; p for trend = 0.027) and 2.66 mmHg (95% CI, 0.26-5.06; p for trend = 0.021), respectively. After multivariate adjustment for covariates, the prevalence odds ratio (POR) of subjects in the highest quintile was associated with a 1.70-fold increase in the risks of hypertension (95% CI, 0.83-3.49; p for trend test = 0.112) over those in the lowest quintile of blood lead concentration, However, it was not statistically significant. Conclusions: This study provided evidence for an association between low- levels of blood lead and elevations in blood pressure and risk for hypertension in the general population of Korea.

Nutritional intake of Korean population before and after adjusting for within-individual variations: 2001 Korean National Health and Nutrition Survey Data

  • Kim, Dong-Woo;Shim, Jae-Eun;Paik, Hee-Young;Song, Won-O;Joung, Hyo-Jee
    • Nutrition Research and Practice
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    • v.5 no.3
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    • pp.266-274
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    • 2011
  • Accurate assessment of nutrient adequacy of a population should be based on usual intake distribution of that population. This study was conducted to adjust usual nutrient intake distributions of a single 24-hour recall in 2001 Korean National Health and Nutrition Surveys (KNHNS) in order to determine the magnitude of limitations inherent to a single 24-hour recall in assessing nutrient intakes of a population. Of 9,960 individuals who provided one 24-hour recall in 2001 KNHNS, 3,976 subjects provided an additional one-day 24-hour recall in 2002 Korean National Nutrition Survey by Season (KNNSS). To adjust for usual intake distribution, we estimated within-individual variations derived from 2001 KNHNS and 2002 KNNSS using the Iowa State University method. Nutritionally at risk population was assessed in reference to the Dietary Reference Intakes for Koreans (KDRIs). The Korean Estimated Average Requirement (Korean EAR) cut-point was applied to estimate the prevalence of inadequate nutrient intakes except for iron intakes, which were assessed using the probability approach. The estimated proportions below Korean EAR for calcium, riboflavin, and iron were 73%, 41%, and 24% from usual intake distribution and 70%, 51%, and 39% from one-day intake distribution, respectively. The estimated proportion of sodium intakes over the Intake Goal of 2,000 mg/day was 100% of the population after adjustment. The energy proportion from protein was within Korean Acceptable Macronutrient Distribution Ranges (Korean AMDR), whereas that of carbohydrate was higher than the upper limit and that of fat was below the lower limit in the subjects aged 30 years or older. According to these results, the prevalence of nutritional inadequacy and excess intake is over-estimated in Korea unless usual intake distributions are adjusted for one-day intakes of most nutrients.

Prevalence and Associated Factors of Osteoporosis among Postmenopausal Women in Chuncheon : Hallym Aging Study(HAS) (춘천지역 폐경 후 여성의 골다공증 유병률과 관련 요인: 한림노년연구)

  • Jang, Soong-Nang;Choi, Young-Ho;Choi, Moon-Gi;Kang, Sung-Hyun;Jeong, Jin-Young;Choi, Yong-Jun;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.5
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    • pp.389-396
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    • 2006
  • Objectives: A community-based, cross-sectional survey was conducted to determine theprevalence of osteoporosis and to evaluate the effects of body composition, health behaviors and reproductive history on bone density in postmenopausal women. Methods: The study subjects were 362 postmenopausal women, aged 45 years old or over, who were invited to the hospital. Information on their socio-demographic characteristics and the potential risk factors such as their past medical history, smoking, alcohol intake, exercise, diet and menstrual/reproductive histories were collected by trained interviewers. Weight, height, the body mass index ($kg/m^{2}$), and body composition variables were measured. Bone mineral density of the lumbar spine was measured by dual energy X-ray absorptiometry (DXA). Results: The prevalence of osteoporosis was 30.6% in the $45{\sim}64$ years old women, 52.5% in the elderly women aged $65{\sim}74$, and 68.7% in the women aged 75 years or over. After adjustment for the effect of potential covariates, those women in the highest 25% (4th quartile) of the lean body mass are less likely to have osteoporosis (aOR=0.31, 95% CI=0.12-0.76), compared with the lowest quartile group. More parity also had significantly detrimental effects on osteoporosis. Conclusions: These findings suggest that the prevalence of osteoporosis in postmenopausal women increased with age from 46.3% of those aged 45-64 to 68.7% for those aged 75 and over. Lean body mass and parity appeared significant contributor to bone mineral density in postmenopausal women in this population.

Association Between Meat Consumption and Carotid Intima-Media Thickness in Korean Adults With Metabolic Syndrome

  • Oh, Sun-Min;Kim, Hyeon-Chang;Ahn, Song-Vogue;Chi, Hye-Jin;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.6
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    • pp.486-495
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    • 2010
  • Objectives: The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. Methods: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. Results: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (${\geq}5$ servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. Conclusions: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (${\geq}5$ servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.

A Study on the design of the outpatient and inpatient conversion factors based on the medical expenditure budget system (진료비 예산에 기초한 외래 및 입원 환산지수 설계에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.470-478
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    • 2020
  • In this paper, a theoretical model that separates one single conversion factor into two conversion factors for both outpatients and inpatients is introduced. By using hypothetical numbers, two conversion factors and an adjustment factor were calculated. The major implications are as follows. Firstly, by introducing two conversion factors, a minimum incentive mechanism for admitting outpatients to a clinic and high risk inpatients to a hospital was installed. Secondly, the introduction of two conversion factors decreased the drive to admit outpatients to a hospital by reducing the economic benefits for the hospital. Thirdly, it is possible to make explicit contracts for several factors rather than a single conversion factor, so that it can be used as an appropriate management tool for rapidly increasing medical expenses. Finally, this research can be used to set up policy tools to establish a proper healthcare delivery system in Korea by inducing behavioral changes in healthcare institutions.

Association of Toll-Like Receptor 5 Gene Polymorphism with Susceptibility to Ossification of the Posterior Longitudinal Ligament of the Spine in Korean Population

  • Chung, Won-Suk;Nam, Dong-Hyun;Jo, Dae-Jean;Lee, Jun-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.8-12
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    • 2011
  • Objective: Ossification of the posterior longitudinal ligament (OPLL) has a strong genetic component. Specific gene polymorphisms may be associated with OPLL in several genes which regulate calcification in chondrocytes, change of extracellular collagen matrix and secretions of many growth factors and cytokines controlling bone morphogenesis. Toll-like receptor 5 (TLR5) may playa role in the pathogenesis of OPLL by intermediate nuclear factor-kappa B (NF-${\kappa}B$). The current study focused on coding single nucleotide polymorphisms (SNPs) of TLR5 for a case-control study investigating the relationship between TLR5 and OPLL in a Korean population. Methods: A total of 166 patients with OPLL and 231 controls were recruited for a case-control association study investigating the relationship between SNPs of TLR5 gene and OPLL. Four SNPs were genotyped by direct sequencing (rs5744168, rs5744169, rs2072493, and rs5744174). SNP data were analyzed using the SNPStats, SNPAnalyzer, Haploview, and Helixtree programs. Multiple logistic regression analysis with adjustment for age and gender was performed to calculate an odds ratio (OR). Results: None of SNPs were associated with OPLL in three alternative models (codominant, dominant, and recessive models; p> 0.05). A strong linkage disequilibrium block, including all 4 SNPs, was constructed using the Gabriel method. No haplotype was significantly associated with OPLL in three alternative models. Conclusion: These results suggest that Toll-like receptor 5 gene may not be associated with ossification of the posterior longitudinal ligament risk in Korean population.