• 한국콘텐츠학회논문지
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• 제13권12호
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• pp.900-909
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• 2013

본 연구의 목적은 요양병원에 입원한 알츠하이머 치매환자의 재원기간에 영향을 미치는 요인을 분석하는 것이다. 분석 자료는 건강보험심사평가원의 2009년 환자표본데이터를 사용하여 추출하였고, 요양병원에 입원한 65세 이상의 노인이면서 알츠하이머 치매로 입원한 178개 병원의 총 538명을 분석에 이용되었다. 요인은 환자 측 변수와 요양병원의 구조특성변수이며, 환자특성변수는 성별, 연령, 중증도를 사용하였고, 중증도는 요양병원 수가처치 코드를 이용하여 5개의 그룹(의료고도, 의료중도, 문제행동군, 인지장애군, 의료경도)으로 분류하였다. 구조특성변수는 병상수, 의사수, 간호사수, 그리고 CT 보유수를 연구모형에 포함하여 분석하였다. 다중회귀분석결과에서 병원의 구조변수는 환자의 재원기간에 통계학적으로 유의한 영향은 없었다. 환자변수 중에서 중증도의 경우 의료고도와 문제행동군에서 통계학적으로 유의한 영향을 미치는 것으로 나타났으나 모두 음의 관계를 갖는 것으로 나타났다. 이는 중증도가 높은 의료고도에서 레퍼런스 그룹인 의료중도에 대해 양의 관계를 가질 것이라는 예상과는 상반된 결과였다. 이러한 결과는 알츠하이머 치매환자의 특성과 병원의 구조적특성이 환자의 재원일수 변이에 큰 영향을 미치지 않는다는 가능성을 시사하고 있다. 요양병원은 일반 급성기 병원과는 다른 환자의 질병 특성을 지니고 있고, 수가 지불체계에 대해서도 다른 특성을 가진다. 특히 최근 대두되는 '사회적 입원' 문제와 같이 환자의 사회경제적인 요인에 의한 변이가 대두되는 시점에서, 재원기간에 영향을 미칠 수 있는 사회경제적인 요인에 대한 연구가 지속적으로 필요할 것으로 보인다.

• The Korean Journal of Physiology and Pharmacology
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• 제12권2호
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• pp.83-87
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• 2008

The fyn-related kinase (FRK) belongs to the tyrosine kinase family of protein kinases. Recent studies have shown that Frk affects pancreatic beta cell number during embryogenesis and promotes beta cell cytotoxic signals in response to streptozotocin. To investigate the genetic association between FRK polymorphisms and the risk of obesity in Korean population, single nucleotide polymorphisms (SNPs) in the FRK gene region were selected and analyzed. The body mass index (BMI) was calculated, and biochemical data (systolic blood pressure, diastolic blood pressure, hemoglobin A1C, triglyceride, total cholesterol, high density lipoprotein, and low density lipoprotein) of blood sample from each subject were also measured. One hundred fifty five healthy control and 204 overweight/obesity subjects were recruited. Genotype frequencies of six SNPs [rs6568920 (+8391G>A), rs3756772 (+56780A>G), rs3798234 (+75687C>T), rs9384970 (+68506G>A), rs1933739 (+72978G>A), and rs9400883 (+75809A>G)] in the FRK gene were determined by Affymetrix Targeted Genotyping Chip data. According to the classification of Korean Society for the Study of Obesity, control (BMI 18 to < 23) and overweight/obesity (BMI$\geq$23) subjects were recruited. For the analysis of genetic data, EM algorithm, SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were used. Multiple logistic regression analysis (codominant, dominant, and recessive models) was performed. Age and gender as covariates were adjusted. For biochemical data, Student's t test was used. The mean value of BMI in the control and overweigh/obesity groups was 21.1${\pm}$1.2 (mean${\pm}$SD) and 25.6${\pm}$2.0, respectively. All biochemical data of the overweight/obesity group were statistically significance, compared with the control group. Among six SNPs, two linkage disequilibrium (LD) blocks were discovered. One block consisted of rs1933739 and rs9400883, and the other comprised rs3756772 and rs3798234. One SNP (rs9384970, +68506G>A) showed an association with overweight/obesity in the codominant model (p=0.03). Interestingly, the AA genotype distribution in the overweight/obesity group (n=7, 3.5%) was higher than those in the control group (n=1, 0.6%), which is not found in either Japanese or Chinese subjects. Therefore, the AA genotype of rs9384970 may be a risk factor for development of obesity in Korean population. The results suggest that FRK may be associated with overweight/obesity in Korean population.

• Asian Journal for Public Opinion Research
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• 제5권3호
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• pp.228-249
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• 2018

In 2015, the population of elderly people in Thailand was 16% of the total population and is predicted to be over 20% by 2021 and nearly 28% by 2031. The increase of the elderly population in Thailand has also increased the proportion of dependent elderly people, and caring for them poses many challenges for both families and the government. This descriptive method research aimed to survey the health status of dependent older people in the rural community of Lampang province in northern Thailand. The participants consisted of 62 older people and 62 primary family caregivers from Hong Ha Health Promoting Hospital, Lampang, Thailand (totaling 124 people). The researchers assessed the health status of older people and their activities of daily living (ADL). In addition, researchers assessed the health status and stress of caregivers. All the participants were interviewed about their experiences with caregiving. The results showed that most of the older respondents were female with an average age of 78.15 years. Based on the ADL assessment, 50 of the 62 older persons were homebound while the rest were bedridden. The majority of older people had chronic or long-term conditions that required hospitalization from time to time. Their frequent health problems included oral disorders such as tooth decay or caries/gum disease/no teeth, reduced sight, psychological disorders, knee pain and risk of falling, low BMI, risk of malnutrition, and urinary leakage and incontinence (58.06%, 66.13%, 62.90%, 70.97%, 38.71%, 66.13%, and 37.10%, respectively). Usual care provided by the family members included personal hygiene care, food preparation and feeding, medication management, housekeeping and organizing necessary equipment, supply of needed equipment, prevention of falls, helping with travel for medical checkups and treatment, and providing companionship. Families experienced shortages of medical supplies, daily use equipment, lack of employment, inadequate income, and difficulty accessing health care services due to lack of transportation. Some caregivers experienced caregiving stress related to a lack of social interactions as well as routine caregiving activities. Families need different types of support in order to promote the well-being of older people and caregivers. This highlights the need for a community participation model for the care of older people in order to reflect sustainable long-term outcomes.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5721-5727
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• 2014

Objectives: To evaluate the performance of clustering methods used in the prognostic assessment of categorical clinical data for hepatocellular carcinoma (HCC) patients in China, and establish a predictable prognostic nomogram for clinical decisions. Materials and Methods: A total of 332 newly diagnosed HCC patients treated with hepatic resection during 2006-2009 were enrolled. Patients were regularly followed up at outpatient clinics. Clustering methods including the Average linkage, k-modes, fuzzy k-modes, PAM, CLARA, protocluster, and ROCK were compared by Monte Carlo simulation, and the optimal method was applied to investigate the clustering pattern of the indices including platelet count, platelet/lymphocyte ratio (PLR) and serum aspartate aminotransferase activity/platelet count ratio index (APRI). Then the clustering variable, age group, tumor size, number of tumor and vascular invasion were studied in a multivariable Cox regression model. A prognostic nomogram was constructed for clinical decisions. Results: The ROCK was best in both the overlapping and non-overlapping cases performed to assess the prognostic value of platelet-based indices. Patients with categorical platelet-based indices significantly split across two clusters, and those with high values, had a high risk of HCC recurrence (hazard ratio [HR] 1.42, 95% CI 1.09-1.86; p<0.01). Tumor size, number of tumor and blood vessel invasion were also associated with high risk of HCC recurrence (all p< 0.01). The nomogram well predicted HCC patient survival at 3 and 5 years. Conclusions: A cluster of platelet-based indices combined with other clinical covariates could be used for prognosis evaluation in HCC.

• 대한인간공학회지
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• 제30권5호
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• pp.637-644
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• 2011

Objective & Background: When applying various evaluation tools that analyze work posture risk through observation, accurate measurement of body flexion angle is very important. Method: This study investigated differences and appropriateness of 5 different existing reference points commonly used in the analysis of the work posture. Twenty five ergonomist and trained professionals were participated in this study. A Same flexion angle was utilized for the evaluation of risk assessment of musculoskeletal disorders using five different reference points to investigate the degree of difference between them. To investigate how different the observers' preferred flexion angle measuring methods were compared to the ISO 11226 Reference Posture, a virtual body model was constructed using the Poser 6.0 program. Six types of body flexion postures were constructed, and since neck flexion differs according to body angle, five types of neck flexion postures were constructed with the trunk bending $20^{\circ}$ forward, making up a total of 30 virtual flexion postures. Results: Results showed that the observers used personally preferred reference points instead of reference points recommend in the evaluation tools. Also the results revealed the their seems to be 6 types of flexion angle for the trunk and 11 types of measurement methods for the neck flexion angle in the form of personally preferred reference points. The results showed that a mean difference of $14^{\circ}$($4{\sim}23^{\circ}$) occurred in the trunk, and a mean difference of $20^{\circ}$($-8{\sim}51^{\circ}$) occurred in the neck. To increase accuracy when using the 5 evaluation tools in combination, the ISO 11226 standards, observers' preferred flexion posture standards, and common flexion posture standards of the evaluation tools were compared with the reference points of the 5 evaluation tools. Results showed considerable variance in angle difference for each evaluation tool. Conclusion: According to the results of this study, considering the angle difference between the flexion angle reference points of the evaluation tool and the reference points selected by the observers, it is concluded that instead of personally preferred reference points, the standardized reference points to enhance the accuracy and the objectivity. Application: The result of this study can be used as reference guide to develop the standardized reference point in the future.

• 한국응용과학기술학회지
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• 제38권4호
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• pp.1117-1128
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• 2021

본 연구의 목적은 에너지 소비 및 심폐 능력 향상을 위한 고강도 유산소 운동, 근력 및 근지구력 강화를 위한 서킷 트레이닝, 생활 습관 변화 교육으로 구성된 4주간의 건강증진 중재 프로그램이 과체중 또는 비만 초등학생의 비만도, 체력수준, 인슐린 저항성 및 대사증후군 미치는 영향을 조사하는데 있다. 과체중 또는 비만 아동 23명을 비만군으로, 정상체중 아동 15명을 정상군으로 선발하였다. 건강증진 프로그램은 총 4주간, 주 3일, 1일 2시간의 운동시간과 1시간의 교육으로 구성되었다. 비만도(체질량지수, 허리둘레, 체지방률), 체력(근력, 근지구력, 유연성, 심폐체력), 인슐린 저항성 및 대사증후군 위험요인(혈압, 공복 혈당, 중성지방, 고밀도 지단백 콜레스테롤)을 측정하였다. 프로그램 참여 후, 비만도의 유의미한 감소는 없었지만, 비만 아동의 체력수준, 인슐린 저항성 및 대사 증후군 위험 요인은 상당한 개선이 있었다. 결과적으로 여름캠프 참여를 통해 비만 초등학생의 체력수준 향상, 인슐린 저항성 감소 및 대사증후군 위험요인의 빈도 감소에 효과가 있는 것으로 밝혀졌다.

• Journal of Nutrition and Health
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• 제54권3호
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• pp.247-261
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• 2021

본 연구는 제6기 2015년도 국민건강영양조사 자료를 활용하여 만 19-64세 한국 성인의 주요 식사 패턴을 도출한 후, 식사 패턴과 인슐린 저항성 간의 상관성을 분석하기 위해 수행되었다. 그 결과는 다음과 같다. 대상자의 식사 패턴을 요인분석 방법으로 분석한 결과, 'Healthy Korean meal pattern', 'Western meal pattern', 'White rice, alcohol, meat pattern'으로 나타났다. 'Healthy Korean meal pattern' 점수가 높을수록 연령이 높게 나타났으며, 식사 패턴에 따른 영양소 섭취량 분석 결과, 'Healthy Korean meal pattern' 섭취 점수가 높을수록 총 에너지, 탄수화물, 단백질, 비타민 A, 비타민 C, 칼슘, 인, 철, 칼륨, 식이섬유의 섭취가 유의하게 증가하였으며 'Western meal pattern' 섭취 점수가 높을수록 총 에너지, 단백질, 지방, 콜레스테롤의 섭취가 유의하게 증가하였고, 'White rice, alcohol, meat pattern' 점수가 높을수록 총 에너지와 나트륨의 섭취는 유의하게 증가하였고, 탄수화물, 비타민 C, 칼슘, 인, 칼륨, 식이섬유의 섭취는 유의하게 감소하였다. 식사 패턴에 따른 인슐린 저항성의 위험도를 분석한 결과 'Healthy Korean meal pattern'과 'Western meal pattern'은 인슐린 저항성과 유의한 연관성을 보이지 않았고, 'White rice, alcohol, meat pattern'은 인슐린 저항성의 위험도와 양의 연관성을 보였다. 이상의 결과로부터 'White rice, alcohol, meat pattern'의 식사를 많이 할수록 인슐린 저항성의 위험도가 높아지는 것을 알 수 있었다. 본 연구는 단면연구라는 제한점이 있으므로 향후 식사 패턴과 인슐린 저항성의 상관성을 확인할 수 있는 전향적 코호트 등의 연구가 필요하다.

• 대한통합의학회지
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• 제9권3호
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• pp.87-97
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• 2021

Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.

• 한국산업보건학회지
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• 제32권4호
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• pp.402-413
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• 2022

Objectives: In this study, the scale of exceeding the extreme heat exposure standard at the construction site was estimated using the nationally approved statistical data and wet bulb globe temperature modeling method. By comparing and analyzing the modeling results with the existing work environment monitoring results, the risk of heat exposure at outdoor construction sites was considered. Methods: Using the coordinates of second level administrative districts and meteorological observatories as the key, the automated synoptic observing system data and building permit data for 2021 were matched. The wet-bulb temperature was obtained using Stull's formula, and the globe temperature was obtained using the Tg_KMA2006 model. WBGT was calculated using these. Excess rates were obtained compared to exposure limits for heavy work-continuous work and moderate work-25% rest. It was compared with the results of the work environment monitoring in 2020. Results: As a result, 1,827,536 cases were estimated for 11,052 workplaces in one year. This is much higher than the 5,116 cases of 3818 workplaces of the existing work environment monitoring results. It is confirmed that the exposure limit was exceeded in 10.6~24.0% of the entire period and 70.2~84.1% of the peak period of the heat wave. It is very high compared to 0.9% of the existing work environment monitoring result. Conclusions: It is necessary to improve the system of monitoring and statistics related to extreme heat. Additional considerations are needed regarding WBGT estimation methods, meteorological data, and evaluation time. Various follow-up risk assessment studies for other industries and time series need to be continued.

• 한국재난정보학회 논문집
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• 제20권1호
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• pp.106-116
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• 2024

연구목적: 본 논문은 건설 시공현장에서 발생하는 사고 및 잠재적 위험분석을 위한 IoT 및 CCTV 기반 안전모니터링을 실시하고 추락, 충돌 등 위험 또는 이상현상을 탐지하여 무전기 등을 이용한 예·경보 및 챗봇서비스를 구축하는 방법을 제시하는데 목적이 있다. 연구방법: 건설현장 스마트 건설기술 사례 및 문헌분석을 통하여 안전관리 모델을 제시한다. 연구결과: '건설사고 통계'에 따르면 2021년 건설업 사고재해자는 26,888명으로 전체 사고재해의 26.3%가 건설업에서 발생하였고, 건설업 안전사고 사망자는 417명으로 전체 산업재해 사망자의 50.5%에 달한다. 이런한 건설재해의 개선 방안으로, IoT 건전성모니터링 기반 스마트 건설기술을 활용한 건설현장 안전관리 AI 챗봇서비스를 제시한다. 근로자 등 이해관계자가 참여하는 건설현장은 비계공정 및 개구부, 위험기계기구류 접근 등 사업장 내부 주요 위험구역을 선정하여 인공지능 챗봇시스템을 구현하여 실증하였다. 결론: 건설현장 인공지능 챗봇서비스 실증결과에 대한 참여근로자의 만족도 조사에서 90점 이상을 받아 상업화 가능성을 확인하였다.