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The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly (농촌지역 노인들의 인지기능 장애와 사망과의 관련성)

  • Sun, Byeong-Hwan;Park, Kyeong-Soo;Na, Baeg-Ju;Park, Yo-Seop;Nam, Hae-Sung;Shin, Jun-Ho;Sohn, Seok-Joon;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.630-642
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    • 1997
  • The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

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The Impact of Human Resource Innovativeness, Learning Orientation, and Their Interaction on Innovation Effect and Business Performance : Comparison of Small and Medium-Sized vs. Large-Sized Companies (인적자원의 혁신성, 학습지향성, 이들의 상호작용이 혁신효과 및 사업성과에 미치는 영향 : 중소기업과 대기업의 비교연구)

  • Yoh, Eunah
    • Korean small business review
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    • v.31 no.2
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    • pp.19-37
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    • 2009
  • The purpose of this research is to explore differences between small and medium-sized companies and large-sized companies in the impact of human resource innovativeness(HRI), learning orientation(LO), and HRI-LO interaction on innovation effect and business performance. Although learning orientation has long been considered as a key factor influencing good performance of a business, little research was devoted to exploring the effect of HRI-LO interaction on innovation effect and business performance. In this study, it is investigated whether there is a synergy effect between innovative human workforce and learning orientation corporate culture, in addition to each by itself, to generate good business performance as well as a success of new innovations in the market. Research hypotheses were as follows, including H1) human resource innovativeness(HRI), learning orientation(LO), and interactions of HRI and LO(HRI-LO interaction) positively affect innovation effect, H2) there is a difference of the effect of HRI, LO, and HRI-LO interaction on innovation effect between large-sized and small-sized companies, H3) HRI, LO, HRI-LO interaction, innovation effect positively affect business performance, and H4) there is a difference of the effect of HRI, LO, HRI-LO interaction, and innovation effect on business performance between large-sized and small-sized companies. Data were obtained from 479 practitioners through a web survey since the web survey is an efficient method to collect a national data at a variety of fields. A single respondent from a company was allowed to participate in the study after checking whether they have more than 5-year work experiences in the company. To check whether a common source bias is existed in the sample, additional data from a convenient sample of 97 companies were gathered through the traditional survey method, and were used to confirm correlations between research variables of the original sample and the additional sample. Data were divided into two groups according to company size, such as 352 small and medium-sized companies with less than 300 employees and 127 large-sized companies with 300 or more employees. Data were analyzed through t-test and regression analyses. HRI which is the innovativeness of human resources in the company was measured with 9 items assessing the innovativenss of practitioners in staff, manager, and executive-level positions. LO is the company's effort to encourage employees' development, sharing, and utilizing of knowledge through consistent learning. LO was measured by 18 items assessing commitment to learning, vision sharing, and open-mindedness. Innovation effect which assesses a success of new products/services in the market, was measured with 3 items. Business performance was measured by respondents' evaluations on profitability, sales increase, market share, and general business performance, compared to other companies in the same field. All items were measured by using 6-point Likert scales. Means of multiple items measuring a construct were used as variables based on acceptable reliability and validity. To reduce multi-collinearity problems generated on the regression analysis of interaction terms, centered data were used for HRI, LO, and Innovation effect on regression analyses. In group comparison, large-sized companies were superior on annual sales, annual net profit, the number of new products/services in the last 3 years, the number of new processes advanced in the last 3 years, and the number of R&D personnel, compared to small and medium-sized companies. Also, large-sized companies indicated a higher level of HRI, LO, HRI-LO interaction, innovation effect and business performance than did small and medium-sized companies. The results indicate that large-sized companies tend to have more innovative human resources and invest more on learning orientation than did small-sized companies, therefore, large-sized companies tend to have more success of a new product/service in the market, generating better business performance. In order to test research hypotheses, a series of multiple-regression analysis was conducted. In the regression analysis examining the impact on innovation effect, important results were generated as : 1) HRI, LO, and HRI-LO affected innovation effect, and 2) company size indicated a moderating effect. Based on the result, the impact of HRI on innovation effect would be greater in small and medium-sized companies than in large-sized companies whereas the impact of LO on innovation effect would be greater in large-sized companies than in small and medium-sized companies. In other words, innovative workforce would be more important in making new products/services that would be successful in the market for small and medium-sized companies than for large-sized companies. Otherwise, learning orientation culture would be more effective in making successful products/services for large-sized companies than for small and medium-sized companies. Based on these results, research hypotheses 1 and 2 were supported. In the analysis of a regression examining the impact on business performance, important results were generated as : 1) innovation effect, LO, and HRI-LO affected business performance, 2) HRI by itself did not have a direct effect on business performance regardless of company size, and 3) company size indicated a moderating effect. Specifically, an effect of the HRI-LO interaction on business performance was stronger in large-sized companies than in small and medium-sized companies. It means that the synergy effect of innovative human resources and learning orientation culture tends to be stronger as company is larger. Referring to these result, research hypothesis 3 was partially supported whereas hypothesis 4 was supported. Based on research results, implications for companies were generated. Regardless of company size, companies need to develop the learning orientation corporate culture as well as human resources' innovativeness together in order to achieve successful development of innovative products and services as well as to improve sales and profits. However, the effectiveness of the HRI-LO interaction would be varied by company size. Specifically, the synergy effect of HRI-LO was stronger to make a success of new products/services in small and medium-sized companies than in large-sized companies. However, the synergy effect of HRI-LO was more effective to increase business performance of large-sized companies than that of small and medium-sized companies. In the case of small and medium-sized companies, business performance was achieved more through the success of new products/services than much directly affected by HRI-LO. The most meaningful result of this study is that the effect of HRI-LO interaction on innovation effect and business performance was confirmed. It was often ignored in the previous research. Also, it was found that the innovativeness of human workforce would not directly influence in generating good business performance, however, innovative human resources would indirectly affect making good business performance by contributing to achieving the development of new products/services that would be successful in the market. These findings would provide valuable managerial implications specifically in regard to the development of corporate culture and education program of small and medium-sized as well as large-sized companies in a variety of fields.

Four-year change and tracking of serum lipids in Korean adolescents (강화지역 청소년의 4년간 혈청 지질의 변화와 지속성)

  • Lee, Kang-Hee;Suh, Il;Jee, Sun-Ha;Nam, Chung-Mo;Kim, Sung-Soon;Shim, Won-Heum;Ha, Jong-Won;Kim, Suk-Il;Kang, Hyung-Gon
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.1 s.56
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    • pp.45-59
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    • 1997
  • It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.

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Biliary Atresia in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담도폐색증 - 대한소아외과학회회원 대상 전국조사 -)

  • Choi, Kum-Ja;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.H.;Park, K.W.;Park, W.H.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Jhung, S.Y.;Jhung, S.E.;P.M., Jung;S.O., Choi;Choi, S.H.;Han, S.J.;Huh, Y.S.;Hong, C.;Hwbang, E.H.
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.143-155
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    • 2002
  • A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

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