• Journal of Environmental Impact Assessment
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• v.33 no.4
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• pp.143-154
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• 2024

Heat waves caused by climate change are rapidly increasing health damage to vulnerable groups, and to prevent this, the national, regional, and local governments are establishing climate crisis adaptation policy. A representative climate crisis adaptation policy to reduce heat wave damage is to expand the number of cooling centers. Because it is highly effective in a short period of time, most metropolitan local governments, except Jeonbuk, include the project as an adaptation policy. However, the criteria for selecting a cooling centers are different depending on the budget and non-budget, so the utilization rate and effectiveness of the cooling centers are all different. Therefore, in this study, we developed logistic regression models that can predict and evaluate areas with a high probability of expanding cooling centers in order to implement adaptation policy in local governments. In Incheon Metropolitan City, which consists of various heat wave-vulnerable environments due to the coexistence of the old city and the new city, a logistic model was developed to predict areas where heat waves can be cooling centered by dividing it into Ganghwa·Ongjin-gun and other regions, taking into account socioeconomic and environmental differences. As a result of the study, the statistical model for the Ganghwa·Ogjin-gun region showed that the higher the ground surface temperature and the more and more the number of elderly people over 65 years old, the higher the possibility of location of cooling centers, and the prediction accuracy was about 80.93%. The developed logistic regression model can predict and evaluate areas with a high potential as cooling centers by considering regional environmental and social characteristics, and is expected to be used for priority selection and management when designating additional cooling centers in the future.

• 한국노년학
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• v.40 no.3
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• pp.543-563
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• 2020

As people age and their physical functions are declined, they stay longer in the home, thus being more affected by the home environment. Many studies have shown the association between the home environment and health. However, little is known about the effect of the home environment on disability and depression of older people with functional limitation. This study, therefore, aimed to examine the moderating effect of the home environment on the pathway between walking limitation and instrumental activity of daily living(IADL) disability, and the relationship between IADL disability and depression. We performed logistic regression and multiple linear regression analyses with data on 3,027 participants from the 2018 Seoul Aging Survey. As results, first, older people who lived home with poor conditions showed a higher risk of walking limitation(OR=1.487, 95% CI: 1.250 - 1.770), IADL disability(OR=1.594, 95% CI: 1.303 - 1.949), and depression(OR=1.943, 95% CI: 1.553 - 2.430). Second, the home environment moderated the relationship between walking limitation and IADL disability. Older people with walking limitation who lived in poor housing condition experienced more IADL disability than others. Third, after controlling for walking limitation, the home environment had significant moderating effect on the relationship between IADL disability and depression. Elderly with IADL disability living in poor home experienced higher risk of depression. Based on these results, the study suggests the necessity of home modification intervention targeting functional limitation of older adults as strategy for preventing disability and depression, and enabling aging in place.

• 한국노년학
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• v.40 no.4
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• pp.729-746
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• 2020

For the development and better use of information and communication technology(ICT) for promoting health and quality of life in older people, it is important to understand personal factors associated with ICT use. The aims of this study were to describe the pattern of ICT use according to health characteristics of elderly and to investigate significant factors related to ICT use among three age groups. The data of 2017 National Survey of Older Koreans was used for analysis and 10,058 of older adults aged 65 and over were included for study participants. As results, first, the young old(65~74) used more functions of ICT than the middle-old(75~84) and the old-old(85 and over). Second, ICT was more used among older people with good conditions in chronic disease, subjective health, cognition, depression, vision, hearing, walking and IADL. Third, higher prevalence of ICT use was significantly associated with age, education, household income, subjective health, depression, cognitive function, vision limitation and walking limitation. Fourth, factors influencing the use of ICT were a little different among three age groups. For the young-old(65~74), subjective health, depression, cognitive decline, walking limitation, and IADL disability were significant factors affecting on ICT use. For the middle-old(75-84), subjective health, depression, cognitive decline, vision, hearing, and walking limitation were related with their ICT use. For the old-old(85 and over), only cognitive function and depression were associated with their ICT use. Based on these results, this study suggested the need to consider multiple health conditions for developing and using ICT for older adults.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.418-426
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• 2019

Purpose: This study analyzed the features of humeral head decentralization in large to massive rotator cuff tears with a shoulder dislocation in the elderly. Moreover, shoulder instability and treatment were reviewed. Materials and Methods: From May 2005 to February 2017, Group A containing 45 cases (45 patients) over 65 years old accompanied by a large or massive rotator cuff tear with a shoulder dislocation and Group B containing 45 cases (45 patients) without a shoulder dislocation were enrolled. The mean ages in Groups A and B were 73.2 and 72.1 years old, and the mean follow-up periods were 30.7 and 31.3 months, respectively. Twenty-one cases (46.7%) in Group A underwent rotator cuff repair, and 8 cases (17.8%) underwent concomitant rotator cuff repair with Bankart repair. Sixteen cases (35.6%) underwent reverse total shoulder arthroplasty for cuff tear arthropathy. 45 cases (100%) in Group B underwent rotator cuff repair. The off-the center and head elevation were measured in the preoperative magnetic resonance imaging (MRI) of Groups A and B. The preoperative and postoperative visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score in Groups A and B were compared. Results: In Groups A and B, the mean off-the centers were posterior 7.41 mm and posterior 2.02 mm (p=0.03), and the mean head elevations were superior 6.66 mm and superior 2.44 mm (p=0.02), respectively. The mean ASES scores of Groups A and B were 32.8 and 33.4 before surgery, and 77.1 (p=0.02) and 78.1 (p=0.02) after surgery (p=0.18), respectively. The mean UCLA scores of Groups A and B were 13.1 and 12.8 before surgery, and 28.9 (p=0.02) and 29.5 (p=0.01) after surgery (p=0.15), respectively. Conclusion: Patients over 65 years old with a shoulder dislocation in large to massive rotator cuff tears had higher off-the center and head elevation on the preoperative MRI than those without a shoulder dislocation. This measurement can help predict preceding shoulder instability. Early rotator cuff repairs should be performed and other treatments, such as Bankart repair and reverse total shoulder arthroplasty, should also be considered.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4723-4733
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• 2015

This study was to examine the effect of perceived health status, self-esteem and quality of life on life satisfaction of community dwelling elders school participants. A cross-sectional descriptive study was conducted with a survey of 269 older people in person 3 senior center welfare at G City. The data were analyzed with t-test, ANOVA, Pearson's correlation coefficients and multiple regression using SPSS WIN 21.0 program. The mean score of the was life satisfaction $27.05{\pm}6.63$. Life satisfaction was had a positive correlation with self-esteem (r=.676 p<.001) and a negative correlation with perceived health status(r=-.6.02, p<.001) and quality of life(r=-.536, p<.001). The result of the regression indicated that perceived health status, self-esteem, quality of life explained 59.3% of variance in life satisfaction. The result suggest that it is necessary to develop strategies to promote life satisfaction for community dwelling elders to improve life satisfaction.

• Journal of the Korea Convergence Society
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• v.7 no.6
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• pp.317-325
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• 2016

The purpose of this study was to examine the effect of the education intervention program as a nutrition program and exercise for the improvement of metabolic syndrome in women who voluntarily participated in health program in public health centers over 30 years of age. The subjects of this study were 120 women who completed the 12 - week obesity clinic program among the 400 obesity clinic participants in the northeastern of Seoul. Exercise and nutrition programs were administered on a daily basis for 1 hour every week for 12 hours with exercise and nutrition for 1 week to assess the effect of the participants on the risk factors of metabolic syndrome in health program. The metabolic syndrome and the risk of the disease were examined by analyzing the metabolic syndrome risk factors, change magnitude and change rates before and after the intervention. Waist circumference(p <.001), systolic blood pressure (p <.001), diastolic blood pressure (p <.001) and body mass index (p <.001) decreased during the 12 - week health program. Body weight (p <.01), waist circumference (p <.05), BMI (p <.01) and fat mass (p <.05) decreased more in the age group below 50 years.

• The Korean Journal of Applied Statistics
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• v.22 no.4
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• pp.771-780
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• 2009

Cataract is the main cause of blindness and visual impairment, especially, age-related cataract accounts for about half of the 32 million cases of blindness worldwide. As the life expectancy and the expansion of the elderly population are increasing, the cases of cataract increase as well, which causes a serious economic and social problem throughout the country. However, the incidence of cataract can be reduced dramatically through early diagnosis and prevention. In this study, we developed a prediction model of cataracts for early diagnosis using hospital data of 3,237 subjects who received the screening test first and then later visited medical center for cataract check-ups cataract between 1994 and 2005. To develop the prediction model, we used random forests and compared the predictive performance of this model with other common discriminant models such as logistic regression, discriminant model, decision tree, naive Bayes, and two popular ensemble model, bagging and arcing. The accuracy of random forests was 67.16%, sensitivity was 72.28%, and main factors included in this model were age, diabetes, WBC, platelet, triglyceride, BMI and so on. The results showed that it could predict about 70% of cataract existence by screening test without any information from direct eye examination by ophthalmologist. We expect that our model may contribute to diagnose cataract and help preventing cataract in early stages.

• Journal of Biomedical Engineering Research
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• v.31 no.3
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• pp.217-226
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• 2010

The lower limb orthosis with a pneumatic rubber actuator, which is intended for the assistance and the enhancement of muscular activities of lower limbs was developed in this study. Compared to other knee extension assistive devices being developed by other researchers, our device is designed especially for the elderly people and intended only for slight assistance so that the subjects can keep their muscular strength. For the effectiveness of system, muscular activities of major muscles in lower limbs during sit-to-stand (STS) and squat motion were measured and analyzed. Subjects were performed the STS and squat motion with and without lower limb orthosis. We made comparison muscular activities between with and without lower limb orthosis. Lower limb orthosis was controlled using muscular stiffness force feedback that is controlled by muscular activities of the measured muscle from force sensor. For analysis of muscular activities, electromyography of the subjects was measured during STS and squat motion, and these were measured using MP 150(BIOPAC Systems, Inc.). Muscles of interest were rectus femoris(RF), vastus lateralis(VL), vastus medialis(VM) and vastus intermedius(VI) muscles in lower limbs of the right side. A biodex dynamometer was used to measure the maximal concentric isokinetic strength of the knee extensors of wearing and not wearing orthosis on right side. The test were performed using the concentric isokinetic mode of test with the velocity set at 60°/s for muscles around the knee joints. The experimental result showed that muscular activities in lower limbs wearing orthosis using muscular stiffness force of a vastus medialis muscle was reduced and knee extension torque of an knee joint wearing lower limb orthosis was increased. With this, we confirmed the effectiveness of the developed lower limb orthosis.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.165-170
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• 2016

Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

• Korea Journal of Hospital Management
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• v.25 no.2
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• pp.45-56
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• 2020

Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.