• Investigative Magnetic Resonance Imaging
• /
• v.25 no.3
• /
• pp.164-171
• /
• 2021

Purpose: Mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD). Brain atrophy in this disease spectrum begins in the medial temporal lobe structure, which can be recognized by magnetic resonance imaging. To overcome the unsatisfactory inter-observer reliability of visual evaluation, quantitative brain volumetry has been developed and widely investigated for the diagnosis of MCI and AD. The aim of this study was to assess the prediction accuracy of quantitative brain volumetry using a fully automated segmentation software package, NeuroQuant^®, for the diagnosis of MCI. Materials and Methods: A total of 418 subjects from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease cohort were included in our study. Each participant was allocated to either a cognitively normal old group (n = 285) or an MCI group (n = 133). Brain volumetric data were obtained from T1-weighted images using the NeuroQuant software package. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to investigate relevant brain regions and their prediction accuracies. Results: Multivariate logistic regression analysis revealed that normative percentiles of the hippocampus (P < 0.001), amygdala (P = 0.003), frontal lobe (P = 0.049), medial parietal lobe (P = 0.023), and third ventricle (P = 0.012) were independent predictive factors for MCI. In ROC analysis, normative percentiles of the hippocampus and amygdala showed fair accuracies in the diagnosis of MCI (area under the curve: 0.739 and 0.727, respectively). Conclusion: Normative percentiles of the hippocampus and amygdala provided by the fully automated segmentation software could be used for screening MCI with a reasonable post-processing time. This information might help us interpret structural MRI in patients with cognitive impairment.

• Journal of Korean geriatric psychiatry
• /
• v.21 no.1
• /
• pp.35-40
• /
• 2017

Objective : This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. Methods : We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. Results : In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=$10.74{\pm}3.482$ : $7.25{\pm}4.475$, p=0.0184). Conclusion : These results may suggest that 'Community-based the Goal-Achieving program' has efficacy in reducing geriatric depressive symptoms.

• Journal of Environmental Health Sciences
• /
• v.48 no.2
• /
• pp.59-65
• /
• 2022

Background: Since people move through microenvironments rather than staying in one place, they may be exposed to both indoor and outdoor PM_2.5 concentrations. Objectives: The aim of this study was to assess the exposure level of each sub-population group and evaluate the contribution rate of the major microenvironments. Methods: Exposure scenarios for sub-population groups were constructed on the basis of a 2019 Time-Use survey and the previous literature. A total of five population groups were classified and researchers wearing MicroPEM simulated monitoring PM_2.5 exposure concentrations in real-time over three days. The exposure contribution for each microenvironment were evaluated by multiplying the inhalation rate and the PM_2.5 exposure concentration levels. Results: Mean PM_2.5 concentrations were 33.0 ㎍/m³ and 22.5 ㎍/m³ in Guro-gu and Wonju, respectively. When the exposure was calculated considering each inhalation rate and concentration, the home showed the highest exposure contribution rate for PM_2.5. As for preschool children, it was 90.8% in Guro-gu, 94.1% in Wonju. For students it was 65.3% and 67.3%. For housewives it was 98.2% and 95.8%, and 59.5% and 91.7% for office workers. Both regions had higher exposure to PM_2.5 among the elderly compared to other populations, and their PM_2.5 exposure contribution rates were 98.3% and 94.1% at home for Guro-gu and Wonju, respectively. Conclusions: The exposure contribution rate could be dependent on time spent in microenvironments. Notably, the contribution rate of exposure to PM_2.5 at home was the highest because most people spend the longest time at home. Therefore, microenvironments such as home with a higher contribution rate of exposure to PM_2.5 could be managed to upgrade public health.

• The Journal of The Korea Institute of Intelligent Transport Systems
• /
• v.21 no.4
• /
• pp.115-124
• /
• 2022

Unlike the semi-public system of city buses, Seoul's townbus are operated on a private operating system, which is poor condition to the changes in the environment. Sales decreased due to a decrease in the number of passengers due to COVID-19 and a demand for conversion due to the advent of competitive transportation methods, and the financial support of Seoul Metropolitan Government is continuously increasing. In this study, to analyze the characteristics of townbus operated by a private operating system, the townbus sales and surplus companies were analyzed by what factors were affected. For the analysis data, townbus financial statements of Seoul in 2018 were used, and townbus sales and surplus companies were applied as dependent variables, and townbus operation system, satisfaction survey, humanities and social variables, and subway and public bicycle characteristics were applied as independent variables. As a result of the analysis, the sales is affected by operating hours per vehicle, in-vehicle safety, the number of households, the number of elderly people, and public bicycle variables, and surplus companies are affected by in-vehicle safety, reliability, and public bicycle variables. In particular, public bicycles, a competitive means of transportation, had an impact on industry sales, and the townbus business environment is expected to become more difficult as time goes by. The industry is seeking self-rescue measures, and Seoul is required to strengthen financial support so that townbus can operate stably.

• The Journal of KAIRB
• /
• v.5 no.1
• /
• pp.21-32
• /
• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• 한국노년학
• /
• v.29 no.4
• /
• pp.1577-1589
• /
• 2009

The purpose of this study was to compare the health status, functional status, and home environment hazards by the fear of falling and explore the factors that contribute to the fear of falling. This was a descriptive study. Data were collected for two years with 973 older adults who enrolled in a health center at A city. Trained nurses visited subjects' home and collected data using Resident Assessment Instrument MDS-HC. The average age of the subjects was 76.8 (±7.6) and female was 74.8%. 20.7% of subjects reported fear of falling. In terms of the fear of falling, two groups were compared. There were significant differences in vision, urinary incontinence, pain that interrupts daily activity, unstable gait, comorbidities, frequency of depressive or anxious sign. The greater the age, IADL and ADL dependency, comorbidities, unstabled gait, the more fear of falling. In conclusion, this study reassured the importance of assessing the major factors related to fear of falling such as age, IADL and ADL, comorbities, gait among older adults. This study will contribute to establish strategies for preventing fall. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

• Journal of Practical Engineering Education
• /
• v.15 no.3
• /
• pp.751-759
• /
• 2023

In the era of global aging and the retirement of baby boomers, the response is very intensive and dynamic. As baby boomers actually retire, the terms for middle-aged people have been diversified into middle-aged, midle-elderly, and the new middle, which are also evident in the training process. In line with the timing, the government and academia are also making efforts to advance the development of training courses for middle-aged, along with organizing terms for middle-aged. From this point of view, this study aims to analyze the performance of the three-year training courses (2018-2020) for the new middle at Korea Polytechnics and suggest the direction of development of the new middle training course. As a result of the study, the three-year performance of the Shin middle-aged training course gradually increased, but the completion rate and employment rate gradually decreased, indicating that countermeasures were needed. In addition, campus performance in the metropolitan area was higher than that in the non-capital area, so a plan for this deviation was needed. In addition, the need for the integrated operation of the existing 'middle-aged' and 'the new middle' courses operated by Korea Polytechnics was suggested, and measures to specialize in the new middle-aged were proposed.

• Journal of Industrial Convergence
• /
• v.21 no.10
• /
• pp.65-80
• /
• 2023

Through inductive content analysis, this study sought to examine the crisis experienced by the institution, the quality of service, and the distrust of the system and institution based on the experience of distrust in the home-visiting care service of bbeneficiary and guardians. FGI was conducted on five managers of institutions that provide home-visiting care services. As a result, the central phenomenon was found: deterioration of service quality, distrust of systems and institutions, and difficulties in opera-ting long-term care institutions. In order to improve the quality of home-visited care services and build trust in care workers and institutions, first, home-based associations or operating corporations should develop new education program plans and manuals to strengthen the capabilities of care workers and social workers. Second, the NHIS's monitoring system and the professional management system of care workers should be established. Third, it is necessary to improve awareness of the role, expertise, and rights of care workers, and fourth, improvement measures are required to reduce the turnover rate of care workers, which is the cause of the deterioration of the quality of long-term care services.

• Dementia and Neurocognitive Disorders
• /
• v.23 no.1
• /
• pp.30-43
• /
• 2024

Background and Purpose: The SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention (SUPERBRAIN) proved the feasibility of multidomain intervention for elderly people. One-quarter of the Korean population over 65 years of age has mild cognitive impairment (MCI). Digital health interventions may be cost-effective and have fewer spatial constraints. We aim to examine the efficacy of a multidomain intervention through both face-to-face interactions and video communication platforms using a tablet personal computer (PC) application in MCI. Methods: Three hundred participants aged 60-85 years, with MCI and at least one modifiable dementia risk factor, will be recruited from 17 centers and randomly assigned in a 1:1 ratio to the multidomain intervention and the waiting-list control groups. Participants will receive the 24-week intervention through the tablet PC SUPERBRAIN application, which encompasses the following five elements: managing metabolic and vascular risk factors, cognitive training, physical exercise, nutritional guidance, and boosting motivation. Participants will attend the interventions at a facility every 1-2 weeks. They will also engage in one or two self-administered cognitive training sessions utilizing the tablet PC application at home each week. They will participate in twice or thrice weekly online exercise sessions at home via the ZOOM platform. The primary outcome will be the change in the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Conclusions: This study will inform the effectiveness of a comprehensive multidomain intervention utilizing digital technologies in MCI.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.44 no.1
• /
• pp.107-118
• /
• 2016

The Seoul metropolitan government announced an open design competition for reconfiguring the annex building of the National Tax Service Building site on Sejong-daero as a space for citizens to commemorate the 70th anniversary of Korea's liberation. The site, built during the Japanese colonial period, has been in use ever since. This study, as one of the entries for the competition, described the strategy and design contents by drawing the concept and main points of the design through an analysis of the historical context of the site. As the guidelines instructed to consider the value of the Sejong-daero area and the cultural heritage through a comprehensive analysis, this study specified the site as a place connecting the past, present and future. Since the foundation of the Joseon dynasty, the Korean Empire and the Japanese colonial period, Sejong-daero has been a main site for important events and activities along with the change of the city structure. Jungdong, to the rear of the site, was a place for adopting new culture during the beginnings of modern Korea, while adjacent places like Duksugung, the Anglican church, and the Seoul City Council building have also been historic urban landscapes of the historical layers of time as the city has changed. When Gojong announced the Korean Empire, the city structure was remodeled with this site as the center along with Sogong-ro, Wongudan and so forth. In this study, public interest stated in the guidelines was focused and the relevance of the road and the plaza was considered from the view of an historic urban landscape by a comprehensive analysis with Sejong-daero as the center. The restoration of public interest was to be drawn as the concept of the object site by considering the current status and the change around the site and Jungdong at the rear. Returning the site to the public is ambiguous with the relevance of the restoration of public interest and as the symbol of the idea of the Korean Empire by Gojong's announcement. The object site, having the characteristic of being returned to the public, must ensure public interest and therefore the design strategy has been established with the keywords of openness, connection and void. As a result of a review of the alternatives, a plan for a square has an 8% slope, just as the original site does, and provides ramps for convenient access for all, including the disabled and the elderly, and is connected to the grounds adjacent. No construction is allowed at the terrace square of the Anglican church level and the main square connected to the pedestrian street, so a variety of modern city utilization can be done. The value of the site at which this design is aimed shall be given back to the public with the concepts of modern democracy, independence, and the vision of Gojong by reinterpreting the space from a modern viewpoint. This study focused on the processes of establishing a main concept and strategy rather than the content of the design details, and the suggestion is meaningful in that the design for the object site with historic backgrounds and the layers of time can continue to be grown.