Individuals In Korea Research Articles

Dysbiotic signatures and diagnostic potential of gut microbial markers for inflammatory bowel disease in Korean population

Fecal samples were collected from 640 individuals in Korea, including 523 patients with IBD (223 with Crohn’s disease [CD] and 300 with ulcerative colitis [UC]) and 117 healthy controls. The samples were subjected to cross-sectional gut metagenomic analysis using 16 S rRNA sequencing and bioinformatics analysis. Patients with IBD, particularly those with CD, exhibited significantly lower alpha diversities than the healthy subjects. Differential abundance analysis revealed dysbiotic signatures, characterized by an expansion of the genus Escherichia-Shigella in patients with CD. Functional annotations showed that functional pathways related to bacterial pathogenesis and production of hydrogen sulfide (H2S) were strongly upregulated in patients with CD. A dysbiosis score, calculated based on functional characteristics, highly correlated with disease severity. Markers distinguishing between healthy subjects and patients with IBD showed accurate classification based on a small number of microbial taxa, which may be used to diagnose ambiguous cases. These findings confirm the taxonomic and functional dysbiosis of the gut microbiota in patients with IBD, especially those with CD. Taxa indicative of dysbiosis may have significant implications for future clinical research on the management and diagnosis of IBD.

Factors influencing air passengers' intention to purchase voluntary carbon offsetting programs: The moderating role of environmental knowledge

BackgroundThis paper aims to investigate the factors that influence air passengers' intention to purchase the VCO program by applying the extended Theory of Planned Behavior. Furthermore, we examine how the influence of these factors on purchasing intention varies according to passengers' levels of environmental knowledge. MethodsWe surveyed 319 individuals in Korea who have had air travel experience within the past three years and are planning future air travel. The collected data were analyzed using SPSS 25.0 and AMOS 25.0. To verify validity and reliability, we conducted confirmatory factor analysis and reliability analysis. Hypotheses were tested using a structural equation model, and the moderating effect of environmental knowledge was verified through multi-group analysis. FindingsOur findings revealed that personal norms, subjective norms, attitudes, and perceived behavioral control influence customers' intentions to purchase VCO program, in that order. Additionally, a critical aspect of our research is the multigroup analysis that demonstrates how environmental knowledge moderates the effects of attitudes and personal norms on purchase intentions. This indicates that the level of environmental awareness significantly shapes the decision-making process for participating in VCO program. Our study provides valuable insights for developing effective communication strategies to promote VCO program, emphasizing the need for tailored approaches based on individuals’ environmental knowledge. OriginalityThis study is the first to analyze the intention to purchase voluntary carbon offset (VCO) program among Korean passengers. We conducted a comprehensive analysis based on the extended Theory of Planned Behavior (TPB) and investigated how the relative influence of each factor varies depending on the level of environmental knowledge.

Baseline glycated albumin level and risk of type 2 diabetes mellitus in Healthy individuals: a retrospective longitudinal observation in Korea

Glycated albumin (GA) reflects glycemic status for the past three weeks. GA level demonstrates a strong correlation with HbA1c level and is used as an adjunctive biomarker for diagnosis and monitoring of type 2 diabetes mellitus (T2DM). In this study, we validated the predictive performance of baseline GA for development of T2DM in healthy individuals in Korea. From August 2013 to September 2014, the medical records of 3,771 healthy Koreans were retrospectively reviewed. Each participant was categorized into tertiles based on initial GA level. During the follow-up period through May 2020, study participants were evaluated for T2DM using HbA1c, fasting glucose level, and a self-reported diagnosis history. Baseline GA level by tertile (T1 to T3) was 10.4 ± 0.8% (mean ± SD), 12.1 ± 0.3%, and 13.7 ± 0.9%, respectively. The median follow-up was 5.97 years, during which 4.9% (186 of 3,771) of the participants developed T2DM. After adjusting for confounding factors, the hazard ratio for the development of T2DM in the highest GA level group (T3) compared to the reference group (T1) was 2.46 (95% CI, 1.7 to 3.58, p < 0.001 for trend) with a Harrell’s C index of 0.80 (95% CI, 0.76 to 0.83). Also, within highest group of baseline HbA1c and FG levels, higher GA levels were associated with an increased HRs for T2DM. In conclusion, Our study confirms that the risk of T2DM increases with baseline GA level. Additional follow-up of the cohort is warranted to investigate the correlations between GA and other clinical indicators including diabetic complications.

A novel approach to quantifying individual's biological aging using Korea’s national health screening program toward precision public health

Accurate prediction of biological age can inform public health measures to extend healthy lifespans and reduce chronic conditions. Multiple theoretical models and methods have been developed; however, their applicability and accuracy are still not extensive. Here, we report Differential Aging and Health Index (DAnHI), a novel measure of age deviation, developed using physical and serum biomarkers from four million individuals in Korea's National Health Screening Program. Participants were grouped into aging statuses (< 26 vs. ≥ 26, < 27 vs. ≥ 27, …, < 75 vs. ≥ 75 years) as response variables in a binary logistic regression model with thirteen biomarkers as independent variables. DAnHI for each individual was calculated as the weighted mean of their relative probabilities of being classified into each older age status, based on model ages ranging from 26 to 75. DAnHI in our large study population showed a steady increase with the increase in age and was positively associated with death after adjusting for chronological age. However, the effect size of DAnHI on the risk of death varied according to the age group and sex. The hazard ratio was highest in the 50–59-year age group and then decreased as the individuals aged. This study demonstrates that routine health check-up biomarkers can be integrated into a quantitative measure for predicting aging-related health status and death via appropriate statistical models and methodology. Our DAnHI-based results suggest that the same level of aging-related health status does not indicate the same degree of risk for death.

Exploring Clonal Hematopoiesis in Chronic Graft Versus Host Disease Patients: A Comprehensive Study

Introduction Clonal hematopoiesis (CH) is a prevalent condition characterized by the presence of genetic mutations in hematopoietic cells, without being associated with any overt hematological malignancy. Emerging evidence has linked CH to various health complications, potentially contributing to higher morbidity rates in cancer survivors and individuals with chronic inflammatory diseases. Increased inflammation has been identified as a consequence of CH-related mutations, which may underlie these risks. Chronic graft versus host disease (cGVHD), debilitating complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT), is a multisystem inflammatory disease. However, to date, the relationship between CH and cGVHD remains poorly understood. This study aims to investigates the potential role of CH in increasing the risk of developing cGVHD. Methods Research was conducted on patients who met the following inclusion criteria; (1) adult (age ≥ 18 years) acute myeloid leukemia (AML) patients who had previously consented to blood banking at a human resources bank and signed a residual specimen research agreement (IRB: H-2202-100-1302); (2) received allo-HSCT between Jul 2013 and Oct 2020; (3) experienced cGVHD of any NIH severity; (4) had peripheral blood sample taken after the occurrence of cGVHD but without relapse at that time, evidenced by &amp;gt;95% donor chimerism. The sequencing of 24 CH-related genes reported to date was performed at a sequence depth of ≥1000X, and the results were reported with a sensitivity of 99.9% and an accuracy of 99.9%. Analysis was conducted on patients with Variant Allele Frequency (VAF) ranging from 2.0% to less than 30.0%, classifying them as CH positive. Result A total of 134 patients who met the inclusion criteria were included in the analysis. The mean age at matched sibling donors (MSD) (n=41, 30.6%), unrelated donors (UD) (n=38, 28.4%) and haplo-identical donors (HID) transplants (n=55, 41.0%) was 48, 45 and 43 years for recipients, respectively, with no statistically significant difference (p=0.220). However, there was a significant difference in the mean age of donors, with 45, 32 and 32 years for MSD, UD and HID transplants, respectively (p&amp;lt;0.001). Among the cGVHD patients, 11.9% (16/134) tested positive for CH. The majority of these CH+ patients had a DNMT3A mutation (11) followed by TET2 (2), ASXL1 (1) and PPM1D (1). Between the CH- and CH+ groups, there were no statistically significant differences in age (both recipient and donor), gender, and clinical outcomes including relapse and death. A trend towards a higher incidence of CH+ was observed in patients receiving HID transplants, with 3/41 (7.3%) for MSD, 3/38 (7.9%) for UD, and 10/55 (18.2%) for HID, although this difference was not statistically significant (p=0.177). In addition, we could not observe the differential impact of donor age on the incidence of CH+ after allo-HSCT. The distribution of CH was further analyzed based on clinical outcomes, dividing patients into severe cGVHD and non-severe cGVHD groups. The results showed that patients with a mutation in the TET2 gene, which contributes to CH, accounted for 6.9% (2/29) of the total patients in the severe cGVHD group, while it was 0% (0/105) in the non-severe cGVHD group. Next, we compared CH data from cGVHD patients to a cohort of 5205 healthy individuals in Korea, where a CH positivity rate of 7.9% was observed. We found a statistically significant increase in the odds ratio for CH positivity in the overall cGVHD population after adjusting for age. The highest detection of CH, including the DNMT3A gene, was observed when adjusting for recipient age (odds ratio of CH 2.41[1.39-4.19], p= 0.002) and when adjusting for donor age (odds ratio of CH 3.79[2.10-6.83], p= 0.001). Conclusion In this study, we found that 11.9% of cGVHD AML patients who underwent allo-HSCT tested positive for CH, with DNMT3A mutation being the most common. There was a trend towards a higher incidence of CH+ in HID transplant although it was not statistically significant. Compared to healthy individuals, cGVHD patients had a significant higher risk for CH positivity, particularly when adjusting for age. For the deeper understanding of CH's role in post-transplant complications, further analysis with incorporating the data regarding baseline genetic information from recipients and donors and non-cGVHD patients after allo-HSCT would be warranted.

Achieving active aging of older people with gratitude, independence, and government support—A biographical narrative approach

AbstractThis article aims to explore the perspectives and experiences of elderly individuals in Korea regarding active aging in their daily lives. The research utilizes Schütze's biographical narrative approach and involves six participants, comprising two males and four females aged between 73 and 82. The data collected undergoes analysis using Schütze's six‐step biographical narrative analysis method, resulting in the following key findings. The first significant finding in their biographical stories is that participants have gone through poverty, lack of education, economic activity, early marriage, dedicated child‐rearing, and the challenging times in Korea following the end of Japanese colonial rule and the Korean War. Secondly, the study discovered that older people could achieve a balanced and active life obtained from the love of family and friends, sincere faith, enjoyable social activities, precious jobs, and safety concerns by adopting a positive and appreciative approach toward life. The study's third finding highlights that older individuals wish to be self‐reliant, value government benefits, seek more economic opportunities, and need better social services to assist them during their vulnerable later years for active aging. Therefore, the thesis recommends that the Korean government provide older individuals with expanded healthcare management, caregiving services, and employment opportunities.

재한중국인의 범죄 안전의식이 삶의 질에 미치는 영향

In line with the recent global trend of globalization, active exchanges in the politics, economy, and culture of each country are taking place. In Korea, the number of foreigners coming for purposes such as studying abroad, employment, and business investment is increasing. Among them, individuals with Chinese nationality account for the highest proportion of all foreigners residing in Korea. Foreigners living in Korea, including those of Chinese origin, are adapting to a new environment, undergoing life and social changes such as adjustments to living conditions, food, human relationships, and language. Most importantly, Chinese individuals in Korea are more susceptible to becoming victims of crime due to characteristics unfamiliar to Korean society, such as difficulties in reporting damages and weak self-defense capabilities. These factors lower their quality of life and give rise to various problems. Hence, this study aims to assist Chinese individuals in Korea in improving their safety and quality of life. It seeks to achieve this by identifying the impact of crime safety awareness on their quality of life, and by establishing a theoretical basis for interventions and support for the Chinese community in Korea.&#x0D; Regarding the research methodology, a survey was conducted from April 26 to May 18, 2023, with all 101 responses used for analysis. Descriptive statistics, reliability analysis, t-tests, ANOVA, and hierarchical regression analysis were performed as analytical methods.&#x0D; The research analysis revealed several key findings. First and foremost, the demographic characteristics influencing the quality of life of Chinese individuals in Korea are marital status and educational background. Marital status is particularly significant when individuals are married, and the final education level being graduate school graduation or higher is also influential. Furthermore, based on the results of hierarchical regression analysis, the demographic factors affecting quality of life are marriage and middle school graduation. Crime safety awareness, which has an impact on quality of life, is correlated with an awareness of crime and engagement in crime prevention activities. Awareness of crime has a positive effect (+), indicating that an increase in awareness leads to an improvement in quality of life. Conversely, involvement in crime prevention activities has a negative effect (-), indicating that quality of life decreases with an increase in crime prevention activities.&#x0D; Drawing from these research results, the study concludes and suggests the need for community-level crime-fighting and prevention programs to improve the quality of life for Chinese individuals in Korea. Additionally, the study recommends the development and support of various psychological, counseling, and educational programs to alleviate the fear of crime victimization and enhance the overall well-being of the Chinese community in Korea. The study emphasizes the importance of conducting further research on crime safety awareness among Chinese individuals in Korea, particularly focusing on the fear of crime victimization, through subsequent studies. It underscores that intervention and support for the adaptation of Chinese individuals in Korea are critical aspects to consider.

Influence of job satisfaction on SRH and happiness among Korean disabled workers: findings from the panel survey of employment for the disabled 2016-2018.

An understanding of the economic life activities of persons with disabilities (PWD) is important. Their ability to perform tasks and an increase in their income are more likely to yield an improvement in their Self-Rated Health (SRH) and happiness. However, there is still a lack of understanding of the specific associations among PWD in South Korea. Thus, this study conducted a longitudinal analysis of the association between job satisfaction and SRH, happiness among the Korean PWD. After excluding missing values, data on 1,637 participants at baseline (1st wave) were analyzed using the chi-square test, t-test, Analysis of Variance (ANOVA) and generalized estimating equation (GEE) model for data from 1st to 3rd Panel Survey of Employment for the Disabled (PSED). All analyses were conducted using the SAS statistical software package, version 9.4. Compared to very high job satisfaction group, low job satisfaction group was more likely to experience negative SRH [odds ratio (OR): 3.497, value of p: <0.0001] and experience low happiness (B: -0.291, value of p: <0.0001). Furthermore, in terms of the overall satisfaction with current job among the PWD, compared to the 'very satisfied' group, 'very unsatisfied' group had higher negative SRH (OR: 5.158, value of p: 0.003) and lower happiness (B: -0.327, value of p: <0.0001). This study suggests that increasing job satisfaction of PWD possibly leads to decreased negative SRH and to increased happiness, resulting in better SRH and happiness. Furthermore, it suggests the establishment of systemic, policy-oriented measures to enhance the employment opportunities for disabled individuals in Korea and create an inclusive working environment that aligns with their respective job responsibilities.

Who Do We Turn to and What Do We Get? Cultural Differences in Attachment Structure and Function Among East Asian and Western Individuals.

To whom do we turn for support in times of need, and what does the support from close others convey? The present research investigated how the structure and function of attachment differ for individuals in East Asian and Western cultures. In three studies, using survey and daily diary data, we examined the role of the romantic partner as an attachment figure, and the consequences of receiving responsive support in close relationships among individuals in Korea and the United States. As expected, the role of the romantic partner as an attachment figure was less emphasized for Koreans compared with U.S. participants. Also, responsive support from close others was more strongly linked to affiliation-related end states (i.e., in-group agency) for Koreans than U.S. individuals. The present research demonstrates the need to consider nuanced cultural influences in the attachment literature for the broader application of the theory.

Gender Inequalities in Mental Health During the COVID-19 Pandemic: A Population-based Study in Korea.

This study explored the effect of the coronavirus disease 2019 (COVID-19) pandemic on psychosocial stress in prime working-age individuals in Korea, focusing on gender inequalities. We hypothesized that the impact of COVID-19 on mental health would differ by age and gender, with younger women potentially demonstrating heightened vulnerability relative to men. The study involved data from the Korea Community Health Survey and included 319 592 adults aged 30 years to 49 years. We employed log-binomial regression analysis, controlling for variables including age, education, employment status, marital status, and the presence of children. The study period included 3 phases: the period prior to the COVID-19 outbreak (pre-COVID-19), the early pandemic, and the period following the introduction of vaccinations (post-vaccination). The findings indicated that women were at a heightened risk of psychosocial stress during the early pandemic (relative risk [RR], 1.01; 95% confidence interval [CI], 0.98 to 1.05) and post-vaccination period (RR, 1.07; 95% CI, 1.04 to 1.10) compared to men. This pattern was prominent in urban women aged 30-34 years (pre-COVID-19: RR, 1.06; 95% CI, 1.02 to 1.10; early pandemic: RR, 1.16; 95% CI, 1.08 to 1.25; post-vaccination period, RR, 1.22; 95% CI, 1.14 to 1.31). The COVID-19 pandemic has exerted unequal impacts on psychosocial stress among prime working-age individuals in Korea, with women, particularly those in urban areas, experiencing a heightened risk. The findings highlight the importance of addressing gender-specific needs and implementing appropriate interventions to mitigate the psychosocial consequences of the pandemic.

The Relationships between Food, Recreation Expense, Subjective Health, and Life Satisfaction: Case of Korean People with Disability

The influence of subjective health and life satisfaction among disabled individuals is unknown. The purpose of this study was to determine the impact of food and recreation expenditure on subjective health and life satisfaction among disabled individuals in Korea. Data from the Panel Survey of Employment for the Disabled from 2016–2018 was utilized. Econometric analyses, least squares, fixed effect, and random affect models were applied. Results showed that monthly food and recreation cost exerted an inverted U-shaped impact on both subjective health and life satisfaction. These findings have policy implications showing a relationship between social and economic variables and health outcomes. This study also sheds light on the literature by clarifying the relationship among four attributes employing the disabled.

Epidemiology and subtype distribution of Blastocystis among asymptomatic volunteers in Korea: a multicenter study

Background: Blastocystis is a genus of intestinal, anaerobic protozoan parasites that can be isolated from humans, animals, and the environment. We aimed to determine the distribution of Blastocystis and subtypes (STs) using stool samples obtained from healthy volunteers at collection centers in Korea. Methods: A total of 478 stool samples from volunteers were collected at five collection centers throughout Korea. The presence of Blastocystis was determined using PCR based on the small subunit (SSU) rRNA gene, and Blastocystis STs were confirmed through sequencing of the SSU rRNA gene. Results: Molecular analysis revealed the presence of Blastocystis in 27 (5.6%) of the enrolled participants. Two STs were identified: ST3 (66.7%) and ST1 (33.3%). The positive rates of Blastocystis varied by geographical region, ranging from 1.2%–12.0%. ST3 was the predominant subtype in all centers except one, where only ST1 was isolated. Phylogenic analysis showed clustering based on ST, but no significant differences were found among the regions. There was no association between Blastocystis colonization and either age or sex of the participants. Conclusions: The results of this multicenter study demonstrated colonization by Blastocystis, mainly ST3, in the gastrointestinal tracts of asymptomatic individuals in Korea.

Evaluation of an air quality warning system for vulnerable and susceptible individuals in Korea: an interrupted time series analysis.

This study was conducted to elucidate the effects of an air quality warning system (AQWS) implemented in January 2015 in Korea by analyzing changes in the incidence and exacerbation rates of environmental diseases. Data from patients with environmental diseases were extracted from the National Health Insurance Service-National Sample Cohort database from 2010 to 2019, and data on environmental risk factors were acquired from the AirKorea database. Patient and meteorological data were linked based on residential area. An interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after AQWS introduction. Adjustment variables included seasonality, air pollutants (carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter less than 10 μm in diameter, and ozone), temperature, and humidity. After AQWS implementation, the incidence of asthma gradually decreased by 20.5%. Cardiovascular disease and stroke incidence also significantly decreased (by 34.3 and 43.0%, respectively). However, no immediate or gradual decrease was identified in the exacerbation rate of any environmental disease after AQWS implementation. Sensitivity analyses were performed according to age, disability, and health insurance coverage type. Overall, the AQWS effectively mitigated the occurrence of most environmental diseases in Korea. However, the relationships between alarm system implementation and reduced incidence differed among diseases based on the characteristics of vulnerable and sensitive individuals. Our results suggest that by tailoring the AQWS to demographic and sociological characteristics and providing enhanced education about the warning system, interventions can become an efficient policy tool to decrease air pollution- related health risks.

Changing trends in the incidence and spectrum of cancers between 1990 and 2021 among HIV-infected patients in Busan, Korea

BackgroundLong-term follow-up data on cancer incidence and spectrum among human immunodeficiency virus (HIV)-infected individuals in Korea have been scarce. Material and MethodsThis retrospective cohort study included HIV-infected individuals visiting a tertiary care hospital in Busan, South Korea between 1990 and 2021. The observation was divided into 4 periods. The incidence rate was calculated using direct standardization on age and sex, stratified by calendar period. ResultsOf the 1,297 patients, 92 patients (7.1%) were diagnosed with 97 cancers. Excluding 37 patients with prevalent cancer, 1,260 patients were followed for a total of 8,803.7 person-years (PYs), and 55 patients developed 60 incident cancers including 5 second primary incident cancers. In men, the AIDS-defining cancer (ADC) incidence decreased from 294.7 per 100,000 PYs in 1990–1997 to 124.8 per 100,000 PYs in 2014–2021, while the non-AIDS-defining cancer (NADC) incidence increased from 0 per 100,000 PYs to 316.5 per 100,000 PYs during the same period. The proportion of virus-unrelated NADCs (VU-NADCs) increased from 33.3% in 1998–2005 to 49% in 2014–2021. The proportion of human papillomavirus-associated cancers (HPVACs) has recently increased in both ADCs and NADCs. The median time from HIV diagnosis to their first cancer was 1.48 years for ADCs, 6.11 years for VR-NADCs, 8.3 years for VU-NADCs, and 11.5 years for HPVACs. ConclusionThe incidence of NADCs is increasing with the aging of HIV-infected patients, and thus, it is necessary to promote cancer screening and prevention programs.

An Analysis of the Demographics and Clinical Characteristics of Transgender and Intersex Populations in Korea: A Retrospective Study Using HIRA Database.

Transgender and intersex populations have long remained under-documented in South Korea, largely due to the absence of comprehensive epidemiological data. With increasing societal acknowledgment, there's an urgent need to understand the demographics and health challenges faced by these communities. This retrospective, large-scale data study included people who received the F64 codes from the Korean Health Insurance Review &amp; Assessment Service between January 2007 and December 2021. Demographics, gender-affirmative treatments, and psychiatric related medications were examined. Between 2007 and 2021, 8,602 patients were diagnosed with "gender identity disorder" and 45 with "intersex." A steadily increasing annual prevalence was observed, peaking at 986 cases in 2021. The majority (79.8%) were aged between 10 and 30. Nearly half (53.2%) exhibited mental and behavioral disorders. Two-thirds had been prescribed anxiolytics or sedatives either before or after diagnosis. Merely 12.1% received hormone therapy covered by health insurance. This is the first large-scale study highlighting the demographics and clinical characteristics of the transgender and intersex populations in Korea. The study reveals a consistent growth of these communities over the past 15 years, with a significant proportion under 30 years of age facing mental and behavioral challenges. Findings underscore the need for targeted healthcare interventions, early psychological support, and comprehensive insurance coverage tailored to the specific needs of these individuals in Korea.

Association of Waist Circumference with the Risk of Inflammatory Bowel Disease: a Nationwide Cohort Study of 10 Million Individuals in Korea.

Metabolic syndrome may share the pathophysiology of adipose tissue dysregulation and inadequate immune response with inflammatory bowel disease [IBD]. We determined the association of abdominal obesity [AO] with the risk of developing IBD. We conducted a nationwide population-based cohort study using the Korean National Health Insurance Services database. A total of 10 082 568 participants of the 2009 national health screening programme were enrolled. Newly diagnosed Crohn's disease [CD] and ulcerative colitis [UC] were identified using the International Classification of Diseases 10th Revision and specialized national codes for rare intractable diseases. Waist circumference [WC] was classified into six groups and compared with the reference values of 85.0-89.9 cm for men and 80.0-84.9 cm for women. AO was defined as a WC of ≥90 cm for men and ≥85 cm for women. During a median follow-up of 9.3 years, the incidence rates of CD and UC were 2.11 and 8.40 per 100 000 person-years, respectively. After adjustment for age, sex, lifestyle behaviours, income and body mass index [BMI], the increase in baseline WC was significantly associated with the risk of developing CD, but not UC, compared to the references. The risk of developing CD in subjects with AO increased significantly compared to those without AO [adjusted hazard ratio, 1.40; 95% confidence interval, 1.21-1.61], regardless of obesity based on BMI. Individuals with AO bore an increased risk of developing CD proportional to WC, but not UC, suggesting that visceral adiposity is related to the pathophysiology of CD.

누가 공론화에 참여할 의향이 있는가?

The public deliberation is emerging as a solution to social conflicts over policy issues in Korea. This study notes that the actual participation of citizens depends on the individual’s willingness to participate, and analyzes the factors that determine participation in public deliberation. In particular, we explore how citizens’ attitudes toward democracy (stealth democracy vs. sunshine democracy) affect their willingness to participate. As a result of the analysis, it is confirmed that individuals in Korea generally decide to participate in public deliberation based on a sunshine attitude rather than a stealth attitude, but that there is also a considerable mix of critical participation that can be viewed as a stealth attitude. This suggests that when designing public deliberation, it is necessary to secure the independence of public deliberation to secure the function of checks and criticism, which are the interests of citizens with stealth attitudes, and to satisfy the preferences of citizens with sunshine attitudes by securing the effectiveness of public deliberation results.

Increase in Potential Low-value Magnetic Resonance Imaging Utilization Due to Out-of-pocket Payment Reduction Across Income Groups in Korea: An Experimental Vignette Study.

ObjectivesThis study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups.MethodsWe conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression.ResultsBefore OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7–49.6% for low back pain; 30.5–39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8–98.0% for low back pain; 78.1–90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache).ConclusionsOOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

Risk Assessment of Mortality in Elderly Individuals: A Nationwide Cohort Study

Introduction: There are several methods that are used to predict emergency room visits or rehospitalization for the elderly. However, existing risk assessment models of mortality in elderly people are limited. The purpose of this study was to ascertain the factors that affect all-cause mortality and to show the risk assessment model of mortality in elderly Koreans. Methods: This was a cohort study conducted using the health checkup data of 246,422 individuals aged ≥60 years, which was provided by the National Health Insurance Service of South Korea between January 1, 2009, and December 31, 2012. The hazard ratios and 95% confidence intervals (CIs) of several conditions and all-cause deaths were estimated using a multivariable Cox proportional hazards model. A nomogram was constructed to visualize the risk factors of mortality; a calibration plot and area under the curve (AUC) were also used to verify the nomogram. Results: Being 85 years or older (100 points) had the greatest influence on all-cause mortality, followed by being underweight (57 points), having more than five chronic diseases (49 points), and ages 78–84 years (45 points); smoking and lack of regular exercise affected mortality to a similar degree. The calibration curves showed good agreement between predictions and observations. The AUC of our nomogram was 0.73 (95% CI: 0.72–0.73). Conclusions: Our results showed the relationship between each condition and mortality rate among elderly individuals in Korea. Our nomogram showed a satisfactory performance in the assessment of the risk of all-cause mortality in elderly Korean people.

National genomic evaluation of Korean thoroughbreds through indirect racing phenotype.

ObjectiveThoroughbred horses have been bred exclusively for racing in England for a long time. Additionally, because horse racing is a global sport, a healthy leisure activity for ordinary citizens, and a high-value business, systematic racehorse breeding at the population level is a requirement for continuous industrial development. Therefore, we established genomic evaluation system (using prize money as horse racing traits) to produce spirited, agile, and strong racing horse populationMethodsWe used phenotypic data from 25,061 Thoroughbred horses (all registered individuals in Korea) that competed in races between 1994 and 2019 at the Korea Racing Authority and constructed pedigree structures. We quantified the improvement in racehorse breeding output by year in Korea, and this aided in the establishment of a high-level horse-fill industry.ResultsWe found that pedigree-based best linear unbiased prediction method improved the racing performance of the Thoroughbred population with high accuracy, making it possible to construct an excellent Thoroughbred racehorse population in Korea.ConclusionThis study could be used to develop an efficient breeding program at the population level for Korean Thoroughbred racehorse populations as well as others.