Role of Healthcare in Korean Long-Term Care Insurance

With the rapid aging of the population, Korea introduced public long-term care insurance for older people in 2008. The long-term care insurance was designed as a separate scheme from the national health insurance, with eligibility qualifications and the certification process based on functional disability, benefits and coverage of community-based and institutional care, and a financing structure through multi-party contributions. Delivering appropriate health services to long-term care beneficiaries who manifest a high prevalence of comorbid chronic conditions with rising healthcare costs, however, presents a particular challenge. The lack of coordination between the health and long-term care sectors, limited consideration of physicians' assessments in the certification process, inadequate provision of health services in long-term care facilities, and overlapping and inefficient use of care resources act as barriers to providing comprehensive healthcare for older beneficiaries. Through active participation in the long-term care system, health professionals can help older patients navigate through the complex long-term care terrain to obtain quality healthcare

The effect of sex and physical frailty on incident disability after 2 years among community-dwelling older adults: KFACS study

Background : This study investigated the impact of physical frailty on the development of disabilities in mobility, activities of daily living (ADL), and instrumental activities of daily living (IADL) according to sex among community-dwelling Korean older adults. Methods : We used data of 2,905 older adults aged 70-84 years from the Korean Frailty and Aging Cohort Study (KFACS) at baseline (2016-2017) and Wave 2 (2018-2019). Fried’s physical frailty phenotype was used to identify frailty. Results : After adjustment, frailty showed a higher impact for women than men on developing mobility disability (odds ratio [OR]=14.00, 95% confidence interval [CI]=4.8–40.78 vs. OR=9.89, 95% CI=4.28–22.86) and IADL disability after two years (OR=7.22, 95% CI=2.67–19.56 vs. OR=3.19, 95% CI=1.17–8.70). Pre-frailty led to mobility disability for women and men (OR=2.77, 95% CI=1.93–3.98 vs. OR=2.49, 95% CI=1.66–3.72, respectively), and IADL disability only for women (OR=3.01, 95% CI=1.28–7.09). Among the IADL components, both men and women who were prefrail or frail showed increased disability in ‘using transportation’. Among men, pre-frailty was significantly associated with disability in “going out” and “shopping”. In women, frailty was significantly associated with disability in “doing laundry,” “performing household chores,” “shopping,” and “managing money”. Conclusions : Physical frailty increased disability over 2 years for women more than men. Physical frailty increased disability in outdoor activity-related IADL components in men and household work-related IADL components in women. This study highlights the need for gender-specific policies and preventative programs for frailty, particularly restorative interventions that focus on women who are physically frail.This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI15C3153), and the Research Program funded by the National Institute of Health, Korea Disease Control and Prevention Agency (2021-ER060500). The funding bodies had no role in the study design the collection, analysis and interpretation of the data; the writing of the report; or the decision to submit this article for publication

Personality of Public Health Organizations’ Instagram Accounts and According Differences in Photos at Content and Pixel Levels

Organizations maintain social media accounts and upload posts to show their activities and communicate with the public, as individual users do. Thus, organizations’ social media accounts can be examined from the same perspective of that of individual users’ accounts, with personality being one of the perspectives. In line with previous studies that analyzed the personality of non-human objects such as products, stores, brands, and websites, this study analyzed the personality of Instagram accounts of public health organizations. It also extracted features at content and pixel levels from the photos uploaded on the organizations’ accounts and examined how they were related to the personality traits of the accounts. The results suggested that the personality of public health organizations can be summarized as being high in openness and agreeableness but lower in extraversion and neuroticism. Openness and agreeableness were the personality traits associated the most with the content-level features, while extraversion and neuroticism were the ones associated the most with the pixel-level features. In addition, for each of the two traits associated the most with either the content- or pixel- level features, their associations tended to be in opposite directions with one another. The personality traits, except for neuroticism, were predicted from the photo features with an acceptable level of accuracy

Relative contributions of the host genome, microbiome, and environment to the metabolic profile

Background Metabolic syndrome is as a well-known risk factor for cardiovascular disease, which is associated with both genetic and environmental factors. Recently, the microbiome composition has been shown to affect the development of metabolic syndrome. Thus, it is expected that the complex interplay among host genetics, the microbiome, and environmental factors could affect metabolic syndrome. Objective To evaluate the relative contributions of genetic, microbiome, and environmental factors to metabolic syndrome using statistical approaches. Methods Data from the prospective Korean Association REsource project cohort (N = 8476) were used in this study, including single-nucleotide polymorphisms, phenotypes and lifestyle factors, and the urine-derived microbial composition. The effect of each data source on metabolic phenotypes was evaluated using a heritability estimation approach and a prediction model separately. We further experimented with various types of metagenomic relationship matrices to estimate the phenotypic variance explained by the microbiome. Results With the heritability estimation, five of the 11 metabolic phenotypes were significantly associated with metagenome-wide similarity. We found significant heritability for fasting glucose (4.8%), high-density lipoprotein cholesterol (4.9%), waist-hip ratio (7.7%), and waist circumference (5.6%). Microbiome compositions provided more accurate estimations than genetic factors for the same sample size. In the prediction model, the contribution of each source to the prediction accuracy varied for each phenotype. Conclusion The effects of host genetics, the metagenome, and environmental factors on metabolic syndrome were minimal. Our statistical analysis suffers from a small sample size, and the measurement error is expected to be substantial. Further analysis is necessary to quantify the effects with better accuracy.N

Decentralized Load Shedding Method Based on Voltage Stability Margin Index Using Synchrophasor Measurement Technology

This study develops an analytical method for assessing the voltage stability margins of a decentralized load shedding scheme; it then examines the challenges related to the existing load shedding scheme. It also presents a practical application for implementing the proposed method, based on the synchrophasor measurement technology in modern power grid operations. By applying the concept of a continuously-computed voltage stability margin index to the configuration of the Thévenin equivalent system, the maximum transfer power could be used as an index to monitor the voltage instability phenomenon and thus determine the required load shedding amount. Thus, the calculated voltage stability margin might be a useful index for system operators in the critical decision-making process of load shedding. Dynamic simulations are performed on real Korean power systems as case studies. Simulation results, when comparing the existing and proposed methods, showed that there was a considerable reduction in the amount of load shedding in the voltage instability scenario. This indicates that the synchrophasor measurement technology has a considerable effect on the proposed load shedding method. The simulation results have validated the performance of the proposed method