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Kim KB, Shin DW, Yeob KE, Kim SY, Han JH, Park SM, Park JH, Park JH. Disparities in the diagnosis and treatment of colorectal cancer among patients with disabilities. World J Gastrointest Oncol 2024; 16:2925-2940. [PMID: 39072168 PMCID: PMC11271766 DOI: 10.4251/wjgo.v16.i7.2925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/28/2024] [Accepted: 04/30/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Little is known about disparities in diagnosis and treatment among colorectal cancer (CRC) patients with and without disabilities. AIM To investigate the patterns of diagnosis, treatment, and survival for people with and without disabilities who had CRC. METHODS We performed a retrospective analysis using the Korean National Health Insurance Service database, disability registration data, and Korean Central Cancer Registry data. The analysis included 21449 patients with disabilities who were diagnosed with CRC and 86492 control patients diagnosed with CRC. RESULTS The overall distribution of CRC stage was not affected by disability status. Subjects with disabilities were less likely than those without disabilities to undergo surgery [adjusted odds ratio (aOR): 0.85; 95% confidence interval (95%CI): 0.82-0.88], chemotherapy (aOR: 0.84; 95%CI: 0.81-0.87), or radiotherapy (aOR: 0.90; 95%CI: 0.84-0.95). The rate of no treatment was higher in patients with disabilities than in those without disabilities (aOR: 1.48; 95%CI: 1.41-1.55). The overall mortality rate was higher in patients with disabilities [adjusted hazard ratio (aHR): 1.24; 95%CI: 1.22-1.28], particularly severe disabilities (aHR: 1.57; 95%CI: 1.51-1.63), than in those without disabilities. CONCLUSION Patients with severe disabilities tended to have a late or unknown diagnosis. Patients with CRC and disabilities had lower rates of treatment with almost all modalities compared with those without disabilities. During the follow-up period, the mortality rate was higher in patients with disabilities than in those without disabilities. The diagnosis and treatment of CRC need improvement in patients with disabilities.
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Affiliation(s)
- Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju 28644, South Korea
| | - Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, South Korea
| | - Kyoung Eun Yeob
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, South Korea
| | - So Young Kim
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, South Korea
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju 28644, South Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju 28644, South Korea
| | - Seon Mee Park
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University, Cheongju 28644, South Korea
| | - Jong Heon Park
- Big Data Steering Department, National Health Insurance Service, Wonju 26464, South Korea
| | - Jong Hyock Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, South Korea
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju 28644, South Korea
- College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju 28644, South Korea
- Department of Preventive Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, South Korea
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Cho H, Park J, Kim B, Han K, Choi HL, Shin DW. Increased Risk of Fracture after Traumatic Amputation: A Nationwide Retrospective Cohort Study. Healthcare (Basel) 2024; 12:1362. [PMID: 38998896 PMCID: PMC11241812 DOI: 10.3390/healthcare12131362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/30/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
The physiological changes and alterations in gait following amputation may increase the risk of fractures. However, there is insufficient research on fracture risk in amputees. Therefore, this study intended to analyze whether the risk of new fractures increases after traumatic amputations. This population-based, retrospective cohort study used data from the Korean National Health Insurance System database. The study included 19,586 participants who had undergone an amputation and 76,645 matched controls. The incidence of any fracture and site-specific fractures (vertebral, hip, and others) according to amputation site(s) and severity of disability due to amputation were evaluated using Cox proportional hazard regression analysis. During the mean follow-up of 4.2 years, amputees had a higher incidence rate (IR) of any fracture (adjusted HR [aHR] 1.47, 95% CI 1.36-1.60), vertebral fracture (aHR 1.63, 95% CI 1.44-1.85), hip fracture (aHR 1.85, 95% CI 1.39-2.46), and other fracture (aHR 1.34, 95% CI 1.20-1.49) compared to that of controls. In the presence of disability, the risks were further increased and were highest among amputees with severe disabilities. All fracture risks were higher in amputees than they were in controls, regardless of lower limb or upper limb amputation. This cohort study demonstrated that traumatic amputees experienced higher incidence of all fractures than did individuals without amputations, and this risk increases with severity of disability. This finding underscores the importance of early screening and lifestyle interventions to address fracture risk in traumatic amputees.
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Affiliation(s)
- Hyeonjin Cho
- International Healthcare Center, Samsung Medical Center, Seoul 06351, Republic of Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Junhee Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Bongseong Kim
- Department of Medical Statistics, Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Hea Lim Choi
- Department of Family Medicine/Executive Healthcare Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 16419, Republic of Korea
| | - Dong Wook Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 16419, Republic of Korea
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Ryu DW, Park J, Lee MJ, Yoo D, Cheon SM. Trends in Physiotherapy Interventions and Medical Costs for Parkinson's Disease in South Korea, 2011-2020. J Mov Disord 2024; 17:270-281. [PMID: 38500248 DOI: 10.14802/jmd.23269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/18/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE Physiotherapy (PT), which is an effective strategy for managing Parkinson's disease (PD), can influence health care utilization. We analyzed trends in health care utilization, PT interventions, and medical costs among patients with PD. METHODS Using data from the Korean National Health Insurance Service from 2011 to 2020, we analyzed the number of patients with PD and their health care utilization and assessed the odds ratio (OR) for receiving regular PTs. RESULTS Over 10 years, 169,613 patients with PD were included in the analysis. The number of patients with PD increased annually from 49,417 in 2011 to 91,841 in 2020. The number of patients with PD receiving PT increased from 4,847 (9.81%) in 2011 to 13,163 (14.33%) in 2020, and the number of PT prescriptions increased from 81,220 in 2011 to 377,651 in 2019. Medical costs per patient with PD increased from 1,686 United States dollars (USD) in 2011 to 3,202 USD in 2020. The medical expenses for each patient with PD receiving PT increased from 6,582 USD in 2011 to 13,475 USD in 2020. Moreover, regular PTs were administered to 31,782 patients (18.74%) and were administered only through hospitalization. Those patients in their 50s with disabilities demonstrated a high OR for regular PTs, whereas those aged 80 years or older and residing outside of Seoul had a low OR. CONCLUSION The PD burden increased in South Korea between 2011 and 2020, as did health care utilization and medical costs. A significant increase in medical expenses can be associated with increased PD incidence and PT interventions. Regular PT applications remain restricted and have barriers to access.
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Affiliation(s)
- Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinse Park
- Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Myung Jun Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Dallah Yoo
- Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang-Myung Cheon
- Department of Neurology, School of Medicine, Dong-A University, Busan, Korea
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Lee D, Cho IY, Chang WH, Yoo JE, Choi HL, Park J, Shin DW, Han K. Fracture Risk Among Stroke Survivors According to Poststroke Disability Status and Stroke Type. Stroke 2024; 55:1498-1506. [PMID: 38686561 DOI: 10.1161/strokeaha.123.044953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/27/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Stroke survivors face physical and cognitive challenges, leading to an increased dependency and a higher fall risk. We aimed to investigate the impact of poststroke disability and stroke type on fracture risk at various sites compared with matched controls. METHODS This retrospective cohort study used data from the Korean National Health Insurance System database (2010-2018), including patients with stroke and 1:1 matched controls. Stroke survivors were grouped based on the presence and severity of their poststroke disability and stroke type. The primary outcome was a newly diagnosed fracture, analyzed by Cox proportional hazard regression analyses adjusting for potential confounders. RESULTS Among 223 358 stroke survivors (mean age, 64.8±10.9 years; 61.2% men), 16 344 fractures occurred during a mean follow-up of 3.7±2.5 years. In matched controls (n=322 161; mean age, 65.4±11.2 years; 61.3% men), 20 398 fractures were identified. Stroke survivors had increased overall fracture risk compared with matched controls (adjusted hazard ratio [aHR], 1.40 [95% CI, 1.37-1.43]). Specifically, hip fracture risk was even greater in stroke survivors (incidence rate per 1000 person-years, 4.7 [95% CI, 4.5-4.8]; aHR, 2.42 [95% CI, 2.30-2.55]) than controls (incidence rate, 2.2 [95% CI, 2.1-2.3]). The risk of vertebral fractures (aHR, 1.29 [95% CI, 1.25-1.34]) and other fractures (aHR, 1.19 [95% CI, 1.15-1.23]) was also higher than that of the control group. Hip fracture risk was the highest among stroke survivors with severe poststroke disability (aHR, 4.82 [95% CI, 4.28-5.42]), although vertebral or other fracture risk was the highest among those with mild poststroke disability. No significant difference in fracture risk was found between hemorrhagic and ischemic stroke survivors when stratified by disability status. CONCLUSIONS Our findings showed increased subsequent fracture risk among stroke survivors, particularly those with poststroke disability and for hip fracture. Bone health assessment and treatment should be emphasized as an essential part of stroke management.
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Affiliation(s)
- Dagyeong Lee
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea (D.L.)
| | - In Young Cho
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (I.Y.C., D.W.S.)
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea (I.Y.C., W.H.C., H.L.C., D.W.S.)
| | - Won Hyuk Chang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea (I.Y.C., W.H.C., H.L.C., D.W.S.)
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (W.H.C.)
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Republic of Korea (J.E.Y.)
| | - Hea Lim Choi
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea (I.Y.C., W.H.C., H.L.C., D.W.S.)
- Department of Family Medicine/Executive Healthcare Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (H.L.C.)
| | - Junhee Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.P.)
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (I.Y.C., D.W.S.)
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea (I.Y.C., W.H.C., H.L.C., D.W.S.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (K.H.)
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Choi HL, Yoo JE, Kim M, Kim B, Park J, Chang WH, Lee H, Han K, Shin DW. Risk of Heart Disease in Patients With Amputation: A Nationwide Cohort Study in South Korea. J Am Heart Assoc 2024; 13:e033304. [PMID: 38726914 PMCID: PMC11179827 DOI: 10.1161/jaha.123.033304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/08/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Amputation confers disabilities upon patients and is linked to substantial morbidity and death attributed to heart disease. While some studies have focused on traumatic amputees in veterans, few studies have focused on traumatic amputees within the general population. Therefore, the present study aimed to assess the risk of heart disease in patients with traumatic amputation with disability within the general population using a large-scale nationwide population-based cohort. METHODS AND RESULTS We used data from the Korean National Health Insurance System. A total of 22 950 participants with amputation were selected with 1:3 age, sex-matched controls between 2010 and 2018. We used Cox proportional hazard models to calculate the risk of myocardial infarction, heart failure, and atrial fibrillation among amputees. Participants with amputation had a higher risk of myocardial infarction (adjusted hazard ratio [aHR], 1.30 [95% CI, 1.14-1.47]), heart failure (aHR, 1.27 [95% CI, 1.17-1.38]), and atrial fibrillation (aHR, 1.17 [95% CI, 1.03-1.33]). The risks of myocardial infarction and heart failure were further increased by the presence of disability (aHR, 1.43 [95% CI, 1.04-1.95]; and aHR, 1.38 [95% CI, 1.13-1.67], respectively). CONCLUSIONS We demonstrate an increased risk of myocardial infarction, heart failure, and atrial fibrillation among individuals with amputation, and the risk further increased in those with disabilities. Clinicians should pay attention to the increased risk for heart disease in patients with amputation.
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Affiliation(s)
- Hea Lim Choi
- Department of Family Medicine/Executive Healthcare Clinic Severance Hospital, Yonsei University College of Medicine Seoul South Korea
- Department of Clinical Research Design & Evaluation Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University Seoul Republic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine Healthcare System Gangnam Center, Seoul National University Hospital Seoul Republic of Korea
- Department of Family Medicine Seoul National University College of Medicine Seoul Republic of Korea
| | - Miso Kim
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Bongsung Kim
- Department of Medical Statistics The Catholic University of Korea Seoul Republic of Korea
| | - Junhee Park
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Heesun Lee
- Division of Cardiology Seoul National University Hospital Healthcare System Gangnam Center Seoul Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science Soongsil University Seoul Republic of Korea
| | - Dong Wook Shin
- Department of Clinical Research Design & Evaluation Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University Seoul Republic of Korea
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
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Meng H, Kim Y, Lee K. Impact of a Service-Learning Program Using Soccer Training on the Emotional and Behavioral Problems of Children with Developmental Disabilities. CHILDREN (BASEL, SWITZERLAND) 2024; 11:467. [PMID: 38671684 PMCID: PMC11049178 DOI: 10.3390/children11040467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Children with developmental disabilities may develop emotional and behavioral problems that arise from difficulties in social interaction, and therefore, a process of providing and testing intervention activities for emotional and behavioral issues in the early stages of development is required. This study evaluated the effects of a 12-week service-learning exercise program on children with developmental disabilities, contrasting it with a control group not engaged in specific physical activities. The participants included 18 children with developmental disabilities who participated in the service-learning exercise program (SLG) and 18 children with developmental disabilities (Non-SLG) who did not participate. The Korean Behavior Assessment System for Children-2 was used to evaluate children's emotional and behavioral problems. A two-way repeated-measures ANOVA was conducted to verify the interaction effect between the group and period according to program participation. The results showed the positive internalization of problem behaviors in the emotional domain (F = 4.291, p = 0.011), attention deficit/hyperactivity (F = 4.761, p = 0.012), and personal adjustment (F = 4.116, p = 0.023) in the SLG group. These results suggest that participation in a service-learning exercise program positively affected emotional and behavioral problems in children with developmental disabilities. This could provide a basis for future research on service-learning exercise programs for children with developmental disabilities.
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Affiliation(s)
- Huan Meng
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea; (H.M.); (Y.K.)
| | - Yonghwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea; (H.M.); (Y.K.)
| | - Kyujin Lee
- School of Social Integration, Adapted Physical Activity, Hankyong National University, Pyeongtaek 17738, Republic of Korea
- Institute of Sports Science, Seoul National University, Seoul 08826, Republic of Korea
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Park GR, Park S, Kim J. Disability acceptance and depressive symptoms: the moderating role of social support. Disabil Rehabil 2024:1-7. [PMID: 38557388 DOI: 10.1080/09638288.2024.2333999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
Purpose: This study aims to estimate (a) the relationship between disability acceptance and depressive symptoms, and (b) how the quality and quantity of social support might moderate the link between disability acceptance and depressive symptoms.Materials and methods: The data for this study included information from 5165 individuals with disability who participated in 3 waves of the Disability and Life Dynamic Panel spanning years 2018 to 2020. This study employed fixed effects models to estimate the association between disability acceptance and depressive symptoms. Interaction models were used to assess the moderating effects of both the quantity and quality of social support.Results: A lower acceptance of disability was positively associated with depressive symptoms. Moreover, both the quantity and quality of social support were associated with a decrease in depressive symptoms. Only the quality of social support played a significant role in moderating the relationship between disability acceptance and depressive symptoms.Conclusion: A lower acceptance of disability increases depressive symptoms in individuals with disabilities. This study underscores the need for interventions to focus on enhancing the quality of social support to mitigate the link between disability acceptance and depressive symptoms.
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Affiliation(s)
- Gum-Ryeong Park
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sujeong Park
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
| | - Jinho Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
- Center for Demography of Health and Aging, University of WI-Madison, Madison, WI, USA
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Kim J, Park GR, Namkung EH. The link between disability and social participation revisited: Heterogeneity by type of social participation and by socioeconomic status. Disabil Health J 2024; 17:101543. [PMID: 37945420 DOI: 10.1016/j.dhjo.2023.101543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/09/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND While prior literature explores the impact of disability on social participation, the distinct characteristics of diverse social activities could further complicate this relationship. Furthermore, this relationship may exhibit heterogeneity when considering socioeconomic status (SES). OBJECTIVE This study aims to investigate whether the relationship between disability and social participation differs depending on the type of social participation, and to what extent this relationship is moderated by SES. METHODS Data from seven waves of the Korean Longitudinal Study of Ageing were analyzed. Various types of social participation, including socializing, leisure, volunteer, political, and religious activities, were considered. Individual fixed effects models were employed to account for unobserved individual-level heterogeneity. To investigate the potential moderating role of SES, an interaction term between disability and SES was included. RESULTS Disability was associated with a decrease in social participation (b = -0.088). When differentiating types of social participation, the associations were negative for socializing and leisure activities (b = -0.092 and b = -0.012, respectively) and positive for volunteer activities (b = 0.012). The negative association between disability and social participation was generally stronger among higher-SES groups than lower-SES groups. Specifically, the negative association with leisure activities was more pronounced among the high-education groups. In contrast, the positive association with volunteer activities was more evident among the low-education group. CONCLUSIONS Disability has a negative association with engagement in socializing and leisure activities and a positive association with engagement in volunteer activities. Policymakers should consider the role of SES in complicating the relationship between disability and social participation.
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Affiliation(s)
- Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA.
| | - Gum-Ryeong Park
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Eun Ha Namkung
- Department of Social Work, Ewha Womans University, Seoul, Republic of Korea
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Yoon WH, Seo J, Je C. Korean autistic persons facing systemic stigmatization from middle education schools: daily survival on the edge as a puppet. Front Psychiatry 2024; 15:1260318. [PMID: 38606409 PMCID: PMC11007699 DOI: 10.3389/fpsyt.2024.1260318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/22/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Korean autistic persons who have endured an integrated secondary education system have been exposed to school bullying, causing trauma and stigma to them. It also blocks them from entering a tertiary education system and a decent work, resulting in a lower quality of life. However, research on how it affects autistic persons has not yet been conducted in Korea. Methods Fourteen adult autistic persons in the Republic of Korea participated in the semi-structured focused group interviews. Their conversations were analyzed through qualitative coding. Results The interview results show the rare voice of Korean autistic people. Although interviewees experienced physical, verbal, and sexual violence against them during the secondary education period, they could not get substantial assistance from schools and society. Interviewees agreed that bullying is inherent in the secondary education system of Korea, even in Korean culture. They experienced the cause of bullying being attributed to them as victims rather than perpetrators, and impunity is given to the bullying assailants. Early analyses of this article confirm that such experiences are combined with the sociocultural climate of elitism, meritocracy, and authoritarianism in the Republic of Korea. Conclusion The study confirmed that the autistic person's bullying experience does not come from the social inability of autistic people but the "profound" competition and discriminative atmosphere of the society. The result urges further studies on the bullying experience of East Asian autistic persons and the construction of Korean intervention strategies to prevent school violence against Koreans with disabilities, especially autistic pupils.
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Affiliation(s)
- Wn-ho Yoon
- Korean Research Center for Guardianship and Trusts, Hanyang University, Seongdong-gu, Seoul, Republic of Korea
| | - JaeKyung Seo
- Korean Research Center for Guardianship and Trusts, Hanyang University, Seongdong-gu, Seoul, Republic of Korea
- Social Welfare Institute, Sungkonghoe University, Guro-Gu, Seoul, Republic of Korea
| | - Cheolung Je
- Korean Research Center for Guardianship and Trusts, Hanyang University, Seongdong-gu, Seoul, Republic of Korea
- School of Law, Hanyang University, Seoul, Republic of Korea
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Park M, Jang SI, Hurh K, Park EC, Kim SH. Increased Risk of Dementia Following a Diagnosis of Hearing Impairment: A South Korean Nationwide Cohort Study. J Alzheimers Dis 2024; 97:679-686. [PMID: 38143356 DOI: 10.3233/jad-230816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Among the older adults, hearing impairment is a common problem and may contribute to dementia. OBJECTIVE Therefore, we aimed to examine the association between hearing impairment and the risk of dementia among older adults in South Korea. METHODS Using the Korean National Health Insurance Service-Senior Cohort from 2005 to 2019, we collected data of 44,728 patients. Hearing impairment was determined using the national disability registry. Propensity score matching (1:1) was performed to match patients with and without hearing impairment (case: 22,364, control: 22,364). A Cox proportional hazards regression model was built to analyze the association between hearing impairment and dementia. RESULTS Patients with hearing impairment had a higher risk of dementia than those without hearing impairment (hazard ratio [HR] = 1.28, 95% confidence interval [CI] = 1.23-1.34). Assessing the degree of disability, both severe (HR = 1.25, 95% CI = 1.16-1.35) and mild conditions (HR = 1.29, 95% CI = 1.23-1.35) had an increased risk of dementia, respectively. CONCLUSIONS Older patients with hearing impairment exhibit an increased risk of dementia, thereby warranting a new approach to dementia care among these patients regardless of the degree of hearing impairment.
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Affiliation(s)
- Minah Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Eulji University College of Medicine, Daejeon, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hoon Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Eulji University College of Medicine, Daejeon, Republic of Korea
- Department of Ophthalmology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
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Yoon JM, Lim DH, Youn J, Han K, Kim BS, Jung W, Yeo Y, Shin DW, Ham DI. Increased risk of Parkinson's disease amongst patients with age-related macular degeneration and visual disability: A nationwide cohort study. Eur J Neurol 2023; 30:2641-2649. [PMID: 37243434 DOI: 10.1111/ene.15896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND PURPOSE The association between Parkinson's disease (PD) and age-related macular degeneration (AMD) has been shown in previous reports. However, the association between the severity of AMD and PD development is unknown. The aim was to evaluate the association of AMD with/without visual disability (VD) with the risk of PD occurrence using the National Health Insurance data in South Korea. METHODS A total of 4,205,520 individuals, 50 years or older and without a previous diagnosis of PD, participated in the Korean National Health Screening Program in 2009. AMD was verified using diagnostic codes, and participants with VD were defined as those with loss of vision or visual field defect as certified by the Korean Government. The participants were followed up until 31 December 2019, and incident cases of PD were identified using registered diagnostic codes. The hazard ratio was calculated for groups (control and AMD with/without VD) using multivariable adjusted Cox regression analysis. RESULTS In total, 37,507 participants (0.89%) were diagnosed with PD. Amongst individuals with AMD, the risk of PD development was higher in individuals with VD (adjusted hazard ratio [aHR] 1.35, 95% confidence interval [CI] 1.09-1.67) than in those without (aHR 1.22, 95% CI 1.15-1.30) compared with controls. Additionally, an increased risk of PD was observed in individuals with AMD compared with controls, regardless of the presence of VD (aHR 1.23, 95% CI 1.16-1.31). CONCLUSIONS Visual disability in AMD was associated with the development of PD. This suggests that neurodegeneration in PD and AMD may have common pathways.
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Affiliation(s)
- Je Moon Yoon
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jinyoung Youn
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Bong Sung Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Wonyoung Jung
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yohwan Yeo
- Department of Family Medicine, Hallym University Dongtan Hospital, Hwasung, Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Study Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Don-Il Ham
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
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