Swallowing Status Comparison between Primary Dysphagia and Post-stroke Dysphagia in Inpatient Rehabilitation Facilities

Ickpyo Hong,Kimberly P. Hreha 대한연하재활학회 2020 Swallowing Rehabilitation Vol.3 No.1

Objectives: To examine the improvement of discharge swallowing status between patients with a primary dysphagia diagnosis and those with post-stroke dysphagia discharged from inpatient rehabilitation facilities (IRFs). Methods: A retrospective cohort design used data from the United States Uniform Data System for Medical Rehabilitation (UDSMR) during 2016 and 2017. Ordinal logistic regression model compared the swallowing status at discharge between the two comparison groups, accounting for baseline patient and clinical characteristics. Multiple imputations with the fully conditional specification method was used to deal with the missing observations for the discharge swallowing status variable. Results: The mean age of the sample was 71.4 years (SD = 12.8). A total of 992 patients were retrieved from the study data, including 64 patients with a primary dysphagia diagnosis and 928 patients with post-stroke dysphagia. Adjusted ordinal logistic regression model revealed that patients with primary dysphagia had lower odds of improving their swallowing status (odds ratio [OR] 0.300; 95% Confidence Interval [CI] 0.142, 0.636) than those with post-stroke dysphagia at discharge from IRFs. Similarly, the multiple imputations method revealed that patients with primary dysphagia had lower odds of swallowing status improvement at discharge from IRFs (OR 0.563; 95% CI 0.342, 0.925). Discussion: Patients with a primary dysphagia diagnosis receiving rehabilitation services in IRFs demonstrated substantially worse swallowing status compared to those with post-stroke dysphagia in a large national sample. This finding suggests that healthcare providers should be aware of the differences occurring in swallowing improvement across dysphagia diagnosis groups.

Challenges and Opportunities for Occupational Therapy in Big Data Research

Ickpyo Hong,Meredith F. Shields,Mi Jung Lee,Riqiea Kitchens,Karen Ratcliff,Timothy A. Reistetter 대한작업치료학회 2019 대한작업치료학회지 Vol.27 No.5

The advance of information technology with governmental support allows researchers to utilize big data to conduct rigorous rehabilitation-related studies in both the United States and Korea. While big data research has been actively conducted in the United States, few Korean rehabilitation scientists currently conduct big data research. In this paper, we discuss the existing rehabilitation-related big data in Korea and introduce the current big data research trends in the United States. In addition, we provide potential research areas by discussing the previous big data studies in the United States, including 1) functional outcomes, 2) geographical variation, 3) linkage of a population-based cohort to hospital data, 4) cross-national comparison, and 5) scale development. We also discuss various statistical methods required in big data research and compare how these methods differ compared to the traditional research methods in rehabilitation research. Lastly, we discuss the importance of workforce development in rehabilitation-related big data research. We hope this paper will provide occupational therapy scientists and clinicians with practical and useful information about big data research and accelerate big data rehabilitation research communities in Korea.

동북아 환경협력에 대한 비판적 고찰

홍익표(Ickpyo Hong) 한국국제정치학회 2012 國際政治論叢 Vol.52 No.3

북한인권문제를 둘러싼 동북아 국제갈등

홍익표(Ickpyo Hong) 고려대학교 일민국제관계연구원 2012 국제관계연구 Vol.17 No.2

탈북자 문제를 비롯한 북한인권문제로 인해 동북아 국가들 간에 갈등이 전개되고 있다. 이는 이들 간에 비대칭적 권력이 존재하고 서로 상이한 인권관을 내세우는 데서 연원하는 것이다. 문제는 북한인권을 둘러싼 논의가 인권개념이 지닌 불가분성과 통합성을 고려하지 않고 인권을 특정 범주로만 한정하거나 가치의 서열을 따지는 데에 있다. 이런 현실에서‘세 세대 인권’개념은 북한인권문제의 실태를 총체적으로 고찰하고 그 적실성 있는 대안을 마련하는데 있어 유용성이 크다고 판단된다. 그중에서도 집단적이고 연대적인 권리인 3세대 인권은 경제적·사회적·문화적 권리인 2세대 인권과, 시민적·정치적 권리인 1세대 인권을 중심으로 한 기존의 편향적인 인권 인식과 이로 인한 갈등을 완화하고 관련 논의를 보다 풍성하게 이끌 수 있다. This article explores the human rights problems in North Korea and international conflicts in Northeast Asia, focusing on the ‘three generations of human rights’ which were initially proposed by the French jurist Karel Vasak. Most recent research on North Korean human rights issues reflect the different perspectives that are characterized by unproductive argument and a failure to build consensus. Particularly helpful in this regard is the interconnected three generations of human rights. this is a valuable conceptual tool for critical thinking and solving the human rights problems in North Korea.

코소보전쟁에 대한 독일의 외교정책

홍익표(Ickpyo Hong) 한국국제정치학회 2000 國際政治論叢 Vol.40 No.2

유럽연합과 국민국가 관계의 변화 : '복합압력’과 '갈등ㆍ협력의 동학’을 중심으로

홍익표(Ickpyo Hong) 고려대학교 일민국제관계연구원 2004 국제관계연구 Vol.9 No.1

This paper has attempted to examine the relationship between the European Union (EU) and national states in the EU system. In the developments of the EU over the last two decades decision-making competencies are shared across multiple levels of polity-subnational, national and supranational. In this regard, it can be mentioned that the EU system becomes multi-level system which describes the dispersion of decision-making competencies across multiple layers. The changing role of national states is pivotal in interpreting the EU system. National states have lost some of their control in their territories and are being melded into a multi-level polity by numerous subnational and supranational actors. In examining the relationship between the EU and national states, this paper takes up the model of multi-level and points out two set of ideal types: conflict and cooperation, exclusion and inclusion. This types result from complex interactions among various actors in multiple levels, are fairly associated with character and structure of state, civil society and national politics.

Age-specific findings on lifestyle and trajectories of cognitive function from the Korean Longitudinal Study of Aging

Seungju Lim(Seungju Lim),Eunyoung Yoo(Eunyoung Yoo),Ickpyo Hong(Ickpyo Hong),Ji-Hyuk Park(Ji-Hyuk Park) 한국역학회 2023 Epidemiology and Health Vol.45 No.-

OBJECTIVES: Few longitudinal studies have explored age-related differences in the relationship between lifestyle factors and cognitive decline. This study investigated lifestyle factors at baseline that slow the longitudinal rate of cognitive decline in young-old (55-64 years), middle-old (65-74 years), and old-old (75+ years) individuals. METHODS: We conducted an 11-year follow-up that included 6,189 older adults from the Korean Longitudinal Study of Aging, which is a cohort study of community-dwelling older Koreans. Lifestyle factors, including physical activity, social activity (SA), smoking, and alcohol consumption were assessed at baseline. Cognitive function was measured at 2-year intervals over 11 years. Latent growth modeling and multi-group analysis were performed. RESULTS: The influence of lifestyle factors on the rate of cognitive decline differed by age. Smoking at baseline (-0.05; 95% confidence interval [CI], -0.11 to -0.00, per study wave) accelerated cognitive decline in young-old individuals, whereas frequent participation in SA at baseline (0.02; 95% CI, 0.01 to 0.03, per study wave) decelerated cognitive decline in middle-old individuals. None of the lifestyle factors in this study decelerated cognitive decline in old-old individuals. CONCLUSIONS: Cognitive strategies based on modifiable lifestyle factors such as smoking cessation in young-old individuals and frequent SA participation in middle-old age individuals may have great potential for preventing cognitive decline. Because the influence of lifestyle factors varied by age group, age-specific approaches are recommended to promote cognitive health.

Identifying Risk of Depressive Symptoms in Adults With Physical Disabilities Receiving Rehabilitation Services: Propensity Score Approaches

Yejin Lee,Ickpyo Hong,Mi Jung Lee,Hae Yean Park 대한재활의학회 2019 Annals of Rehabilitation Medicine Vol.43 No.3

Objective To compare the risk of depressive symptoms in adults with physical disabilities between rehabilitation-receivers and non-receivers. Methods A total of 3,568 adults with physical disabilities were retrieved from the 2014 Korean National Survey on People with Disabilities database. Four covariate adjustment methods (a multivariable regression model, inverse probability of treatment weighting [IPTW] adjusted for normalized weight, IPTW with stabilized weight, and greedy algorithm with 1:1 propensity score matching) were used to estimate the odds of having depressive symptoms. The dependent variable was depressive symptoms and the independent variable was the use of rehabilitation services. Baseline covariates were 19 demographic variables and 10 chronic condition variables. Results The four covariate adjustment methods revealed that adults with physical disabilities receiving rehabilitation services had a higher risk of depressive symptoms than those who did not receive these services (adjusted odds ratio, 1.191–1.294). Conclusion Our findings suggest that adults with physical disabilities receiving rehabilitation services have higher risk of developing depressive symptoms. Therefore, rehabilitation professionals need to pay attention to depressive symptoms and establish therapeutic strategies that can reduce such risk in rehabilitation settings.

노인의 시각, 청각 및 일상생활활동의 관계에 대한 인지기능의 매개효과

남상훈(Sanghun Nam),홍익표(Ickpyo Hong) 대한신경계작업치료학회 2023 재활치료과학 Vol.12 No.1

목적 : 노화에 따른 인지 및 신체기능의 저하는 노인 대상에 흔한 증상이다. 노화에 따른 대표적인 기능저하로 시각과 청각, 인지기능, 일상생활활동의 제한이 있다. 이에 따른 많은 연구들이 각 변수 간의 관계성을조사하였다. 하지만 네 개의 변수 간의 관계성을 파악한 연구는 미흡하다. 따라서 본 연구에서 시각및 청각과 일상생활활동 간의 관계에서 인지기능의 매개효과를 알아보고자 한다. 연구방법 : 본 연구의 대상자는 국민건강보험공단에서 제공하는 건강보험자료 공유서비스에서 노인 장기요양 DB의 36,767명을 대상으로 하였다. 독립변수로 시각과 청각 변수를 추출하였고 종속변수로 기본적 및 수단적 일상생활활동 변수를 추출하였다. 매개변수로는 인지기능 변수를 추출하였다. 추출한변수들을 활용하여 매개효과를 알아보기 위해 경로분석을 진행하였다. 결과 : 대상자는 여성이 27,250명(74.12%)으로 대부분이었으며, 평균 연령은 82.91세(SD = 5.92)이었다. 시각과 기본적 및 수단적 일상생활활동 간의 인지기능 매개효과를 알아본 결과, 시각과 기본적 일상생활활동 간의 관계에서 인지기능이 30%, 시각과 수단적 일상생활활동 간의 관계에서 인지기능이 42% 부분매개 역할을 하였다. 청각과 기본적 및 수단적 일상생활활동 간의 인지기능 매개효과는 기본적일상생활활동에서 50%, 수단적 일상생활활동에서 53% 부분매개 역할을 하였다. 결론 : 노화에 따른 기능저하와 관련된 예방 프로그램은 많은 국가사업으로 진행되어오고 있다. 본 연구의결과를 활용한 시각, 청각, 인지기능, 일상생활활동의 관계를 감안하여 예방 프로그램을 수립한다면성공적인 노화를 도모하는데 도움이 될 것으로 사료된다. Objective : The typical decline in function due to aging includes limitations in vision, hearing, cognitive function, and activities of daily living. Therefore, this study evaluated the mediating effect of cognitive function on the relationship between vision and hearing and activities of daily living. Methods : The participants in this study were 36,767 persons from the long-term care database on older adults provided by the National Health Insurance Sharing Service. The extracted variables were: (i) independent variables: visual and hearing; (ii) dependent variables: basic and instrumental daily living activities; and (iii) mediator variables: cognitive function. Regression analysis was performed evaluate the mediating effects of the extracted variables. Results : Cognitive function showed a mediating effect of 30% on the relationship between vision and basic daily life activities and 42% in the relationship with instrumental daily life activities. The mediating effect was 50% in the relationship between hearing and basic activities of daily living, and 53% in the relationship with instrumental activities of daily living. Conclusion : Prevention programs for functional decline due to aging are in progress in Korea. Based on the results of this study, establishing a prevention program would help promote successful aging.

문화적 프로젝트로서의 유럽통합과 독일의 문화정책

김명섭(MYUNG-SUP KIM),홍익표(Hong Ickpyo) 21세기정치학회 2006 21세기 정치학회보 Vol.16 No.1

The purpose of this article is to explore the features and structures of the European integration as a cultural project bringing into focus the German cultural policy. The cultural policy within the European framework endows the EU with a sense of solidarity based on identity, becomes the foundation of the European project. Germany playing a leading role in integrating the Europe is unique amongst the nations of the EU in the sense that it is federally organized and decentralized. The cultural policy of Germany is largely anchored in the cultural democracy which takes account of equal access to cultural life. But there is a conflict between the efforts to consolidate 'Bürgerrecht Kultur' and the development of cultural policy founded on liberalised economy.