OBJECTIVES: The goal of this paper is to examine the social network effects on post-traumatic sdress disorder (PTSD) in female North Korean immigrants who entered South Korea in 2007. Specifically, it attempts to verify if the density and composition of networks make a difference after controlling for the network size. METHODS: A multivariate logistic regression is used to probe the effects of social networks using the North Korean Immigrant Panel data set. Because the data set had only completed its initial survey when this paper was written, the analysis was cross-sectional. RESULTS: The size of the support networks was systematically related to PTSD. Female North Korean immigrants with more supporting ties were less likely to develop PTSD, even after controlling for other risk factors (odds-ratio for one more tie was 0.8). However, once we control for the size of the network, neither the density nor the composition of the networks remains statistically significant. CONCLUSIONS: The prevalence of the PTSD among female North Korean immigrants is alarmingly high, and regardless of the characteristics of supporting network members, the size of the supporting networks provides substantial protection. This implies that a simple strategy that focuses on increasing the number of supporting ties will be effective among North Korean immigrants who entered South Korea in recent years.
Adult ; Cross-Sectional Studies ; Democratic People's Republic of Korea ; Emigrants and Immigrants/*psychology ; Female ; Humans ; Interviews as Topic ; Life Change Events ; Logistic Models ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors ; *Social Support ; Stress Disorders, Post-Traumatic/diagnosis/ethnology/*psychology

The steering committee of the Korean Academy of Medical Sciences Guideline for Physical Impairment was fully aware of the social processes of disability evaluation from the beginning and thus, developed a series of strategies to examine and incorporate social property of the evaluation into the evaluation guide. Although those strategies could not be implemented to full extent because of lack of budget and time, we believe it worthwhile to share those in this paper as an example of general framework for developing disability evaluation. A series of strategies will be introduced and discussed that views the evaluation process as social per se, and propose a scheme that is designed to obtain growing legitimacy starting from core experts to expanded experts to general public. Also preliminary analyses on surveys of public attitude and experts' opinion with regard to the relative importance of each possible disability revealed the following three facts: 1) Public had difficulty weighing relative importance of many impairments. 2) Regarding some impairments including complex regional pain syndrome many doctors had varied opinions. 3) Public attitude did not always consistent with doctor's opinion. All these findings strongly suggest the need for developing strategies to draw consensus for legitimate and effective evaluation.
Academies and Institutes ; *Consensus ; *Disability Evaluation ; Expert Testimony ; Humans ; Korea ; *Practice Guidelines as Topic ; Public Opinion ; Public Policy ; Social Support

OBJECTIVE: To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly. METHODS: We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support. RESULTS: Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women. CONCLUSION: Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women.
Adult ; Aged ; Aging ; C-Reactive Protein ; Depression ; Female ; Friends ; Humans ; Inflammation ; Male ; Rural Population ; Spouses

OBJECTIVE: This study aimed to examine the effects of the social engagement (size of the social networks, social support, social conflict) by relationship types (spouse, family and kin, and neighbor and friends) on the cognitive functions of older adults in rural communities. METHODS: The participants of this study were normal older adults who participated in the first wave of the Korean Social Life, Health and Aging Project. Five hundred two older adults (men 218, women 284) aged 60 and over (mean age=71.44±6.81) participated. We analyzed the effects of different types of social engagement on Mini-Mental State Examination for Dementia Screening (MMSE-DS) performance using hierarchical multiple regression analysis. RESULTS: The result showed that, after controlling for the education level and age, the social support from the spouse, the conflict with neighbors or friends, the number of neighbors or friends significantly predicted MMSE-DS scores. These three variables accounted for additional 5.2% of the total variance of MMSE-DS. CONCLUSION: Our findings suggest that social engagement (network size, support, conflict) is associated with cognitive function among older adults. However, social engagement in different types of social relationship may contribute differently to cognitive function of older adults.
Adult* ; Aging ; Cognition ; Cognitive Aging ; Cognitive Reserve ; Dementia ; Education ; Female ; Friends ; Humans ; Mass Screening ; Rural Population ; Spouses

PURPOSE: As comprehensive nursing care service has gradually expanded, it has become necessary to explore the various opinions about it. The purpose of this study is to explore the large amount of text data regarding comprehensive nursing care service extracted from online news and social media by applying a semantic network analysis. METHODS: The web pages of the Korean Nurses Association (KNA) News, major daily newspapers, and Twitter were crawled by searching the keyword ‘comprehensive nursing care service’ using Python. A morphological analysis was performed using KoNLPy. Nodes on a ‘comprehensive nursing care service’ cluster were selected, and frequency, edge weight, and degree centrality were calculated and visualized with Gephi for the semantic network. RESULTS: A total of 536 news pages and 464 tweets were analyzed. In the KNA News and major daily newspapers, ‘nursing workforce’ and ‘nursing service’ were highly rated in frequency, edge weight, and degree centrality. On Twitter, the most frequent nodes were ‘National Health Insurance Service’ and ‘comprehensive nursing care service hospital.’ The nodes with the highest edge weight were ‘national health insurance,’‘wards without caregiver presence,’ and ‘caregiving costs.’‘National Health Insurance Service’ was highest in degree centrality. CONCLUSION: This study provides an example of how to use atypical big data for a nursing issue through semantic network analysis to explore diverse perspectives surrounding the nursing community through various media sources. Applying semantic network analysis to online big data to gather information regarding various nursing issues would help to explore opinions for formulating and implementing nursing policies.
Boidae ; Caregivers ; Communications Media ; Humans ; Insurance, Health ; Nursing Care* ; Nursing Services ; Nursing* ; Periodicals ; Semantics* ; Social Media*

The acknowledgements was incorrect in the original publication of this article.

OBJECTIVES: Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m2) in an elderly Korean population. METHODS: This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis. RESULTS: After adjusting for potential confounders, the men with lower density (<0.71) and higher network size (4-6) had the higher BMI (beta=1.089, p=0.037) compared to the men with higher density (>0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (beta=0.885, p=0.049), but not in the men (p=0.140). CONCLUSIONS: Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association.
Aged ; Aged, 80 and over ; *Body Mass Index ; Comorbidity ; Depression ; Female ; Humans ; Male ; Middle Aged ; Regression Analysis ; Republic of Korea/epidemiology ; Self Concept ; Smoking ; *Social Networking

BACKGROUND: Increasing evidence supports an association between age-related loss of muscle mass and insulin resistance. However, the association has not been fully investigated in the general population. Thus, we investigated the association between appendicular skeletal muscle mass (ASM) and insulin resistance in an elderly Korean population. METHODS: This cross-sectional study included 158 men (mean age, 71.8) and 241 women (mean age, 70.6) from the Korean Social Life, Health and Aging Project, which started in 2011. In this study, ASM was measured by bioelectrical impedance analysis and was analyzed in three forms: ASM (kg), ASM/height2 (kg/m2), and ASM/weight (%). The homeostasis model assessment of insulin resistance (HOMA-IR) was used as a measure of insulin resistance. The relationships between the ASM values and the HOMA-IR were investigated by multiple linear regression models. RESULTS: The HOMA-IR was positively associated with ASM (beta=0.43, P<0.0001) and ASM/height2 (beta=0.36, P<0.0001) when adjusted for sex and age. However, after additional adjustment for body weight, HOMA-IR was inversely associated with ASM (beta=-0.43, P<0.001) and ASM/height2 (beta=-0.30, P=0.001). Adjustment for other potential confounders did not change these associations. Conversely, HOMA-IR was consistently and inversely associated with ASM/weight before and after adjustment for other potential confounders. CONCLUSION: Our results support the idea that lower skeletal muscle mass is independently associated with insulin resistance in older adults. When evaluating sarcopenia or muscle-related conditions in older adults, their whole body sizes also need to be considered.
Adult ; Aged* ; Aging* ; Body Size ; Body Weight ; Cohort Studies* ; Cross-Sectional Studies ; Electric Impedance ; Female ; Homeostasis ; Humans ; Insulin Resistance* ; Korea ; Linear Models ; Male ; Muscle, Skeletal* ; Sarcopenia

OBJECTIVES: Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members. METHODS: We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates. RESULTS: In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA. CONCLUSIONS These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.

Objectives: With the surge in the elderly population, a growing interest in the prevention and treatment of geriatric diseases has been observed, along with awareness of the severity of problems associated with dementia, a cognitive impairment. The purpose of this study was to investigate the correlation between chewing ability and cognitive function among elderly people residing in a rural area. Methods: A total of 162 elderly individuals, aged between 65 and 97 years, were surveyed. Trained examiners conducted interviews and assessments of chewing ability, on the basis of the number of remaining teeth, denture status, masticatory performance evaluating gum, ShadeEye-NCC measuring overall change in color of the gum (ΔE), and T-Scan® III analyzing distribution of occlusion patterns. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination-Dementia Screening (MMSE-DS) tool. Results: Participants with a low score in the MMSE-DS were found to have distinguishably lower denture need, smaller number of remaining teeth, and lesser color change in the masticatory performance evaluating gum. In the cognitive impairment group, a tendency of having unilateral and anterior occlusion led to occlusal discomfort and chewing difficulties. Conclusions The study highlights important associations between chewing ability and cognitive function. The finding corroborates that tooth loss may be a predictive risk factor for cognitive impairment.