• 제목/요약/키워드: Drug education

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Development and Testing of the Model of Health Promotion Behavior in Predicting Exercise Behavior

  • O'Donnell, Michael P.
    • Korean Journal of Health Education and Promotion
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    • 제2권1호
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    • pp.31-61
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    • 2000
  • Introduction. Despite the fact that half of premature deaths are caused by unhealthy lifestyles such as smoking tobacco, sedentary lifestyle, alcohol and drug abuse and poor nutrition, there are no theoretical models which accurately explain these health promotion related behaviors. This study tests a new model of health behavior called the Model of Health Promotion Behavior. This model draws on elements and frameworks suggested by the Health Belief Model, Social Cognitive Theory, the Theory of Planned Action and the Health Promotion Model. This model is intended as a general model of behavior but this first test of the model uses amount of exercise as the outcome behavior. Design. This study utilized a cross sectional mail-out, mail-back survey design to determine the elements within the model that best explained intentions to exercise and those that best explained amount of exercise. A follow-up questionnaire was mailed to all respondents to the first questionnaire about 10 months after the initial survey. A pretest was conducted to refine the questionnaire and a pilot study to test the protocols and assumptions used to calculate the required sample size. Sample. The sample was drawn from 2000 eligible participants at two blue collar (utility company and part of a hospital) and two white collar (bank and pharmaceutical) companies located in Southeastern Michigan. Both white collar site had employee fitness centers and all four sites offered health promotion programs. In the first survey, 982 responses were received (49.1%) after two mailings to non-respondents and one additional mailing to secure answers to missing data, with 845 usable cases for the analyzing current intentions and 918 usable cases for the explaining of amount of current exercise analysis. In the follow-up survey, questionnaires were mailed to the 982 employees who responded to the initial survey. After one follow-up mailing to non-respondents, and one mailing to secure answers to missing data, 697 (71.0%) responses were received, with 627 (63.8%) usable cases to predict intentions and 673 (68.5%) usable cases to predict amount of exercise. Measures. The questionnaire in the initial survey had 15 scales and 134 items; these scales measured each of the variables in the model. Thirteen of the scales were drawn from the literature, all had Cronbach's alpha scores above .74 and all but three had scores above .80. The questionnaire in the second mailing had only 10 items, and measured only outcome variables. Analysis. The analysis included calculation of scale scores, Cronbach's alpha, zero order correlations, and factor analysis, ordinary least square analysis, hierarchical tests of interaction terms and path analysis, and comparisons of results based on a random split of the data and splits based on gender and employer site. The power of the regression analysis was .99 at the .01 significance level for the model as a whole. Results. Self efficacy and Non-Health Benefits emerged as the most powerful predictors of Intentions to exercise, together explaining approximately 19% of the variance in future Intentions. Intentions, and the interaction of Intentions with Barriers, with Support of Friends, and with Self Efficacy were the most consistent predictors of amount of future exercise, together explaining 38% of the variance. With the inclusion of Prior Exercise History the model explained 52% of the variance in amount of exercise 10 months later. There were very few differences in the variables that emerged as important predictors of intentions or exercise in the different employer sites or between males and females. Discussion. This new model is viable in predicting intentions to exercise and amount of exercise, both in absolute terms and when compared to existing models.

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임상시험심사위원회 위원과 연구자를 대상으로 임상연구에서 이해상충에 대한 설문조사연구 (Survey of Conflict of Interest in the Clinical Research for IRB Members and Researchers)

  • 맹치훈;강수진;이선주;임현우;최병인;신임희;허정식;권복규;유소영;이미경;신희영;김덕언
    • 대한기관윤리심의기구협의회지
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    • 제2권1호
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    • pp.23-31
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    • 2020
  • Purpose: To obtain opinions from Korean Institutional Review Board (IRB) members' self-evaluation on ability to conduct fairness review of clinical trial protocol with presence of conflict of interest and from investigators and IRB members on financial conflict of interest through surveying. Methods: IRB members and researchers in 9 different hospitals were asked to answer survey questions via email. Results: Responders were 115 personnel (IRB Chair/vice 18, medical member 30, non-medical member 28, and researcher 39) from 9 centers. Compared to IRB medical members, IRB chair/vice respondents scored higher with statistically significance on 10 point scale (8.44±1.381 vs. 7.30±1.685, p=0.005) when asked to self-evaluate fairness reviewing a protocol proposed by an investigator from the same department and a protocol from the company that supports the scientific committee of responders. When reviewing a protocol proposed by a hospital director, non-medical members scored statistically significantly higher than medical-members (7.47±1.76 vs. 8.07±2.70, p=0.034). When asked about the limitation of labor fee for principal investigator on phase 3 Human clinical trials of the Investigational new drug, while the responses range was wide, 60% answered that labor cost of principal investigator should be less than 30% of total budget for clinical trials with a budget of 100 million won. 51.3% answered that there is no need to disclose the labor cost of the principal investigator in the consent form. Since every investigator can be influenced unconsciously by conflict of interest, the answer that 'responder agrees that there is need for management' was the most chosen answer (IRB member 61.8%, investigator 64.1%, multiple answers allowed). Conclusion: Considering scores on questions of fairness by IRB members were between 7.23-8.56 on scale of 0 to 10 point when IRB members were asked about reviewing a clinical trial protocol, it cannot be said with absolute certainty that there is no issue regarding fairness in the review process. Therefore, there should be more ways to safeguard fairness for these issues. There is a need that the disclosure amount of honorarium from sponsor should be lower than 100 million Korean won. Considering the results of the survey in which respondents expressed their thoughts, it is likely that more education on the concept of conflict of interest is needed.

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일부 전북지역 노인들의 일상생활동작능력과 수단적 일상생활동작능력 (Activities of Daily Living and Instrumental Activities of Daily Living of Elderlies in Chollabuk-Do Area)

  • 이기남;정재열;장두섭;이성국
    • 농촌의학ㆍ지역보건
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    • 제25권1호
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    • pp.65-83
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    • 2000
  • 본 연구는 일부 전라북도 지역에 거주하는 노인을 대상으로 1999년 6월에서 12월까지 ADL, IADL의 정도와 이에 영향을 줄 수 있는 일반적 특성과의 관련성을 알아보고자 시도되었다. 조사대상 노인은 전체 281명이었고 이중 여자가 195명(69.6%)이었고 남자가 85명(30.4%)이었다. 남성과 여성의 평균연령은 70.8세와 71.9세 이었다. 질병유무에 있어서는 있다가 81.1%이었고 없다가 18.9%이었다. 질병의 유병률에 있어서는 운동 골관절질환은 50.1%, 기타가 15.0%, 순환기 질환이 10.5%, 소화기 질환이 9.4%, 치과질환이 8.5%, 호흡기 질환이 6.3%이었다. 최근에 이용한 의료기관에서는 병의원이 40.0%, 한방병의원이 16.8%, 보건소가 14.5% 약국이 10.9%, 기타가 10.0%, 치과의원이 7.8%이었다. 증상의 호전여부에 대해서는 보통이다가 62.3%, 호전되었다가 19.4%, 호전되지 않았다가 18.2%이었다. 건강상태에 있어서는 나쁘다가 37.1%, 좋다가 35.7%, 보통이다가 27.1%이었다. 일상생활동작능력(ADL)은 6점이 67.1%, 5점이 27.9%, 4점이 2.1%이었고 여성의 ADL이 남성보다 낮은 경향이 있었다. 수단적 일상생활동작능력(IADL)은 5점이 50.4%, 3점이 19.3% 4점이 12.1%이었고 여성의 IADL이 남성보다 낮은 경향이 있었다. 일상생활동작능력(ADL)에 있어 장해빈도가 높은 순으로 보면 실금 28.9%, 목욕 6.1%, 식사 2.9%, 집안 걸어다니기 2.5%, 화장실 1.8%, 옷 갈아입기 1.4%이었고 6항목 모두 남성보다 여성의 장해빈도가 높았다. 일상생활동작능력에서 고 ADL 67.1%, 중 ADL 32.5%, 저 ADL 0.4%로 연령의 증가에 따라 고 ADL은 감소하는 경향이 있었고 중 IADL은 증가하는 경향이 있었다. 수단적 일상생활동작능력(IADL)에 있어 장해빈도가 높은 순으로 보면 현금출납 42.9%, 청구서 지불(납부) 31.8%, 시장보기 21.1%, 식사준비 16.4%, 버스이용 11.8%이었다. 식사준비를 제외한 모든 항목에서 여성이 남성보다 IADL에 있어 장해빈도가 높았다. 수단적 일상생활동작능력에서 고 IADL 50.4%, 중 IADL 42.5%, 저 IADL 7.1%로 연령증가에 따라 고 IADL은 감소하는 경향이었고 중 IADL은 증가하는 경향이 있었다. 일반적 특성에 따른 ADL의 평균은 5.56이었고 학력과 건강상태가 통계학적으로 유의한 변수이었다. 일반적 특성에 따른 IADL의 평균은 3.76이었고 연령, 성별, 학력, 직업, 배우자 유무, 동거가족, 생활비 부담, 건강상태, ADL 분류가 통계학적으로 유의성있는 변수이었다. 단계적 중회귀분석결과 일상생활동작지수(ADL)와 종교, 건강상태 그리고 수단적 일상생활동작지수(IADL)와 교육수준, 동거가족, 생활비, 건강상태가 통계학적으로 관련성이 있는 설명변수이었다.

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현장실사를 통한 급식유헝별 위생관리실태 분석 (Analysis of Critical Control Points through Field Assessment of Sanitation Management Practices in Foodservice Establishments)

  • 곽동경;이경미;장혜자;강영재;홍완수;문혜경
    • 한국식품조리과학회지
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    • 제21권3호
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    • pp.290-300
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    • 2005
  • 본 연구에서는 우리나라 집단급식소를 HACCP 지정유무 및 급식 유형별로 분류하여 위생관리 실태를 평가하여 유형별 문제점을 파악하고 개선방안을 제시하였다. 평가내용은 총 105개 항목, 9개의 영역으로 개인위생, 식재료의 공급, 식품의 저장, 생식품과 조리된 식품의 분리취급, 배식, 세척과 소독, 쓰레기처리, 방충$\cdot$구서 대책, 시설$\cdot$설비 관리영역으로 구성되어 있다. 조사대상급식소는 급식유형에 따라 발생되는 문제점을 고려하기 위해 중$\cdot$고등학교급식소, 대학교급식소, 사업체급식소를 대상으로 이루어졌다. 본 연구의 결과를 하면 다음과 같다. 1. 서울, 경기, 경남지역의 집단급식소 20개소를 대상으로 이루어졌다. 중$\cdot$고등학교급식소 7곳과 대학교 급식소 4곳, 사업체 급식소 9곳을 대상으로 하였다. HACCP 지정급식소는 6곳으로 중 고등학교가 3곳, 사업체 3곳을 포함한다. 평균 중식수는 약 1,400식 정도의 규모이며, 평균 근무인원은 약 34명 정도로 나타났다. 조리원 1인당 맡고 있는 식수는 평균 103식 정도로 양호한 작업량을 보였다. 2. 전체 평균점수는 105점 만점에 72.3점을 보였고 평균 43.9항목$(65.5\%)$이 준수되었고 18.9항목$(30.0\%)$이 비준수로 집계되었다. HACCP 지정업체와 비지정업체간의 비교에서는 HACCP 지정업체가 모든 영역에서 비지정업체에 비해 위생관리가 잘 이루어지고 있었으며 특히 시설$\cdot$설비영역에서 많은 차이를 보였다. 3. 급식유형별 비교에서는 중$\cdot$고등학교급식소가 다른 급식유형에 비해 많은 영역이 잘 이루어지고 있었다. 특히 방충$\cdot$구서대책이나 세척과 소독, 생식품$\cdot$조리식품의 분리취급에서 위생적으로 관리되고 있었다. 반면 대학교 급식소는 위생관리가 제대로 수행되지 않는 유형으로 시급히 보완되어야 하겠다. 특히 대학교 급식소는 방충$\cdot$구서 대책, 쓰레기처리, 시설$\cdot$설비영역, 식재료영역의 이행 수준이 낮게 나타났다. 이상의 결과에서 급식소의 위생관리를 철저히 수행하기 위해서는 본 연구에서 사용된 위생관리 모니터링 도구를 이용하여 정기적으로 평가하는 동시에 그 결과를 종업원에게 알려주고, 교육$\cdot$훈련에 적극 활용하는 것이 필요하다. 집단급식소의 경우 인력의 유동이 심하고 시간제 조리원이 많아 교육의 효과를 보기 어려운 경우가 많지만 지속적인 교육과 조직문화 창달을 통해서 그 효과를 배가 시켜야 하겠다. 또한 식당 홀뿐 아니라 주방내의 작업환경의 개선을 통해서 좀 더 효율적으로 위생관리 될 수 있는 급식 시스템의 구축도 필요하겠다. 식중독예방을 위한 방안으로 본 연구에 사용된 것과 같은 체계적인 모니터링 도구를 활용한 지속적인 자가 진단과 개선 및 시정이 철저하게 이루어져야 할 것이다. 본 연구의 제한점은 훈련된 연구원이 직접 현장 점검하는 방법을 채택하여 경제적, 시간적 한계로 인해 샘플수가 적었다. 그러므로 우리나라 집단급식소의 수에 비해 적은 수의 급식소를 대상으로 하여 대표성이 다소 결여되었다. 따라서 우리나라 집단급식소의 위생관리 실태를 완전하게 파악하기 위해서는 더 많은 연구자들이 급식소의 위생관리 실태조사에 참여하고, 이를 데이터베이스화하여 객관적으로 평가하는 작업이 필요할 것으로 사료된다

종합병원의 뇌.척수.근골격계 입원환자의 가정간호요구 (The Demand for Home Nursing Care of Hospital Inpatients in Brain-Spine and Musculoskeletal Diseases)

  • 김상순;김재귀
    • 가정간호학회지
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    • 제1권
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    • pp.57-70
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    • 1993
  • 본 연구는 입원환자들의 가정간호사제도에 대한 찬반여부 및 가정간호 서비스 내용과 그 요구도를 파악하기 위하여 대구시내 3개 종합병원에서 1993년 9월 6일부터 10월 9일까지 뇌질환, 척추질환 및 근골격계질환으로 입원한 환자중 퇴원예정에 있는 환자 242명을 대상으로 설문지에 응답하도록 하여 자료를 수집하였다. 가정간호제도를 찬성한 환자는 66.1%(161명)이었으며 반대는 33.5%(81명)이었다. 환자의 일반적 특성별로는 30세에서 49세 사이가 75.5%, 중소도시에 거주하는 75.9%로 높은 찬성율을 보였다. 특히 의료보호 환자군에서는 40.0% 낮은 찬성율을 보였다. 척추손상 환자의 75.6%가 찬성한 반면 복합질 환자는 54.5%의 찬성율을 보였다. 그리고 거동 가능한 환자의 69.4%, 임종을 기다리는 환자의 80.0% 및 조기퇴원을 희망하는 환자의 73.9%가 가정 간호사제도를 찬성하였다. 가정간호사제도를 찬성하는 환자(161명)의 찬성 이유는 주치의와 계속적인 연결을 갖고 싶어서가 37.3%로 가장 높았고, 그 다음 병원에 오기가 블편해서였고 기능적 상태에 따라 찬성 이유간에는 유의한 차이가 있었다(p<0.05). 가정간호사제도를 반대하는 환자(81명)의 이유를 보면 병원보다 질이 낮을 것같다가 가장 많았고, 방문이 번거롭다 및 가정에서 가족이 돌볼 수 있어서의 순이였다. 조기퇴원을 원하는 환자는 74.8%였으며 조기퇴원 이유는 병원생활이 지루하기 때문에가 57.5%로 가장 많았고, 조기퇴원을 원하지 않는 환자는 질병상태에 대한 불안감 때문에가 54.0%로 가장 높았다. 가정간호사제도를 찬성한 환자들에게 가정간호서비스 내용을 23개 항목으로 나눈 요구 빈도에서 앞으로 수혜받기를 원하는 가정간호활동 내용은 회복촉진, 합병증예방, 상담 및 건강관리지도로 76.4%로 가장 많았으며, 그 다음의 투약관리 및 지도 (62.1%), 활력증상의 정기적인 측정(555.9%)의 순이었고 임종간호(3.7%) 및 호흡유지를 위한 간호(9.9%) 등은 요구빈도가 가장 낮았다. 가정간호서비스 항목에 있어서 진단내용, 환자의 기능적 상태, 합병증 유무 등에 따라서는 큰 차이 없이 회복촉진, 합병증예방상담 및 건강관리지도 항목에서 가장 높은 요구도를 나타냈고 나머지 간호요구는 큰 차이가 없었다.

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질적 간호제공을 위한 간호단위 시범 운영 효과에 관한 임상적 연구 (A Clinical Study for Promoting Quality Nusing Care in a University Hospital)

  • 이애주;김선한;성영희;유순애;권인각;정연이;남혜경;권은정
    • 대한간호
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    • 제32권5호
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    • pp.66-77
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    • 1994
  • The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

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장티브스에 관한 임상적 관찰 (Clinical review of Typhoid Fever Patients)

  • 최정신
    • 대한간호학회지
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    • 제6권1호
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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집단치료사업에 따른 간흡충증의 역학적 변동에 관한 조사 (Studies on the Epidemiological Change of Clonorchiasis After Mass Chemotherapy in Highly endemic Areas)

  • 주경환;주봉덕;임한종;이준상
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.80-93
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    • 1987
  • Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.

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진단방사선 일반촬영에서의 X-ray Beam Collimator 사용 전국 실태조사 (Nationwise Survey of the X-ray Beam Collimator Utilization in General Diagnostic Radiograph)

  • 김지혜;성동욱;김정욱;신진호;이순근;정경일;엄종권;이기남;성호진;김윤현;김혁주
    • 한국의학물리학회지:의학물리
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    • 제24권2호
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    • pp.119-126
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    • 2013
  • 방사선 검사에서 CR, DR의 도입으로 인해 X-선속 조사야의 사용이 경시되고 있는 실정이다. 일반방사선 검사에서 검사 부위별 조사야를 적절히 사용하고 있는지에 대해 현장 실태 조사와 설문 조사하고, 조사야의 기준의 필요성을 강조하며 표준 조사야를 제시하고자 한다. 서울, 경기도, 전라도, 충청도, 강원도, 부산 지역 총 333개 의료기관을 대상으로 X-선속 조사야의 사용 실태를 현장 조사하여, 검사부위별, 의료기관종별, 영상종류별로 조사야 조절의 사용 여부를 분석하였다. 또한 조사야 조절이 방사선피폭에 미치는 영향과 인식을 평가하기 위해 종합병원 10곳, 병원 10곳, 의원 10곳의 일반촬영실에 근무하는 168명의 방사선사를 대상으로 X-선속 조사야 조절이 환자피폭선량 저감화에 끼치는 영향에 대한 인식, 조사야 조절 방법과 실제 사용하고 있는 검사부위별 X-선속 조사야 크기를 설문 조사하였다. 검사부위별 적합한 조사야을 사용하고 있는 의료기관은 61.3%이었으나, 주요 장기가 밀집된 요추 검사의 경우에는 적합한 사용이 49.9%에 불과하였다. 의료기관종별에서는 종합병원이 약 69%, 영상종류별로 보면 DR을 사용하는 병원의 65.0%에서 적합한 조사야을 사용하였다. 설문 조사에서는 응답자의 97.6%가 조사야 조절이 환자에게 끼치는 선량을 줄일 수 있다고 인식하고 있었으나, 실제로 부위별 X-선속 조사야의 크기를 조절하여 검사하는 경우는 83.3%이었다. 일반방사선 검사에서 적절한 조사야를 사용하는 경우가 실태조사를 통해 낮게 나타났으며 이는 환자에 대한 방사선 피폭선량을 줄이기 위한 노력이 시급히 필요하며, 조사야에 대한 통일된 표준 규격이 필요하여 철저한 교육이 동반되어야 한다.

특수건강진단에서 발견된 고혈압 및 간질환 유소견자의 건강관리 실태에 관한 조사 (A Study on the Status of Seeking Intervention among the Workers with Health Problems Identified by the Workers' Periodic Health Examination)

  • 정해관;김정순;문옥륜;임현술
    • Journal of Preventive Medicine and Public Health
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    • 제25권4호
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    • pp.343-356
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    • 1992
  • Authors studied the workers' knowledge about the health problems detected through the previous workers' periodic health examination, content of follow-up management ana actions taken for their health problem detected on previous health examination. From June to September 1992, workers' periodic health examination was peformed on workers employed in 10 companies located in 2 middle-sized Korean cities. A questionnaire survey was done far 150 workers who reported to have $D_2$ result of either hypertension or liver disorder at the previous workers' periodic health examination done in 1991. The results are as follows; 1. Of 160 workers who had $D_2$ result of either hypertension or liver disorder in previous examination one year before, only 85 workers(51.3%, 43 workers with hypertension, 38 workers with live disorder) responded that they have such disorders. The other 65 workers responded to questionnaire were all those with C results. Respondents' knowledge about their diagnoses was relatively precise (95.2% in hypertension group, 94.6% in liver disorder group) but knowledge about classification of diseases was poor. 2. The main efforts to solve the health problem nab self management (20 spells, 55.3%), visiting clinic or hospital(6 spells, 12.8%), use of herb medicine (2 spells, 4.3%) and use of drug store(2 spells, 4.3%) in hypertension group. In liver disorder group, 30 spells (71.4%) relied on self management,6 spells (14.3%) on hospital or clinic and 9 spells (21.4%) had no effort to improve the health problem. Content of self management was low salt diet, quit smoking, regular exercise and quit alcohol drinking in order. Avoidance of salt in diet was high in hypertension group and quitting alcohol drinking was high in liver disorder group. In those with self management, 80.7% of hypertension group and 83.3% of liver disorder group continued previous effort. Those, however, who utilized clinic or hospital, only 16.7% and 50.0% were still visiting hospital or clinic. 3. Fifty seven percent of hypertension group and 64.3% of liver disorder group was presently smoking,8.5% and 11.9% reduced smoking and 21.3% and 14.3% stopped smoking. Forty nine percent of hypertension group and 28.6% of liver disorder group was presently drinking. Reduced alcohol intake was reported in 29.8% and 40.5%, 12.8ole and 23.8% stopped alcohol drinking. Sixty six percent of hypertension group and 73.8% of liver disorder group did no regular exercise, but 12.8% and 11.9% of each group increased their physical exercise far last one year. Forty three percent of hypertension group and 38.l% of liver disorder group was overweight (defined by bodymass index greater or equal than 25). Reduced body Weight was reported in 17.2% and 16.7% of each group. Reduced dietary salt intake was high in hypertension group (51.5%). The study results suggest that follow-up management after workers' periodic health examination is not satisfactory. In order to improve this situation, adequate information on the result of the workers' periodic health examination should be distributed to each worker group with health education and counselling.

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