• 제목/요약/키워드: Epidemiologic indices

검색결과 12건 처리시간 0.033초

우리나라 당뇨병의 역학적 규모와 당뇨병 관리현황 파악을 위한 표본설계의 평가 (An Evaluation of Sampling Design for Estimating an Epidemiologic Volume of Diabetes and for Assessing Present Status of Its Control in Korea)

  • 이지성;김재용;백세현;박이병;이준영
    • Journal of Preventive Medicine and Public Health
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    • 제42권2호
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    • pp.135-142
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    • 2009
  • Objectives : An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. Methods : We analyzed about 250 million medical insurance claims data submitted to the Health Insurance Review & Assessment Service with diabetes as principal or subsequent diagnoses, more than or equal to once per year, in 2003. The database was re-constructed to a 'patient-hospital profile' that had 3,676,164 cases, and then to a 'patient profile' that consisted of 2,412,082 observations. The patient profile data was then used to test the validity of a proposed sampling frame and methods of sampling to develop diabetic-related epidemiologic indices. Results : Simulation study showed that a use of a stratified two-stage cluster sampling design with a total sample size of 4,000 will provide an estimate of 57.04%(95% prediction range, 49.83 - 64.24%) for a treatment prescription rate of diabetes. The proposed sampling design consists, at first, stratifying the area of the nation into "metropolitan/city/county" and the types of hospital into "tertiary/secondary/primary/clinic" with a proportion of 5:10:10:75. Hospitals were then randomly selected within the strata as a primary sampling unit, followed by a random selection of patients within the hospitals as a secondly sampling unit. The difference between the estimate and the parameter value was projected to be less than 0.3%. Conclusions : The sampling scheme proposed will be applied to a subsequent nationwide field survey not only for estimating the epidemiologic volume of diabetes but also for assessing the present status of nationwide diabetes control.

체질특성과 화병의 상관관계에 대한 연구 - 화병역학연구 자료에 기반하여 - (Study on Correlation between Four Constitution Characteristics and Hwa-byung - Based on Hwa-byung Epidemiologic Study Data -)

  • 서현욱;정선용;김명근;김종우
    • 동의신경정신과학회지
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    • 제22권2호
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    • pp.15-25
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    • 2011
  • Objectives : The aim of this study was to find correlations between characteristics of Four constitution and Hwa-byung. Methods : Clinical data were collected from Hwa-byung Epidemiologic study data. we selected 130 self-labelled Hwa-byung patients data and 83 of them were diagnosed as Hwa-byung by SCID. We used Hwa-byung SCID, Hwa-byung scale, CES-D, STAI, STAXI and Personality and Physiological Symptom Questionnaire(PPSQ) as evaluation tools. We performed statistical analysis of each 2 groups, self-labelled Hwa-byung group(N=130) and diagnosed Hwa-byung group(N=83). Results : 1. In self-labelled Hwa-byung group, Greater yin score showed significant negative correlation with 3 indices of Hwa-byung scale and significant positive correlation with 1 index. Lesser yin score showed significant positive correlation with 6 indices. In diagnosed Hwa-byung group, Greater yin score showed significant negaitive correlation with 5 indices. In both groups, Lesser yang score showed no significant correlation with any indices of Hwa-byung scale. 2. In self-labelled Hwa-byung group, Greater yin score showed significant negative correlation with both trait anger score and state anger score of STAXI. Lesser yin score showed significant positive correlation with trait anxiety score, state anxiety score and CES-D score self-labelled Hwa-byung group. Lesser yang score showed significant positive correlation with anger-out score of STAXI. But Lesser yin score showed significant negative correlation with same index diagnosed Hwa-byung group. Conclusions : 1. The higher Greater yin score, suppression or denial, psychological defense mechanism, become more stronger. 2. The higher Lesser yin score, anger-out tendency become more weakened and increased prevalence of Hwa-byung symptoms. 3. The higher Lesser yang score, anger-out tendency become more stronger.

원내 로타바이러스 위장관염의 임상-역학적 연구 (2001-2005년) (Clinico-epidemiologic Study of Nosocomial Rotaviral Gastroenteritis, 2001-2005)

  • 윤영아;이승우;이경일;윤유숙;황자영;임정우;강진한;이준성
    • Pediatric Infection and Vaccine
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    • 제16권2호
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    • pp.123-130
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    • 2009
  • 목 적: 원내 감염 로타바이러스 위장관염의 역학적 및 임상적 특성을 지역사회 획득 감염과 비교하고자 하였다. 방 법: 2001년 1월부터 2005년 12월까지 5년간 로타바이러스 위장관염으로 입원한 환아 들 중, 원내 감염군(100명)과 지역사회 획득 감염군(528명)의 역학적 특성을 비교하였다. 또한 지역사회 획득 감염군 중 연령을 일치시킨 100명을 대상으로 임상적 특성을 비교하였다. 결 과: 양군 간에서 남녀비는 1:4 및 1:5를 보였으며, 원내 감염군의 평균 연령이 지역사회 획득 감염군에 비해 더 낮았다 (21.9${\pm}$15.5개월 vs.16.6${\pm}$10.3개월, P <0.001). 연령별, 연도별 분포와 계절별 발생은 양군에서 비슷한 양상을 보였다. 5년간 연도별 발생 수에 대한 원내 감염 비율은 9.8-22.4 %를 보였으며, 원내 감염 발생 수는 2003년에, 지역사회획득 감염 발생 수는 2002년에 가장 많았다. 임상 양상 비교에서 원내 감염군에서 발열 기간이 길었으나(P<0.001), 설사 중등도에 서는 양군에서 차이가 없었다(P =0.07). 검사실 소견에서 원내 감염군의 백혈구 수가 더 높았으나(P =0.04), BUN의 평균값(P =0.02) 및 20 mg/dL 이상인 환아의 수(16% vs. 4%, P=0.01)는 지역사회 획득 감염군에서 더 많았다. 결 론: 원내 감염 로타바이러스 위장관염은 사회획득 감염 위장염과 비교하여 연령별, 연도별, 계절적 발생 양상 및 임상양상에서 유사하였다.

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21세기 초 한국의 인구구조 및 질병양상 (Perspective on Population Characteristics and Health Problems of Koreans in 21st Century)

  • 김정순
    • Journal of Preventive Medicine and Public Health
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    • 제27권2호
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    • pp.175-185
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    • 1994
  • In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

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Comparison of Different PCR-Based Genotyping Techniques for MRSA Discrimination Among Methicillin-Resistant Staphylococcus aureus Isolates

  • Kim, Keun-Sung;Seo, Hyun-Ah;Oh, Chang-Yong;Kim, Hong
    • Journal of Microbiology and Biotechnology
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    • 제11권5호
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    • pp.788-797
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    • 2001
  • The usefulness of three PCR methods were evaluated for the epidemiological typing of Staphylococcus aureus: an enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR), repetitive extragenic palindromic element PCR (REP-PCR), and 16S-23S intergenic spacer PCR (ITS-PCR). The analysis was performed using a collection of S. aureus strains comprised of 6 reference and 79 isolates from patients with various diseases. Among the 85 S. aureus strains tested, 6 references and 6 isolates were found to be susceptible to methicillin, whereas the remaining 73 isolates were resistant to it. PCR methods are of special concern, as conventional phenotypic methods are unable to clearly distinguish among methicillin-resistant S. aureus (MRSA) strains. The ability of the techniques to detect different unrelated types was found to be as follows: ERIC-PCR, 19 types; REP-PCR, 36 types; and ITS-PCR, 14 types. On the basis of combining the ERIC, REP, and ITS fingerprints, the 85 S. aureus strains were grouped into 56 genetic types (designated G1 to G56). The diversities for the 85 S. aureus strains, calculated according to Simpson\`s index, were 0.88 for an ERIC-PCR, 0.93 for a REP-PCR, and 0.48 for an ITS-PCR, and the diversity increased up to 0.97 when an ERIC-PCR and REP-PCR were combined. The above discrimination indices imply that the genetic heterogeneity of S. aureus strains is high. Accordingly, this study demonstrates that DNA sequences from highly conserved repeats of a genome, particularly a combination of ERIC sequences and REP elements, are a convenient and accurate tool for the subspecies-specific discrimination and epidemiologic tracking of S. aureus.

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자살 태도, 삶의 인식, 우울이 청소년의 자살에 미치는 영향 (Effects of Suicidal Attitudes, Perception of Life, and Depression on Adolescents' Suicide)

  • 이상은;이은진;함옥경
    • 한국융합학회논문지
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    • 제12권7호
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    • pp.305-315
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    • 2021
  • 본 연구의 목적은 청소년의 자살 태도, 삶의 인식, 우울이 자살(사고, 계획, 시도)에 미치는 영향을 조사하는 것이다. I 지역 중학교 2학년 학생 889명의 일반적 특성, 자살에 대한 태도(ATTS), 삶의 인식, 우울증(K-CESD-R) 등의 자료를 분석하였다. 자살 사고가 있는 학생은 246명(27.6%), 자살 계획은 85 명(9.5%), 자살 시도는 46 명(5.1%)이었다. 남학생보다 여학생이, 외모 만족도가 낮을수록, 우울이 높을수록, 주관적 정신건강, 신체건강이 낮을수록, 여가 만족도가 낮을수록 자살(사고, 계획, 시도)이 높아졌다. 자살 사고의 예측 요인은 우울, 주관적 정신건강, 외모 만족도, 자살 태도 중 해결책, 허용성이었고, 자살 계획의 예측 요인은 우울, 주관적 정신건강, 자살 태도 중 해결책, 허용성이었고, 자살 시도의 예측 요인은 우울, 자살 태도 중 허용성이었다. 본 연구 결과는 청소년 자살 예방 교육에서 우울을 낮추고 삶의 인식과 자살 태도를 바꾸기 위한 다양한 노력이 필요함을 시사한다.

파월국군장병의 고엽제 위해에 관한 예비적 역학조사 (A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War)

  • 김정순;임현술;이홍복;이원영;박영주;김성수
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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장기요양 인정자의 신체적 및 정신적 기능 상태와 삶의 질과의 관계 (Relationship Between Status of Physical and Mental Function and Quality of Life Among the Elderly People Admitted from Long-Term Care Insurance)

  • 김형선;배남규;권인선;조영채
    • Journal of Preventive Medicine and Public Health
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    • 제43권4호
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    • pp.319-329
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    • 2010
  • Objectives: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). Methods: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. Results: The mean scores of QOL among all the subjects was $55.4{\pm}15.62$ (Grade I: $49.7{\pm}14.17$, Grade II: $56.8{\pm}14.62$, Grade III: $59.4{\pm}16.36$), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). Conclusions: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

출생 및 영아사망 신고체계 및 전산정보체계 개발 (Birth and Infant Death Reporting System via Computer Network)

  • 박정한;이영숙;이정애;조현;정영해;박순우;전혜리
    • 보건행정학회지
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    • 제8권2호
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    • pp.125-148
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    • 1998
  • Accurate vital statistics are essential for a national health planning and evaluation. Among various vital statistics, birth and death rates, and infant and matemal mortality rates together with the causes of death are the very basic ones for above purposes as well as for the maternal and child health management. These statistics are based on the birth and death reports. It is required by law to report every birth and death within one month after its occurrence. However, in case of a neonatal death occurring prior to the birth report, most of the birth and death are not reported. Thus accurate infant and maternal mortality rates are not available yet in Korea. The main objective of this study is to develop a birth and infant death reporting system via computer network. We designed a new birth report form based on the current form and data from the analysis of medical record forms of 14 hospitals. A new form is basically addition of essential medical information to the current birth report form. Since a revision of the rules and regulations related wtih the birth report is necessary to use a new form, we kept the current from intact to make it acceptable to the government office for a field trial. We also developed computer programs for data input for birth and death reports at a medical faciltiy, data processing for production of maternal and child health indices at a health center, and management of maternal and child health services including immunization and postantal care at health center. The birth certificate and birth report can be printed out at a medical facility. The computer packages were programmed by Borland Delphi 3.0 and can be run under Windows 95 system. We proposed a new birth and death reporting system via computer network after a field trial for data input, transmission, and processing. The medical and demographic data o birth and death at medical facilities will be sent to health centers directly via computer network. The health center will retain the medical data for analysis and forward only the data for birth and death reports required by current regulations to the Dong, Up, or Myun Office. Once the birth or death is reported via computer network to the Dong Office, then the Dong Office will notify the baby's mother of the birth report and request to submit the baby's name by mail. When the baby's name its submitted. the Dong Office will forward the birth reports to the Common Court and Statistics Agency in the same way as the current system, Upon the completion of birth registration of the Common Court, the court will issue the birth certificate to mother which will be used in lieu of the family record. The advantages of proposed birth and death reporting system via computer network ar as follows ; I) The accuracy, timing, and completeness of reporting will be improved and more accurate maternal and child health indices can be obtained, ii) The maternal and child health services of health center will be obtained, iii) Epidemiologic data for pregnancy and birth can be obtained, iv) Manpower for birth and death reporting will be saved.

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고 비시지 접종률 상태에서 초등학생들의 투베르쿨린 조사를 통한 감염률 추정 조사 (Tuberculin Survey to Estimate the Prevalence of Tuberculosis Infection of the Elementary Schoolchildren under High BCG Vaccination Coverage)

  • 김희진;오수연;이진범;박윤성;류우진
    • Tuberculosis and Respiratory Diseases
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    • 제65권4호
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    • pp.269-276
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    • 2008
  • 연구배경: 결핵 감염률은 결핵 실태를 파악하기 위한 기본 지표임에도 불구하고 1995년 전국실태조사를 마지막으로 실시되지 못하고 2000년 결핵정보감시체계로 대체되었다. 비시지 접종률이 높은 현 상황에서 무반흔자를 대상으로 한 감염률 조사는 실행이 어려우며 비시지 접종자를 대상으로 투베르쿨린 조사에 대한 비시지 영향 분석과 비시지 반흔과 상관없는 결핵 감염률 조사가 필요하다. 방 법: 2006년에 전국 초등학교 1학년생들을 대상으로 각 시도별 아동 수를 추계한 후 학교를 대상으로 단면조사 연구를 하였다. 총 대상자 수는 40개 학교의 5,148명이 비례할당법으로 선정, 조사되었다. 투베르쿨린 검사는 2단위의 PPD RT 23 0.1 ml를 좌측 전박에 피내 주사한 후 48~72시간 후에 가장 긴 횡직경을 측정하였다. 비시지 반흔에 대해서도 각각 조사하였다. 결 과: 비시지 무반흔자는 6.3%였다. 평균 경결 크기는 0 mm 반응자 1,882명(46.8%)를 포함하여 $3.7{\pm}4.4mm$ 였다. 결핵 감염률은 10 mm 이상을 양성 반응으로 했을때 10.9% (439명)였다. 연간결핵감염위험률은 평균 연령을 6세로 하여 1.91%였다. 결핵 감염률은 비시지 반흔유무에 따른 유의한 차이는 없었다[11.2% vs. 7.6% (OR:1.54, 95% CI: 0.98~2.43)]. 16 mm를 정점으로 한 거울영상법으로는 감염률과 연간결핵감염위험률이 각각 2.4%와 0.4%였다. 결 론: 결핵 감염률과 연간결핵감염위험률은 기존 방법으로 할 경우 높은 비시지 접종률로 인해 높게 나타났다. 결핵 감염률이 높지 않은 국가에서는 거울영상법이 두 지표를 추정하는데 보다 더 적합한 것으로 보인다.