• 제목/요약/키워드: Health practices index

검색결과 63건 처리시간 0.031초

입원환자 질병유형의 구성에 의한 지역별 진료기능에 관한 연구 (A Study on the Regional Function of Health Care by the Disease Pattern of the Inpatients)

  • 최현림;이상일;신영수;김용익
    • Journal of Preventive Medicine and Public Health
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    • 제21권2호
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    • pp.390-403
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    • 1988
  • The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.

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Breast Cancer Risk and Early Diagnosis Applications in Turkish Women Aged 50 and Over

  • Ceber, Esin;Mermer, Gulengul;Okcin, Figen;Sari, Dilek;Demireloz, Mahide;Eksioglu, Aysun;Ogce, Filiz;Cakır, Dilek;Ozenturk, Gulsun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5877-5882
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    • 2013
  • Background: The aim of the study was to determine breast cancer risk and early diagnosis applications in women aged ${\geq}50$. Materials and Methods: This cross-sectional, descriptive field study focused on a population of 4,815 in Mansuro$\breve{g}$lu with a 55.1% participation rate in screening. In the study, body mass index (BMI) was also evaluated in the calculation of breast cancer risk by the Breast Cancer Risk Assessment Tool (BCRA) (also called the "Gail Risk Assessment Tool"). The interviewers had a three-hour training provided by the researchers, during which interactive training methods were used and applications were supported with role-plays. Results: The mean age of the women participating in the study was $60.1{\pm}8.80$. Of these women, 57.3% were in the 50-59 age group, 71.7% were married, 57.3% were primary school graduates and 61.7% were housewives. Breast-cancer development rate was 7.4% in the women participating in the study. When they were evaluated according to their relationship with those with breast cancer, it was determined that 73.0% of them had firstdegree relatives with breast cancer. According to the assessment based on the Gail method, the women's breast cancer development risk within the next 5 years was 17.6%, whereas their calculated lifetime risk was found to be as low as 0.2%. Statistically significant differences (P=0.000) were determined between performing BSE-CBE and socio-demographic factors. Conclusions: It was determined that 17.6% of the participants had breast cancer risk. There was no statistically significant difference between the women with and without breast cancer risk in terms of early diagnosis practices, which can be regarded as a remarkable finding. It was planned to provide training about the early diagnosis and treatment of breast cancer for people with high-risk scores, and to conduct population-based breast cancer screening programs.

활동제한에 따른 한국 노인의 식생활 및 영양섭취 평가: 2019년 국민건강영양조사 자료를 이용하여 (A study on the nutrient intake of the elderly in Korea based on activity limitations: data from the 2019 Korea National Health and Nutrition Examination Survey)

  • 김소영;이영미
    • Journal of Nutrition and Health
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    • 제55권5호
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    • pp.543-557
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    • 2022
  • 본 연구는 제8기 1차년도 (2019년) 국민건강영양조사 자료를 이용하여 65세 이상 활동제한이 있는 노인과 정상 노인의 영양섭취 실태를 비교 분석하였으며, 주요 연구결과는 다음과 같다. 첫째, 활동제한군의 평균 연령은 73.8세로 정상군 72.6세보다 높았다 (p = 0.010). 또한, 활동제한군은 도시보다 농촌에서 생활하는 비율이 높았으며 (활동제한군 37.8%, 정상군 22.9%, p < 0.001), 1인 가구로 구성된 비율이 정상군에 비해 높았다 (활동제한군 28.1%, 정상군 17.2%, p = 0.004). 둘째, 주관적인 건강상태에서 활동제한군 (62.7%)은 건강이 나쁘다고 인지하는 비율이 정상군 (19.3%)에 비해 높았고 (p < 0.001), 평소 스트레스 역시 활동제한군이 정상군에 비해 대체로 많이 인지하고 있는 것으로 나타났다 (p = 0.001). 셋째, 식습관을 분석한 결과 활동제한군은 모든 끼니에서 대상자의 절반 가량이 혼자 식사를 하고 있어 정상군에 비해 혼자식사비율이 유의적으로 높았고 (p < 0.05 for all), 한달 평균 외식빈도가 5.0회로 정상군 7.4회에 비해 유의적으로 적었다 (p < 0.001). 넷째, 활동제한군은 정상군에 비해 탄수화물의 에너지 섭취 기여율이 높았고 (p = 0.026), 지방의 에너지 섭취 기여율은 낮았다 (p = 0.011). 활동제한군은 정상군에 비해 곡류 섭취량은 많았고 (p = 0.001) 채소류 섭취량은 적었으며 (p = 0.039), 에너지 (p = 0.021), 단백질 (p = 0.031), 리보플라빈 (p = 0.037)의 영양소적정섭취비가 낮았다. 다섯째, 영양섭취부족율은 활동제한군이 23.3%로 정상군 13.0%보다 유의적으로 높았으며 (p = 0.001), 건강식생활실천율은 활동제한군이 유의적으로 낮았다 (p < 0.001). 이와 같은 연구 결과를 종합해보면, 활동제한 노인은 영양관리가 우선시되어야 함에도 불구하고 오히려 영양관리가 취약함을 알 수 있었다. 향후, 활동제한 노인들의 식사관리를 지원하는 재가노인복지시설을 대상으로 한 체계적인 영양관리 시스템 도입이 필요하며, 활동제한이 있는 재가노인을 위한 식사지침 등 영양교육 프로그램 개발이 필요할 것이다.

성인 알레르기비염 특이형 삶의 질 측정도구 개발 및 평가 (Development and Evaluation of Allergic Rhinitis-Specific Quality of Life (ARSQOL) Scale for Adults)

  • 이혜숙;박은옥
    • 대한간호학회지
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    • 제46권5호
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    • pp.675-686
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    • 2016
  • Purpose: The purpose of this study was to develop an Allergic Rhinitis-Specific Quality of Life (ARSQOL) scale and verify its validity and reliability. Methods: ARSQOL was developed in 5 steps. Items for the preliminary instrument of ARSQOL were developed through a literature review and deep interviews with allergic rhinitis patients. Face validity with Content Validity Index (CVI), construct validity using factor analysis, and known group comparison, criterion validity test using correlation between ARSQOL and total nasal symptoms score (TNSS) were conducted to evaluate the validity of ARSQOL. Cronbach's ${\alpha}$ was used to evaluate the reliability of ARSQOL. Results: CVI for the items in the final ARSQOL were. 92. Five factors including discomfort associated with nasal symptoms (4 items), physical function (7 items), mental function (5 items), sleep disorder and social function (4 items), and problems of daily life (6 items) were identified through factor analysis and these five factors explained 66.6% of the total variance. The correlation coefficient between TNSS and the total score of life quality was -.69. In the group comparison, the persistent allergic rhinitis group showed lower ARSQOL scores than the intermittent patient group, and moderate to the severe allergic rhinitis patient group presented poorer ARSQOL than the mild symptom patient group. The Cronbach's ${\alpha}$ reliability coefficient was .95. Conclusion: Results show that the ARSQOL has good reliability and validity and thus ARSQOL is a useful scale for clinical practices and research as a measure of quality of life in adults with allergicr hinitis.

Dietary intakes and obesity of Malaysian adults

  • Lee, Yi Yi;Muda, Wan Abdul Manan Wan
    • Nutrition Research and Practice
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    • 제13권2호
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    • pp.159-168
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    • 2019
  • BACKGROUND/OBJECTIVES: Over the past few decades, Malaysia has been experiencing an increased prevalence of overweight and obesity that threatens the health of Malaysians. Poor dietary intake is one of the major contributors to the development of obesity and many non-communicable diseases. The dietary intakes of adults in Malaysia were assessed to determine the association between the dietary intake variables and the body mass index (BMI) and waist circumference (WC) measurements. This study examined whether the dietary intake achieved the recommended nutritional guidelines and compared the intakes between both sexes. SUBJECTS/METHODS: The height, weight, and WC of four-hundred-and-ninety adults (n = 490) in Malaysia were measured using standard procedures. The three-day 24-hour dietary recalls were conducted on 422 out of the 490 adults and their dietary intakes were evaluated in detail. The selected dietary intake variables were used to determine the associations with the obesity indicators. RESULTS: Among the participants, 52.8% were overweight or obese. After data analysis, the mean energy intake was 1,550 kcal/day, in which male participants had a significantly higher energy and macronutrients intake than females. Protein consumption and its percentage of energy contribution exceeded the recommended range. The consumption of fruits, vegetables, and milk and milk products were lower than the recommended number of servings for a healthy diet. The male participants consumed significantly more servings of carbohydrate-based foods, meat, and fats, oils, and sweets than females. Among the selected dietary intake variables, only the carbohydrate intake was negatively associated with the BMI (Estimate b = -0.008) and WC measurements (Estimate b = -0.019) after adjusting for covariates. CONCLUSIONS: This study evaluated the dietary intakes of a sample of Malaysian adults and its association with the obesity indicators. The results highlight the need for improvements and modifications of the dietary intake of Malaysians to reduce the overweight and obesity rates.

Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • 제11권1호
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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유럽 및 오세아니아의 기능성 축산물과 식육제품에 대한 운영현황 및 관리방안 (Management Practices on Functional Meats and Meat Products in European Countries and the Oceania Area)

  • 최지훈;최윤상;김학연;김현욱;김진만;김천제
    • 한국축산식품학회지
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    • 제30권5호
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    • pp.703-716
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    • 2010
  • 본 연구는 유럽과 오세아니아의 선진국형 기능성 축산물 및 식육제품의 운영현황 및 관리방안을 연구 분석함으로서 국내 실정에 부합되는 규격기준 표준화와 관리방안 및 제도를 마련하는데 있어서 기초 자료를 제시하는데 있다. 우리나라를 비롯하여 전 세계적으로 국제경쟁력 강화 차원 등의 여러 여건 변화로 식품의 3차적 기능이 점차 강조되고 있다. 따라서 우리나라 자체적으로 기능성 축산물에 대한 정확한 정의와 범위를 확립하는 것이 시급하다. 식품에 기능성 표시를 허용하는 것은 이미 국제적인 대세이다. 유럽과 오세아니아에서도 별도의 기능성 축산물에 관한 법률이나 관리제도가 없으나 식품의 기능성 강화 측면에서 영양표시기준(nutrition claims)과 건강표시기준(health claims)을 통해 식품을 관리하고 있다. 강화 영양소에 대한 표시기준은 일부에 국한되어 있어 이들 기준을 사용하여 국내의 기능성 축산물 및 식육가공품에 적용할 경우, 기능성 지표물질 및 허용량의 설정이 반드시 이루어져야 할 것으로 보이며, EU와 호주 뉴질랜드에서 운영하는 제도 이외의 다른 선진국의 사례를 바탕으로 기능성 축산물에 대한 표준화가 이루어져야 할 것으로 보인다. 또한 기능성 축산물 및 식육제품의 표시를 확립하기 위해서는 현재 시중에 유통되고 있는 제품에 사용되는 기능성 소재 조사 및 각 기능성 소재가 인체에 유해한지 안전성에 대한 연구가 필요하며, 이들 소재의 적정 사용범위 설정을 위한 data base를 확립하기 위해 많은 실험적인 연구가 요구된다.

중년여성의 체중관리 실태와 성인병 위험도 (Weight Control and Cardiovascular Risk in Middle-Aged Women)

  • 김정아;정승교
    • 재활간호학회지
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    • 제7권1호
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    • pp.33-47
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    • 2004
  • The purpose of this study was to investigate weight control practices and cardiovascular risk in middle-aged women. 304 middle-aged women were selected as subjects from thirties to fifthies living at J city in Chung-Buk Do. Data were collected using a questionnaire, anthropometric measurements, BP & total cholesterol level in serum from April 1, to June 30, 2003. The results of this study were as follows: The middle-aged woman's age is average $43.95{\pm}7.09yr$ and mean BMI(body mass index) was $23.54{\pm}3.09\;kg/m^2$. Underweight, normal weight, overweight, obese women were 3.0%, 39.5%, 27.9% and 29.6%respectively. Subjects perceived own as 'Slim' 5.9%, 'ordinary' 45.7%, 'Fat' 48.4%. Their weight perception coincide their own actual body weight but as many as 41.8% of overweight and 9.0% of obese perceived themselves as being 'ordinary'. Middle age women with past weight control experience were 55.6%, and only 35.5% was doing weight control at present. Of these subjects, 71.4% reported wanting to lose weight and the primary reason of weight control was to improve their appearance(39.53%). The most frequently reported weight control behavior was 'exercise' followed 'dieting', but 39.6% reported using 'diet food', 12.4% 'behavior modification', 12.4% 'fasting', and 'diet-drug'(3.6%) or 'smoking'(3.6%). Effective weight control methods were thought regular exercise(97.1%) & dieting (79.3%). And behavior modification(71.4%) or diet camp(60%) were effective, too. An average waist circumference was $79.80{\pm}9.47cm$, waist/hip ratio was $86.63{\pm}6.78$, waist/height ratio was $50.43{\pm}6.10$. In the index of abdominal obesity, 79.7 % of middle-aged women was waist/height ratio over 0.46, 65.3% was waist/hip ratio over 0.85, 28.4% was waist circumference over 85cm. There were significant differences in the degree of abdominal obesity according to age and BMI. In the index of cardiovascualr risk, 10.9% of middle aged women was systolic hypertension over 140mmHg, 18.7% was diastolic hypertension over 90mmHg and 10.6% was hypercholesterolemia over 200mg/dl. There was significant difference in systolic hypertension ratio according to age. There was significant difference in diastolic hypertension ratio according to age and obesity. There were significant differences in hypercholesterolemia accorting to obesity. The abdominal obesity indices and the levels of T-cholesterol in the serum, systolic and diastolic BP increased significantly according to age. T-cholesterol in serum was predicted 2.6% by waist/height ratio. And systolic BP was predicted 15.2% by waist/height, add BMI to 16.8%. Subject's diastolic BP was predicted 12.1% by BMI. Therefore waist/height ratio and BMI were significant factors for the predictors of cardiovascular risk. There was significant correlation between index of obesity and cardiovascular risk. T-cholesterol in serum had correlation with waist/eight ratio(r=0.174) and waist circumference(r=0.48). Systolic BP had correlation with waist/height ratio(r=0.387), and BMI(=0.371). diastolic BP correlation had correlation with BMI(r=0.343) and waist/height ratio(r=0.327). In conclusion, The prevalence of obesity was 29.6% in 304 cases, and increased as age after menopause increased. Middle-aged women's weight perception and actual BMI coincide but some of them did not. Trial to reduce weight was attempted. But most of them did not actually. Undesirable weight control method such as using drugs, fasting, smoking was used by some women. It is important to educate about health weight control methods and raise their awareness of exact body figures. High frequency of abdominal obesity in middle-aged women had correlation with hypertension and hypercholesterolemia. Abdominal index such as waist/height ratio, waist circumference, waist/hip ratio was used. Women's hypertension, hypercholesterolemia significantly related to body mass index and abdominal obesity.

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사회학 분야의 연구데이터 특성과 지적구조 규명에 관한 연구 (An Investigation on Characteristics and Intellectual Structure of Sociology by Analyzing Cited Data)

  • 최형욱;정은경
    • 정보관리학회지
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    • 제34권3호
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    • pp.109-124
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    • 2017
  • 여러 학문 분야에서 데이터의 공유와 재이용에 관한 관심이 증가하고 있다. 실제로 다른 연구자의 데이터를 다시 연구에 사용하고 인용을 부여하는 관행이 서서히 자리를 잡아가고 있다. 이러한 변화를 반영하여 톰슨로이터는 Data Citation Index(DCI)라는 데이터인용 색인 데이터베이스 서비스를 2012년부터 제공하기 시작하였다. DCI는 모든 학문의 전 영역에서 데이터의 인용 현황을 저널의 논문과 유사하게 집계한다. 본 연구에서는 데이터인용이 활발한 사회학 분야의 인용된 연구데이터를 분석하여 해당 분야의 특성과 지적구조를 규명하고자 하였다. 이를 위해 논문인용을 기반으로 한 사회학 분야의 지적구조와 비교하였으며, 사회학 분야의 연구데이터의 특성과 고유한 지적구조를 살펴보고자 하였다. 분석을 위한 데이터는 두 종류로 수집하였다. 첫째는 DCI에서 'Sociology'로 주제 검색을 수행하여 총 8,365건의 인용된 데이터를 수집하였다. 둘째로, 논문 인용 분석과의 비교를 위해서 Web of Science에서 'Sociology'로 주제 검색을 수행하여 총 12,132건의 데이터를 수집하였다. 이 두 데이터를 활용하여 저자키워드 동시출현단어 분석을 수행한 결과, 데이터를 기반으로 한 사회학 분야는 2영역 15군집으로 구성된 반면, 논문을 기반으로 한 사회학 분야는 3영역 17군집으로 나타났다. 내용적인 특성을 살펴보면, 전통적으로 사회학의 지적구조를 나타낸다고 볼 수 있는 논문 기반 사회학과 달리 사회학 분야의 연구데이터는 의학 분야와의 활발한 접목을 찾아볼 수 있으며, 그 중에서도 공중보건과 심리학이 중심 영역인 것으로 나타났다.

영아의 섭식패턴에 따른 성장발육의 종단적인 비교 연구 (The Longitudianl Study of the Growth by Feeding Practice in Early Infancy)

  • 안홍석
    • Journal of Nutrition and Health
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    • 제30권3호
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    • pp.336-348
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    • 1997
  • The objectives of this study were to examine the growth pattern of infants by anthropometric measurement according to the 5 feeding practices of infants with the subject of two hundred healthy newborn babies from their birth till sixty month of age at intervals of two months. Breast group(BF, n=38), formula group(FF, n=102) and mixed group(ME, n=14) were fed breast milk, formula milk, breast and formula milk, from birth till 6 mo. of age, respectively. Convert 1 group (C1F, n=14) and covert 2 group(CF, n=32) were fed breast milk and mixed milk at 2 mo. of age afterthat switched to formula milk, respectively. From these, the following results were made. All the infants of this study showed superiority to Korean standard growth rate in regards to each growth item for each month age. In the case of males, at their birth, the subscapular skinfold thickness and the total skin fold thickness in the BF group was significantly larger than in MF group and FF group(p<0.05). At 6th month age, the chese circumference of MF group was 45.9cm, and significantly larger than those of BF, FF and C2F groups(p<0.05). In the case of females, at theri birth and 2nd month age, there was no difference among all the feeding groups in regards to each growth rate. At 4th month age, the Kauf index of C1F group was 16.21 and significantly lower than those of four groups(p<0.05). And total skinfold thickness in BF group was larger than in C1F group. The increase rate per month age of all growth items were larger at 2nd month age than at the later months both in males and in females. And until 2nd month age males showed more increase than females in regards to each growth item but after 2nd month age, this sapect did not show up. Multiple linear regression was used to determine predictive factors for infant growth. It was expected that at 6th month age, in the measurement of head circumference and chest circumference and cross-sectional fat area, BF-males were bigger by 22-39% of the explanation index than the infants of other groups. As a result, in spite of the significant lower intakes of energy and nutrients in breast-fed infants than in formula-fed infants, breast-fed infants showed more growth than the average of Korean infant standard growth rate at every month age, and showed no significant growth difference among feeding groups.

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