• 농촌의학ㆍ지역보건
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• 제7권1호
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• pp.74-79
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• 1982

Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

• 한국간호교육학회지
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• 제9권2호
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• pp.264-275
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• 2003

The purpose of this study were to develop a smoking preventive education program for elementary students and evaluate it's effectiveness. This study was a quasi experimental study under the nonequivalent control group with pretest-posttest design. The subjects of this study were 62 who are attending elementary school(31 for each group), 2 different district elementary school. The subjects were matched by grade, similar in anti-smoking educational background of smoking, as well as their residence and income level of their families. The instruments used in this study was 18 criterion referenced test items modeled by Dick & Carey that were developed by researchers for evaluating the subjects' knowledge and attitude about smoking. A pretest was administered a week before treatment The program given to the experimental group is composed of the texts explaining the poisonous substances in tobacco, social and cultural harmfulness of smoking to the body and psychology, indirect smoking, smoking of pregnant women, motives of smoking, refusal skills of smoking; and for the subjects' understanding and the better results of study - pictures, role play, discussion, text through computer based multi-media, puzzle searching for hidden pictures, cross-word puzzle, and finally compensation. The data were collected for 50 days form mid- September to the end of October in the year of 2000, composed of formative evaluation, pre-test and summative evaluation via 2 sessions. Accordingly, the collected data were analysed by t-test, paired t-test, repeated measure ANOVA by the SAS program. This research summarize the findings as follows; 1. There was a significant difference in knowledge between the experimental group(after 1 wks t=10.4680, p=.0001; after 4 wks t= 9.310, p=.0001) and control group(after 1 wks t=0.0420, p= .9669; after 4 wks t= -0.378 p=.7079) in between the results of 1 and 4 week after education in summative evaluation (F=27.45, P=.0001). 2. There was non statistical significant difference in attitude between the experimental group (after 1 wks t=1.2292, p=0.2286 ; after 4 wks t=1.330, p=0.1935) and control group (after 1 wks t=0.1819, p=0.8569 ; after 4 wks t=0.2970, p=0.7685) in between the results of 1 and 4 week after education in summative evaluation(F=0.71, P=0.494). To sum up, the statistics of conclusive analysis evaluative for the children under school age of the 'knowledge acquisition' about smoking harmfulness. On the other hand, as there was already sound attitude about smoking, the evaluation of attitude was non significant difference between control group and experimental group, just there was partially significant difference.

• 한국보건간호학회지
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• 제3권1호
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• pp.18-37
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• 1989

This study was done in order to analyze the factors which influenced the performance level of community health practitioners' task. Interview survey was done during the period from August to October, 1986. Interviewee were 166 CHPs among total of 217 CHPs in Kyonggi province area. Multiple stepwise regression and canonical correlation analysis were used to identify major factors influenced to perform community health practitioners' task. The results of this study were summarized as follows: 1. General characteristics of CHPs 1) Personal characteristics The average age of CHPs was 37.8 years and their marital status was $77.6\%$ of married, educational back-ground was $65.3\%$ of junior college graduation. Their job career was $38.6\%$ of between 1-3 years, $33.3\%$ of between 3-5 years, $22.2\%$ of less than 1 years. Most of CHPs$(62.8\%)$ were fully satisfied with their job, $33.3\%$ were moderately, and $3.8\%$ were not satisfied. 2) Working environmental condition Only $31.7%$ of CHPs were satisfied with their working condition of primary health post, $26.6\%$ were not satisfied. Half of CHPs$(52.5\%)$ replied having good cooperation with health center, $10.1\%$ replied bad. Cooperation with health subcenter was good in $32.9\%$, and bad in $21.9%$. Cooperation with private health institutions was good in $34.2\%$, bad in $21.6%$. 2. Performance level of community health practitioners' task Among a total of 52 contents of their functions medical history taking. physical examination, referral of diagnostic laboratory work-up($(86.4\%)$, health assessment of pregnant women$(82.1\%)$, development of health information system$(79.4\%)$, supervision of health workers $(78.4\%)$, follow-up of family planning acceptors$(77.3\%)$, and follow-up of family planning acceptors' side effects$(77.3\%)$ were actively performed. Diagnosis of pregnancy$(62.1\%)$, sampling of drinking water for quality test$(52.5\%)$, making list of equipment' & supplies $(51.5\%)$, evaluation of primary health post activities $(37.6\%)$, organization of village health workers$(32.4\%)$ and management of village health workers $(30.1\%)$ were poorly performed. 3. Stepwise multiple regression analysis of job function The factors which influenced the performance level of community health practitioners' function were age, marital status, educational level, job career, job satisfaction, satisfaction of working environment of primary health post, cooperation of health center, cooperation of health center, cooperation of private health instiutions in orders. These 9 variables were able to explain job function from $25.7\%$ of program planning to $6.7\%$ of management of common disease. 4. Canonical correlation analysis between the performance of function and general characteristics of CHPs. Cooperation of private health institutions was found to be the factor influencing task performance of community organization, management of primary health post, technical supervision of health personnels. Job satisfaction of CHPs was also found to be the factor influencing task performance of family planning, management of common disease and maintenance of health information system.

• 교육녹색환경연구
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• 제16권3호
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• pp.9-17
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• 2017

본 연구는 단설유치원 교직원과 교육청의 시설담당공무원을 대상으로 장애물 없는 생활환경 인지도와 유치원의 장애물 없는 생활환경 구축을 위해 강화 또는 완화해야 할 편의시설을 조사하였다. 또한 장애물 없는 생활환경 조성을 위해 기설 단설유치원의 개선 편의시설에 대해서 조사하여 개선방안을 도출하였다. 첫째, 제도적 측면에서 우리나라 현행 "장애인 노인 임산부 등의 편의증진 보장에 관한 법률 시행규칙"을 개정하여 유치원의 의무 권장 설치대상 편의시설과 그에 따른 장애물 없는 생활환경 인증기준을 변경할 필요가 있다. 둘째, 시설 환경적 측면에서 기설 유치원에 장애물 없는 생활환경 인증 제도를 적용하기 위해서는 지형 또는 건물 구조상 개선이 어려운 항목은 배점을 낮게 조정하여 기설 유치원이 장애물 없는 생활환경 인증을 받을 수 있도록 활성화할 필요가 있다. 셋째, 사회 인식적 측면에서 장애물 없는 생활환경에 대한 인지도가 아직도 높지 않은 것으로 나타났다. 교육청 및 인증기관을 중심으로 장애물 없는 생활환경 인증제도에 대한 홍보와 교육을 강화하여야 한다. 기존유치원과 신설유치원의 장애물 없는 생활 환경 조성 방향의 핵심은 보호능력과 안전의식이 부족한 유아의 특성을 감안하는 것이다. 모든 출입구의 높이 차이를 제거하고 자동문을 설치하여 편리성과 안정성을 높이고, 위생시설은 유아가 사용하기 편리하도록 적절한 높이와 공간 확보가 필수적이다. 최근 유아기 공동체 활동이 강화됨에 따라 강당이나 도서관의 각종 편의시설 확충과 피난안전시설도 강화되어야 한다. 본 연구는 사회적 약자인 유아들의 교육 생활 공간인 단설유치원을 대상으로 장애물 없는 생활환경 조성 방안을 연구하였다는 점에서 의의가 있다. 따라서 향후 본 연구를 토대로 기설 유치원에 적합한 장애물 없는 생활환경 인증지표에 대한 개선 연구가 시도된다면 유치원의 장애물 없는 생활환경 변화를 촉진할 수 있는 계기가 될 것으로 기대한다.

• Journal of Nutrition and Health
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• 제40권sup권
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• pp.29-38
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• 2007

The purpose of this study was to establish an association between the percent of energy from total sugar and disease prevalence of obesity, hypertension, dyslipidemia, insulin resistance, and metabolic syndrome with the context of the current population dietary practice in Korea. The Korean National Health and Nutrition Survey, 2001 and 2002 dataset were used as the source of data for this research. Usual nutritional intakes for over 20 years old people were calculated from the two non-consecutive dietary intake data from KNHANES 2001 and 2002 dataset. SAS and SUDAAN were used for statistical analyses. Sample weighted means, standard errors, and population percentages were calculated, and multiple logistic regression model with adjustment for covariates were used to determine the odds ratios(ORs) and 95% confidence intervals. Subjects were categorized as 3 ways and compared the LS means and ORs for heath factors. First, subjects excluding pregnant women, were categorized according to percent of energy from the usual total sugar intakes as ${\leq}10%$, 11-15%, 16-20%, 21-25%, >25%. Risk of LDL cholesterol showed a tendency to increase in the '>25%' group compared to the '<10%' group. The risks of the other health effects did not show any significant differences. Second, the subjects were categorized considering both Acceptable Macronutrient Distribution Range(AMDR) from carbohydrate and %Energy from total sugar as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-25%', and '$CHO{\geq}70%$ & Total sugar ${\geq}25%$'. The risk of obesity tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}25%$' group compared to the 'CHO<55% & Total sugar ${\leq}10%$'. Third, the subjects were categorized as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-20%', and '$CHO{\geq}70%$ & Total sugar ${\geq}20%$'. The risk of obesity also tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}20%$' group compared to the 'CHO<55% & Total sugar ${\geq}20%$' group. In conclusion, risk of LDL cholesterol showed a tendency to increase in the over 25% total sugar intake group, and the risk of obesity tended to increase in the 20-25% total sugar intake and high carbohydrate intake group. The risks of hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome were not associated with total sugar intakes. More research to elucidate the association for Korean between the intakes of total sugar, added sugar, glucose, fructose, and sweeteners and diseases prevalences shoud be excuted in the future.

• 대한방사선기술학회지:방사선기술과학
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• 제40권1호
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• pp.35-40
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• 2017

본 연구는 임신초기 초음파에 의해 측정된 임산부의 복부 피하지방두께(Abdominal Subcutaneous Fat Thickness; ASFT)와 임신중기 발현되는 임신성당뇨(Gestational Diabetes Mellitus; GDM)와의 연관성을 확인하고 GDM 예측을 위한 ASFT의 기준을 알아보고자 하였다. 286명의 임산부를 대상으로 임신초기 ASFT를 측정한 후 임신중기 GDM 선별검사(50 g OGTT) 140 mg/dL 이상을 고위험군으로 산정하고 산모연령, 임신 전 체질량지수, 임신 중 체중증가량과 함께 비교 분석하였다. ROC 곡선분석을 이용하여 GDM 예측을 위한 ASFT의 cut-off value를 결정하였다. 산모연령, 임신 중 체중증가량은 임신중기 GDM과 관련성이 없었으며, 임신 전 체질량지수와 임신초기 ASFT는 정상군과 GDM 고위험군에서 의미있는 차이를 보였다. GDM 예측을 위한 ASFT의 cut-off value는 2.23 cm(AUC 0.913, Sensitivity 76.19%, Specificity 93.72%)로 결정하였다. 임신초기 초음파로 측정된 ASFT는 임신중기 GDM 예측을 위한 중요한 지표로 유용하게 평가되었다. 따라서 ASFT는 GDM을 조기에 인식하는데 있어서 보조적인 진단지표로 활용할 수 있을 것으로 사료된다.

• 대한방사선기술학회지:방사선기술과학
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• 제39권4호
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• pp.549-555
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• 2016

본 연구는 다운증후군 위험도의 예측을 위해 통합선별검사를 실시한 산모를 대상으로, 각 표지자의 유의성에 대한 평가를 하였다. 초음파로 측정한 NT 영상, 산모혈청 PAPP-A, AFP, uE3, hCG, 인히빈 A의 상관성을 후향적으로 분석하였다. 그 결과 NT, uE3, hCG, 인히빈 A와 유의한 상관관계를 보였다(p<.001). ROC분석에서 인히빈 A의 AUC가 0.851로 다운증후군의 가장 큰 예측인자로 분석되었으며. cut-off value 1.33 MoM(민감도 87.5%, 특이도 71.5%)으로 결정되었다. 결론적으로 통합선별검사에서 인히빈 A가 다운증후군을 예측하는 가장 유용한 인자로 나타났다. 이에 각 표지자(parameter)들의 cut-off value를 바탕으로 통합선별검사의 단점을 보완한다면 다운증후군 선별의 독립적인 지표로 사용될 수 있을 것으로 사료된다.

• 대한핵의학회지
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• 제15권1호
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• pp.1-11
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• 1981

To evaluate the diagnostic accuracy of the measurement of free thyroxine (FT4) by radioimmunoassay, we measured free $T_4\;and\;T_4,\;T_3,\;T_3RU$, TSH and TBG serum levels by radioimmunoassay in 18 healthy persons and 52 patients with various thyroid diseases and 11 normal pregnant women. The results are as follows. 1. In 19 cases of overt hyperthyroidism, $T_3,\;free\;T_4$ and FTI, $T_4/TBG$ ratio reflect hyperfunction in all cases. $T_4$ is increased in 94% (18/19) and TBG and TSH are decreased in 79% (15/19). 2. In 8 patients with overt hypothyroidism, TSH is increased in all cases and free $T_4$ and FTI is decreased in all cases. $T_4$ is decreased in 87.5% (7/8), $T_3$ is decreased in 75% (6/8) and $T_4/TBG$ ratio is decreased in 62.5% (5/8). 3. In 5 patients who are clinically in euthyroid state after treatment of hyperthyroidism, $T_4,\;free\;T_4$, FTI and TSH are in the normal range in all cases and $T_3$ is normal in 60% (3/5) and slightly increased in 40% (2/5). 4. In 10 patients who showed clinically borderline hypothyroidism after treatment of hyperthyroidism, TSH is increased in all cases and free $T_4$ and FTI are decreased in all cases, but $T_4\;and\;T_3,\;T_4/TBG$ ratio are in the normal limit in all cases. So after treatment of hyperthyroidism, TSH, free $T_4$ or FTI are recommended as optimal thyroid function test. 5. In normal pregnancy, free $T_4$, FTI and $T_4/TBG$ ratio reflect normal function, but the other parameters revealed unreliable due to the influence of increased TBG. Also TBG and TSH level in pregnancy is increased significantly compared with normal healthy control group. 6. The coefficients of correlation between free $T_4$ and FTI were 0.862 (p<0.001) and 0.685 (p<0.001) between free $T_4\;and\;T_4/TBG$ ratio. In most patients, diagnostic value of free $T_4$ was comparable and even superior to FTI, so free $T_4$ measurement can be used routinely with thyrotropin assay in the diagnosis of hypothyrodism or with $T_3$ for the diagnosis of hyperthyroidism.

• 대한한의학회지
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• 제16권2호
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• pp.9-16
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• 1995

1994년 3월부터 1995년 2월까지 1년동안 말초성 안면신경마비로 경희의료원 한방병원 침구1과에 침치료를 받기 위하여 내원한 환자중 발병한지 1주일 이내로 이부(耳部) 대장포진(帶狀疱疹)이나 종양 또는 외상을 당하지 않은 초발환자 44명을 대상으로 일주일에 3회씩 합곡(合谷)(L14), 족삼리(足三里)(ST36), 영향(迎香)(LI20), 찬죽(BL2), 예풍(TE17), 지창(地倉)(ST4), 협차(頰車)(ST6), 수구(水溝)(GV26), 승장(承漿)(CV24), 양백(陽白)(GB14)과 어요(魚腰)(Ex-HN4)를 선혈(選穴)하여 자침하고 치료경과를 관찰하였다. 지창(地倉)에서 협차(頰車), 수구(水溝)와 승장(承漿)에서 지창(地倉), 양백(陽白)에서 어요(魚腰)로는 투자법을 실시하였다. 환자의 평균연령은 39.3세이었고, 여성이 63.6%를 차지하였고 그중 한 명은 임신중이었다. 안면신경마비의 회복판정 척도는 House-Brackmann facial nerve grading scales를 사용하여 초진부터 초진후 7주까지 또는 7주이내 완전히 회복될 때까지 매주 평가하였다. 86.4%의 환자가 초진후 7주이내에 완전히 회복 되었으며, 회복되는데 걸리는 기간은 평균 3.7주로 관찰되었다.

• 농촌의학ㆍ지역보건
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• 제19권1호
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• pp.41-52
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• 1994

The aim of this study was to assess the people's need for visiting health services in a rural area. In recent years, the great concern for the visiting health services has aroused in Korea. Stratified cluster sample for a household survey was used to select 1,255(8.4%) Households from Yonchon county. This study was undertaken from July 26 to August 7 in 1993. Medically defined need, usually expressed by the prevalencies or rates of specific disease, was evaluated with the use of criteria established by medical and nursing professors and expressed by the percent of specific objects for the visiting health services. Perceived need represented by the acceptability for the visiting services and willingness to paying for it, also, evaluated. The major results were as follows : 1. Of the 348 patients with hypertension, 201 were the non-compliant patients, the rate of the non-compliant hypertension patients in 4,577 study population was 7.4%. 2. Of the 141 diabetic patients, 73 were the non-compliant patients, the rate of the non-compliant hypertension patients in 4,577 sample population was 2.7%. 3. The number of patients with severe musculo-skeletal disease was 24, the rate was 0.9% above the age 30. 4. Of the 514 elderly, 33 were the elderly without any family member, the rate was 8.4%. Those with severely decreased activity of daily living were 13. 5. Infants with high risks were 12, pregnant women and neonates were 5, patients discharged within 1 week and with special equipments such as peritoneal dialysis, stoma, TPN etc. were 17, and patients with cancer were 5. Total number of the objects needed visiting health services was 752(18.43%) of the 4,577 study population. Perceived need evaluated were as follows; The acceptance rate of visiting health services was 74.9%, The kinds of visiting health services such as family health protection and promotion, early detection of hypertension, physiotherapy, health education and counseling were needed in the order of high rate The price willing to pay for visiting health services per visit was about 3,000-5,000Won. In conclusion, Visiting health services programme to be developed should have priority to the prevention of complications of chronic disease such as hypertension, diabetes milletus, elderly disease and health promotion.