• 제목/요약/키워드: Primary vaccination

검색결과 114건 처리시간 0.028초

관할지역 주민의 보건진료소에 대한 태도와 이용양상 (Utilization Pattern and Percept ion and Attitude of Rural Residents towards Primary Health Post)

  • 박춘나;박재용;한창현
    • 농촌의학ㆍ지역보건
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    • 제26권2호
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    • pp.79-96
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    • 2001
  • 보건진료소 관할지역주민들의 보건진료소에 대한 이용양상과 인식도를 파악하기 위하여 2000년 12월 10일부터 2001년 1월15일까지 경상북도 상주시 지역 24개 보건진료소 관할지역 753가구(가구원 1,803명)에 대해 설문조사를 실시하였다. 전체가구원의 지난 2주간의 급성질환 이환율은 29.6%이었으며 이들의 의료기관 이용률은 98.3% 이었다. 연령별로는 60-69세가 35.4%로 가장 높았는데 연령이 높을수록, 학력이 낮을수록 이환율이 높았다. 전체 가구원의 1년간 만성질환 이환율은 19.2%이었으며 이들의 의료기관 이용률은 92.8% 이었다. 만성질환 이환율은 70세 이상에서 37.2%로 가장 높았고, 연령이 높을수록, 학력이 낮을수록 유의하게 높았다. 급성질환시 의료이용은 보건진료소 이용이 89.5%로 대부분을 차지하였으며, 만성질환시에는 보건진료소 이용이 40.2%이었고 병 의원 이용이 48.9%이었다. 조사시점 이전 1년간의 보건진료소 이용 경험률은 94.8%이었고 진료목적 이외 방문 경험률은 72.2%이었으며, 73.3%의 응답자가 보건교육을 받은 경험이 있었다고 하였다. 응답자의 98.5%가 보건진료소의 위치를 알고 있었고, 건강관리에 도움이 된다는 인식이 98.6%, 지역발전과의 관련성에는 84.3%가 큰 역할을 수행한다고 하였으며, 보건진료소의 필요성에 대해서는 97.4%가 필요하다고 응답하였다. 보건진료소의 주된 업무는 질병치료, 예방접종, 건강상담 순으로 인식하였으며 보건진료소가 중점적으로 시행해주기를 원하는 업무는 주민건강상담 및 관리가 31.6%로 가장 높았다. 보건진료소 진료비에 대해서는 88.9%가 싸다고 하였고, 보건진료원의 친절도는 98.4%가 친절하다고 하였으며 서비스 만족도도 97.0%로 매우 높았다. 보건진료소에 대한 불만사항은 약의 종류가 부족하다가 42.9%로 가장 높았고 시설이 좋지않다가 15.8%이었다. 조사대상 지역주민들은 지리적 여건과 경제적 여건에 의해 보건진료소를 많이 이용하고 있었으며 보건진료소에 대한 주민들의 만족도도 높았고 필요성도 절감하고 있었다. 그리고 질병치료업무 이외의 보건사업에 대한 요구도 많았고 의약품과 의료시설 및 장비에 대한 불만이 큰 점을 감안하여 보건진료소를 계속적으로 유지 운영하되 보건진료소의 기능의 재정비, 시설 장비의 보강, 그리고 보건진료원의 교육훈련강화를 통해 벽오지 주민에게 바람직한 의료서비스를 제공할 수 있도록 적극 지원해야 할 것이다.

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Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3595-3604
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    • 2015
  • Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

National HPV Immunisation Programme: Knowledge and Acceptance of Mothers Attending an Obstetrics Clinic at a Teaching Hospital, Kuala Lumpur

  • Ezat, Sharifa Wan Puteh;Hod, Rozita;Mustafa, Jamsiah;Mohd Dali, Ahmad Zailani Hatta;Sulaiman, Aqmar Suraya;Azman, Azlin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2991-2999
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    • 2013
  • Background: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves. Materials and Methods: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique. Results: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%. Conclusions: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.

엔비로의 첨가.급여가 계사내 유해가스와 육계의 생산성에 미치는 영향 (Effects of Dietary Supplemental Enviro on Noxious Gas of Poultry House and Performance of Broiler Chicks)

  • 류경선;박재홍;서경석;김상호
    • 한국가금학회지
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    • 제28권1호
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    • pp.49-54
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    • 2001
  • Two experiments were conducted to investigate the influence of dietary supplemental Enviro on noxious gas of environmental controlled poultry house and performance of broiler chicks. Diets contained 21.5, 19.00 CP and 3,100, 3,200 kcal/kg ME, respectively for starting and finishing period. Enviro were supplemented with 0, 0.2, 0.4, 0.6 and 0, 0.1, 0.2, 0.3% in Expt. 1 and 2, respectively. $CO_{2}$ and ammonia gas were periodically detected for finsihing period in Expt. 1. Weight gain, feed intake and feed conversion(FC) were measured for five weeks in Expt. 2. ND antibody titer were also measured after primary and booster vaccination at two and three weeks old. Blood cholesterol and nutrients digestibility were In Expt. 1, ammonia and $CO_{2}$ gas of chicks fed 0.2% Enviro showed 32.8ppm and 1,719ppm in poultry house and significantly decrease compared to that of control(P〈0.05). $CO_{2}$ gas was 1,814ppm in 0.4% Enviro treatments and also significantly lower than control(P〈0.05), but tended to be increased compared to that of 0.2% Enviro treatments, In Expt. 2, weight gain of chicks fed 0.1 and 0.2% Enviro was significantly increased for starting period(P〈0.05), but was not statistically different for finishing period. Feed intake was no significantly different of all treatments. Chicks showed lower FC in 0.3% Enviro treatment for starting period(P〈0.05) than others, but was not for finishing period. ND AB titer of chicks fed Enviro was prone to be higher than control, but was not significantly different. Total blood cholesterol was not significantly different of all treatments, but tended to be high in 0.1 and 0.2% Enviro treatments. HDL of chicks fed those levels showed significantly higher than control(P〈0.05), whereas LDL was tended to be decreased in those treatments. The digestibilites of crude protein and fiber were improved in 0.1 and 0.2% Enviro treatments relative to those of control, but was not statistically different. However, crude ash digestibility was significantly improved in 0.1 and 0.2% Enviro treatments(P〈0.05). Chicks also showed AMEn in 0.1, 0.2% Enviro treatments, but was no significance. The results of these experiments indicated that 0.1% Enviro supplement would be maximize the performance of broiler chicks.

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신증후출혈열의 혼합백신을 접종한 햄스터에서의 면역성 조사 (Immune Reaction of the Vaccinated Hamsters with Combined Hantaan-Puumala Vaccine)

  • 이호왕;주용규;최용수;우영대;안창남;김훈;장양석
    • 대한바이러스학회지
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    • 제27권1호
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    • pp.39-47
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    • 1997
  • A large number of viruses belonging to Genus Hantavirus in Family Bunyaviridae are etiologic agents for hemorrhagic fever with renal syndrome (HFRS), or hantavirus pulmonary syndrome (HPS). Hantaan (HTN), Seoul (SED), Belgrade (BEL), Puumala (PUU) serotype viruses are well known causative agents for HFRS in Eurasian continent. Among those viruses Hantaan and Seoul serotypes are well known to cause HFRS in Korea, but there are some sporadic incidence by other than Hantaan or Seoul viruses. Recently we have developed the combined Hantaan-Puumala virus vaccine to prevent world-wide occuring HFRS. This combined vaccine is formalin inactivated, suckling mouse and suckling hamster brain extracts for Hantaan and Puumala viruses, respectively. Protein contents of this purified candidate vaccine is $27\;{\mu}g/ml$, which contains 1,024 ELISA antigen units to each virus, but content of myelin basic protein which is causing experimental allergic encephalomyelitis is less than 0.1 ng/ml. Thirty hamsters were given twice at one month interval intra-muscularly and bled on 30 days after each vaccination from retro-orbital sinus vein. Antibody titers were tested against 5 major serotype viruses, Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses by IFA and PRNT. The mean IF antibody titers on 30 days after primary shot were 78.4, 68.8, 68.8, 37.9, and 15.6; mean neutralizing antibody titers were 65.4, 12, 6.1, 65.6 and 0.5 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively. The mean IF antibody titers on 30 days after booster shot were 686.9, 567.5, 550.4, 516.3, and 430.9; and neutralizing antibody titers were 710.8, 41.9, 24.3, 409.9, and 1.6 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively.

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국내 양돈장의 차단방역 수준 평가 및 돼지써코바이러스 2형 감염의 위험요인에 관한 연구 (Assessing Biosecurity Practices on Commercial Pig Farms across Korea and Risk Factors for Porcine Circovirus Type 2 Infection)

  • 최성현;박선일
    • 한국임상수의학회지
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    • 제32권4호
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    • pp.324-329
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    • 2015
  • The primary aim of this study was to investigate biosecurity practices in pig farms and to determine the major risk factors associated with PCV2 infection for a sampled swine population in Korea. To this end, we analyzed data from a cross-sectional study of 296 farrow-to-finish farms, which was conducted between March and September 2014 to explore the prevalence of swine disease at farm level. Face-to-face interviews by on-site visit of trained veterinarians were conducted with the farm owners or managers using a standardized questionnaires with information about basic demographical data and management practices. Farms were classified as negative or positive through the use of infection profiles that combined data on serological testing including PCR antigen test result, antibody titer and sero-conversion pattern at each age category taking into account vaccination status. Data were analyzed using multivariate ordinal logistic regression. Results from this study indicated that biosecurity level of the farms was considered not good given low compliance of the biosecurity programs and facilities in the farm: off-site removal of dead stocks (7%), off-site location of storage facility for incoming feeds (12.6%), off-site pick-up location for finishers (19.3%), restrictions on feed supplier vehicles for farm entrance (19.6%), restriction of finisher trucks entering the farm (22.4%), and restriction on manure disposal trucks entering the farm (26.4%). In the final model (n = 255), allowance of finisher truck driver to the pig unit had increased risk of infection (OR = 2.4, 95% CI 1.22-4.67) whereas farms with a sign forbidding the entrance had decreased risk of infection (OR = 0.19, 95% CI 0.10-0.58). Further comprehensive research with larger sample size is required to better understand the multifactorial characteristic that some predisposing risk factors that were not available in this study. To the best knowledge of the authors, this was the first study to use empirical data to report risk factors associated with PCV2 infection in the Korean pig farms. Results from the current study could be used to decide optimal biosecurity measures to reduce the impact of PCV2 infection to farmers and policy makers.

양호겸직교사의 배치근거 및 분포양상 (A study on the distribution basis and aspect of teachers holding additional school health)

  • 이정임
    • 한국학교보건학회지
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    • 제2권1호
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    • pp.58-90
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    • 1989
  • This study was attempted to contribute to the development of school health by providing the basic data about the distribution basis and distribution aspect of teachers holding additional school health that are in charge of school health business in parimary schools, middle schools and high schools without any nurse-teacher. This study analyzed literatures about the history, related laws, organization and professional manpower of school health. The emphasis was set on the distribution basis of theachers holding additional school health. The results of this study are as following: 1. The school health of the world dates to the late 18th century in Europe where was free supplying with food for poor children. The school health of Korea orginated from smallpox vaccination which was executed with appearance of modern schools in the late 19th century. 2. The related laws of school health began as a part of Education Law with was constituted in 1949. By the School Health Law constituted in 1967 and the enforcement ordinance of School Health made firm the legal basis of school health. 3. The administrative organs of school health are the Ministry of Education in center and each Board of Education in cities and provinces. For the first time in 1979, the department of school health was established in the organization of the Ministry of Education. And at about the same time of establishment of the department of school health, health section was established in the department of social physical-training in locality. 4. In the manpower of school health which was presented in the related statute of school health, there are the ward chief of education, the superintendent of educational affair, of cities and districts, the mayors, the governors of provinces, the school managers, the principals, the school doctors, the school pharmacists, and the nurse-teachers, including teachers holding additional school health as the practical manpower of school health. 5. In order to get some information on distribution aspect of teachers additional school health, this study made up a questionnaire from August 3 to August 11, 1988. The subjects of this study were 212 leachers who took part in the yearly training for teachers holding additional school health from Kyunggi province, Chungbuk province and Jeonbuk province. The results of the questionnaire are as following: 1. The distribution percentages of teachers holding additional school health according to each Board of Education wich schools are subject to, are as following:70.1% (Kyunggi), 76.5% (Chungbuk), and 81.4% (Jeonbuk). There was a significant difference. The distribution percentages of teachers holding additional school health according to the school levels of 3 provinces are as following: 74.1% (Primary schools), 77.8% (Middle schools), 76.7% (High schools). There were little significant differences. 2. The distribution according to the general characteristics of the subject schools: There were 64.2 percent of primary schools and 35.8 percent of middle schools among 212 schools. 91. 5 percent of schools were located in districts. Public schools formed 55.7% and then national schools were higher in percentage than private schools. 58.5 percent of schools had 1-9 classes, 64.6 percent of schools had 101-500 students, and 90 percents of schools had 1-20 teachers. In considering student sex, the coed school showed the high distribution percentage (Primary schools : 100%, Middle schools: 81.6%). 3. The distribution according to the characteristics of teachers holding additional school health: 93.3 percent of teachers were female, and more than 60 percent of teachers were 20-29 years old. As the age got higher, the percentage became lower. There were little significant differences by marital status. In considering their educational status, 86.8 percent of teachers in primary schools were from teacher's colleges, and 64.5 percent of teachers in middle schools were from education colleges. In considering teaching career, 46.7 percent of teachers had teaching career of less than 2 years. 73.6 percent of teachers had held additional school health for less than one year. More than 80 percent of teachers had participated in the training one time or twice. More than 70 percent of teachers had 1-2 additional jobs except for the school health business. The motivation to hold additional school health is most caused by mandatory order, which accounts for more than 80.0 percent. In considering interesting degree concerning school health, lukewarm answer is the highest of 62.7 percent, followed by affirmative answer of 23.6 percent. In considering their contentment degree respecting additional school health job, "discontent or very discontent"is the highest of 47.6 percent. As a descontent reason of additional school health job, overwork is the highest factor of 37.9 percent. Among addiitional school health job, the most difficult affair is nursing service to be 34.0 percent, followed by health education of 31.6 percent. It testify the need of professional. The source of knowledge about school health has been acquired from masscommunication or private health experience, which account for as much as 56.1 percent. It shows seriousness of lack of professionalism. With regard to neccessity of school health experts, 95.8 percent represents absolute need. With above consideration of study results, I propose as follows : 1. I propose that the authorities concerned unify and improve statute respecting current school health which has not been steadfastly supporting school health business by ambiguity of expression and dualization. 2. I propose that the authorities concerned give the school manager, school staffs and parents of students educational chance with which they can acknowledge the importance of school health and in which they can participate as well as set up alternative policy plan to be albe to vitalize school health committee. 3. I propose that administrative organization practicable to taking totally charge of school health business is established within the Ministry of Education. 4. I propose that the authorities concerned back up and cooperate in an attempt by make school health better and desirable toward development by way of appointing qualitied health teachers on the basis of legally regular teacher staffs.

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농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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통합보건지소 설치 전후 주민들의 보건지소 이용율 변화 및 관련요인 (Utilization Rate and Related Factors of Unified Health Sub-center Among Rural Residents)

  • 황태윤;강복수;김석범;이경수;강영아
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.107-126
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    • 2002
  • 이 연구일개 통합보건지소 관할 지역 주민들의 통합보건지소 설치 전후의 보건지소 이용 양상 및 관련 요인, 그리고 보건지소 이용 만족도에 대한 설문조사 결과와 통합 전후 보건지소의 진료 및 보건사업 실적을 비교, 분석함으로써 통합보건지소 운영이 해당 지역 주민들의 보건지소 이용에 미친 영향을 평가하여 향후 효율적인 통합보건지소 운영을 위한 기능 강화와 역할 방향을 제시하는데 기초자료를 제공하고자 수행되었다. 연구 대상지역은 통합 후 보건지소가 폐쇄되는 지역인 경주시 감포읍과 통합보건지소가 설치되는 지역인 양북면이었으며, 통합지역에 인접한 대조지역으로 선정하였다. 연구 대상지역 주민들 중 표본 추출된 일부 주민들을 대상으로 통합 전에 1차 조사(1996년 9월)를 실시하고, 보건지소가 통합된(1997년 11월)후 2000년 2월에 2차 조사를 실시하여 연구 분석 자료를 수집하였고, 통합 전후 각 보건지소의 진료 및 보건 사업 실적 등의 기존 자료를 참고하였다. 최종 연구 분석 대상자는 감포읍, 양북면, 양남면이 각각 156명, 147명, 146명이었으며, 보건지소 이용 경험률은 감포읍 지역에서는 통합 전 26.9%에서 통합 후 21.2%로 감소하였으나, 양북면 지역은 24.5%에서 29.3%로, 양남면 지역은 23.3%에서 35.6%로 증가하였다. 평균 이용횟수는 감포읍 지역에서는 2.6회에서 1.0회로 통계적으로 유의하게 감소하였으나, 양북면 지역과 대조 지역에서는 다소 증가하였다. 통합지역과 양남면에서 보건지소 이용 경험 여부와 이용 횟수의 변화에 모두 유의하게 관련된 요인은 만성질환 유무이었고, 통합지역 내 감포읍과 양북면으로 구분한 지역 변수는 통합보건지소 이용 경험에 유의한 관련 요인이었다. 만성질환 이환자들의 치료 의료기관으로는 병 의원이 가장 많았으며, 통합 지역 중 양북면에서는 통합 후 보건지소 이용이 증가하였다. 보건지소 이용 만족도는 전체적으로 통합 후 증가하였으나, 의료서비스의 유용성 점수는 다른 만족도 항목에 비하여 점수가 낮았고, 지리적 접근성 항목의 점수는 감포읍이 통합 후 유의하게 감소하였다. 통합보건지소의 일반 진료 실적은 통합지역 내 감포읍과 양북면 보건지소의 통합 전 일반 진료 실적의 총계보다 증가하였고, 예방접종 건수, 가정방문 건수, 방사선 촬영 건수, 보건교육 인원 및 상담 건수 등도 증가하였으나, 일부 만성병 관리 및 영유아 관리 인원은 감소하였다. 보건증 발급, 자동차 운전면허 적성검사, 그리고 임상병리 검사는 통합보건지소에서 새로 추가된 의료서비스였다. 양남면 보건지소에서는 일반진료 조제 건수와 보건교육 실시 인원 및 상담 건수는 증가 하였으나, 예방접종 건수, 학교보건사업실시 인원 등은 감소하였다. 이상의 결과를 정리하면 감포읍 주민들은 통합 후 보건지소 이용에 어느 정도 장애를 받고 있고, 통합보건지소 운영 성과는 기존 보건지소의 운영 성과에 비하여 크게 개선되었다고 할 수는 없으나, 통합보건지소에 대한 전반적인 만족도는 증가하였으며 새로 추가된 의료서비스는 주민들의 의료이용에 편의성을 제공하였다고 볼 수 있다. 향후 보건지소의 농어촌지역에서의 역할과 기능을 유지하고 통합보건지소 고유의 설립 취지를 살리며, 지역주민들에게 형평성 있는 일차보건의료가 제공될 수 있도록 보다 효율적인 운영 방안의 모색이 이루어져야 할 것이다.

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도시·농촌지역 주민의 건강행태에 관한 연구 (A Study on Health Behavior of the Populations in Urban and Rural Area)

  • 이정미;권근상;이주형;전갑성
    • 농촌의학ㆍ지역보건
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    • 제30권2호
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    • pp.213-225
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    • 2005
  • 도시 농촌지역 주민의 건강형태를 알아보기 위하여 전주 및 고창, 순창, 임실, 부안, 무주, 장수, 진안 지역에서 살고 있는 만 20세 이상의 2,086명을 대상으로 2001년 7월 1일부터 9월 30일까지 3개월 동안 설문조사를 실시한 결과 다음과 같았다. 1. 조사대상자의 일반적 특성은 성별, 연령, 결혼상태에서 도시와 농촌이 비슷한 분포였다. 교육수준은 도시에서 전문대졸 이상이 42.0%, 농촌에서는 중졸이하가 37.2%로 가장 높게 나타나, 농촌과 도시에서의 교육수준이 현저한 차이를 보였다(p<0.01). 직업은 도시에서 가정주부(26.1%), 일반사무직(18.9%)로 나타난 반면, 농촌에서는 일반사무직(20.6%), 농 어 축산업(21.3%), 가정주부(19.5%)순으로 나타났다(p<0.01). 2. 도시, 농촌에 따른 주관적 건강상태에 대한 생각은 도시와 농촌이 비슷한 분포였다. 복용한 건강식품은 도시에서 영양제와 보약이 22.1%와 24.1%로 농촌의 18.8%와 20.8%보다 높게 나타났다(p<0.05). 또한 만성질환의 유병률은 22.2%였으며, 도시와 농촌에 차이는 없었다. 3. BMI 25이상인 경우가 조사대상자 중 17.4%였으며, 도시와 농촌이 비슷한 수준이었다. 음주와 흡연, 충분한 수면여부 또한 도시와 농촌이 비슷한 분포를 보였고, 운동에서만이 주 1회 이상 하는 경우가 도시에서 44.8%, 농촌에서 37.1%로 농촌보다 도시가 높게 나타났다(p<0.01). 4. 식생활습관에서 커피음용과 육류섭취는 도시와 농촌에서 비슷한 분포를 보였고, 과식은 도시에서 73.5%, 농촌에서는 66.9%로 농촌보다 도시에서 현저하게 높게 나타났다(p<0.01). 규칙적인 식사와 음식을 짜게 먹는 경우, 채소의 섭취가 도시보다 농촌에서 많이 하는 것으로 나타났다(p<0.01). 5. 종합검진은 도시와 농촌이 비슷하였고, 적어도 3-4년에 한번 받는 경우는 58.7%였다. B형간염예방접종은 대상자이나 실시하지 않은 경우가 도시에서 17.5%, 농촌에서 11.5%로서 농촌보다 오히려 도시에서 예방접종을 실시하지 않은 경우가 많았으며, 암검사는 받은적이 있다고 응답한 경우가 도시에서 33.1%, 농촌에서 27.8%로 농촌보다 도시에서 더 높게 나타났다(p<0.05). 6. 자각적 건강상태를 종속변수로설정하고, 나머지 일반적 특성 및 건강형태, 건강검진을 독립변수로하여 다변량분석 한 결과, 성별, 연령, 직업, 교육수준, 운동여부가 자각적 건강상태에 영향을 미치는 것으로 나타났다(p<0.05). 또한 만성질환과 관련이 있을 것으로 예상되는 변수를 다변령분석 한 결과 연령, 교육수준, BMI, 육류섭취정도, 암검사여부의 변수들이었다(p<0.05). 이상의 결과로 전북지역에 거주하는 도시와 농촌지역주민들의 건강형태는 운동 및 식생활 습관, 건강검진에서 차이를 보였으며, 자각적 건강상태와 만성질환에 영향을 미칠것으로 생각되는 변수로는 연령과 교육수준, 운동 및 BMI 등이 나타나 앞으로 연구 뿐 아니라 보건사업 계획에도 이러한 사항을 고려하여야 할 것으로 사료된다.

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