• Journal of Preventive Medicine and Public Health
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• 제46권sup1호
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• pp.50-54
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• 2013

Out-of-home mobility is necessary for accessing commodities, making use of neighborhood facilities, and participation in meaningful social, cultural, and physical activities. Mobility also promotes healthy aging as it relates to the basic human need of physical movement. Mobility is typically assessed either with standardized performance-based tests or with self-reports of perceived difficulty in carrying out specific mobility tasks. Mobility declines with increasing age, and the most complex and demanding tasks are affected first. Sometimes people cope with declining functional capacity by making changes in their way or frequency of doing these tasks, thus avoiding facing manifest difficulties. From the physiological point of view, walking is an integrated result of the functioning of the musculoskeletal, cardio-respiratory, sensory and neural systems. Studies have shown that interventions aiming to increase muscle strength will also improve mobility. Physical activity counseling, an educational intervention aiming to increase physical activity, may also prevent mobility decline among older people. Sensory deficits, such as poor vision and hearing may increase the risk of mobility decline. Consequently, rehabilitation of sensory functions may prevent falls and decline in mobility. To promote mobility, it is not enough to target only individuals because environmental barriers to mobility may also accelerate mobility decline among older people. Communities need to promote the accessibility of physical environments while also trying to minimize negative or stereotypic attitudes toward the physical activity of older people.

• 대한지리학회지
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• 제44권6호
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• pp.813-832
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• 2009

농촌지역의 과소화에 따라 의료서비스에 대한 공간적 접근성이 제한되고, 노령화에 따른 의료서비스의 수요가 급격히 증가함에 따라, 최근 방문보건서비스와 같은 서비스 제공자가 수요자에게 직접 이동하는 새로운 형태의 의료서비스가 많은 주목을 받고 있다. 이러한 의료환경의 변화는 공공 의료기관의 한정된 의료자원을 효율적으로 배분하고 운영하기 위한 혁신적이고 과학적인 접근법개발에 대한 요구를 증대시키고 있다. 이러한 배경하에서 본 연구의 목적은 방문 의료서비스 제공을 위한 구역 설정 모델을 수립하고, GIS 환경에서 구역 설정 모델을 구현하는 자동구획절차(AZP) 알고리즘을 개발하는 것이다. 구역 설정 모델은 구역 내 이동성, 구역간 업무량 균형, 연속성 등의 조건을 고려한다. 이동성에 대한 세 개의 서로 다른 목적함수를 평가한다; 1) 구역 내 단위 지역간 네트워크 거리의 합 최소화, 2) 구역 내 단위 지역간 공간상호작용 최대화, 3) 구역 내 단위 지역을 순회하는 경로의 길이 최소화. 모델을 위한 AZP는 GIS 환경에서 개발되었고, 농촌의 방문보건 사례에 적용되었다. 결과는 개발된 AZP를 업무량 균형과 연속성 제약조건하에서 각 목적함수에 대하여 상이한 구획체계를 산출할 수 있음을 보여준다.

• 한국산업보건학회지
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• 제32권3호
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• pp.231-241
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• 2022

Objectives: The purpose of this study is to evaluate the input status of exposure-related information in the working environment monitoring database (WEMD) and special health examination database (SHED) for the construction of a national exposure surveillance system. Methods: The industrial and process code input status of WEMD and SHED for 21 carcinogens from 2014 to 2016 was compared. Data from workers who performed both work environment monitoring and special health examinations in 2019 and 2020 were extracted and the actual status of input of industrial and process codes was analyzed. We also investigated the cause of input errors through a focus group interview with 12 data input specialists. Results: As a result of analyzing WMED and SHED for 21 carcinogens, the five-digit industrial code matching rate was low at 53.5% and the process code matching rate was 19% or less. Among the data that simultaneously conducted work environment monitoring and special health examination in 2019 and 2020, the process code matching rate was very low at 18.1% and 5.2%, respectively. The main causes of exposure-related data input errors were the difference between the WEMD and SHED process code input systems from 2020, the number of standard process and job codes being too large, and the inefficiency of the standard code search system. Conclusions: In order to use WEMD and SHED as a national surveillance system, it is necessary to simplify the number of standard code input codes and improve the search system efficiency.

• 한국식품위생안전성학회지
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• 제38권1호
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• pp.12-18
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• 2023

쇠고기 이력추적제는 소 개체마다 이력번호를 부여하여 수입쇠고기가 한우고기로 둔갑하는 사례를 막고, 소비자에게 구입한 한우고기의 세부 이력 정보들을 제공하는 데 도움을 준다. 이번 연구는 2021년-2022년 서울지역 대형 축산물판매업소에서 유통되는 한우고기 344건에서 DNA 동일성 검사를 실시하여 이력번호 등 주요 표시정보들의 진위를 판별하였다. 그 결과 45건(13.1%)에서 이력번호가 불일치한 것으로 확인되었다. 불일치율은 2021년(14.7%)에 비해 2022년(11.3%) 감소하였고, 도심서북권 20.7%, 동북권 14.4%, 서남권 및 동남권 10.2% 순으로, 북부권(16.9%)이 남부권(10.2%)에 비해 높게 나타났다. 또한 6개 브랜드 중 B사 및 D사는 이력관리가 양호한 반면, E사 및 A사는 이력관리가 취약한 것으로 확인되었고, 통계적으로 유의한 결과 차이를 보였다(P<0.001). 이력번호 불일치 시료의 실제 이력번호는 업소 내 입(출)고 거래내역 자료를 근거로 조사하였고, 그 결과 실제 이력번호 확인율은 53.9%에 불과하였으나, 확인된 범위 내에서 시료의 표시정보 진위 판별 결과, 거짓 표시는 이력번호 13.1%, 성별 2.9%, 도축장명 2.2%, 등급 1.6% 순으로 나타났고, 품종(한우) 거짓 표시는 없었다. 거짓 표시 축산물의 유통 차단을 위해 표시정보의 신속한 진위 판별이 중요하므로 업소 내 이력번호가 기재된 날짜별 부분육 소분할 작업내역 작성을 의무화하는 법적 근거 마련이 필요하다. 본 연구 결과는 투명한 축산물 유통 거래 질서 정착을 위한 이력관리 방향 설정에 참고자료로 활용하고자 한다.

• 지역사회간호학회지
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• 제33권3호
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• pp.269-278
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• 2022

Purpose: This study analyzed the retention factors of Korean community health practitioners who sustained over 20 years based on a multi-dimensional framework. This study suggests global implications for nurses working in rural or remote areas, even during a worldwide pandemic. Methods: The participants were 16 Korean community health practitioners who worked in rural or remote locations for over 20 years. This study identified nurses' key retention factors contributing to long service in rural and remote areas. This is a qualitative study based on the narrative method and analysis was conducted using grounded theory. A semi-structured questionnaire was conducted based on the following: the life flow of the participants' first experience, episodes during the work experience, and reflections on the past 20 years. Results: First, personal 'financial needs' and 'callings' were motivation-related causal conditions. The adaptation of environment-work-community was the contextual condition leading to intervening conditions, building coping strategies by encountering a lifetime crisis. The consequences of 'transition' and 'maturation' naturally occurred with chronological changes. The unique factors were related to the 'external changes' in the Korean primary health system, which improved the participants' social status and welfare. Conclusion: Considering multi-dimensional retention factors was critical, including chronological (i.e., historical changes) and external factors (i.e., healthcare systems), to be supportive synchronously for rural nurses. Without this, the individuals working in the rural areas could be victimized by insecurity and self-commitment. Furthermore, considering the global pandemic, the retention of nurses is crucial to prevent the severity of isolation in rural and remote areas.

• Journal of Preventive Medicine and Public Health
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• 제57권2호
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• pp.185-196
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• 2024

Objectives: Excess mortality associated with long-term exposure to fine particulate matter (PM_2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM_2.5 by considering the potential non-linear concentration-response relationship in Korea. Methods: Daily cause-specific mortality rates and PM_2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM_2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM_2.5 concentrations below 15 ㎍/m³. Overall deaths attributable to short-term PM_2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM_2.5 exposure. Results: Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM_2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM_2.5. The estimated number of all-cause excess deaths due to short-term PM_2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472). Conclusions: Our findings indicate an association between short-term PM_2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM_2.5.

• Nutrition Research and Practice
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• 제16권6호
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• pp.755-764
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• 2022

BACKGROUND/OBJECTIVES: Cardiovascular diseases (CVDs) are the leading cause of death in Koreans, and eating habits, including diet quality, are among the etiologies of these diseases. Recently, various studies on regional health disparities have been conducted. However, there are limited studies on their relationship with nutritional factors. This study aimed to identify the magnitude of regional disparities in diet quality and prevalence of CVD in Korean adults. SUBJECTS/METHODS: This study included 17,646 participants aged ≥ 20 years from the 7^th (2013-2016) Korean National Health and Nutrition Examination Survey. Participants were classified into four groups based on their residential areas: City 1, City 2, City 3, and non-city. Demographic characteristics, health-related factors, body mass index (BMI), metabolic syndrome index, diet quality, and CVD prevalence were evaluated. RESULTS: In terms of demographic characteristics, age (P < 0.001), marital status (P < 0.001), educational level (P < 0.001), and income (P < 0.001) were lower in the non-city category. Health-related factors such as monthly drinking rate (P < 0.01) and mental stress (P < 0.05) were the highest in City 1 and lowest in the non-city group. Conversely, the current smoking rate (P < 0.05), BMI (P < 0.05), and prevalence of metabolic syndrome (P < 0.001) were the highest in the non-city group (P < 0.05). The non-city group also had the highest prevalence of CVDs (35.6%). This group had the lowest diet quality index (68.36 ± 0.22, P < 0.01), caused by low intake of fruit and calcium, a lack of sodium moderation, and an overall imbalance in the macronutrient and fatty acid ratio. When the diet quality index was increased by 1, the odds ratio for the prevalence of CVDs was reduced by 0.991 (P < 0.001), but this was not the case in all regions. CONCLUSIONS: This study provides useful information and data in identifying and resolving the regional health disparities related to CVD prevalence and implementation of public health nutrition systems.

• 한국학교보건학회지
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• 제17권2호
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• pp.127-150
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• 2004

Objectives: The purpose of this study is to provide a basic structure for the establishment of the direction of school health programs, an overview of the historical changes of school health programs and their results, and a conceptual framework on school health programs. Methods: The data analysis has been done using a statistical almanac, relevant laws and regulations, operation handbook of the program, theses, reports, records of public hearings, and other reports as a technical research primarily based on evidence. The methodology of this research classifies the development and growth transition of school health programs during a historical period through the investigation of regulations, organization, manpower, and its program via its development process and to provide a basic tool to design a solid school health policy. Results: A The growth and development of school health programs The development of school health programs was classified into three different periods including the forthcoming period (1945~1967), the completion period (1967~1993), and the actualization period based on the establishment of legislation for School Health Law, other relevant legislation, and the contents of school health programs (1993~present). B. Policy direction of school health programs School health programs have reestablished their goals and range based on basic direction, and developed the W1it model of information structure for school health program management and its basic structure. Finally, the stepwise support system through the building of the school health support center is recommended. (1) The basic direction of school health programs has proposed 7 basic goals to reestablish the policy direction of health improvement based on total health. (2) The W1it model of information system and the school health information system for school health program management has been developed to utilize positive management. (3) School health policy through the study of the health laws and systems has been developed. The necessity of school health support center for the policy support, functional support and operation support has also been proposed. Conclusions: It is necessary to build a school health support center that consists of health professionals in charge of policy support, functional support, and program support of school health programs in order to realize and develop new policy.

• 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.

• 대한간호학회지
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• 제26권3호
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• pp.576-590
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• 1996

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.