• Title/Summary/Keyword: Rural medicine

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A Study of Farmer's Syndrome in Choongju Area (충주지역 전업농민의 농부증에 관한 연구)

  • Chang, Soung-Hoon;Lee, Kun-Sei;Lee, Won-Jin
    • Journal of agricultural medicine and community health
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    • v.23 no.1
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    • pp.15-26
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    • 1998
  • To find the prevalence of the Farmer's syndrome and the related factors, we investigated 909 farmers who and older than 30 years and live in Choongju area. The farmers were interviewed individually with a questionnaire from July 18 through 31, 1997. The results are as follows; The prevalence of Farmer's syndrome was 21.0% in male and 45.1% in female. The age prevalence of Farmer's syndrome was higher in thirties and forties than fifties and over sixties in both sex. Farmer's syndrome was significantly higher in low educational status, low income, low family members and more than 20 years of farming group. However, Farmer's syndrome was significantly higher in non smoking and non alcohol intake group, there were no significant differences according to smoking and alcohol intake after stratification by sex. The most frequent symptom in male was lumbago(60.5%), the second was numb limb(49.8%), the third was shoulder stiffness(43.2%) and the fourth was dizziness(31.5%). In female, the most frequent symptom was lumbago(81.3%), the second was numb limb(70.2%), the third was dizziness(62.2%) and the fourth was shoulder stiffness(55.9%). All of these four symptoms are significantly higher in female than in male. With multiple logistic regression for Farmer's syndrome, sex(OR of female=3.3) number of family(OR of <=1.9) and duration of farming(OR of $\geq$2.0 yr=1.5) were turned out to be significant variables.

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Community Care for Cancer Patients in Rural Areas: An Integrated Regional Cancer Center and Public Health Center Partnership Model

  • Kang, Jung Hun;Jung, Chang Yoon;Park, Ki-Soo;Huh, Jung Sik;Oh, Sung Yong;Kwon, Jung Hye
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.226-234
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    • 2021
  • Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

Drug Resistance Patterns of the Bacterial Strains Isolated from Rural Areas and an Urban General Hospital (무의촌균주(無醫村菌株) 및 병원균주(病院菌株)의 항균제(抗菌劑) 내성(耐性) 양상(樣相)에 관(關)한 연구(硏究))

  • Rhee, Kwang-Ho;Kim, Ik-Sang;Shin, Hee-Sup;Cha, Chang-Yong;Lee, Seung-Hoon;Chang, Woo-Hyun;Lim, Jung-Kyoo
    • The Journal of the Korean Society for Microbiology
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    • v.15 no.1
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    • pp.19-32
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    • 1980
  • Besides the benefits of antimicrobial agents in the control of various infectious diseases, widespread and prolonged use of particular antimicrobial agents has brought about the increase of drug-resistant strains in a community and the profound changes in the pattern of infectious diseases. In Korea, there are some remote villages where no clinics and drug stores are available and the residents in those areas are assumed to have fewer chances to contact with antimicrobial agents. In the present study, the differences in susceptibilities to 14 antimicrobial agents between the isolates from rural areas(R) and Seoul National University Hospital(SNUH, H) were studied. The isolates and their numbers were Staphylococcus aureus, R;55, H;68), Enterococci(R;28, H;30), Escherichia coli(R;40, H;40), Enterobacter aerogenes(R;25, H;21) and Klebsiella pneunoniae(R;58, H;67). Minimal inhibitory concentrations(MIC's) of penicillin, ampicillin, carbenicillin, cephalexin, tetracycline, oxytetracyline, doxycycline, minocycline, gentamicin, kanamycin, streptomycin, erythromycin, troleandomycin and co-trimoxazole were determined by agar dilution method. I. Comparison of MIC's and resistant strain proportions between isolates from SNUH and rural areas. MIC's and/or resistant strain proportions of the isolates from SNUH were significantly higher than those of the isolates from rural areas in the cases of 1. S. aureus to doxycycline, streptomycin and kanamycin. 2. E. coli to penicillin, ampicillin, carbenicillin, tetracycline, oxytetracycline, doxycycline, minocycline, streptomycin, kanamycin, erythromycin and co-trimoxazole. 3. E. aerogences to carbenicillin, tetracycline, oxytetracycline, doxycycline, minocycline, streptomycin, kanamycin, genaamicin and co-trimoxazole. 4. K pneunoniae to penicillin, ampicillin, tetracycline, oxytetracycline, doxycycline, monocycline, streptomycin, kanamycine, gentamicin and co-trimoxazole. However, the mean MIC and resistant strain proportion of S. aureus to tetracycline were higher in isolates from rural areas than in those from SNUH and Enterococci showed no differences in susceptibilities to the antimicrobial agents between isolates from rural areas and from SNUH. Therefore, in general, differenes in susceptibility to these antimicrobial agents between the isolates from rural areas and SNUH were remarkably greater and broader in gram negative enteric bacteria. II. Multiple drug resistance pattern. Patterns and incidences of multiple drug resistance were studied with penicillin, ampicillin, tetracycline, cephalexin, gentamicin, streptomcin, kanamycin and co-trimoxazole in Enterococci, E. coli, E. aeroges and K. pneumoniae. There appeared significant differences in the incidence of multiply drug-resistant strains and multiple drug resistance patterns between the isolates from SNUH and rural areas in Enterococci, E. coli, E. aerogenes and K. pneumoniae. However, there was no difference in the incidence of multiply drug-resistant strains between isolates of S. aureus from SNUH and rural areas but the pattern of multiple resistance of the SNUH strains of S. aureus was diverse, while that of the rural strains was predominantly confined to penicillin-tetracycline combination. The incidence of multigly drug-resistant strains and diversity of their patterns were the highest in E. coli strains isolated from SNUH and there were no multiply drug resistant strrains in Enterococci and K. pneumoniae strains isolated from rural areas. The number of drug-resistance determinants was also different between the isolates from rural areas and SNUH. Most of the multiply drug-resistant strains of E. coli, E. aerogenes and K. pneumoniae isolated from SNUH were resistant to more than 3 kinds of antimicrobial agents, most frequently to ampicillin, tetracycline and streptomycin, while multiply drug-resistant strains from rural areas were resistant to 2 kinds of antimicrobial agents among ampicillin, tetracycline and streptomycin. With drug-resistant E. coli strains, resistance to tetracycline which was used most widely since 1951 was most frequently involved as a part of mutliple drug-resistance, followed by resistance to ampicillin and streptomycin. This strongly suggests that emergence of drug-restant strains in a community is directly dependent on the selective pressure exerted by the antimicrobial agent used. III. Cross resistance. Cross resistance of bacteria was studied among tetracycline penicillin, aminoglycoside and macrolide derivatives by analyzing correlation coefficients of sucseptibilities using the least square method. In this study, there were high correlations among the susceptibilities to related derivatives. It appears that the relatively low correlations in susceptibilities present in some cases are due to intrinsic resistance of E. aerogenes to penicillin, Enterococci to aminoglycoside and E. coli E. aerogenes and K. pneumoniae to macrolide derivatives.

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Rural Health subcenter Utilization Pattern and Its Related Factors (일부 농촌지역 주민의 보건지소 이용 양상과 관련요인)

  • Sohn, Seok-Joon
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.97-106
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    • 1994
  • In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the inhabitants in Kogsung district, a questionnaire survey was carried out for objects of 708 population. The results observed were as follows; 1. The annual utilization rate of a rural health subcenter for a basic health service unit was 27.5 per 100 persons, and annual mean visiting times was 1.43 times. 2. The most frequent disease by, annual health subcenter utilization illness was respiratory disease(26.5%), and the next was musculoskeletal disease(23.9%), gastrointestinal disease(15.9%) by order. 3. Favorite reasons for community health subcenter utilization were lower medical cost(23.4%), near distance from living place(20.7%) and lower disease severity(19.5%) by order. But disfavorite reasons for it were non effective treatment(26.2%), insufficient equipment(25.4%) and absence of specialist(17.4%) by order. 4. Insufficient items about community health subcenter utilization were restriction of treatment limit(47.1%), lower reliance(22.4%) and not punctral(21.8%) by order. 5. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization were age, educational level and the nearest medical facility class. 6. There was no difference between recognition for a community health subcenter's work and actual utilizing service, and desirable works for it were disease preventing service, disease control of elderly and sanitation control by order. These results suggested that to increase the utilization of rural health subcenter and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, expansion of health equipment and recognition about access time.

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Health services Information Need Difference between Urban and Rural Area in Sooncheon City (순천시 지역적 특성에 따른 보건의료정보 요구도 비교)

  • in, Hye-Young;Oh, Hyohn-Joo
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.413-425
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    • 2000
  • The purpose of this study was to compare the health services information need between urban area and rural area in Sooncheon City. For accomplishing this purpose, we selected 1,060 adults randomly, 744 urban residents and 314 rural residents were surveyed from 1st, December to 31st, December in 1999. Compared the difference between two areas by cross tabulation, and chi-square test were used. The results of this study are as follows: 1. There were statistically difference in sociodemographic characteristics between urban residents and rural residents, such as age, education, job, income, and insurance payment(p<0.001). 2. According to the health utilization behavior, types of health facility, satisfaction of medical cost, and satisfaction of medical results were statistically different between the two areas(p<0.001). Also utilization of the health service center, and accessibility were statistically different between urban and rural areas(p<0.001). 3. Experiencing the health service information, type of health service information, methods of information, effectiveness, and satisfaction were statistically different between the two areas(p<0.001). 4. And experience of using computer, and internet and preference of method of health service information were statistically different between urban and rural areas. Therefore, the construction of health information system should be carefully reviewed by community health service centers and they should consider the different residents information needs, and accessibility and convenience of community residents.

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A Comparative Study of Childhood Immunizational Level between Urban and Rural Areas (도시(都市)와 농촌지역(農村地域)의 영유아 예방접종률(豫防接種率) 비교조사(比較調査))

  • Park, Jung-Han;Kim, Jung-Nam;Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.137-147
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    • 1985
  • To assess the childhood immunization level of urban and rural areas, 250 mothers of $6{\sim}23$ months old children residing in Namsan 1 Dong, Taegu, and 264 mothers of the same age children residing in five areas of Kyungsan Gun where community health practitioners are assigned were interviewed in March, 1984. Immunization rate for BCG was 98.0% in urban area and 95.8% in rural area. Among children who had BCG vaccination 91.4% of them were immunized within 1 month after birth in urban area and 88.1% in rural area. The percentage of children who received three doses of DPT vaccine was 83.2% in urban, and 87.5% in rural area ana that for the polio vaccine was 80.8% in urban and 87.9% in rural area. Only a few children have never been immunized with either BCG or DPT or polio vaccine. Overall immunization rate for measles was 64.4% in urban area while it was 55.3% in rural area and that for mumps and rubella was 50.4% in urban area as compared with 36.0% in rural area. However, among children of 15 months old and above the percentage of measles vaccination was 85.3% in urban area and 73.7% in rural area. Mumps and rubella vaccination rate was 77.6% in urban area and 62.4% in rural area. These differences in measles, mumps and rubella vaccination rates between urban and rural areas were statistically significant (p<0.05). Such findings as improved immunization level, no significant differences in BCG, DPT and polio vaccination rate between urban and rural areas, and fewer mothers in rural area have not vaccinated their children than mothers in urban area because of their ignorance may be attributed to the general improvement of living standard and implementation of the maternal and child health services of the government. Nevertheless many of the mothers in rural as well as urban area have not immunized their children on time and measles, mumps and rubella vaccination rates are substantially lower than other childhood immunizations. Future immunization activity should be geared to reinforcing these areas.

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Study on the Relationship between Health Risk Behaviors of Rural Residents by Regional Scale (지역 규모에 따른 농촌주민의 건강위험행동 관계 연구)

  • Seungyeon Cho
    • Journal of agricultural medicine and community health
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    • v.49 no.2
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    • pp.111-120
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    • 2024
  • Objective: This study aimed to analyze the correlation between factors affecting health risk behaviors of rural residents according to regional scale. Methods: Restricted-access data from the 2016~2021 Korea National Health and Nutrition Examination Survey and the multivariate probit model were used. As for health risk behaviors, smoking, drinking, lack of aerobic exercise, low level of healthy eating index, unvaccination, and non-participation in health examination were considered. Results: Controlling for individuals' socio-demographic characteristics, in general, correlation coefficients between unobservable factors affecting health risk behaviors were significant. However, the magnitude and statistical significance of the correlation coefficients varied by regional scale (dong/eup/myeon). This suggests that rural residents engage in health risk behaviors due to their different characteristics compared with urban dwellers, which also varies by whether residents are located in eup or myeon area. Conclusion: It is necessary to differentiate health care services between urban and rural areas in terms of type of service and programs based on the relationship between unobservable factors affecting each type of health risk behaviors.

Sleep Habits and Insomnia-Associated Factors in Korean Adult Population: A Cross-sectional Survey of Three Rural Communities (한국 성인의 수면습관 및 불면증 관련 요인 : 3개 농촌지역주민을 대상으로 한 단시적 연구)

  • Jeong, Do-Un;Sohn, Chang-Ho;Sung, Joo-Hon;Chang, Song-Hun;Lee, Kun-Sei;Lee, Won-Jin;Shin, Hai-Rim;Lee, Bu-Ok;Cho, Soo-Hun
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.201-212
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    • 1997
  • Objectives: We attempted to study sleep habits and insomnia-associated factors in Korean rural adult population. Methods : In 1,441 adult subjects of three rural communities selected by cluster sampling, we administered an epidemiologic survey using questionnaire methods from July 14, 1996 to July 28, 1996. Results : 1) Mean sleep latency and mean time to sleep again after awakening during nocturnal sleep were longer in females than in males. Females suffered more frequently from insomnia symptom, awakening during nocturnal sleep. morning headache, dysphoric mood in the morning, and the feeling of 'not refreshed' on waking-up than males. 2) The older age group (defined as those older than 65 years) was found to have earlier bed-time, longer sleep latency, more frequent nocturia, longer time to sleep again after awakening during nocturnal sleep, and more frequent insomnia symptom. 3) The presence of insomnia symptom more than once a week was significantly associated with suffering from physical illness, being divorced-separated-widowed, frequently feeling depressed, nocturia, or low education level. 4) In multiple logistic regression analysis, old age, being female, low education level, frequently feeling depressed, and nocturia were independently associated with the presence of insomnia symptom more than once a week. Conclusion : We conclude that, in a Korean rural adult population, insomnia symptom increases with age and females usually suffer more from insomnia symptom than males. In addition, low education level, feeling depressed mood frequently, and nocturia are found to be significantly associated independently with the presence of insomnia symptom more than once a week.

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Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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