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Analyzing the Operational Differences of Foodservice Center for Homebound elderly by the Presence of the Dietitian (영양사 유무에 따른 재가노인 급식서비스 제공기관의 실태 분석)

  • Jeong, Hyeon-Yeong;Yang, Il-Seon;Chae, In-Suk;Lee, Hae-Yeong
    • Journal of the Korean Dietetic Association
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    • v.10 no.2
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    • pp.197-204
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    • 2004
  • The purposes of this study was to analyze the operational difference of foodservice center for homebound elderly by the presence of the dietitian. The questionnaire was developed to measure all variables for menu management and distributed to 103 meal service centers in charge of congregate meal service program and 57 centers for home-delivered meal service program. The data of 160 centers in charge of congregate meal service and home-delivered service centers were usable for analysis. Statistical data analysis was completed using the SAS 8.1 package program for descriptive analysis and chi-square test. Only 21.9% meal service centers had dietitians, what is more, they were not professionals who did menu management but foodservice managers, volunteers, cook or social workers. The current foodservice programs for the homebound elderly were operated without professional. In the part of menu managemet, dietitians were more actively involved in menu planning in the elderly foodservice center in the presence of the dietitians. The performance level of healthcare service was not significantly different, but the nutrition education in the elderly foodservice center with the dietitians was more frequently performed than that without the dietitians(p<0.05). In the food purchasing and food production management, the significant differences were shown that in the elderly foodservice centers in the presence of the dietitians, the proportion of the contract purchasing was significantly higher than that of direct purchasing(p<0.01). In food sanitary management, the significant differences were not shown in the part of management of keeping meal for identifying the cause of food-borne illness and left-over, but the sanitation education for the foodservice employees was performed more frequently by the presence of the dietitians(p<0.01). In conclusion, the foodservice management was more systematically conducted in the elderly foodservice centers in the presence of the dietitians than that without dietitians. The elderly foodservice program has offered the health-related support for homebound elderly. Although there were several problems in elderly foodservice management, the program delivered well-targeted, effective, and efficient nutrition services and wide range of supportive service to the at-risk older population. It needs to be managed by professional for the improvement in the elderly foodservice.

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Epidemiologic Investigation on an Outbreak of Cholera in Gyeongsangbuk-do, Korea, 2001 (2001년 경상북도에서 발생한 콜레라 유행에 관한 역학조사)

  • Lee, Jun-Ho;Lee, Kwan;Kim, Jun-Chul;Lee, Sang-Won;Go, Un-Yeong;Yang, Byung-Kuk;Lee, Jong-Koo;Kim, Moon-Sik;Lim, Hyun-Sul
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.4
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    • pp.295-304
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    • 2002
  • Objectives : This study was carried out to investigate the cause, magnitude and transmission route of the cholera outbreak in 2001 Methods : The study population were those persons who ingested foods at the restaurant, were confirmed as cholera patients, had symptoms of diarrhea and sewed as workers at the restaurant. A questionnaire survey and microbiological examinations on the microbes isolated from rectal swabs were conducted. Of the cases, 316 food histories were surveyed by an analysis of the restaurant menu. Results : There were 139 confirmed cases of cholera reported in Korea in 2001. Of these, 104 were related to the restaurant. By region, Gyeongsangbuk-do had the highest incidence with 91 cases. Of these 91 cases, 74 had ingested foods at the restaurant, 2 were employees and 3 were secondary infection cases within the families. The results of the odds ratio analysis of the 316 persons having ingested foods at the restaurant were as follows: sandwiches 5.07 (95% CI, 1.85-14.59), soybean curd 2.45 (95% CI, 1.09-5.56), noodles 2.34 (95% CI, 1.24-4.42), steamed squid 2.01 (95% CI, 1.17-3.47) and vinegared rice 1.82 (95%, CI, 1.08-3.09). It was certain the restaurant in question was the cause of the 2001 outbreak. Conclusions : We suspected that more than one restaurant employee contaminated foods served at the restaurant. In addition, eating raw fishes purchased at the Pohang Fisheries infected the employees of the restaurant. There is a possibility that these raw fishes were themselves contaminated by cholera bacilli in the sea.

Microbiological Hazard Analysis of Sundae (Korean Sausage) Made of Meat By-Products (식육 부산물을 활용한 순대의 미생물학적 위해 분석)

  • Cheong, Jin-Sook;Kim, Yun Jeong;Om, Ae-Son
    • Journal of Food Hygiene and Safety
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    • v.37 no.3
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    • pp.181-188
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    • 2022
  • Despite the recent increase in the consumption level of the processed meat-byproducts, the health and safety issue has consistently been raised in the processes of production, distribution and consumption. The purpose of this study is to analyze and evaluate the microbiological hazard elements in the Korean sausage, "Sundae," to present not only the safety standard of meat by-product vendors based on HACCP (Hazard Analysis Critical Control Point), but also the quality control criteria and sanitary arrangements of small manufacturers. For the study, the microbiological hazards in 24 raw materials, 7 manufacturing processes, 40 facilities and tools, 17 workplace environment, and 12 workers were analyzed. The analysis revealed the hazardous elements in the initial stages with 6.28 and 4.07 log CFU/g of total aerobic count and coliforms, respectively, detected from the porcine blood and 3.23 log CFU/g of coliforms from the porcine small intestines. The result also showed that the total aerobic counts and coliforms in the process of mixing and filling process exceeds the standards in the hygiene guidelines by Natick with the total aerobic counts of 5.23, 5.45 log CFU/g, and the coliforms of 3.25, and 3.31 log CFU/g, respectively. Although the detected total aerobic count and the coliforms in the filling and washing rooms exceeded the standards, it was found that the total aerobic count was significantly reduced by 98% after cleaning and disinfecting and no coliforms was detected in any process thereafter. In order to achieve high level of safety in the manufacturing processes of Sundae, the separation of washing and disinfection room from the other sections and the sanitation control of the workers must be preceded, along with strict monitoring in the storage and distribution processes. The study raises necessity for additional studies for the safety evaluation of the processed meat-byproducts and further researches on the validity of the critical limits.

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

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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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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Microbiological Hazard Analysis for HACCP System Application to Vinegared Pickle Radishes (식초절임 무의 HACCP 시스템 적용을 위한 미생물학적 위해 분석)

  • Kwon, Sang-Chul
    • Journal of Food Hygiene and Safety
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    • v.28 no.1
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    • pp.69-74
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    • 2013
  • This study has been performed for 150 days from February 1 - June 31, 2012 aiming at analyzing biologically hazardous factors in order to develop HACCP system for the vinegared pickle radishes. A process chart was prepared as shown on Fig. 1 by referring to manufacturing process of manufacturer of general vinegared pickle radishes regarding process of raw agricultural products of vinegared pickle radishes, used water, warehousing of additives and packing material, storage, careful selection, washing, peeling off, cutting, sorting out, stuffing (filling), internal packing, metal detection, external packing, storage and consignment (delivery). As a result of measuring Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, E. coli O157:H7, Clostridium perfringens, Yeast and Mold before and after washing raw radishes, Bacillus cereus was $5.00{\times}10$ CFU/g before washing but it was not detected after washing and Yeast and Mold was $3.80{\times}10^2$ CFU/g before washing but it was reduced to 10 CFU/g after washing and other pathogenic bacteria was not detected. As a result of testing microorganism variation depending on pH (2-5) of seasoning fluid (condiment), pH 3-4 was determined as pH of seasoning fluid as all the bacteria was not detected in pH3-4. As a result of testing air-borne bacteria (number of general bacteria, colon bacillus, fungus) depending on each workplace, number of microorganism of internal packing room, seasoning fluid processing room, washing room and storage room was detected to be 10 CFU/Plate, 2 CFU/Plate, 60 CFU/Plate and 20 CFU/Plate, respectively. As a result of testing palm condition of workers, as number of general bacteria and colon bacillus was represented to be high as 346 $CFU/Cm^2$ and 23 $CFU/Cm^2$, respectively, an education and training for individual sanitation control was considered to be required. As a result of inspecting surface pollution level of manufacturing facility and devices, colon bacillus was not detected in all the specimen but general bacteria was most dominantly detected in PP Packing machine and Siuping machine (PE Bulk) as $4.2{\times}10^3CFU/Cm^2$, $2.6{\times}10^3CFU/Cm^2$, respectively. As a result of analyzing above hazardous factors, processing process of seasoning fluid where pathogenic bacteria may be prevented, reduced or removed is required to be controlled by CCP-B (Biological) and threshold level (critical control point) was set at pH 3-4. Therefore, it is considered that thorough HACCP control plan including control criteria (point) of seasoning fluid processing process, countermeasures in case of its deviation, its verification method, education/training and record control would be required.

Microbiological Hazard Analysis for HACCP System Application to Non Heat-Frozen Carrot Juice (비가열냉동 당근주스의 HACCP 시스템 적용을 위한 미생물학적 위해 분석)

  • Lee, Ung-Soo;Kwon, Sang-Chul
    • Journal of Food Hygiene and Safety
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    • v.29 no.2
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    • pp.79-84
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    • 2014
  • This study has been performed for about 270 days at analyzing biologically hazardous factors in order to develop HACCP system for the non heat-frozen carrot juice. A process chart was prepared by manufacturing process of raw agricultural products of non heat-frozen carrot juice, which was contained water and packing material, storage, washing, cutting, extraction of the juice, internal packing, metal detection, external packing, storage and consignment (delivery). As a result of measuring Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, Enterohemorrhagic E. coli before and after washing raw carrot, Standard plate count was $4.7{\times}10^4CFU/g$ before washing but it was $1.2{\times}10^2CFU/g$ detected after washing. As a result of testing airborne bacteria (Standard plate count, Coliform group, Yeast and Fungal) depending on each workplace, number of microorganism of in packaging room, shower room and juice extraction room was detected to be 10 CFU/Plate, 60 CFU/Plate, 20 CFU/Plate, respectively. As a result of testing palm condition of workers, as number of Standard plate count, Coliform group and Staphylococcus aureus was represented to be high as $6{\times}10^4CFU/cm^2$, $0CFU/cm^2$ and $0CFU/cm^2$, respectively, an education and training for individual sanitation control was considered to be required. As a result of inspecting surface pollution level of manufacturing facility and devices, Coliform group was not detected in all the specimen but Standard plate count was most dominantly detected in scouring kier, scouring kier tray, cooling tank, grinding extractor, storage tank and packaging machine-nozzle as $8.00{\times}10CFU/cm^2$, $3.0{\times}10CFU/cm^2$, $4.3{\times}10^2CFU/cm^2$, $7.5{\times}10^2CFU/cm^2$, $6.0{\times}10CFU/cm^2$, $8.5{\times}10^2CFU/cm^2$ respectively. As a result of analyzing above hazardous factors, processing process of ultraviolet ray sterilizing where pathogenic bacteria may be prevented, reduced or removed is required to be controlled by CCP-B (Biological) and critical level (critical control point) was set at flow speed is 4L/min. Therefore, it is considered that thorough HACCP control plan including control criteria (point) of seasoning fluid processing process, countermeasures in case of its deviation, its verification method, education/training and record control would be required.