• 보건행정학회지
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• 제20권3호
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• pp.36-57
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• 2010

The degree of income inequality deepened by health care expenditure was useful in assessing the health security level. This exploratory study was conducted to provide a basic evidence to prove the necessity of reinforcement the benefit coverage of South Korea's health security systems. Data from the Household Income and Expenditure Survey of Korea and Luxembourg Income Study were used. Income inequality indices before and after deduction of health care expenditure were computed, and the degree of the increase in the indices was compared among 13 countries. The degree of decrease against the effect of income inequality reduction policies by health care expenditure was determined. The relationships between the national characteristics and the increase in income inequality were examined. In South Korea, all income inequality indices increased after deducting health care expenditure, but the difference was not high compared to the mean of 13 countries. However, the degree of decrease against the effect of income inequality reduction policies by health care expenditure was high, compared to the mean of 13 countries. The proportion of public sector spending on health care proved to be statistically significant with the increase of income inequality indices (p<0.05). In the context of the continuous increase in health care expenditure, if benefit coverage of health security systems is not reinforced, income inequality will all the more increase due to health care expenditure. In the establishment of the policies for reinforcement of the benefit coverage, income inequality after deduction of health care expenditure should be continuously monitored.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.55-58
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• 2012

Mycobacterium szulgai is a rare nontuberculous mycobacterium found in Korea. It is an opportunistic pathogen and is usually isolated from patients with a history of alcoholism, chronic pulmonary disease, or an immunocompromising condition. We present here a case of M. szulgai isolated from a patient with a history of pulmonary tuberculosis. A 54-year-old man was admitted with dyspnea and febrile sensation. He had a history of pulmonary tuberculosis which occurred 30 years earlier and treatment with anti-tuberculosis medication. His chest computed tomography scan showed cavitary consolidation in both upper lungs. A sputum acid-fast bacilli (AFB) smear was positive and anti-tuberculous medication was started. However, a polymerase chain reaction for mycobacterium tuberculosis was negative and anti-tuberculous medication was stopped. M. szulgai was isolated on 3 separate sputum and bronchial wash fluid AFB cultures. He was treated with clarithromycin, rifampicin, and ethambutol. After 1 month, a sputum AFB smear and culture became negative and no additional M. szulgai were isolated during a 16-month treatment.

• 한국보육지원학회지
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• 제15권6호
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• pp.21-40
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• 2019

Objective: The purpose of this study is to find the tendencies and differences of mother's child-rearing anxiety before and after their children enter into elementary school, to analyze the factors influencing child-rearing anxiety at each time, and thereby to seek a support plan at the time of transition. Methods: The subjects of this study were 181 mothers who participated in two surveys which were conducted before and after their child entered into elementary school. Results: Firstly, mother's child-rearing anxiety before and after their children's entrance into elementary school was at a middle level, but increased significantly when they experienced their children's transition to elementary school. Secondly, mother's child-rearing anxiety, before their children's entrance into elementary school, was influenced by private education, the collection of educational information, cognitive ability, whether or not to develop a work status change plan, and birth order sequentially. Thirdly, child-rearing anxiety after their children's entrance into elementary school was significantly influenced by child-rearing anxiety before their children's entrance into elementary school and the mother's employment. Conclusion/Implications: This study is meaningful in the point that it suggested the necessity for the cooperation between multiple systems, such as systematic and stepwise parenting education, the importance of offering information to educational institutions and local governments, and for work- family support policy to prioritize children in order to support children's successful transition into elementary school.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.355-360
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• 1999

1995년 1월과 7월에 전라남도 일부 농촌지역에 거주하는 20세 이상의 주민 3,085명을 대상으로 자가건강인지도를 측정하였다. 이후 3년간의 지역의료보험 지불자료에서 나타난 의료이용도 및 해당 지역 행정관청의 사망신고 자료를 이용하여 사망여부를 파악하여, 이들 변수들과 자가건강인지도와의 관련성을 조사해본 결과, 다음과 같은 결과를 얻었다. 1) 지역의료보험 대상자 1,090명에서 자가건강인지도에 대한 설문을 실시하기 이전인 1994년의 의료이용량에 비해 이후 3년간의 의료이용량이 자가건강인지도 불량군에서 더 많았으며, 수진일과 투약일은 더 크게 증가하였다. 2) 조사대상자 3,085명중 3년간의 사망자는 123명으로 연령과 성별을 보정한 생존분석 결과, 자가건강인지도 불량군이 양호군에 비해 더 높은 사망위험도를 나타냈다. 94년 지역의료보험에 가입되었던 1,376명중 사망자는 72명, 연령과 성별, 그리고 94년도 의료이용량을 보정 한 생존분석 결과 유의한 차이는 보이지 않았다. 이상의 결과를 요약해 볼 때, 비교적 단기간의 비교를 통해서도 의료이용도와 사망은 자가건강인지도에 따라 차이가 발생함을 알 수 있다. 특히 기존에 같은 정도의 의료이용을 하는 사람 중에서도 자신을 건강하지 않게 생각하는 사람이 향후 의료이용량이 더 크게 증가할 것으로 예측되었다. 따라서 자가건강인지도의 측정은 향후 개인 및 지역사회집단의 의료이용도와 사망 등 건강상의 문제를 예측하는데 유용한 도구로 사용할 수 있을 것으로 생각된다.

• Journal of Korean Biological Nursing Science
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• 제24권4호
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• pp.243-252
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• 2022

Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p=.027), with fewer post-transplantation days (p=.027), absence of acute rejection (p=.004), or high self-efficacy (p<.001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β=0.29, p<.001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion: Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.

• Tuberculosis and Respiratory Diseases
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• 제44권3호
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• pp.661-668
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• 1997

종양세포에 의한 hyperamylasemia는 드물게 보고되고 있으며 주로 폐암에 의하고 조직형은 선암으로 보고되어 있다. 이때 생성되는 아밀라제는 타액형으로 췌장질환에 의한 것과는 구별이 되며 hyperamylasemia에 의한 임상적인 증상은 없다. 저자등은 소세포성 폐암으로 진단받은 54세 남자 환자에서 아밀라제 농도가 상승되어 있음을 발견하고, 임상경과 및 검사결과 아밀라제를 분비하는 소세포성 폐암으로 진단하고 문헌 고찰과 함께 보고하는 바이다.

• 대한지역사회영양학회지
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• 제24권6호
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• pp.497-511
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• 2019

Objectives: This study aimed to develop a school-centered healthy eating environment for children in elementary care classrooms and prevent incorrect eating habits and obesity through the development and application of standardized healthy eating habit-forming educational materials. Methods: Ten schools in eight districts of Gyeonggi-do and 400 students from 19 care classes were selected. Based on the developed educational materials, the program was applied to students once in two weeks. 'Notices for Parents' forms were also sent to the students' home to educate their parents. Pre and post-surveys were conducted to evaluate the effectiveness of the education. The pre-education, education, and aftercare were conducted from September 28 to September 31, 2016, from October 3 to November 30, 2016, and from December 5 to December 9, 2016, respectively. Results: The healthy eating program for elementary care classes was designed to develop a school-centered healthy eating environment and provide standardized educational material for healthy eating habits. Twelve educational topics were developed: , , , , , , , , , , , and . Moreover, the materials were produced in four forms: for students, for after school caring teachers, for external specialists, and for parents. The effectiveness evaluation was conducted to confirm the application of the program. The average eating habits score was 3.3 ± 0.6, with no significant difference between before and after application. The score of overall satisfaction of the education was 3.9 ± 0.9. The most satisfying content was 'Did you get to know how to eat evenly?'. Significant increases were observed in two contents for parents regarding their children's knowledge changes after the education: 'Five nutrients needed for growing children' and 'Knowing sugar foods and sugar-containing foods'. On the other hand, their educational satisfaction was 3.6 ± 0.6, which was lower than the children's satisfaction. This might be because their education was conducted only through the 'Notices for Parents' form. Conclusions: In the long term, the healthy eating habit-formation education for lower elementary school children is expected to be beneficial. To prevent obesity and establish healthy eating habits of children, it is important to develop healthy eating education programs centered on elementary school aftercare classes, including the development of educational materials and an application system through connection with the home and community.

• 임상간호연구
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• 제20권3호
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• pp.313-325
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• 2014

Purpose: This study aimed to develop the protocol of kangaroo care for premature infants and to evaluate its effects including physiologic responses of premature infants, their parents'anxiety, and neonatal nurses'perception regarding the kangaroo care. Methods: Kangaroo care protocol was developed through a literature review and validation of an expert group. The developed kangaroo care protocol was tested with 27 preterm infants, 24 parents, and 60 nurses in one neonatal intensive care unit in S hospital. Data were collected from December 2012 to February 2013 and analyzed by descriptive statistics and t-test using the SPSS/Win statistical program. Results: Physiologic responses including heart rate, respiration rate, oxygen saturation, body temperature among premature infants received the kangaroo care were maintained within normal limit. The anxiety levels of the parents who provided kangaroo care for their infants were significantly decreased as it was compared before and after care (t=3.43, p=.002). There were no significant differences in nurses'perceptions about kangaroo care before and after the application of the protocol. Conclusion: The developed kangaroo care protocol is proved to be effective and can be used safely in nursing practice.

• Tuberculosis and Respiratory Diseases
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• 제65권5호
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• pp.396-399
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• 2008

객혈의 원인은 다양하고, 원인을 찾기 위해 침습적인 검사를 포함하여 여러 검사를 필요로 하는 경우가 있다. 인위성 객혈은 환자가 의도적으로 객혈을 만들어 내는 매우 드문 임상증상으로 간과되기 쉽다. 객혈 원인을 찾기 위한 여러 검사에서 특별한 이상소견이 없을 경우에는 인위성 객혈을 감별 진단해야 한다. 특히 본 증례와 같이 반복적인 객혈 호소와 극단적이고 이상한 임상 양상이나 보기 드문 행동을 하는 경우에는 인위성 객혈을 의심해 보아야 한다.

• Tuberculosis and Respiratory Diseases
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• 제57권1호
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• pp.55-60
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• 2004

간질이나 신경성 통증 등으로 많이 쓰이고 있는 phenytoin, carbamazepine, 그리고 phenobarbital등의 항경련제는 피부, 임파절, 간 그리고 폐 등을 포함하는 전신적인 반응을 동반하는 anticonvulsant hyper-sensitivity syndrome을 유발할 수 있다. 그 임상양상은 환자에 따라 매우 다양하며 드물게 치명적인 경과를 가질 수 있어 의심되는 경우에는 약제의 사용중단이 가장 중요한 것으로 알려져 있다. 저자들은 carbamazepine을 투여 후 피부병변, 고열, 호산구증다증, 임파절종대와 호산구성폐렴을 보였던 환자를 anticonvulsant hypersensitivity syndorme으로 진단하고 원인약제 투여중단 후, 증상, 혈액학적 이상소견 그리고 방사선학적 이상소견의 호전이 관찰되었던 1예을 경험하였기에 문헌고찰과 함께 보고하는 바이다.