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Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children (일부 초등학생의 대표적 신체활동의 에너지소비량 측정 및 에너지소비량과 체중과의 상관성 분석)

  • Kim, Jae-Hee;Son, Hee-Ryoung;Choi, Jung-Sook;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.48 no.2
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    • pp.180-191
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    • 2015
  • Purpose: There is a lack of data on the energy cost of children's everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system ($K_4b^2$, Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 cm and 43.6 kg, respectively. Oxygen consumption ($VO_2$), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/kg/min, 1.44 kcal/kg/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, $R^2$ values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

A Study on the Present Situation, Management Analysis, and Future Prospect of the Ornamental Tree Cultivation with respect to Environmental Improvement (환경개선(環境改善)을 위한 녹화수목재배(綠化樹木裁培)의 현황(現況) 및 경영분석(經營分析)과 전망(展望))

  • Park, Tai Sik;Kim, Tae Wook
    • Journal of Korean Society of Forest Science
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    • v.34 no.1
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    • pp.31-46
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    • 1977
  • The study was made to give some helpful information for policy-making on ornamental tree cultivation by doing a survey on general situations, management analysis, and future prospects of the ornamental tree growing. The study was carried out through literature studies related to the subject, questionaire surveys, and on-the-spot investigation. The questionaire surveys could be divided into two parts: pre-questionaire survey and main-questionaire survey. In the pre-questionaire survey, the researchers intended to identify the total number of ornamental tree growers, cultivation areas in size and their locations. The questionaires were sent to each town and county administration authorities, forest cooperatives, and related organizations through-out the nation. The main-questionaires were prepared for detailed study and the questionaires were sent to 200 tree growers selected by option by taking considerations of the number of tree growers and the size of cultivating areas in regions. The main findings and some information obtained in the survey were as follows: 1. The total land for ornamental tree growing was amounted to 1,873.02 hectares and the number of cultivators was totaled to 2,717. 2. The main occupations of the ornamental tree growers were found in horticulture (41.9%), agronomy (25.9%), officialdom (11.3%), animal husbandry (6.5%), business circle(4.8%), and forestry (3.2%) in sequence. 3. The ornamental trees were cultivated mostly upperland (54.8), forest land (19.4%), rice paddy (11.3%) and others. 4. The educational training of the tree growers seemed quite high. The results of the survey indicated that a large number of tree growers was occupied by college graduates (38.7%), and then high school graduates (34.7%), middle school graduates (12.9%) in order. 5. The tree farming was undertaken as a side-job (41.9%) rather than main-job (23.4%), but a few of respondents rated as subsidiary-job (18.6%). 6. The management status classified by the rate of hired labors used was likely to belong to three categories: independant enterprise management (41.9%); half independant management (31.5%); and self-management (32.4%). 7. The majority of the tree growers sold their products to the consumers through middle-man channel (48.4%), or directly to the house-holder and detailers (13.7%), but a few of the respondents answered that they disposed of their products by bidding (11.2%) or by direct selling to the contractors (4.8%). 8. The channel cf marketing seemed somewhat complicated. The results of the survey were as: (1) producers ${\rightarrow}$consumers (22.6%) (2) producers ${\rightarrow}$field middle-men${\rightarrow}$consumers (33.1%) (3) producers ${\rightarrow}$field middle-men${\rightarrow}$first stage brokers${\rightarrow}$consumers (15.3%) (4) producers ${\rightarrow}$field middle-men${\rightarrow}$second stage middle-men${\rightarrow}$brokers${\rightarrow}$consumers (5.7%) (5) producers${\rightarrow}$field middle-men${\rightarrow}$third stage middle-men${\rightarrow}$second stage middlemen${\rightarrow}$brokers${\rightarrow}$consumers (4.8%) 9. It was responded that the margin for each stage of middle-men or brokers was assumed to be 30-50%(33.1%), 20-30%(32.3%), 50-100%(9.7%), and 100-200%(2.4%) in sequence. 10. The difference between the delivery price of consumers and field selling price of the producers seemed quite large. Majority of producers responded that they received half a price compared to the consumer's prices. 11. About two thirds of the respondents opposed to the measure of "Law on Preservation and Utilization of Agricultural Land" in which says that all the ornamental trees grown on flat agricultural lands less than 8 degrees in slope must be transplanted within three years to other places more than 8 degrees in slope. 12. The tree growers said that they have paid rather high land taxes than they ought to pay (38.7%), but come responded that land tax seemed to be appropriate (15.3%), and half of the respondents answered "not known". 13. The measures for the standardization of ornamental trees by size were backed up by a large number of respondents (57.3%), but one third of the respondents showed negative answer (29.8%). 14. About half of the respondents favored the systematic marketing through organization such as forest cooperatives (54%), but quite a few respondents opposed to organizing the systematic marketing channel (36.3%). 15. The necessary measures for permission in ornamental tree cultivation was rejected by a large number of respondents (49.2%) than those of favored (43.6%).

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Effect of Health Promotion Programs in Schoolchildren (초등학교 학생을 대상으로 한 건강증진 프로그램의 효과)

  • Yoo, Joong-Sun;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Seok-Beom;Choi, Kwang-Hae;Kim, Mee-Kyung
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.397-411
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    • 2000
  • The present study was conducted to analyze the degree of changes in knowledge and attitude toward health, arid health promoting activities after providing health education intervention for a year to elementary school children, to examine the factors effecting knowledge, attitude and health promoting practices for obesity and diet, and to analyze whether changes are present in health level according to changes in knowledge on health and health promoting activities. After conducting a pre-survey rio 354 subjects of 3rd and 4th grade students and their mothers in the city area of Kyungju, in April, 1999, 301. responses with the responding rate of 85% were obtained. Final analysis was done with 231 pairs of a student and his/her mother who could be followed up after a year among 301 pairs of the respondents, excluding those students who transferred, those who were excused from school early, those who did not take abdominal fat measurements, and those students and mothers respondents whose survey was incomplete. Based on the changes before and after the intervention, the scores on knowledge about obesity and diet showed a significant difference in normal weight group, and the scores on the attitude toward obesity and diet increased significantly in obesity group but decreased significantly in normal weight group(p<0.01). The scores of practicing health promoting activities were significantly increased in both groups, and although the waist-hip ratio (WHR) did not change in obesity group, the rate increased significantly in normal weight group(p<0.01). As for changes on the knowledge of obesity and diet before and after the intervention while dividing the scores into 3 levels based on the scores of the pre-survey and compared to changes in the scores one year after, in the case of the changes in the scores in the 1st third, the score on the knowledge about obesity and diet changed from 1.3 in the pre survey to 3.7 after the intervention, showing significant increase(p<0.01) The scores of practicing health promoting activities for obesity and diet were significantly increase in all three levels(p<0.01), and the degree of changes in the scores was 7.0 points in the 1st third, 4.4 points for the and third and 1.8 points for the 3rd third, showing a significant difference among the three levels(p<0.01). It was shown that the increase in BMI in those students whose mothers have the education level higher than university was significantly higher than the increase in BMI in those students whose mothers have the education level under high school, and those students whose mothers are in their 30's showed higher changes in practicing health promoting activities for obesity and diet. When the scores of mothers' knowledge and attitude toward obesity and diet were compared by dividing the scores into tertile, the score of students' knowledge changed significantly according to the scores of mothers' attitude toward obesity and diet. In multiple regression analysis on changes in the scores of knowledge about obesity and diet, the student variables of the degree of awareness on the seriousness of obesity, and the scores of previous knowledge on diet and obesity were selected the significant variables, and among the mother variables, the degree of guiding the child on diet and the education level were the significant variables. In multiple regression analysis to analyze the factors effecting changes in the attitude toward obesity and diet, the student variables of the BMI, scores of previous knowledge on obesity and diet, and scores on the previous attitude toward obesity and diet were shown to be significant. In multiple regression analysis on the factors effecting changes in health promoting activities for obesity and diet, the student variables of the BMI, scores on the previous attitude toward obesity and diet, and changes in the scores of obesity and diet were selected the significant variables.

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Problems in the field of maternal and child health care and its improvement in rural Korea (우리나라 농촌(農村)의 모자보건(母子保健)의 문제점(問題點)과 개선방안(改善方案))

  • Lee, Sung-Kwan
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.29-36
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    • 1976
  • Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

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A Survey on the Status of Health Examination among Farmers in a Rural Area (일부 농촌지역 농업종사자들의 건강진단 수검 실태)

  • Park, Soon-Woo
    • Journal of agricultural medicine and community health
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    • v.22 no.1
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    • pp.1-18
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    • 1997
  • This study was carried out to reveal the status of health examination among farmers and to attract more attention to the health care system for farmers. Ten pre-trained medical students interviewed the rural residents 18 years of age and older in eight villages which were randomly selected from a county near Taegu city in Korea, in August 1996. Finally 751 persons were interviewed of whom the percentages of male and female were 41.8%, 58.2% respectively. Among the subjects, 361(48.3%) were fully engaged in farming, 184(24.4%) were partly engaged, and the remaining 206(27.3%) were not engaged in farming at all. The overall prevalence of farmer's disease was 23.0% and there was no significant difference between the group of fully engaged in farming(23.3%) and the group of not-fully engaged(22.9%). But the prevalence of farmer's disease in female subjects(27.8%) was significantly higher than that in male(16.2%)(p<0.01). Among the 288 farmer engaged in spraying pesticide, 113(39.2%) had experienced one or more pesticide related symptoms during last one year, but only 18(15.9%) of them had visited medical facilities due to their symptoms. The experience of receiving education about pesticide was significantly correlated with the degree of wearing protectors during pesticide spraying(p<0.001). Among the 736 persons excluding non-respondents, 281(38.2%) received health examination during last one year ; 176(62.6%) of them received free health examination, and 105(37.4%) received charged one. Among the 533 persons 40 years age and older, only 124(23.3%) had received the 'health examination for the elderly' during last one year, which is provided for the 40 years age and older by Korea medical insurance corporation and medical insurance societies. Most of all beneficiaries of self-employed medical insurance thought the imposed contributions as very expensive(77.4%) or moderately expensive(13.2%). The great majority of farmers are exposed to various health risk factors including pesticide, high temperature, overwork etc. comparable to industrial workers. But farmers are excluded from the regular yearly worker's health examination because of not belonging to a company despite they pay relatively more medical insurance contributions compared with the industrial workers and the urban self-employed medical insureds. It is necessary to develop special health management program for farmers such as the special health examination for the industrial workers exposed harmful agents.

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Effects of Sesame Meal on Growth Performances and Fatty acid Composition, Free Amino Acid Contents, and Panel Tests of Loin of Hanwoo Steers (참깻묵이 거세 한우의 비육성적과 등심의 지방산 조성, 유리 아미노산 함량 및 관능평가에 미치는 영향)

  • Kim, Sung Il;Cho, Bong Rae;Choi, Chang Bon
    • Journal of Animal Science and Technology
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    • v.55 no.5
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    • pp.451-460
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    • 2013
  • The feed value of sesame meal, a main agricultural by-product from the northern area of Gyeongsangbuk-do province, was assessed in Hanwoo steers. A total of twelve Hanwoo steers (average BW = 412.08 kg) were allocated into a Control (fed no sesame meal) or Treatment (fed sesame meal from 14.6 months of age) group, considering BW and ages, and the animals were fed for a total of 480 days. The final BW, total gain and ADG for the Control and Treatment groups were 741.17 kg and 762.67 kg, 331.84 kg and 347.84 kg, and 0.69 kg and 0.72 kg, respectively, showing better performances in sesame meal-fed animals. Feed requirements during the whole experimental period improved by feeding sesame meal (15.31 and 14.87 for Control and Treatment group, respectively). Hanwoo steers fed sesame meal also showed a 22.83 kg heavier cold carcass weight (424.17 kg and 447.00 kg in the Control and Treatment group, respectively), and 2.41% improved dressing percentages (58.60% and 57.22% for the Control and Treatment group, respectively). The area of the M. longissimus dorsi was $91.83cm^2$ and $88.33cm^2$ in the Control and Treatment group, respectively. The final yield of A and B grade meat were 50 : 50% and 33.3 : 66.7% from the Control and Treatment group, respectively. The average marbling score was 4.83 and 5.50, and the numeric values for quality grade was 2.17 and 2.67 for the Control and Treatment group, respectively, showing better beef quality in sesame meal-fed Hanwoo steers. In fact, there were two animals with beef quality $1^{{+}{+}}$ in the sesame meal-fed group. The melting point of lipid extracted from the M. longissimus dorsi of Hanwoo steers was significantly (p<0.05) lower in the Treatment group ($28.28^{\circ}C$) compared to the Control group ($30.65^{\circ}C$). The composition of saturated fatty acids, $C_{14:0}$ (myristic acid) and $C_{16:0}$ (palmitic acid), were significantly lower in sesame meal-fed animals, 4.70% and 2.20% for myristic acid, and 30.55% and 27.12% for palmitic acid, in the Control and Treatment group, respectively. In contrast, there were no significant differences in C18:0 (stearic acid) composition between the groups. The composition of a representative unsaturated fatty acid, $C_{18:1}$ (oleic acid), was significantly higher in Treatment animals (49.89%) than Control animals (44.29%) (p<0.05). The ratio of total monounsaturated fatty acids / saturated fatty acids; M/S) was 1.10 and 1.36 for the Control and Treatment groups, respectively, showing remarkably higher ratios in sesame meal-fed group. The content of glutamic acid, related to beef flavor, was significantly higher in the Treatment group (3.35 mg/100 g) compared to the Control group (1.88 mg/100g) (p<0.05). The tenderness score, evaluated by an eight-point scale in the panel test, and overall palatability (based on juiciness, flavor, oiliness, and umami) were significantly higher in the Treatment group (5.67 and 5.23, respectively) than the Control group (3.83 and 4.60, respectively) (p<0.05). In conclusion, the current results imply that sesame meal could serve as a good supplement for Hanwoo steers for producing high quality beef.

Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.15-41
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    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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Epidemiological Studies of Clonorchiasis. - I. Current Status and Natural Transition of the Endemicity of Clonorchis sinensis in Gimhae Gun and Delta, a High Endemic area in Korea (간흡충증(肝吸虫症)의 역학(疫學) - I. 고도유행지(高度流行地) 김해지방(金海地方)에 있어서의 간흡충감염(肝吸虫感染)의 현황(現況)과 자연추이(自然推移))

  • Kim, D.C.;Lee, O.Y.;Lee, J.S.;Ahn, J.S.;Chang, Y.M;Son, S.C.;Moon, I.S.
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.44-65
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    • 1983
  • As a part of the epidemiological studies of clonorchiasis, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Gimhae Gun and delta area a high endemic area in Korea in recent years, prior to the introduction of praziquantel which will eventually influence the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author(Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The prevalence rate of clonorchiasis in the general population of the villages was 48.1% on the average out of a total of 484 persons examined. The average of those of the riverside-delta area was 65.2% and 43.0% in the inland area. Among the schoolchildren, the prevalence rate was 8.2% on the average out of a total of 1,423 examined. By area, the prevalence rate was 10.8% in the riverside delta area and 2.8% in the inland area. By sex, difference in the prevalence was seen only in the inhabitants of the inland area showing 52.4% in the male and 33.5% in the female. 2) In the natural transition of the infection, the prevalence rate among the inhabitants has decreased from 68.8% in 1967 to 48.1% in 1983, and in the schoolchildren from 56.4% in 1967 to 8.2% in 1983. The reduction rate was higher in the riverside-delta area than in the inland area. 3) In the prevalence rate by age, 11.9% was first seen in the 5-9 age group and the rate gradually increased up to 75.0% in the 50-59 age group. By sex, the rate was higher in the male than in the female in the 20-29 age group and over. 4) In the natural transition of the prevalence rate by age, the reduction rate of the infection during the past 16 years was greater in the younger age groups up to the 40-49 age group and reached the same level in the age group 50-59. Reduction was seen again in the age group over 60s. By sex, the reduction rate was greater in the female than in the male in the 20-29 age group and over. By area, the reduction rate was greater in the riverside delta area than in the inland area, particularly in the young age groups. 5) In the intensity of the infection among the cases, the mean egg out-put per mg feces per infected cases(EPmg) in the inhabitants was 6.3. EPmg of those of the river-side-delta area was 15.4 and that of the in-land was 2.8. On the other hand, in the schoolchildren, EPmg was 3.2, and no difference was seen between the two areas, the river-side-delta area and the inland area. 6) In the transition of the intensity of the infection by area, EPmg among the inhabitants inexplically increased from 7.8 in 1967 to 15.4 in 1983. This was probably caused by uneven specimen collection in the process of sampling the population. EPmg of the inhabitants in the inland area and those of the schoolchildren of both riverside delta and inland areas showed a similar decrease in the past 16 years. 7) The intensity of the infection by age showed a relatively low level in the 20-29 age group and below, and EPmg 5.1-9.5 was seen in the 30-39 age group and over. Sex, Epmg was 5.8 in the male and 4.7 the female. By in 8) In the transition of the intensity of the infection, EPmg decreased from 6.2 in 1967 to 5.4 in 1983. By age, in contrast to the figures of 1967 in which EPmg gradually increased with some fluctuation from 1.1 in the 0-4 age group to peak 10.5 in the 50-59 age group, in 1983 lower intensity of the infection was seen in the age group from 10-14 to 20-29 with the EPmg range of 0.6-2.7. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 43.2% of the cases were in 0.1 0.9 and 34.6% in 1.0-4.9. As a whole by cumulative percent, 44.6% of them were under 0.9 as light infection and 86.1% of them under 9.9 up to moderate infection. By sex, no difference was seen in Epmg. 10) In the transition of the distribution by the range of Epmg, the cases were distributed up to the range 80.0-99.9 in 1967 and to 60.0-79.9 in 1983. By cumulative percent, in the range of 0.1-0.9 and less, light infection, 34.3% of them were distributed in 1967 and 44.6% in 1983 with about 10% increase. In the range of 5.0-9.9 and less, up to moderate infection, 83.2% in 1967 and 86.1% in 1983 of the cases were seen, respectively. 11) The practice of raw freshwater fish consumption among the inhabitants seems to have decreased in recent years. Those who admitted to raw freshwater fish consumption in the last two years among the infected inhabitants were 59.3%, although 86.8% of them professed to have experience with raw freshwater fish consumption. 31.7% of those who have had experience of the raw freshwater fish consumption denied any further consumption in recent years. From an interview of 543 school-children, 24.1% of them admitted to an experience of raw freshwater fish consumption. However, those who have practised in the past two years comprized 17.9%. Those who denied raw freshwater fish consumption in recent years among those who had such experience were 26.0% out of 131 interviewed. The rate of raw freshwater fish consumption in both inhabitants and schoolchildren were higher in the male than in the female. On the contrary, the rate of those who did not practise in recent years among those who had experience of raw freshwater fish consumption was higher in the female than in the male. 12) The major reason for the reduction of raw freshwater fish consumption among the local inhabitants was the risk of the fluke infection. However, it has become apparent that such change of taste has resulted from water pollution impact which has affected throughout the areas of the freshwater systems in this locality since last several years. 13) In animal survey, Clonorchis infection was seen in 14.8% of 88 dogs examined and 3.7% of 27 house rats examined. It was noted that populations of dogs and cats have increased in the villages surveyed. Although the prevalence rate was lower in the present survey than those of 1967, the significance of the animals as the reservoir host has not changed. 14) Prevalence rate of Clonorchis infection by cercariae in the first intermediate host, Parafossarulus manchouricus, was 0.6% out of 517 snails examined. The infection rate was lower in comparison with 2.3% out of 2,124 examined in 1967. Moreover, sharp decreases in number and distribution of the intermediate host snails in many watershed areas of the huge freshwater systems in this locality seemed to reduce transmission of Clonorchis in connection with the intermediate host stage of its life cycle. 15) Clonorchis infection in the second intermediate fish hosts was relatively low. The mean number of Clonorchis metacercaria per fish in Pseudorasbora parva was 517 in 1983, whereas it was 1943 in 1968 through 1969. Environmental water pollution has also caused the decreased fish population density in these areas, and this has also apparently affected to the practice of raw freshwater fish consumption among the local inhabitants. 16) In conclusion, endemicity of Clonorchis infection in Gimhae Gum and delta area of the Nagdong River has sharply decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the land water systems of this locality. The pollution has upset the ecosystems comprizing of the intermediate hosts of Clonorchis in many areas, and also affected to a significant extent to the discontinuance of the local inhabitants for raw freshwater fish consumption.

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