• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.422-430
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• 2021

Objectives: Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19. Methods: The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression. Results: Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative. Conclusions: Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

• 대한간호학회지
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• 제51권6호
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• pp.758-768
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• 2021

Purpose: This study aimed to conduct a job analysis of nurse carecoordinators and to identify the frequency, importance and difficulty of each task of their job. Methods: A committee for developing a curriculum (DACUM) was formed and members of the committee defined nurse care coordinators' jobs and enumerated the duties, tasks and task elements by applying the DACUM technique. Then nurse care coordinators enrolled in the pilot project evaluated the frequency, importance and difficulty of each task. Results: From the job descriptions of nurse care coordinators, we identified 12 duties and 42 tasks. Each task comprised 1~5 task elements. Among tasks, 'assess the patient's general health status' was carried out most frequently. Nurse care coordinators perceived that 'check vital signs' and 'strengthen patient competence to promote health behaviors' were more important than all other tasks. The most difficult task was 'develop professionalism as a nurse care coordinator'. Conclusion: The nurse care coordinators' roles developed in this study will serve as the key guidelines for human resource management of care coordinators. Further, job specifications for nurse care coordinators need to be developed, which is necessary for designing education and training programs. We also need to integrate primary health care as an essential component in nursing education.

• 보건행정학회지
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• 제32권4호
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• pp.356-367
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• 2022

Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases. Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease. Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use. Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

• Journal of Medicine and Life Science
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• 제19권3호
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• pp.103-108
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• 2022

In 2021,the incidence of newly notified tuberculosis in Jeju Province decreased by 23.0% compared to that in the previous year. This was the largest decline among the 18 municipalities studied. This study aimed to examine trends in the incidence of tuberculosis among different age and sex groups in Jeju Province between 2017 and 2021. This study observed the number of new cases in the annual report from 2017 to 2021, published by the Jeju Center for Infectious Diseases Control and Prevention. The average annual percentage change (AAPC; %) was calculated to determine the trend in crude incidence rates over the past 5 years by sex and age. While a P-value of <0.1 was considered marginally significant, aP-value of <0.05 was considered statistically significant. The AAPC of all age groups in Jeju Province had negative values. In men,there was a statistically significant decrease in ages 30-34, 40-44, 45-49, and 50-54 years and a marginally significant decrease in ages 35-59, 55-59, 60-64, 65-69, 75-79, and ≥80 years. In women, a statistically significant decrease was observed among patients aged 30-34, 35-39, and ≥80 years, and a marginally significant decrease was observed among patients aged 45-49, 50-54, 60-64, 65-69, and 75-79 years. A statistically significant decrease in tuberculosis was observed among patients in their 30s and 40s, and elderly patients aged ≥80 years comprised the group vulnerable to tuberculosis. Based on these findings, tuberculosis prevention and screening programs conducted in Jeju Province were effective.

• Journal of Preventive Medicine and Public Health
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• 제55권2호
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• pp.134-143
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• 2022

Objectives: Many governments have imposed-and are still imposing-mobility restrictions to contain the coronavirus disease 2019 (COVID-19) pandemic. However, there is no consensus on whether policy-induced reductions of human mobility effectively reduce the effective reproduction number (Rt) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several studies based on country-restricted data reported conflicting trends in the change of the SARS-CoV-2 Rt following mobility restrictions. The objective of this study was to examine, at the global scale, the existence of regional specificities in the correlations between Rt and human mobility. Methods: We computed the Rt of SARS-CoV-2 using data on worldwide infection cases reported by the Johns Hopkins University, and analyzed the correlation between Rt and mobility indicators from the Google COVID-19 Community Mobility Reports in 125 countries, as well as states/regions within the United States, using the Pearson correlation test, linear modeling, and quadratic modeling. Results: The correlation analysis identified countries where Rt negatively correlated with residential mobility, as expected by policymakers, but also countries where Rt positively correlated with residential mobility and countries with more complex correlation patterns. The correlations between Rt and residential mobility were non-linear in many countries, indicating an optimal level above which increasing residential mobility is counterproductive. Conclusions: Our results indicate that, in order to effectively reduce viral circulation, mobility restriction measures must be tailored by region, considering local cultural determinants and social behaviors. We believe that our results have the potential to guide differential refinement of mobility restriction policies at a country/regional resolution.

• 보건행정학회지
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• 제33권4호
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• pp.421-431
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• 2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion: Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

• 한국간호교육학회지
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• 제30권1호
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• pp.71-81
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• 2024

Purpose: This study aimed to identify the relationship between nursing professionalism and nursing intention for patients with emerging infectious diseases of nursing students who had experienced coronavirus disease 2019 (COVID-19), with a focus on the mediating effect of e-Health literacy. Methods: The study surveyed 177 nursing students who had experienced COVID-19. The data were collected using self-reported questionnaires. The collected data were analyzed using IBM SPSS statistics 25.0, and the mediating effect was analyzed through the SPSS Process macro model 4. Results: Nursing professionalism (β=.26, p=.002) and e-Health literacy (β=.18, p=.021) were found to be significant predictors of nursing intention for patients with emerging infectious diseases. In addition, e-Health literacy partially mediated the relationship between nursing professionalism and nursing intention for patients with emerging infectious diseases. Conclusion: e-Health literacy was a mediating factor in the relationship between the nursing professionalism and nursing intention of nursing students for patients with emerging infectious diseases. In order to improve nursing intention of nursing students for patients with emerging infectious diseases, it is important to develop an education program that can enhance their e-Health literacy as well as nursing professionalism.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.135-149
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• 2001

목 적 : 예방접종 사업의 안정화를 위해서는 발생된 이상반응이 적절하게 보고되고, 발견된 이상반응에 대하여 신속하고 정확한 원인 규명을 위한 역학조사를 시행하여 조사된 결과에 따라 적절하게 대응하는 것이 필요하다. 이에 연구자들은 1995년부터 2000년까지 국가 보상을 신청하거나 보고된 예방접종 후 이상반응 감시체계를 통해 보고된 이상반응 사례들을 수집하여 보고 사례와 국가 보상의 변화 양상과 사례의 역학적 특성을 파악하여 이상반응 감시체계의 개선 방향을 제시할 수 있는 기반을 마련하고자 하였다. 방 법 : 1995년부터 1996년까지 예방접종 후 이상반응에 대하여 국가보상신청을 하거나 국립보건원 방역과로 보고된 61건을 대상으로 국가보상 신청시 제출한 자료와 역학조사와 관련된 모든 자료들을 수집, 정리하여 사례들의 역학적 특성들을 파악하였으며, 역학조사 방법과 보상과 관련된 사항들에 대하여 정리 분석하였다. 결 과 : 연도별 보고 건수는 1995년 12명, 1996년 3명, 1998년 12명, 1999년 5명, 2000년 29명으로 총 61명이었으며, 이 중 사망자는 24명(39.3%)이고, 이 중 16명(66.7%)에서 부검이 시행되었다. 보상 심의를 신청한 경우는 36건(59.0%)이었는데, 이 중 17건(47.2%)이 보상받았고, 역학조사를 실시한 경우는 49건(80.3%)이었다. 보고 사례 중 보상 신청 사례는 1995~1998년에는 17건 중 15건(88.2%), 1999~2000년에는 38건 중 15건(76.3%)으로 감소하였으나, 심의 결과 보상을 받는 비율은 1995~1998년 26.6%에서 1999~2000년 53.3%로 증가하였다. 보고 사례 중 역학조사가 이루어진 경우는 1995~1998년에는 17건 중 14건(82.4%), 1999~2000년에는 38건 중 29건(76.3%)으로 역학조사를 실시하는 비율은 감소하였으나 반드시 역학조사가 필요하나 누락되는 경우는 개선되었다. 이상반응 발생을 인지한 후 역학조사에 착수하기까지의 소요시간이 1일 이내인 경우가 1995~1998년에는 전체의 25%에 불과하던 것이 1999년 이후에는 전체의 43.5%로 증가하였다. 전체 이상반응 발생에 있어 남녀간 차이는 보이지 않지만 사망자 21명만을 살펴보면 남자가 14명(66.7%), 여자가 7명(33.3%)으로 남자가 2배나 많았다. 연령별 분포는 정기예방접종이 집중되어 있는 생후 2개월부터 24개월까지가 전체의 75.4%를 차지하고 있다. 접종에서 발병까지의 기간은 전체의 78.4%가 접종 후 일주일 이내에 발생하였다. 결 론 : 보고체계 도입 이후 역학조사가 필요한 경우 대부분에서 조사가 시행되었고, 보고를 받고 신속하게 조사를 착수하는 비율이 증가한 것은 긍정적인 변화로 평가된다. 그러나, 전체적으로 보았을 때 외국에 비하여 감시체계를 통해 보고되는 사례 수가 매우 적어 이상반응의 역학적 양상을 파악함에는 제한점이 있다. 예방접종 사업의 안정성 확보라는 목표를 달성하기 위해서는 무엇보다 보고율 향상을 위한 노력이 경주되어야 할 것으로 생각된다.

• Pediatric Infection and Vaccine
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• 제19권1호
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• pp.19-27
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• 2012

목 적 : 최근 부모들의 맞벌이, 조기 교육 등의 이유로 이른 나이부터 보육시설을 이용하는 영유아가 증가하고 있다. 이러한 사회 환경의 변화 속에 5세 이하 어린이들의 보육시설 이용 현황과 이와 관련된 감염성 질환 실태 및 예방접종 현황에 대하여 조사하였다. 방 법 : 2011년 6월 10일부터 6월 16일까지 전국의 5세 이하의 자녀를 둔 부모 1,000명을 대상으로 온라인 설문조사를 실시하였다. 표본오차는 95% 신뢰수준에서 ${\pm}3.1%$이고, 표본추출은 지역별, 성별, 연령별 비율에 따라 무작위 할당표본 추출(quota sampling)방법을 사용하였다. 설문조사는 크게 인구통계학적 특성, 단체 보육시설 이용 현황, 소아의 감염성 질환 경험, 예방접종 유무 관련 4개 주제로 나누고 그 속에 세부 문항을 두어 총 16개의 문항을 구성하였고, 설문결과를 수집하여 통계적 분석을 시행하였다. 결 과 : 5세이하의 영유아들의 보육시설 이용율은 78.5%였고 이 중 약 84%가 3세 이전부터 보육시설을 처음 이용한 것으로 나타났다. 보육시설을 이용하는 영유아(58%)가 그렇지 않은 영유아(34%)보다 감염성 질환을 경험한 비율이 더 높았다(P<0.001). 감염성 질환 중에서 장염(47.1%), 중이염(41.8%), 폐렴(19.1%) 등의 순으로 경험 비율이 높았고, 각 질환의 재발 여부는 중이염이 28.1%로 가장 높고 뒤이어 장염 (22.4%), 폐렴 (11.9%)의 순으로 조사되었다. 각 질환을 앓은 영유아의 약 70% 정도가 생후 24개월 이전에 이들 질환을 처음 경험한 것으로 나타났다(폐렴 75.2%, 장염 77.1%, 중이염 71%). 예방접종율은 국가필수예방접종이 90.4%인데 반하여 기타예방접종은 중복응답을 포함하여 b형 헤모필루스 인플루엔자 백신(76.6%), A형 간염(63.3%), 폐구균 백신(59.4%), 로타바이러스 백신(43.1%) 순으로 나타났다. 결 론 : 이번 연구에서 이른 나이부터 단체생활을 시작하는 영유아가 많았고, 이들의 감염성 질환 경험률이 더 높은 것으로 나타나 이 시기의 감염성 질환 예방을 위해 손씻기 등의 개인위생에 보다 힘쓰고 시기에 맞게 백신접종을 하도록 해야 한다. 또한 소아 감염 전문가들에 의한 보육시설에서의 표준화된 감염관리 지침 제정과 함께 보육현장에서의 교육을 통하여 보육시설에서의 감염 전파를 막기 위한 보다 적극적인 노력이 필요하다.

• 생태와환경
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• 제39권1호통권115호
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• pp.110-118
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• 2006

화옹유역 체절에 따라 조성되는 담수호와 유입하천에서의 레저활동이 안전하게 이루어지기 위해서는 인체건강에 안전한 수질의 확보가 우선되어야 한다. 이 지역의 수질안전을 평가하기 위해서 남양천 소유역에 대해 현장자료를 이용하여 QUAL2E 모형을 적용하여 모의하였고 유량, $BOD_5$,$\;NH_3$-N, T-N, T-P 및 E. coli에 대한 검 ${\cdot}$보정을 실시하였다. 검 ${\cdot}$보정 결과에 의하면 모의값이 실측값을 잘 반영하였으며 모형의 검증을 위해 신뢰도를 분석한 결과 r값이 0.90 이상으로 높게 나타났다. 모의결과에 의하면 현재의 조건에서는 남양천 구간의 지표미생물 E. coli의 농도가 국내 및 국제 휴양용수기준을 모두 초과할 것으로 예측되었다. Beta-Poisson 모형에 의해서 예측한 결과값을 활용하여 위해도 값을 산정하였고, 인자들 간의 불확실성을 고려하여 Monte-Carlo simulation을 적용한 후 95% 신뢰구간의 위해도를 평가하였다. 위해도 평가 결과는 남양천 구간에서 7.9 ${\times}\;10^{-6}\;{\sim}\;9.4\;{\times}10^{-6}$으로 장내질병을 유발가능한 수준인 $10^{-4}$보다 낮은 수준이었다. 그러나, 담수호와 직접 연결되어 낚시나 수영과 같은 레저활동을 하기에 수량이 풍부한 조건을 갖추고 있는 R4지점 등의 경우에는 위해도 범위가 질병 이동이 가능한 수준인 $10^{-6}\;{\sim}\;10^{-8}$의 수준을 나타내었다. 이러한 결과에 의하면, 현재 상태에서는 남양천 구간의 하천용수를 휴양용수로 사용하는 데에 직접적인 위해성은 낮으나, 질병 이동의 가능성이 있는 범위이다. 따라서 인체에 안전한 휴양용수 수질 확보를 위해서는 유역의 오염발생원에서 오폐수처리를 통해 하천 수질이 휴양용수로서 사용하는 데에 적합하도록 충분한 차집시설과 환경 기초시설의 설치 운영이 필요할 것으로 판단된다.