• 한국학교ㆍ지역보건교육학회지
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• 제1권2호
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• pp.87-104
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• 2000

The purpose of this study was to obtain the basic data as a improvement method through the fact-revealing concerning the drinking water management of school and utilization of student. The problems of the research are as follows: First, to investigate status of management of drinking water by area and school. Second, to investigate student's utilization of drinking water by area and school. 1,400 students was selected at 45 elementary and middle-high schools located in Kang-won province, and this study was constituted of two questionnaires(for school's questionnaire and student's questionnaire). The results was analyse through the frequency analysis, $x^2$-test on the basis of the above research problem by SPSS program. The findings of this research are as follows; 1) The Management of School Drinking Water First, the source of school drinking water was mostly piped water. Inspection of water quality has been fulfilled under four times a year, in the other hands, from the result inspection, the schools which was given inadequate determination was 22.2%. Second, reservoir cleaning and hygiene inspection failed far short of the regulations. Especially, reservoir cleaning was managed by exterior consignment industry not low-level officials. Third, school water drinking was the most supplied through the type of water purifier. Water purifier has been distributed to city-located and middle-high school highly, factually the water from water purifier was served with water cup. Fourth, the selection standard of water drinking manager showed slightly differently by school, accordingly there need to develope integrated system with the respective to its effective systematic management. Fifth, water cup was mostly treated by only water clear, which is to vindicate the problems concerning hygiene management. 2) Utilization of school student on Drinking Water First, Disbelief on drinking water of school student was very high. Especially, proportion of middle-high school student's disbelief of drinking water was higher than elementary school student, also girls higher than boys. Many of student have heard to don't drink water from around people. And there were showed meaningful differences by area and school. Second, It was showed many student recognize had to utilize water purifier, boiled water. However, they have still drunken the tap water or portable water from their home. Third, Many of student showed negative response with the respective to the management conditions of drinking water in classroom, There were showed meaningful differences by area and school. From the fact-revealing of water cup management, Students mostly answered to 'only water clear' and the answer of 'None use' or 'With personal cup' was higher. Fourth, In bad experience of Drinking Water, student mostly answered to 'occasionally' and there were showed meaningful differences by school. student's disease experience with school drinking water was few and there were showed meaningful differences by area and gender.

• 농촌의학ㆍ지역보건
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• 제16권1호
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• pp.61-69
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• 1991

Serodiagnosis of Clonorchis sinensis infections will probably be a first choice tool for screening of clonorchiasis in a future because of increasing difficulties in collection and examination of stools. The sensitive test such as ELISA can he used effectively. However there are some limitations in serological diagnosis for the detection of serum antibody. One of the major problems is the non-specificity of the antigens which produce cross reaction with other helminthic infection sera. To solve this problem. many investigators have tried to purify the antigens used. In this study, we determined the antigenic profile of the crude saline extract antigen of C. sinensis at early developmental stage based on SDS-PAGE and immunoblotting techniques for the purpose of understanding the nature of C. sinensis worm antigen The following results were obtained : 1) The SDS-PAGE showed many protein hands ranging from 10Kd to 91Kd relative molecular weight. Among them, 66, 46, 40, 33, 27, 24, 16, 14 and 10Kd bands were observed as a principle bands. The protein components of C. sinensis changed chronologically during their early developmental period. 44Kd band was stained unclearly in antigen of 2 weeks worm, but changed to concentrated state in antigen of 5 weeks worm. 35Kd band was found in antigen of 2 weeks worm, however this band was disappeared in antigen of 5 weeks worm. 22Kd band also lost its staining property gradually. 2) In spite of differences in antigenic profile, there was no differences in the data obtained by microplate ELISA using each antigen preparation. Absorbance value began to rise in between 2 to 3 weeks after infection. 3) By EITB. serum antibody recognized major protein bands with molecular weight of 91, 85, 63, 46, 40, 33, 24, 14 and 10Kd hand respectively. Among them 66, 33, 17 and 14Kd bands were observed as non-specific band because they reacted even in normal control sera. Generally, gradual increase of positive reactions were observed as the infection period of C. sinensis was prolonged. In other hand, the reaction of 10Kd hand did not occurred when 26th week sera was tested. 4) The positive reactions using antigens of 2 weeks worm, especially on 40 and 24Kd bands, were most strong and sharply demarcated compared to those of 3~5 weeks worm antigen.

• 대한예방한의학회지
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• 제1권1호
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• pp.126-136
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• 1997

To procide basic data for improvement of oriental medical care system, the questionnaire interview was carried out with community peoples, over 20 years old, selected randomly in Seoul, Pusan, Taegu and Taejon err. from 10th Mar. to 20th Apr. 1996. The result were summarized as follows: 1. In the general characteristics of subjects, the highest portion of each part was 52.4% of male, 22.4% of thirties, 37.1% of college graduates, 19.1% of married, 30.6% of town dwellers, 63.3% of muddle social class, 26.6% of housewife, 19.3% of student, 16.6% officer and 11.6% of professional technician. 2. The portion of subjects agree to open oriental clinic in western medicine hospital was 60.0%, that of disagreement was 20.1%, Among 60.0% of agreement group, the high rate was showed in female, fifties, middle school graduates, unemployed, middle social level. 3. The rate of positive responses in system of a herb specialist was 64.7%, that of negative responses was 11.6%. Among positive responses, the groups of high rate were male. twenties, above college graduates, student, middle-high social level and city dwellers. 4. In the question whether a pack of herb medicine should be included in medical insurance or not, the rate of agreement was 74.3%, that of disagreement was 4.1%. Amount agreement subjects, the high rate was showed in male, young age, high educated, city dwellers, professional technician middle social class. 5. In the cost of oriental medical care, the portion was divided by 70.3% of expensiveness,25.6% of moderate, 4.1% of low price. among 70.3% of high price, the high rate was in female, forties, agrolivestock-fishery, and town dwellers. 6. In the question what the herb doctor should do for the improvement of oriental medicine, the highest rate was 54.2% in further study. The next was 23.0% in need of western medical and 9.1% in no complain in present situation. Among 54.2% of further study, the high rate was showed in male, forties, high school graduate, profession technician, high social level, christian, married and city dwellers. 7. About institution of oriental care, 86.8% of subjects answered to need of improvement, 8.0% of them replied no problem as present. Amount 86.8% of subjects, the high rate was showed in male, twenties, above college graduate, sales, singles, high social level and city dwellers. 8. About necessity of western medical care instrument in oriental medical hospital, the rate of sightly need was 47.5%, inevitably need was 37.7%, no need was 6.3%, the Positive subjects were showed high rate in male, officer, singer, the younger age, the higher educated, better social level and city dwellers. These results might be useful information for establishing of oriental medical care policies, which open oriental medical clinic in western medical hospital, equip western medical care instrument in oriental medical hospital, improve oriental medical care instrument carry out a herb specialist system, balance the resonable medical care cost and effort for further study & research on oriental medicine to satisfy increasing need of oriental medicine.

• 가정∙방문간호학회지
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• 제6권
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Parasites, Hosts and Diseases
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• 제51권6호
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• pp.727-733
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• 2013

Despite the existence of effective anthelmintics, parasitic infections remain a major public health problem in Southeast Asia, including Thailand. In rural communities, continuing infection is often reinforced by dietary habits that have a strong cultural basis and by poor personal hygiene and sanitation. This study presents a survey of the prevalence of intestinal parasitic infections among the people in rural Thailand. The community-based cross-sectional study was conducted in villages in Khon Kaen Province, northeastern Thailand, from July to August 2013. A total of 253 stool samples from 102 males and 140 females, aged 2-80 years, were prepared using formalin-ethyl acetate concentration methods and examined using light microscopy. Ninety-four individuals (37.2%) were infected with 1 or more parasite species. Presence of parasitic infection was significantly correlated with gender (P=0.001); nearly half of males in this survey (49.0%) were infected. Older people had a higher prevalence than younger members of the population. The most common parasite found was Opisthorchis viverrini (26.9%), followed by Strongyloides stercoralis (9.5%), Taenia spp. (1.6%), echinostomes (0.4%), and hookworms (0.4%). The prevalence of intestinal protozoa was Blastocystis hominis 1.6%, Entamoeba histolytica 0.8%, Entamoeba coli 0.8%, Balantidium coli 0.4%, Iodamoeba b$\ddot{u}$tschlii 0.4%, and Sarcocystis hominis 0.4%. Co-infections of various helminths and protozoa were present in 15.9% of the people. The present results show that the prevalence of parasitic infections in this region is still high. Proactive education about dietary habits, personal hygiene, and sanitation should be provided to the people in this community to reduce the prevalence of intestinal parasite infections. Moreover, development of policies and programs to control parasites is needed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4379-4386
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• 2013

Projection of cancer incidence is essential for planning cancer control actions, health care and allocation of resources. Here we project the cancer burden at the National and State level to understand the magnitude of cancer problem for the various calendar years from 2011 to 2026 at 5-yearly intervals. The age, sex and site-wise cancer incidence data along with populations covered by the registries were obtained from the report of National Cancer Registry Programme published by Indian Council of Medical Research for the period 2001-2004. Pooled age sex specific cancer incidence rates were obtained by taking weighted averages of these seventeen registries with respective registry populations as weights. The pooled incidence rates were assumed to represent the country's incidence rates. Populations of the country according to age and sex exposed to the risk of development of cancer in different calendar years were obtained from the report of Registrar General of India providing population projections for the country for the years from 2001 to 2026. Population forecasts were combined with the pooled incidence rates to estimate the projected number of cancer cases by age, sex and site of cancer at various 5-yearly periods Viz. 2011, 2016, 2021 and 2026. The projections were carried out for the various leading sites as well as for 'all sites' of cancer. In India, in 2011, nearly 1,193,000 new cancer cases were estimated; a higher load among females (603,500) than males (589,800) was noted. It is estimated that the total number of new cases in males will increased from 0.589 million in 2011 to 0.934 million by the year 2026. In females the new cases of cancer increased from 0.603 to 0.935 million. Three top most occurring cancers namely those of tobacco related cancers in both sexes, breast and cervical cancers in women account for over 50 to 60 percent of all cancers. When adjustments for increasing tobacco habits and increasing trends in many cancers are made, the estimates may further increase. The leading sites of cancers in males are lung, oesophagus, larynx, mouth, tongue and in females breast and cervix uteri. The main factors contributing to high burden of cancer over the years are increase in the population size as well as increase in proportion of elderly population, urbanization, and globalization. The cancer incidence results show an urgent need for strengthening and augmenting the existing diagnostic/treatment facilities, which are inadequate even to tackle the present load.

• 의료법학
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• 제9권1호
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• 한국융합학회논문지
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• 제12권5호
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• pp.373-383
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• 2021

우리 사회는 빠른 속도로 고령화가 진행되고 있다. 이러한 초고령화 사회에서는 의료비 증가도 늘어나고 있으며 이 상황은 사회보장제도의 지속가능성을 저하시키는 국가적인 문제로 인식되고 있다. 이를 해결하기 위해 노인 건강관리를 위한 다양한 서비스가 추진되어왔지만 대부분 취약계층, 만성질환 발병 후 건강관리에 집중해 왔으며 예방차원의 건강관리는 부족하였고 대부분 시범사업으로 그치고 있는 것이 현실이다. 이에 본 논문에서는 국내외 노인대상 건강관리 서비스의 현황을 분석하고 이를 근거로 한계점과 개선점을 분석하여 IoT 기반의 토탈실버케어센터 구축을 제안하였다. IoT 기반의 토탈실버케어센터는 다양한 센서, 의료기기, 스마트밴드 등을 통해 노인들의 건강상태를 편리하게 모니터링 할 수 있으며, 이를 바탕으로 긴급히 방문해야 하는 사용자를 구분하여 간호제공자의 시간절약 및 업무의 효율화를 통해 간호서비스의 질을 향상시킬 수 있다. 또한 사용자의 건강상태 변화가 있는 경우 건강간호 중재를 적시에 제공할 수 있을 뿐만 아니라 실시간 영상시스템을 통해 정신적인 어려움을 극복하는데 도움을 줄 수 있다.

• 농촌의학ㆍ지역보건
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• 제21권1호
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• pp.61-73
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• 1996

본 조사는 포항시민의 환경에 대한 인식과 환경오염실태를 조사 분석하여, 이를 통하여 포항시의 환경정책을 펴 나가는 데 기초자료로 활용할 목적으로 읍 면 동의 시청업무 당당 공무원의 면담조사를 통하여 1995년 9월 6일부터 9월 20일까지 포항지역에 거주하고 있는 만 20세이상의 남여 1,059명을 대상으로 하였다. 통합포항시의 가장 중요한 당면문제는 응답자의 47.3%가 교통문제를 꼽고 있으며 다름으로 환경문제가 22.7%, 문화시설문제 11.6%, 식수문제 9.9% 교육문제 5.1%, 민생치안문제 2.1% 순으로 나타났다. 환경오염 책임에 대한 질문에서 응답자의 55.1%가 시민각자에게 책임이 있다고 대답했다. 가정에서 배출되는 쓰레기중 음식물 쓰레기 48.1%, 문화생활 쓰레기 21.8%, 재활용가능 쓰레기 15.6%, 1회용품 14.5% 순으로 나타났다. 규격봉투를 사용시 불편한 점은 66.9%가 봉투가 잘 찢어지는 재질에 문제가 있다고 했다. 수도물에 대한 이상 경험 조사에서 '이물질발생'과 '앙금이 생긴다'가 가끔 또는 자주 있다고 반응했다. 현재 식수로 사용하고 있는 실태를 조사한 결과 약수를 떠와서 마시는 사람이 45.9%로 가장 않았고, 수도물 26.7%, 지하수 17.0%, 생수(사서 마심) 9.3% 순으로 나타났다. 포항시의 공기오염원에 대한 조사에서 78.0%가 포항제철을 비롯한 연관단지를 들고 있으며, 16.6%가 자동차 매연 및 가스, 공사장 먼지 1.7% 순으로 나타났다. 남구지역은 호흡 장애가 더 많았고, 북구지역은 시야방해, 악취발생피해가 유의하게 높았다(P<0.05). 포항시의 수질오염의 주원인에 대해서, 공장폐수 56.2%, 가정하수 36.4%, 축산폐수 5.6% 순으로 나타났다. 북구지역 남구지역은 자동차소음, 남구지역은 오후에 공장과 항공기 소음 공해를 호소했다(P<0.05).

• 농촌의학ㆍ지역보건
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• 제38권1호
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• pp.1-13
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• 2013

본 연구에서는 국민건강영양조사자료를 이용하여 IDF 기준에 의한 우리나라 20세 이상 성인의 대사증후군 유병률과 관련 요인을 규명하고자 시행되었다. 2010년 제5차 국민건강영양조사에 참여한 5670명의 자료를 이용하였다. 본 연구에서 자료 분석은 SAS 9.2 통계분석프로그램을 사용하였으며, 분석 시 복합표본설계를 이용하여 표본추출한 자료에 적용하는 SAS 명령어를 사용하였으며, 표본 추출률을 반영한 설계가중치, 무응답률, 사후 층화, 극단 가중치 처리단계를 거쳐 최종 산출된 개인가중치를 모두 적용하였다. 인구학적 특성, 생활습관, 가족력 등에 따른 모집단의 대사증후군의 유병률 추정치와 집단간 유병률의 차이를 비교하였고, 대사증후군 관련 요인을 파악하기 위하여 교차비 추정치와 이의 95% 신뢰구간을 구하였다. 우리나라 성인의 대사증후군 유병률은 18.8%였다. 인구학적 특성별로 대사증후군 유병률을 살펴보면, 남성 16.8%, 여성 20.7%였다. 20대 연령은 4.5%, 70대는 43.1%로 연령이 많을수록 대사증후군 유병률은 유의하게 높았으며, 교육수준이 초등학교인 경우 38.0%, 대학교 졸업은 12.9%로 교육수준이 낮을수록 대사증후군 유병률이 높았다. 전문관리직인 경우에 12.8%, 농업 및 단순 노무직인 경우 20.4%, 무직인 경우 21.8%로 직업에 따라 대사증후군 유병률에 차이가 있었고, 미혼인 경우 대사증후군 유병률은 5.5%로 가장 낮고, 이혼 또는 별거인 경우는 대사증후군 유병률이 40.6%였다. 알코올 의존문제가 있는 경우 23.6%의 대사증후군 유병률을 보였고, 체질량 지수가 25이상인 경우에 대사증후군은 43.7%로 나타났다. 대사증후군 유병률에 대한 교차비와 95% 신뢰구간을 살펴보면, 여성의 교차비가 1.59(1.20-2.11), 20대 연령집단을 기준으로 하였을 때, 50대의 교차비가 3.95(2.11-7.37), 60대는 5.62(2.98-10.61), 70세 이상은 10.56(5.25-21.25)으로 나타났다. 초졸 학력에 비해 고졸학력의 교차비가 0.52(0.37-0.74), 사무직이 전문직과 비교하여 2.14(1.27-3.60), 기혼자에 비해 이혼하거나 별거중인 군의 교차비가 1.72(1.15-2.59), 알코올 의존문제가 있는 경우 교차비가 1.86(1.16-2.98), 비만군이 정상 체중군과 비교하여 14.08(10.62-18.70)으로 유의한 관련성을 보였다. 그 외에 다른 요인들에 의한 대사증후군 유병위험은 통계적으로 유의하지 않았다. 본 연구는 IDF 기준을 적용하여 우리나라 성인의 대사증후군 유병률과 대상자의 특성에 따라 대사증후군 유병률을 파악하고, 교차비를 산출하여 관련요인을 확인하였다는 점에서 의미가 있다. 향후 연구에서는 여러 가지 대사증후군 진단기준을 적용하여 우리나라와 다른 나라의 대사증후군 유병률과 관련요인을 비교하고 우리나라 인구집단에 더 적합한 진단기준이 무엇인지를 확인하는 연구가 필요할 것으로 사료된다. 또한 본 연구는 단면조사 자료를 이용한 분석이므로 대사증후군 관련 요인은 시간적 전후관계를 파악할 수 없었다. 향후 연구에서 전향적 조사 자료를 이용할 필요가 있다고 사료되며, 생활습관을 보다 정확하게 평가할 수 있는 도구를 이용하여 측정할 것을 제안한다.