• 한국노년학
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• 제29권1호
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• pp.149-175
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• 2009

본 연구는 제도 시행 초기인 2008년 10월 현재 여러 부분에서 동시다발적으로 발생하는 노인장기요양보험 재가서비스의 다양한 문제점과 원인을 파악하여 분석한 후, 그에 대한 개선방안을 마련하는 데 목적이 있다. 연구방법은 크게 선행 연구된 2차 자료를 분석하는 문헌조사와 관련 전문가를 대상으로 하는 서베이 조사방식을 통해 진행되었다. 자료의 분석은 길버트와 스펙트의 정책분석틀에 근거하여 대상자체계, 급여(서비스)체계, 재정체계, 전달체계의 영역으로 구분하여 분석하였다. 본 연구를 통해 도출된 노인장기요양보험 재가서비스의 문제점은 첫째, 대상자체계에서는 가입대상자와 서비스 대상자의 불일치, 수요자 추계의 문제점 및 등급판정 관련 문제 등이 있으며, 둘째, 서비스 체계에서는 서비스 인력의 전문성 결여, 방문요양기관 인력기준 완화로 인한 서비스 질 저하, 서비스 이용시간 제한의 불합리성 및 방문요양 수가의 등급별 균등지급의 문제가 있는 것으로 나타났다. 셋째, 재정체계에서는 본인부담금과 비급여항목으로 인한 이용자 부담과중, 기존운영비 지원 기관에 대한 지원중단으로 인한 서비스의 사각지대 발생 및 구조조정 및 파트타임 증가로 서비스 질 저하 문제가 나타났으며, 마지막으로 전달체계에서는 서비스의 질 관리체계 미비, 재가장기요양기관 남설로 인한 과다 경쟁, 영리적 운영으로 인한 서비스 공공성과 질저하, 대상자 모집의 어려움으로 인한 운영난 및 요양보호사 교육기관 난립으로 인한 과다배출과 부실교육 등의 문제가 있는 것으로 조사되었다. 이상의 결과에 근거하여 다음과 같이 제언하였다. 첫째, 장기적으로 가입자와 서비스 대상자를 일치시킬 필요가 있다. 둘째, 공단직원의 전문성 향상 및 인력충원이 필요하며, 셋째, 등급외자에 대한 효율적 서비스 연계, 넷째, 체계적인 요양보호사 관리시스템 구축 및 서비스 표준지침서 개발, 다섯째, 서비스 내용과 절차에 관한 일부 법규의 수정이 필요하며, 여섯째, 본인부담금의 일부 조정도 필요하다. 일곱째, 노인복지법에 의한 재가시설에 운영비를 지원해야 하며, 여덟째, 관리감독 기관의 모니터링 시스템 강화 및 서비스 제공 기관과 서비스 인력에 대한 평가 체계 마련, 그리고 마지막으로 기관설치 기준의 강화가 필요하다.

• Asian-Australasian Journal of Animal Sciences
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• 제16권11호
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• pp.1666-1672
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• 2003

The objective of this study was to evaluate the potential of an alumninosilicate clay, marketed under the trade name Biotite V, to improve growing-finishing pig performance and to determine its effects on nutrient digestibility and excretion. Sixty crossbred pigs (22.3${\pm}2.7kg$, Camborough 15 Line female${\times}$Canabred sire) were assigned on the basis of sex, weight and litter to one of four dietary treatments in a $2{\times}4$ (two sexes and four treatments) factorial design experiment. The experimental diets were based on barley and soybean meal and contained 0, 0.25, 0.5 or 0.75% biotite during the growing period (22.3-60.5 kg) and 0, 0.5, 1.0 or 1.5% biotite during the finishing period (60.5-110.3 kg). Each pig was allowed access to its own individual feeder for 30 min twice daily (07:00 and 15:00 h). Individual pig body weight, feed consumption and feed conversion were recorded weekly. The pigs were slaughtered at a commercial abattoir when they reached an average weight of 110.3 kg. Carcass weight was recorded and dressing percentage calculated. Carcass fat and lean measurements were obtained with a Destron PG 100 probe between the 3rd and 4th last ribs, 70 mm of the midline. Total tract digestibility coefficients for dry matter, energy, nitrogen and phosphorus were determined using three males and three females per treatment starting at an average weight of $52.2{\pm}3.8kg$. These pigs were housed under identical conditions as those used in the growing stage and were fed the same diets modified only by the addition of 0.5% chromic oxide as a digestibility marker. Over the entire experimental period (22.3-110.3 kg), daily gain was unaffected (p>0.05) by the inclusion of biotite in the diet. There was a cubic response for feed intake (p=0.06) and a quadratic response (p=0.07) for feed conversion due to biotite. Feeding biotite produced no significant (p>0.05) linear or quadratic effects on any of the carcass traits measured. Dry matter digestibility decreased linearly (p=0.02) with increasing levels of biotite in the diet. However, digestibility coefficients for energy, nitrogen and phosphorus were unaffected (p<0.05) by biotite inclusion. Lactobacilli and enterobacteria numbers were unaffected by inclusion of biotite while Salmonella was not detected in any of the fecal samples. The overall results of this experiment indicate that biotite inclusion did not reduce fecal excretion of nitrogen or phosphorus and failed to improve nutrient digestibility. Neither growth rate nor carcass quality was improved while a modest improvement in feed conversion was observed at lower levels of inclusion. Based on the results of this experiment, it would be difficult to justify the routine inclusion of biotite in diets fed to grower-finisher pigs. Whether or not a greater response would have been obtained with pigs of a lower health status is unknown.

• 대한지역사회영양학회지
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• 제25권3호
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• pp.204-213
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• 2020

Objectives: This study examined the dietary characteristics and needs for community kitchens among young adults of single-person households in Seoul according to the cooking attitude. Methods: During April 2018, an online survey was conducted on young adults of single-person households in their 20s and 30s residing in Seoul. The respondents were classified into the more positive cooking attitude group (More Positive Group; n=152, mean=4.11) and the less positive cooking attitude group (Less Positive Group; n=190, mean=3.03) based on the mean score (3.51) of the 4-item 5-point Likert scales measuring the cooking attitude. The responses of the two groups were compared. Results: Approximately 90% of the More Positive Group had the cooking ability to prepare ordinary meals or more advanced cooking skills, whereas only 61% of the Less Positive Group had such skills. Approximately a half of the More Positive Group cooked at home three times a week or more; only 30% of the Less Positive Group did so, and more than 30% of the group seldom cooked. The More Positive Group had higher mean scores in the levels of satisfaction with dietary life and care for food safety and nutrition than the Less Positive Group. Approximately 30% of all the respondents expressed their needs for community kitchens. The most frequently answered reason for such needs was "being able to have a meal with others". Conclusions: The young adults of single-person households with a more positive cooking attitude possessed a higher cooking ability, cooked more often, and cared more about food safety and nutrition than those with a less positive cooking attitude. There were moderate needs for community kitchens among young adults of single-person households living in Seoul. Therefore, societal efforts to improve their cooking attitude would be meaningful for improving their quality of dietary life. Cooking lessons or social dining programs based on community kitchens could be an option.

• Asian-Australasian Journal of Animal Sciences
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• 제14권7호
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• pp.986-993
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• 2001

In balance experiments with rats either 25 or 50% of the casein protein in the control diet was replaced with one of the following eight sun-dried tropical biomass products: water spinach plants (WS) (Ipomoea aquatica Forsk), leucaena leaves (LL) (Leuceana leucocephala), duckweed plants (DW) (Lemma minor L.), groundnut foliage (OF) (Arachis hypogaea L.), trichantera leaves (Tric) (Trichantera gigantea), indicago leaves (Ind) (Indigofera hirsuta), mungbean foliage (Mb) (Phaseolus aureus), and cassava leaves (CL) (Manihot esculenta Crantz). The experiment included 102 rats with six individuals per treatment group. In three of the 16 biomass treatment groups, feed intake and weight gain of the rats were unacceptably low, and therefore they were excluded from the statistical evaluation, The crude protein (CP) content of the biomass products varied between 20.9% (Tric) and 33.2% (DW), whereas the content of NDF varied between 18.5% (Ind) and 32.2% (DW) of dry matter (DM). The total content of essential amino acids (g/16 g N) was comparable with that of alfalfa meal, except for GF and Tric, which were inferior. Between plant species, differences in dietary digestibility of organic matter (dOM) and CP (dCP) were observed (p<0.001). Also, the replacement level negatively influenced dOM and dCP (p<0.001). The lowest values for dOM (p<0.001) were observed for diets including biomass products with the highest content of NDF (OF, Tric, Mb, LL). Digestibility of CP was negatively affected by level of protein replacement. Significant (p<0.001) differences were found in N-retention and biological value among diets with different biomass products. The most favourable overall results were obtained for DW, WS and CL. The main factors affecting the nutritive value of the diets tested were their NDF content, dCP and AA profile of the biomass. Also antinutritive component(s) may have influenced the process of digestion and metabolism of some of the biomass products.

• 벤처창업연구
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• 제10권2호
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• pp.59-67
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• 2015

본 연구는 서울시 Y구의 노인복지관 및 종합사회복지관에서 운영하고 있는 경로식당의 서비스요인(위생상태, 종사자, 편리성, 음식, 접근성, 환경, 사회적 관계)이 재이용의도에 미치는 영향력과, 이 과정에서 급식만족도가 갖는 매개효과를 파악하고자 하였다. 연구대상은 경로식당을 이용하는 65세 이상 노인으로, 총 310명이 최종 유효표본으로 적용되었다. 분석은 SPSS 19.0을 활용하였고, 연구결과 첫째, 인구사회학적 특성 중 임대주택/기타, 서비스요인의 모든 요인이 급식만족도에 영향을 미치는 것으로 나타났다. 둘째, 인구사회학적 특성 및 서비스요인, 급식만족도와 재이용의도의 관계를 파악한 결과, 인구사회학적 특성 중 학력, 서비스요인 중 모든 요인이 재이용의도에 영향을 미치는 것으로 나타났다. 셋째, 인구사회학적 특성 및 서비스요인과 재이용의도의 관계에 있어 급식만족도의 매개효과를 검증한 결과, 서비스요인 중 종사자와 급식만족도가 재이용의도에 정(+)의 영향을 미치는 것으로 나타났다. 따라서 경로식당 서비스의 질적 제고 및 만족도 향상을 위한 각 지자체의 지속적인 관심과 투자, 노력이 요구되며, 나아가 급식환경 개선을 위한 다각적 방법이 모색되어야 할 것이다.

• 대한지역사회영양학회지
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• 제4권2호
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• pp.207-218
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• 1999

The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enhance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk＋education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk＋education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk＋education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk＋education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk＋education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk＋education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model $R^2$=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk＋education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducing drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.

• 대한영양사협회학술지
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• 제5권1호
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• pp.74-84
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• 1999

The purpose of this study was to investigate a plan of middle/high school foodservice systems which could properly provide nutrition for juveniles' health. Questionnaires were developed and distributed to: 245 middle schools with 271 parents, 328 students, 180 teachers, and 345 administrators; 163 high-schools with 223 parents, 466 students, 179 teachers, and 163 administrators in Seoul and Kyunggi province. The results of this study were as followed. For the desirable feeding type as in-school meal plan, 62.2% responded to the current elementary school feeing type:10.3% responded to a lunch-box prepared at home; and 38.0% responded to free dining out type. For a feeding operation type, school administrators, teachers and parents favored the current school feeding systems in elementary schools with proportion of 68.2%, 47.7%, and 87.6% as respectively. Also, 20.3% of school administrators, 22.6% of teachers, and 6.9% of parents preferred contract management. A total of 27.6% of teachers, 9.2% of school administrators, and 3.7% of parents responded to a lunch-box prepared at home. There was a significant difference between the responses for establishing the main body of financial burden to solve the problem of financial burden which could be the most obstacle to bring middle/high school feeding system into operation. For the management of school feeding systems when brought into operation, 88.7% out of 470 responded schools and 89.9% out of 227 responded teachers reported that an expert should manage school feeding systems. For futuristic direction, an effective joint cooking type between schools which may be the way to solve the difficulties in securing the appropriate space and to decrease the financial burden, the problem of transportation for delivering feeding products, low quality of feeding, and sanitation can occur. Therefore, the distance between schools which operate a joint cooking system will affect as a major factor. Furthermore, concrete examination of plans for introduction of various types of school feeding and institutional devices for management system and supervision of operation should become a condition precedent.

• 대한지역사회영양학회지
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• 제10권1호
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• pp.101-110
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• 2005

This survey was carried out to obtain the information concerning nutritional status, including factors of food habits and nutrient intake of the long-lived elderly men and women living in Ganghwa-gun. In order to assess the quality of dietary intake among the elderly, a survey was conducted during December 2003 of 103 subjects who were over 85 years of age. Dietary nutrient intake data were obtained through the 24 hr recall method. Chi-square test and t-test were the main data analysis method. Their dietary habits such as three meals a day and a regular meal time have shown that they have generally good eating habits. Average daily calorie intake ($\%$ RDA) was 1233.2 kcal ($68.8\%$) for male and 1215.8 kcal ($75.8\%$) for female which were lower than the Recommended Dietary Allowances (RDA) for Koreans. Energy intake of females got closer to RDA than that of male. Protein intake was 49.3 g for male and 46.9 g for female (which was $82.3\%$ RDA for male and $85.1\%$ RDA for female) for elderly person, the proportion of animal protein to total protein intake were $45.2\%$ for male and $39.0\%$ for female. Average CPF ratio of energy intake for both male and female were 68.7 : 16.1 : 15.2 and 69.6 : 15.4 : 15.0. SFA : MUFA : PUFA ratio of the subject was 0.78 : 1.03 : 1.00 for male and 0.64 : 0.92 : 1.00 for female. Calcium intakes for both males and females were 321.3 mg and 377.2 mg. Vitamin A was the nutrient found to be least sufficient. Mean daily intakes of most of the vitamins and minerals for both males and females were lower than RDA except vitamin C and Zn for female, especially $\%$ RDAs of vitamin A, Ca for male and vitamin A for females were less than $50\%$ of RDA. In conclusion, long-lived elderly in Ganghwa areas did not consume enough nutrients quantitatively as well as qualitatively, especially Ca, Fe, vitamin A, vitamin $B_2$ and vitamin E. These results suggest that nutritional guidelines for older Koreans should focus on the maintenance of adequate energy intake. In addition, selection of foods with high protein and calcium, such as dairy food, should be emphasized, particularly in the long-lived elderly.

• 대한예방한의학회지
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• 제24권2호
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• pp.71-82
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• 2020

Objectives : The purpose of this study is to evaluate clinical utilization by measuring compliance with the use of mobile health applications (AtopyPHR developed in a previous study) for patients with atopic dermatitis. Methods : Based on the AtopyPHR and the input period and frequency survey results for each symptom item, a scenario for measuring compliance was derived. The study period was 4 weeks. Participants installed AtopyPHR app and Telegram app on their smartphones, conducted user training on the app, and recorded symptoms using the app for 4 weeks. At the 2nd and 4th week visits, the AtopyPHR data recorded by the user can be viewed on the web page and used for medical decision. Compliance was analyzed by the date the symptoms were recorded. Results : There were 28 participants, all (100%) were compliant, and the compliance was 96.8. The patients were 1 to 18 years old, and the average age was 8.2±5.7 years, 10 males and 18 females. The actual date of participation in recording symptoms was 28.6±0.56 on average. Compared to Week 1, compliance decreased at Week 2, and Week 4 had the highest compliance. Daily check, daily emotion, stool/urine/sleep, and meal management showed high compliance, SCORAD and quality of life were higher than required to record. Conclusions : AtopyPHR was effective in compliance. The results of this study could be used to collect personal health data in daily life through the AtopyPHR, improving participant compliance. It is considered to be meaningful because it measured the compliance with the symptom record actually recorded using the mobile app rather than a questionnaire. This study may be useful not only for personal health care but also for medical decisions, as opinions are given by experts who treat atopic dermatitis.

• 미생물학회지
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• 제49권1호
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• pp.90-94
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• 2013

최근 국내외로 MRSA, VRE 등의 다약제 내성 균주의 분리빈도가 매년 급증하고 있고, 시판하고 있는 항생제 중 가장 효능이 강력한 제품들도 다약제 내성균 출현율이 증가함에 따라 이를 극복할 새로운 항생제의 개발이 요구되고 있다. 다약제 내성균에 유효한 항생제의 예로 vancomycin, teicoplanin, linezolid가 다약제 내성균에 유효한 의약품으로 쓰이고 있으며 방선균이나 Bacillus 등의 배양액에서 다약제 내성균에 유효한 물질의 발굴에 대한 연구가 활발히 진행되고 있다. 특히 넓은 항균범위를 가지고, 체내 축척이 적은 항생물질에 개발에 대한 연구가 활발히 진행되고 있다. 본 연구진은 국내 서해안의 갯벌에서 Bacillus 속 미생물을 수종 분리하였으며, 다약제 내성균에 항균 활성을 지니는 MP56 균주를 선발하였고, 균주 동정 결과 Bacillus subtilis 와 99.93%의 16S rRNA 상동성을 나타냄을 본 연구에서 확인하였다. 국내외 연구진에 의하여 다수의 Bacillus 속 미생물이 분리된 바가 있으며, 항균 물질에 대한 연구도 보고된 바 있다. 그러나 국내 갯벌에서 분리된 Bacillus 속 균주 배양액의 임상균주에 대한 항균 효능 평가에 관한 연구는 보고된 바가 없다. 본 연구에서 Bacillus 속 균주 MP56 배양액이 국내에서 분리한 임상 균주인 MRSA, IMP 균주에 대해 우수한 항균 활성을 나타내어 최적 발효조건과 항균범위를 본 논문을 통해 보고하였으며, 추후 MP56 균주 배양액에서 항균물질의 분리, 정제 및 구조 규명을 위한 후속 연구를 수행 할 예정이다.