• 한국직업건강간호학회지
• /
• 제4권호
• /
• pp.5-29
• /
• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of Nutrition and Health
• /
• 제50권1호
• /
• pp.32-40
• /
• 2017

소아기의 과체중 혹은 비만은 성인기의 만성질환의 onset 위험을 증가시키는 대사이상을 야기하므로 관련된 obesogenic 환경 (나트륨 섭취 등)을 제어할 필요가 있다. 본 연구에서는 소아기의 과도한 소금섭취가 신장의 재흡수 기능을 조절하는 SLC12A3기능장애로 이어져 고혈압 및 비만을 야기하는지를 확인하고자 하였다. 서울 구로구에 소재한 8~9세 초등학생 752명 (남학생: 379명 여학생: 373명)을 대상으로 BMI가 85 percentiles이상을 비만군으로, 이하를 정상군으로 분류하였다. SLC12A3 rs11643718 유전자형은 GG (wild)와 GA + AA로 분류하여 신체계측, 혈액검사, 식이조사 등을 비교분석하였다 대상자의 남아가 여아보다, 비만군이 정상군보다 신체지수, 혈액지수, 식사섭취량이 여아보다 높았다. 남녀 모두 비만군에서 높은 TG와 낮은 HDLc를 보여주었지만 비만한 남아는 혈압에, 비만한 여아는 인슐린저항성에 더 민감한 반응을 보였다. 비록 남녀차이는 있지만 비만군 및 정상군 모두에서 SLC12A3의 GA + AA형이 GG형보다 혈압과 체중이 높았다. GG 유전자형을 가지고 있는 소아는 혈중 LDLc, FBS, insulin등이 높거나 식이 콜레스테롤섭취가 증가할수록 비만이 될 위험도가 증가하였고 엽산의 섭취가 증가할수록 비만위험도는 감소하였다. 반면, GA + AA 유전자형을 가지고 있는 소아는 고나트륨 (> 4,000 mg/day)섭취시 비만위험도 (odd ratio)가 15.57배 증가하였고 남아 (22.84배)에서 더욱 위험도가 높았다. HDLc의 경우는 유전자형에 관계없이 증가할수록 비만위험도가 감소하였다. 결론적으로 SLC12A3 (rs11643718) 유전자의 A allele를 가진 형이 나트륨에 특이적으로 반응하여 과체중위험을 증가시키는 것으로 생각된다.

• 한국농공학회지
• /
• 제26권2호
• /
• pp.69-84
• /
• 1984

This study was carried out to investigate the time distribution of single storms and to establish the model of storm patterns in korea. Rainfall recording charts collected from 42 metheorological stations covering the Korean peninsula were analyzed. A single storm was defined as a rain period seperated from preceding and succeeding rainfall by 6 hours and more. Among the defined single storms, 1199 storms exceeding total rainfall of 80 mm were qualified for the study. Storm patterns were cklassified by quartile classification method and the relationship between cummulative percent of rainfalls and cummulative storm time was established for each quartile storm group. Time distribution models for each stations were prepared through the various analytical and inferential procedures. Obtained results are summarized as follows: 1. The percentile frequency of quartile storms for the first to the fourth quartile were 22.0%, 26.5%, 28.9% and 22.6%, respectively. The large variation of percentile frequency was show between the same quartile storms. The advanced type storm pattern was predominant in the west coastal type storm patterns predominantly when compared to the single storms with small total rainfalls. 3. The single storms with long storm durations tended to show delayed type storm patterns predominantly when compared to the single storms with short storm durations. 4. The percentile time distribution of quartile storms for 42 rin gaging stations was estimated. Large variations were observed between the percentiles of time distributions of different stations. 5. No significant differences were generally found between the time distribution of rainfalls with greater total rainfall and with less total rainfall. This fact suggests that the size of the total rainfall of single storms was not the main factor affecting the time distribution of heavy storms. 6. Also, no significant difference were found between the time distribution of rainfalls with long duration and with short duration. The fact indicates that the storm duration was no the main factor affecting the time distribution of heavy storms. 7. In Korea, among all single storms, 39.0% show 80 to 100mm of total rainfall which stands for the mode of the frequency distribution of total rainfalls. The median value of rainfalls for all single storms from the 42 stations was 108mm. The shape of the frequency distribution of total rainfalls showed right skewed features. No significant differences were shown in the shape of distribution histograms for total rainfall of quartile storms. The mode of rainfalls for the advanced type quartile storms was 80~100mm and their frequencies were 39~43% for respective quartiles. For the delayed type quartile storms, the mode was 80~100mm and their frequencies were 36!38%. 8. In Korea, 29% of all single storms show 720 to 1080 minutes of storm durations which was the highest frequency in the frequency distribution of storm durations. The median of the storm duration for all single storms form 42 stations was 1026 minutes. The shape of the frequency distribution was right skewed feature. For the advanced type storms, the higher frequency of occurrence was shown by the single storms with short durations, whereas for the delayed type quartile storms, the higher frequency was shown gy the long duration single storms. 9. The total rainfall of single storms was positively correlated to storm durations in all the stations throughout the nation. This fact was also true for most of the quartile storms. 10. The third order polynomial regression models were established for estimating the time distribution of quartile storms at different stations. The model test by relative error method resulted good agreements between estimated and observed values with the relative error of less than 0.10 in average.

• Journal of Preventive Medicine and Public Health
• /
• 제28권4호
• /
• pp.845-862
• /
• 1995

모유수유를 시작하지 않는 산모의 특성과 모유수유 중단을 예측해주는 특성을 찾아내기 위하여 1년간 매달 전화면담으로 추적조사를 실시하였다. 등록대상자는 대구시의 대학병원 산부인과와 개업산부인과 각각 1개소에서 1991년 9월부터 11월까지 분만한 산모로서 최종분석에 이용된 자는 대학병원에서 166명, 개업산부인과에서 316명으로 총 482명이었다. 모유수유 중단은 고형식 유무에 관계없이 100% 인공수유로 전환하여 1주일 이상 지속하는 것으로 정의하였다. 대상자의 평균연령은 27.3세(표준편차 3.2)였다. 모유수유를 중단한 산모와 지속한 산모간의 특성차이는 다중지수회귀분석시 출신지, 직업, 출산방법, 모성의 건강을 위해 좋다고 생각되는 수유방법 등이었다. 한 달 이상 모유수유를 지속한 242명의 산모를 추적조사시에 모유수유 중단의 중앙값은 5개월이었으며 추적 대상자의 25%, 75%가 각각 3개월, 9개월에 모유수유를 중단하였다. Cox's proportional hazard model로 분석시 9년이하의 교육수준인 산모에 비하여 $10\sim12$년을 교육받은 산모는 2.63배(95% 신뢰구간 $1.50\sim4.60$), 13년 이상의 교육을 받은 산모는 3.55배(95% 신뢰구간 $1.99\sim6.33$)나 모유수유 중단을 할 가능성이 더 높았다. 전업 주부에 비하여 시간제 근무를 하는 주부는 1.99배(95% 신뢰구간 $0.86\sim4.57$) 모유수유 중단의 가능성이 더 높았고 취업 주부는 1.55배(95% 신뢰구간 $0.96\sim2.51$) 더 높았다. 이러한 결과는 모유수유를 시작하지 않는 것과 관련된 변수와 모유수유 중단과 관련된 변수들이 다를 수 있다는 사실을 시사해주며 모유수유 증진을 위한 전략 역시 출산 후 시기에 따라 달라져야 한다는 것을 시사해준다.

• 근관절건강학회지
• /
• 제3권1호
• /
• pp.37-49
• /
• 1996

The joint diseases threaten modern people's healthy life. They bring about a long pain, an anasarca, loss of joint function or even deformation and rigidity of joint, limiting people's ordinary activities much. The chronic joint patients may be subject to some hypochondria caused by anxiety for their life, social isolation, financial problem and physical disability. Therefore, this population should continue to be duely taken care of by medical personnels. In particular, nurses should adequately help these people to recover and improve their health through suitable adaptations. With such basic conceptions in mind, this study was aimed at reviewing these patients' conditions in their ordinary life before and after a plastic operation for artificial joint replacement as well as their satisfaction with their life. For this purpose, those patients who underwent some plastic operations for artificial joint replacement at university hospitals in Seoul from January 2, 1993 to June 30, 1995 were selected as the population of this study. Among them, 87 people were randomly sampled to answer a questionnaire designed specially. For the surveying tools, Jette's (1980) scale was applied to address the sample people's inconveniences experienced and supports received in their ordinary life, while the scale of Wood, Wylie & Sheafer was used to measure their satisfaction with their life. The collected data were analyzed for percentiles, means, SD, t-test and Pearson's correlations. The results of survey can be summarized as follows ; As a result of t-test the frequencies of other people's support before and after the plastic operation, it was disclosed that those who underwent the operation were supported less frequently. In addition, as a result of t-testing their satisfaction with life before and after the operation, it was found that the operation increased their satisfaction with life significantly. Meanwhile, as a result of t-test inconveniences, frequencies of supports and life satisfaction before and after the plastic operation for artificial knee replacement, it was disclosed that only the inconveniences were significantly reduced after the operation. In contrast, the t-test the variables before and after the plastic operation for artificial hip replacement, it was found that only the frequencies of other people's supports were significant reduced after the operation. Furthermore, the differences 6 months, one year and two years after the plastic operation for artificial joint replacement were t-tested on the variables. As a result, it was disclosed that people's inconvenience, frequencies of supports and life satisfaction were not improved 6 months after the operation but their frequencies of supports decreased significantly one year after, while their inconveniences and life satisfaction were significantly improved two years after. As a result of analyzing the variables with Pearson's correlations, inconveniences and frequency of supports were negatively correlated significantly with the life satisfaction. In conclusion, the plastic operation for artificial joint replacement significantly improved people's living inconveniences, reduced their frequency of other people's support and enhanced their satisfaction with life. To break don the plastic operation for artificial knee replacement improved patients' inconveniences, while the plastic operation for artificial hip replacement not only improved patients' inconveniences but reduced the frequencies of other people's support also. Finally, the finding that the plastic operation for artificial joint replacement brought about the improvement two years after suggests that this period is needed for the patients to adapt themselves to the post-operation conditions.