• 제목/요약/키워드: public health center

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원격의료서비스 수용요인의 구조적 관계 실증연구 (Structural Relationships Among Factors to Adoption of Telehealth Service)

  • 김성수;류시원
    • Asia pacific journal of information systems
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    • 제21권3호
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

일부 비만 초등학생을 위한 건강영양캠프의 효과 평가 (Evaluation of Nutritional Health Camp in Obese Elementary Students)

  • 전예숙;이지은;이용숙;배윤정;김미현;이윤신;김애정;승정자;최미경
    • 한국식품영양학회지
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    • 제20권1호
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    • pp.79-87
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    • 2007
  • 본 연구에서는 어린이 비만의 예방 및 치료방법의 일환으로 비만 어린이를 대상으로 영양 및 건강을 위한 기본 개념습득과 이를 응용할 수 있는 능력 향상을 위한 교육 프로그램을 구성하고 영양지식, 영양태도 및 자아만족도를 교육 전후 비교하여 건강영양캠프의 효과를 평가하였으며, 그 결과를 요약하면 다음과 같다. 캠프 참가 대상자의 평균 연령은 11.5세이었으며, 평균 신장과 체중은 141.9 cm와 52.1 kg이었고, 신장과 체중으로 산출한 비만도는 40.7%이었다. 1일 에너지 섭취량은 남자 어린이 1,522.4 kcal, 여자 어린이 1,494.9 kcal로 남자 어린이가 여자 어린이보다 다소 높았으나 유의한 차이는 없었다. 단백질, 지방, 당질 섭취량은 남자 어린이가 각각 59.5 g, 39.6 g, 232.1 g이었으며, 여자 어린이는 각각 57.8 g, 40.3 g, 227.5 g이었다. 전체 참가 어린이의 평균 무기질 섭취량은 칼슘 392.7 mg, 인 793.2 mg, 철 9.9 mg, 아연 7.2 mg이었으며, 비타민 섭취량은 비타민 A 530.7 ${\mu}$g, 비타민 B$_{1}$ 0.9 mg, 비타민 B$_{2}$ 0.9 mg, 비타민 C 49.1 mg, 엽산 169.3 ${\mu}$g이었다. 성격 검사를 실시한 전체 어린이 중에서 확실한 성격 유형이 나온 어린이는 15명이었다. 그 중 내향성(I)의 그룹은 4명이었고, 11명은 외향성(E)그룹으로 나타나 전체적으로 활달하면서도 적극적인 어린이들로 구성되었다는 것을 알 수 있었다. 아직 뚜렷하게 성격 유형을 결정하지 못한 나머지 28명의 어린이들은 하나 혹은 둘 이상의 U 밴드(undetermined: 결정되지 않은)를 가지고 있었다. 캠프 전 영양지식은 70.0점이었고 캠프 이후 76.5점으로 증가하였으나 유의한 차이는 없었다. 영양태도는 캠프 전 28.3점에서 캠프 이후 31.2점으로 유의하게 증가하였으며(p<0.001), 자아만족도는 캠프 전 32.8점에서 캠프 이후 35.1점으로 증가하였으나 유의한 차이는 없었다. 이상의 연구 결과를 종합할 때 초등학교 비만 어린이의 경우 칼슘, 엽산, 비타민 C, 비타민 B$_{2}$의 영양소에서 평균 필요량보다 부족하게 섭취하고 있는 비율이 높게 나타났으며, 영양교육 전과 비교하여 볼 때 영양태도 점수가 교육 후 유의하게 증가하였고, 유의적이지는 않으나 영양지식과 자아만족도도 증가하였다. 또한 성격 유형 검사 결과 아직 뚜렷하게 성격 유형을 결정하지 못한 어린이들의 비율이 높게 나타나 이러한 성격 유형의 결정 여부 및 각 유형을 참조하여 식생활에서 올바른 식생활 관리 능력과 바람직한 영양태도 및 지식을 습득할 수 있도록 하는 영양교육의 필요성이 높은 것으로 사료된다.

농촌 노인의 일.여가활동 유형에 따른 삶의 만족감 (Study on Life Satisfaction of Groups According to Farm Work and Leisure Activity in Rural Elderly)

  • 김종인;김윤정
    • 농촌지도와개발
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    • 제19권2호
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    • pp.321-353
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    • 2012
  • This study aims to find out ways of improving life satisfaction of rural elderly by investigating their work and leisure activity, two significant axis of the life in later life. For this purpose, researchers and one assistant researcher visited house, senior citizen's center and health center, in order to have interviews with senior citizen above 65, who are currently working in the field. The summary of the research findings are as follows; First, the average size of the farm land which each senior citizen works on is $9,237.92m^2$ and they mostly work for economic reason. During farming season, they work on average 8.62 hour per day. As primary reasons for why farming work is difficult, "insufficient income" was picked. In fact, the average annual income senior citizens earn from farming is about 15.4 million won. 49.1% of sample senior citizens work both on watered farm and farm, and they are engaged in farming 48.82 years on average, showing that most of their lives have been spent on farming. In spite of these difficulties, most senior citizens showed high intention to continue farming work further. Second, senior citizens turn out to spend their leisure time mostly on public leisure activities such as watching TV, hearing radio and gatherings with families, relatives. However, individual activities such as meditation, yoga, drawing and calligraphy turn out to be low because they require foundations to enjoy. Third, senior citizen in rural areas were divided into four groups by farm work and leisure activity: group separated from work and leisure activity(27.09%), group centered to leisure activity(24.42%), group centered to work(23.75%), and group integrated work and leisure activity(23.75%). Fourth, the groups were different depending on demographic characteristics. Namely, male senior citizen, higher educational level, living in elderly couple households, and satisfied with their economic level belonged to the group integrated work and leisure activity. But senior citizen aged above 65 years old and working for their livelihood belonged to the group centered to work, and most of female and senior citizen aged above 80 years old belonged to the group separated from work and leisure activity. Finally, as the result of analysis of differences in life satisfaction according to farm work and leisure activity of senior citizen in rural areas, the group integrated work and leisure activity, and group centered to leisure activity were higher in life satisfaction than the group separated from work and leisure activity, and group centered to work. The above result indicates that life satisfaction of senior citizen depends upon leisure activity rather than work.

선학초 추출물의 항산화 및 항암활성 (The Antioxidative and Antitumor Activity of Extracts of Agrimonia pilosa)

  • 민경진;송진욱;차춘근
    • 한국식품위생안전성학회지
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    • 제23권2호
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    • pp.149-156
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    • 2008
  • 선학초 메탄올 추출물을 유기용매를 이용하여 분획하고 각각의 분획별 항산화 및 항암 활성을 조사하였다. 항산화 활성으로 총페놀, 전자공여능, 아질산염 소거능을, 효소 저해 활성으로 XOase 저해 활성을 조사하였으며, 암세포인 HT-29, SNU-1, HeLa 세포에 대한 성장 저해 활성을 조사하여 기능성 식품으로의 개발 가능성을 알아보고자 하였다. 총 페놀 함량은 EtOAC와 BuOH 분획에서 39.89%, 39.56%로 가장 높았고, 전자공여능 또한 EtOAC 분획에서 92.90% ($500\;{\mu}g/ml$), 94.47% ($1000\;{\mu}g/ml$), BuOH 분획에서 93.77% ($500\;{\mu}g/ml$), 92.90% ($1000\;{\mu}g/ml$)로 90% 이상이었다. 아질산염 소거능도 $1000\;{\mu}g/ml$의 농도에서 50% 이상이었으며, XOase 저해활성은 93.06% (EtOAC) 와 91.73% (BuOH)로 높은 활성을 보였다. 암세포 성장 저해활성을 측정한 결과 hexane 분획에서 가장 높았고 HT-29에 대해 11.63%-90.07%, SNU-1에 대해 16.84%-95.11%, HeLa에 대해 4.44%-96.40%였다. 이상의 결과에서 선학초의 EtOAc, BuOH 분획물은 항산화 활성이 있는 기능성 식품으로의 개발이 가능할 것으로 생각되며, hexane, chloroform 분획은 위암, 대장암과 자궁경부암 치료보조제로서의 개발을 위한 추가적인 연구가 필요하다고 생각된다.

Age of Diagnosis of Breast Cancer in China: Almost 10 Years Earlier than in the United States and the European Union

  • Song, Qing-Kun;Li, Jing;Huang, Rong;Fan, Jin-Hu;Zheng, Rong-Shou;Zhang, Bao-Ning;Zhang, Bin;Tang, Zhong-Hua;Xie, Xiao-Ming;Yang, Hong-Jian;He, Jian-Jun;Li, Hui;Li, Jia-Yuan;Qiao, You-Lin;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.10021-10025
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    • 2014
  • Background: The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Materials and Methods: Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. Results: The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. Conclusions: The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

센서스인구 대 주민등록인구: 지역별 사망률 연구에서 어느 인구를 분모로 사용하여야 하나? (Census Population vs. Registration Population: Which Population Denominator Should be used to Calculate Geographical Mortality)

  • 황인아;윤성철;이무송;이상일;조민우;이민정;강영호
    • Journal of Preventive Medicine and Public Health
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    • 제38권2호
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    • pp.147-153
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    • 2005
  • Objectives: Studies on the geographical differences in mortality tend to use a census population, rather than a registration population, as the denominator of mortality rates in South Korea. However, an administratively determined registration population would be the logical denominator, as the geographical areas for death certificates (numerator) have been determined by the administratively registered residence of the deceased, rather than the actual residence at the time of death. The purpose of this study was to examine the differences in the total number of a district population, and the associated district-specific mortality indicators, when two different measures as a population denominator (census and registration) were used. Methods: Population denominators were obtained from census and registration population data, and the numbers of deaths (numerators) were calculated from raw death certificate data. Sex- and 5-year age-specific numbers for the populations and deaths were used to compute sex- and age-standardized mortality rates (by direct standardization methods) and standardized mortality ratios (by indirect standardization methods). Bland-Altman tests were used to compare district populations and district-specific mortality indicators according to the two different population denominators. Results : In 1995, 9 of 232 (3.9%) districts were not included in the 95% confidence interval (CI) of the population differences. A total of 8 (3.4%) among 234 districts had large differences between their census and registration populations in 2000, which exceeded the 95% CI of the population differences. Most districts (13 of 17) exceeding the 95% CI were rural. The results of the sex- and age-standardized mortality rates showed 15 (6.5%) and 16 (6.8%) districts in 1995 and 2000, respectively, were not included in the 95% CI of the differences in their rates. In addition, the differences in the standardized mortality ratios using the two different population denominators were significantly greater among 14 districts in 1995 and 11 districts in 2002 than the 95% CI. Geographical variations in the mortality indicators, using a registration population, were greater than when using a census population. Conclusion: The use of census population denominators may provide biased geographical mortality indicators. The geographical mortality rates when using registration population denominators are logical, but do not necessarily represent the exact mortality rate of a certain district. The removal of districts with large differences between their census and registration populations or associated mortality indicators should be considered to monitor geographical mortality rates in South Korea.

건강한 영아에서 경피다자법 BCG 접종후 2TU 투베르쿨린 검사의 반응성 (The Reactivity to 2TU PPD Tuberculin Skin Test after Percutaneous Multiple Puncture BCG Vaccination)

  • 노혜옥;이우길
    • Pediatric Infection and Vaccine
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    • 제6권1호
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    • pp.101-106
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    • 1999
  • 목 적 : 최근 국내에서 결핵반응 검사 시약으로 2TU가 소개되면서 결핵의 예방화학 치료 의 기준에 대한 논란이 있어 왔다. 본 연구는 신생아기에 경피다자법으로 BCG를 접종 받은 영아에서의 2TU PPD 검사에 대한 반응을 관찰하고자 하였다. 방 법 : 성균관 의대 삼성제일 병원에서 출생후 생후 1개월째 외래에 방문하여 경피용 건조BCG 백신을 경피다자법으로 접종받고 접종 6개월 후에 추적이 가능하였던 476명을 대상으로 결핵반응 검사를 시행하였다. 검사는 RT23 2TU PPD를 사용하여 좌전박 내측에 0.1mL를 피내주사후 48~72 시간에 경결크기를 측정하였다. 판독시 결핵의 가족력과 BCG 반흔의 총수를 기록하였고 양전 판정은 경결 크기가 5mm 이상인 경우로 하였다. 결 과 : 전체 476명 중 남자 248명(52.1%), 여자 228명(47.9%) 였다. PPD 검사 시기는 BCG 접종후 $6.2{\pm}0.5$(평균${\pm}$표준편차) 개월 후에 시행되었다. RT23 2TU 검사상 평균 경결 크기는 $7.3{\pm}3.2mm$였다. 경결의 분포는 5mm 미만이 14.5%, 5~9mm가 59.9%, 10mm 이상이 25.6%였다. 검사 당시 BCG 반흔의 총수는 $15.5{\pm}3.2$개였다. 결 론 : 경피 다자법 BCG 접종후 2TU PPD 반응 검사 양전률은 85.5%로 좋은 결과를 나타내었다. 그러나 2TU PPD를 일반 병, 의원에서 진단용으로 사용하기 위해서는 좀더 다양한 연령층과 많은 대상에 대한 비교 연구의 축적이 필요할 것으로 생각되었다.

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WEPP Watershed Version을 이용한 홍천군 자운리 농경지 토양유실 예측 및 경사도에 따른 토양유실량 평가 (Evaluation of Sediment Yield Prediction and Estimation of Sediment Yield under Various Slope Scenarios at Jawoon-ri using WEPP Watershed Model)

  • 최재완;현근우;이재운;신동석;김기성;박윤식;김종건;임경재
    • 한국물환경학회지
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    • 제25권3호
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    • pp.441-451
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    • 2009
  • To evaluate the soil erosion best management practices, many computer models has been utilized over the years. Among those, the USLE and SWAT models have been widely used. These models estimate the soil erosion from the field using empirically-based USLE/MULSE in it. However, these models are not good enough to estimate soil erosion from highland agricultural watershed where severe storm events are causing soil erosion and muddy water issues at the receiving watersheds. Thus, physically-based WEPP watershed version was applied to a watershed, located at Jawoon-ri, Gangwon with very detailed rainfall data, rather than daily rainfall data. Then it was validated with measured sediment data collected at the sediment settling ponds and through overland flow. In this study, very detailed rainfall data, crop management data, soil data reflecting soil reconditioned for higher crop production were used in the WEPP runs. The $R^2$ and the EI for runoff comparisons were 0.88 and 0.91, respectively. For sediment comparisons, the $R^2$ and the EI values were 0.95 and 0.91. Since the WEPP provides higher accuracies in predicting runoff and sediment yield from the study watershed, various slope scenarios (2%, 3%, 5.5%, 8%, 10%, 13%, 15%, 18%, 20%, 23%, 25%, 28%, 30%) were made and simulated sediment yield values were analyzed to develop appropriate soil erosion management practices. It was found that soil erosion increase linearly with increase in slope of the field in the watershed. However, the soil erosion increases dramatically with the slope of 20% or greater. Therefore special care should be taken for the agricultural field with slope greater than 20%. As shown in this study, the WEPP watershed version is suitable model to predict soil erosion where torrential rainfall events are causing significant amount of soil loss from the field and it can also be used to develop site-specific best management practices.

Clinical Value of Real Time Elastography in Patients with Unexplained Cervical Lymphadenopathy: Quantitative Evaluation

  • Fu, Ying;Shi, Yun-Fei;Yan, Kun;Wang, Yan-Jie;Yang, Wei;Feng, Guo-Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5487-5492
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    • 2014
  • Ultrasonography is non-invasive and can give useful clues in the diagnosis of cervical lymphadenopathy, However, differential diagnosis is difficult in some situations even combined with color Doppler imaging. The present study was conducted to evaluate the clinical value of real time elastography in patients with unexplained cervical lymphadenopathy using a quantitative method. From May 2011 to February 2012, 39 enlarged lymph nodes from 39 patients with unexplained cervical lymphadenopathy were assessed. All the patients were examined by both B-mode ultrasound, color Doppler flow imaging and elastography. The method of analyzing elasto-graphic data was the calculation of the 10 parametres ("mean", "sd", "area%", "com", "kur", "ske", "con", "ent", "idm", "asm") offered by the software integrated into the Hitachi system. The findings were then correlated with the definitive tissue diagnosis obtained by lymph node dissection or biopsy. Final histology revealed 10 cases of metastatic lymph nodes, 11 cases of lymphoma, 12 cases of tuberculosis and 6 cases of nonspecific lymphadenitis. The significant distinguishing features for conventional ultrasound were the maximum short diameter (p=0.007) and absent of echogenic hilum (p=0.0293). The diagnostic accuracy was 43.6% (17/39 cases) and there were 17 patients with equivocal diagnosis. For elastography, "mean" (p=0.003), "area%" (p=0.009), "kurt" (p=0.0291), "skew" (p=0.014) and "cont" (p=0.012) demonstrated significant differences between groups. With 9 of the 17 patients with previous equivocal diagnoses (52.9%) definite and correct diagnoses could be obtained. The diagnostic accuracy for conventional ultrasound combined elastography was 69.2% (27/39 cases). There were differences in the diagnostic sensitivity of the two methods (p=0.0224). Ultrasound combined with elastography demonstrated higher rates of conclusive and accurate diagnoses in patients with unexplained cervical lymphadenopathy than conventional ultrasound. The quantitative program showed good correlation with the pathology of different lymph node diseases.

부모의 양육지식과 실천 도구 개발 예비연구 (A Pilot Study on Korean Version Development of the Rearing Knowledge and Practice for Infant Parents)

  • 김경운
    • 한국산학기술학회논문지
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    • 제18권12호
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    • pp.485-493
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    • 2017
  • 양육지식은 양육실천에 중요한 관련요인이며 양육지식과 양육실천 정도 사정은 영아기 부모에게 중요하다. 저자는 기 개발된 타당성이 검증된 양육지식 척도(CRKS)와 양육실천 척도(CRPS)의 자국내 도입을 위하여 Saramma와 Thomas가 기 개발한 도구들을 채택하였다. 예비연구가 국제적 언어학적 검증단계에 따라서 수행되었다. 조사대상자는 A의 보건소와 B의 오케타니 마사지실을 방문한 영아 부모 20명이었다. 수집된 자료는 기술통계와 Wilcoxon Rank Sum Test가 도구의 이해도와 일반적 특성에 따른 도구의 평균 정도를 비교하기 위해서 사용되었다. 도구의 신뢰도와 타당도는 Cronbach's alpha, Spearman Correlations을 사용하였다. 대상자의 평균 나이는 33.94(${\pm}2.99$)세였고 영아의 평균 월령은 3.35(${\pm}0.58$)개월였다. CRKS와 CRPS의 이해도는 각각 1.80(${\pm}0.65$)점과 1.33(${\pm}0.54$)점으로 사용하기 쉬웠다. CRKS의 평균점수는 22.50(${\pm}4.89$)점으로 중간점수였고 CRPS의 평균점수는 30.75(${\pm}2.04$)점으로 높았다. CRPS의 Cronbach's alpha는 식이영역이 0.71, 성장과 발달 영역이 0.64, 청결과 보호영역이 0.68, 영아자극 영역이 0.77였다. CRPS의 영아자극과 CRKS의 성장과 발달 영역은 유의한 상관관계가 있었다(r=.530, p=.016). 일반적 특성 중에서 의료인이 비의료인에 비해서 유의하게 CRKS 점수가 높았다(p=0.04). CRKS와 CRPS 척도는 지역사회와 임상실무에서 사용이 간편하고 쉽게 응답할 수 있는 도구로 사용되기를 기대한다.