• 제목/요약/키워드: the aged in community

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혈압 수준과 경동맥 내중막 두께 및 동맥경화반의 관련성 (Association of Blood Pressure Levels with Carotid Intima-Media Thickness and Plaques)

  • 이영훈;권순석;최진수;이정애;최성우;류소연;신민호
    • Journal of Preventive Medicine and Public Health
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    • 제42권5호
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    • pp.298-304
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    • 2009
  • Objectives : The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. Methods : Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives ($\geq$140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. Results : Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT$\geq$1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. Conclusions : Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013

  • Bajpai, Ram;Chaturvedi, Himanshu;Jayaseelan, Lakshmanan;Harvey, Pauline;Seguy, Nicole;Chavan, Laxmikant;Raj, Pinnamaneni;Pandey, Arvind
    • Journal of Preventive Medicine and Public Health
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    • 제49권6호
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    • pp.394-405
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    • 2016
  • Objectives: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. Methods: The present study used data from 139 679 HIV patients aged ${\geq}15$ years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. Results: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for < $100cells/mm^3$ vs. > $350cells/mm^3$), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. Conclusions: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.

양치시설 여부에 따른 초등학생의 구강환경관리능력 및 구강건강관리 행태 변화 (Effect of Toothbrushing Facilities on PHP index and Oral Health-related Behaviors in Elementary schools)

  • 황윤숙;김광수;정재연;유영재;김수화;임미희
    • 한국학교ㆍ지역보건교육학회지
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    • 제14권3호
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    • pp.27-40
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    • 2013
  • Objectives: This study was conducted at a request for cooperation through an analysis of the effect of toothbrushing facilities at a public health center in Seongdong-gu. Also, with the aim of furnishing basic data to the proposal of a program for improving the ability of school aged children in managing oral cavities and developing a correct toothbrushing habit, the study conducted an investigation of how toothbrushing facilities affect change in the oral environment management ability and behavior of oral health care. Methods: From among elementary schools located in Seongdong-gu, Seoul the study selected A Elementary School where toothbrushing facilities were established and have been operated since 2008, B Elementary School in an adjacent region within the jurisdiction of Seongdong-gu where the demographic environment was similar among schools where toothbrushing facilities were newly established in 2012, and C Elementary School without toothbrushing facilities. Then the study was aimed at first grade students of the schools and an investigation was carried out from April to December 2012. Through a dental checkup, the study evaluated the teeth and periodontal health conditions, and a test of the oral environment management ability was undertaken three times. Regarding change of oral health care behavior, the study carried out a self-recording survey. Results: 1. Concerning decayed and filled tooth(dft) and decayed and filled surface (dfs), A Elementary School where toothbrushing facilities have been established and operated from the past showed a relatively lower decayed, missing, and filled teeth index than B Elementary School where toothbrushing facilities were established in 2012 or C Elementary School without toothbrushing facilities; however, there was no significant difference (p>0.05). For CPI, there was no significant difference by school; however, in looking into the difference between boy students and girl students, Code (0) was discovered higher in boy students whereas Code (1) was shown higher in girl students. 2. In the PHP index test in accordance with the existence of toothbrushing facilities before the installation of toothbrushing facilities, for A Elementary School where toothbrushing facilities have been established and operated from the past, the school recorded 4.28 points whereas B Elementary School where the facilities were established in 2012 recorded 3.51 points. Meanwhile C Elementary School without the facilities posted 4.30 points. Therefore there was a statistically significant difference according to the existence of toothbrushing facilities (p<0.05). 3. In a comparison of teeth health care behavior according to the existence of toothbrushing facilities, the number of answers that the respondent did not brush their teeth after lunch over the past one week was higher in B Elementary School and C Elementary School where there were no toothbrushing facilities. Regarding the average number of brushing after lunch for one week, it was discovered higher in A Elementary School (p<0.01). 4. In change of teeth health care behavior before and after the establishment of toothbrushing facilities, the case of answering that the respondents did not brush their teeth after lunch for one week increased more after establishment than before establishment. Also the average number of teeth brushings after lunch for one week decreased further after the establishment of toothbrushing facilities; however, it did not show a significant difference (p>0.05). One of the reasons that they do not brush their teeth, "the lack of a place", decreased significantly after establishment than before establishment (p<0.05), whereas the answer, "because their friends do not brush their tooth" increased greatly after establishment than before establishment; however, there was no significant difference (p>0.05). 5. In the comparison of the degree of knowledge about dental health according to the existence of toothbrushing facilities, the degree of knowledge about dental health was shown significantly higher in A Elementary School with toothbrushing facilities than in B Elementary School and C Elementary School where there were no toothbrushing facilities (p<0.01). Conclusions: Given the above results, it is difficult to attract change in behavior only with an environmental improvement; therefore, it is deemed necessary to develop an educational program that will help children to make a habit of oral health care not only through a school but also through a related policy and financial support of government organizations as well as the construction of the basis of a systematic and consistent cooperative system with relevant organizations.

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일부(一部) 도시저소득층(都市低所得層) 유아원원아(幼兒園園兒)의 영양실태조사(營養實態調査) (Nutrition Survey of Young Children of A Day Care Center in the Low Income Area of Seoul City)

  • 우미경;이은화;이보경;이정수;이정화;이종현;모수미
    • 한국식품영양과학회지
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    • 제14권3호
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    • pp.235-243
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    • 1985
  • A survey of 113 children, aged 4 to 6 years, of the San Cheon a day care center, located in the upland, over populated, poor area of Seoul City, was conducted from July 28 to September 6, 1982, to investigate the dietary and nutritional status, and prevalence of parasitic inpection. House size was 10.1 Pyung; number of households per house, 3.1; number of family member per household, 4.8; and number of family members living together per room, 3.7; on the average. Only 49% of households possess own houses and the others live in the rented houses. About 40% of mothers were engaged income-producing activities within or outside of the home. Mean values of height, weight, arm circumference, girth of chest, and girth of head ranged from 98.4 to 102.2% of KIST mean. However, 13% of the subjects were assessed as undernutrition for 'weight for height'. Mean value of hemoglobin was $12.9{\pm}2.9\;g/dl$ and mean hematocrit value was $35.2{\pm}5.5%$; 17.9% of the subjects were proven to be anemic according to the criteria of the WHO. The positive prevalence of parasitic inpection was 3.3%, significantly lower than that observed in any other area, probably because of community parasitic control project. Intakes of energy and nutrients except thiamin and ascorbic acid were far below RDAs. Carbohydrates for energy provided 71. 2 to 73.8% of total energy intake; protein accounted 11.3 to 12.2%; fat provided 14.5 to 16.6%. Energy intake was divided among breakfast, lunch, evening meal and snack, on the average, in a percentage of 22.0; 23.4; 24.4; 30.2. There was significant correlation between pattern of food consumption and nutrient intakes. The nutrient intakes and quality of foods were highly correlated to the maternal factors, especially mother's educational level. The study suggested that development of nutrition guides for mother and children would be needed to improve nutritional status of those young children.

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지리산국립공원에 방사한 반달가슴곰 동면장소 특성 연구 (Study on the Characteristics of the Hibernating Site for the Released Asiatic Black Bear in Jirisan National Park)

  • 김보현;양두하;정우진;이배근
    • 한국환경생태학회지
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    • 제21권4호
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    • pp.347-355
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    • 2007
  • 러시아 연해주와 북한으로부터 도입하여 지리산국립공원에 방사한 $1{\sim}2$년생 반달가슴곰(Ursus thibetanus ussuricus)의 동면장소 특성을 파악하기 위해 2004년 10월부터 2006년 4월까지 조사한 결과는 다음과 같다. 방사한 곰들은 나무굴, 바위굴, 곰탱이 등 3가지 유형의 동면장소에서 동면을 취하였다. 방사한 곰들의 동면장소는 참나무류가 우점하고 있는 지역으로 해발고도 평균 $923{\pm}221m$, 사면경사 평균 $25.9{\pm}7.9^{\circ}$이었으며, 동면기간은 평균 $98{\pm}9$일 이었다. 동면장소는 방사지점으로부터 평균 $2.8{\pm}2.8km$, 인근마을로부터 평균 $2.0{\pm}0.9km$, 인접 탐방로로부터 평균 $1.9{\pm}1.7km$, 자동차도로로부터 평균 $1.9{\pm}1.0km$ 거리에 위치하고 있는 것으로 분석되었다. 동면장소의 환경특성은 방사지점의 환경요인과 밀접한 상관관계를 가지고 있었다.

가정호스피스기관의 활동에 관한 연구 (Activities of a Home Hospice Organization)

  • 김정희;최영순
    • Journal of Hospice and Palliative Care
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    • 제3권1호
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    • pp.28-38
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    • 2000
  • 목적 : 독립된 가정호스피스 일개 기관에서 서비스를 받은 대상자의 특성과 간호문제, 서비스내용 등을 파악하여 지역사회 가정호스피스 기관의 서비스 향상을 위한 방향을 모색하고자 본 연구를 실시하였다. 방법 : 독립된 가정호스피스기관의 서비스가 시작된 1994년 11월부터 자료가 정리된 1999년 6월까지의 4년 8개월동안 서비스를 이용하고 종료된 환자 113명을 대상으로 기록지에서 필요한 정보를 사전에 작성된 도구에 정리하였으며 빈도, 백분율, 평균 및 범위를 산출하여 분석하였다. 결과 : 1) 일반적 특성으로 평균연령은 57.1세로 60세 이상이 54%였다. 의뢰당시 종교는 기독교가 49.6%, 천주교가 20.7%였으며 동거가족수의 평균은 2.8명이었다. 2) 주로 돌보는 사람으로 배우자는 50.9%였고 며느리, 딸의 순이었다. 대상자는 모두 말기암 진단을 받았으며 소화기계 암이 55.5%로 가장 많았다. 의뢰당시 말기상태를 몰랐던 41명중 31명이 도중에 알게되었다. 3) 서비스 의뢰인은 의사가 72.7%였으며 서비스기간은 평균 6.8주로 58.4%가 1개월 이내에 서비스를 종료하였다. 접촉형태별 평균치는 가정방문 7.2회, 전화연락 5.1회, 병원방문 2.1회, 주치의와 연락 0.7회였다. 4) 대상자의 간호문제로 통증이 89.4%로 가장 많았고 식욕부잔 변비, 우울, 불안등이 관찰되었다. 수행된 간호활동은 약물관리가 85%로 가장 빈번하였으며 가족의 심리지지 77%, 환자 심리지지 58.4%에서 관찰되었다. 영적교제, 식이교육, 관장, 체위변경, 수액요법, 욕창간호는 20%이상의 대상자에게 적용된 간호활동이었다. 5) 서비스 종결에서 사망이 88.5%, 거절이 8%였다. 화인된 사망장소는 가정이 60%, 병원이 39%였다. 결론 : 가정호스피스 사업제공자는 노인에 대한 이해가 필수적이며 특히 통증중재를 위한 준비가 중요하고 서비스대상에 가족이 함께 포함될 수 있어야 한다고 본다 호스피스의 목적을 달성하기 위해 적절한 시기에 의뢰되어야 하며 지역주민의 호스피스에 대한 개방적인 태도를 위한 사업 홍보가 필요하다고 본다.

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시민서비스는 자원봉사의 대척점에 있는가? - 미국의 AmeriCorps와 Senior Corps를 중심으로 (Is Civic Service the Real Antipode of Volunteer Work? - Focusing on AmeriCorps and Senior Corps in the United States)

  • 지은정
    • 사회복지연구
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    • 제45권2호
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    • pp.31-63
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    • 2014
  • 최근 시민참여와 시민서비스에 대한 관심이 높아지고 있지만, 우리나라는 시민서비스에 대한 연구도 부족한 가운데 배척되는 경향이 있다. 활동비 지원 자원봉사에 대한 우려가 큰 가운데 시민서비스가 자원봉사의 기본정신과 다르다는 인식이 크기 때문인 것으로 보인다. 따라서 일반적 통념처럼 시민서비스가 자원봉사의 대척점에 있는지 살펴볼 필요가 있다. 본 연구는 이와 같은 문제의식 아래, 자원봉사와의 비교적 관점에서 시민서비스를 분석하였다. 연구결과, 첫째, 국내에 알려진 것과는 달리, 시민서비스는 자발성과 무보수성의 원칙에서 벗어나지 않는다. 시민서비스가 시민의식을 훼손한 것이 아니라, 오히려 자원봉사 가운데 활동비를 지원받는 단기 간헐적 활동과 의무봉사가 더 큰 문제인 것으로 판단된다. 둘째, 시민서비스와 자원봉사는 자발성, 무보수성보다는 구조적 특성 즉, 목표, 지속성, 공식성에 있어서 차이가 있는 것으로 보여진다. 나아가 미국에서 시민서비스가 정착할 수 있었던 것은 단순히 활동비 수당을 지원했기 때문이 아니라, 지역사회 문제해결과 참여자의 삶의 질 향상을 이끌고 사회적 인정보상, 교육지원을 통해 사회공헌활동에 대한 자긍심과 만족감을 가질 수 있도록 지원했기 때문인 것으로 보인다.

노인의 라이프스타일이 성공적 노후에 미치는 영향 (Influence of Elderly People's Lifestyle on Successful Aging)

  • 신근영;고재욱
    • 한국콘텐츠학회논문지
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    • 제15권9호
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    • pp.243-256
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    • 2015
  • 본 연구는 노인의 라이프스타일의 하위변인인 건강 및 여가 추구, 외향적 도전추구, 안전 및 물질추구, 보수적 가족 추구, 동료관계 추구가 성공적 노후에 미치는 영향을 연구하려고 한다. 연구의 필요성은 한국적 문화를 반영한 연구가 미비하여 고령사회를 맞이한 노인들에 대한 지속적인 연구가 필요하기 때문에 이 연구를 하게 되었다. 노인들의 라이프스타일이 성공적 노후에 미치는 영향에 대해 알아보고 성공적 노후를 위한 사회복지의 실천적 함의를 찾고자 하는 목적에서 이루어졌다. S시 노인종합복지관과 주민자치센터를 이용하는 65세 이상 노인을 대상으로 자기기입법과 대인 면접방법으로 설문조사를 실시하여 분석하였다. 연구방법은 첫째, 신뢰도검증과, 둘째, 기술통계분석을 실시하고, 셋째, 상관관계분석과 가설검증을 위한 다중회귀 분석으로 노인들의 라이프스타일이 성공적 노후에 미치는 영향을 분석한 결과, 라이프스타일의 하위변인인 건강 및 여가 추구, 외향적 도전 추구, 안전 및 물질추구, 보수적 가족 추구, 동료관계 추구는 성공적 노후에 유의미하게 나타났다. 그 중 동료관계 추구, 보수적 가족 추구가 성공적인 노후에 가장 많은 영향을 끼치고 있으며, 노인들의 외로움 중에서 동료간의 화합적인 관계와 보수적 가족 추구를 유지하는 것이 본 연구의 의미라고 할 수 있으며, 고령사회를 맞이하는 노인들의 다양한 문화자본 확보와 쉽게 소비할 수 있는 제도가 필요하다고 생각된다.

한국 65세 이상 노인의 우울증에 영향을 미치는 요인 : 앤더슨 모형을 활용한 융합적 연구 (Factors Affecting Depression in the Elderly Over 65 Years in Korea: Using Andersen's Behavioral Model)

  • 박효은;서인순
    • 한국융합학회논문지
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    • 제10권8호
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    • pp.83-95
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    • 2019
  • 본 연구의 목적은 앤더슨 모형을 적용하여 65세 이상 노인의 우울증에 영향을 미치는 예측 요인을 포괄적으로 파악하고 연구 대상자들의 인구사회학적 요인, 가능요인, 요구요인, 건강행태요인들 간에 연관성을 분석하는 것이다. 연구 대상은 제 6기(2013-2015년) 국민건강영양조사에 참여자 21,724명 중, 65세 이상 노인 3,585명을 대상으로 하였으며, 앤더슨 모형에 따른 우울증 여부에 대한 변수들의 다변량 분석을 위해 위계적 로지스틱 회귀분석을 실시하였다. 위계적 회귀 분석의 결과로 남성은 0.49 배(0.31-0.78) 음의 상관관계를 보였다. 또한 통증이 1.56 배 (1.05-2.31), 스트레스가 0.55 배(1.10-2.19), 보행 운동이 1.44 배(1.03-2.00), 외래 사용이 1.48 배(1.10-1.98)의 양의 상관관계가 있었다. 따라서 지역 주민의 성별에 따른 차별화 된 지원이 필요하며 스트레스 중재와 운동에 대한 추가 지원이 필요하다.

도시.농촌 지역 초등학생의 가족환경, 건강행위 및 건강상태에 관한 비교 (Comparision of Family Environment, Health Behavior and Health State of Elementary Students in Urban and Rural Areas)

  • 배연숙;박경민
    • 지역사회간호학회지
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    • 제9권2호
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    • pp.502-517
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    • 1998
  • This research intends to survey family environment, health behavior and health status of the students in urban-rural elementary schools and analyze those factors comparatively, and use the result as basic material for school health teacher to teach health education in connection with family and regional areas. It also intends to improve a pupil's self-abilitiy in health care. The subjects involve 2,774 students of urban elementary schools and 583 student in rural ones, who were selected by means of a multi -stage probability sampling. Using the questionnaire and school documents, we collected data on family environment, health behavior and health status for 19 days. Feb. 2nd 1998 through Feb. 20th 1998. The R -form of Family Environment Scale (Moos, 1974) was used in the analysis of family environment(Cronbach's Alpha =0.80). Questionnaires of Health Behavior in School-aged children used by the WHO in Europe(Aaro et al., 1986) and the ones developed by the Health Promotion Committee of the Western Pacific(WHO, 1995)(adapted by long Young-suk and Moon Young-hee(1996)) were used in the analysis of health behavior, as well documents on absences due to sickness, school health room-visits, levels of physical strength, height, weight and degree of obesity were used to determine health status. In next step, We used them with an $X^2$-test, t-test, Odds Ratio, and a 95% Confidence Interval. 1. In two dimensions of three, family-relationship (t=3.41, p=0.001) and system -maintenances(t= 2.41, p=0.0l6) the mean score of urban children were significantly higher than those of rural ones. In the personal development dimension however, there was little significant difference. Assorting family environment into 10 sub-fields and analyzing them, we recognized that urban children were superior to rural children in the sub-fields of expressiveness (t =3.47, p=0.001), conflict (t=0.48, p=0.001), active-recreational orientation (t = 1.97, p=0.049) and organization (t=4.33, p=0.000). 2. Referring to the Odds Ratios of urban-rural children's health behaviors, urban children set up more desirable behavior than rural children wear ing safety belts (Odds Ratio =0.32, p=0.000), washing hands after meals(Odds Ratio = 0.43, p= 0.000), washing hands after excreting (Odds Ratio = 0.39, p=O.OOO), washing hands after coming - home ( Odds Ratio = 0.75, p = 0.003), brushing teeth before sleeping(Odds Ratio =0.45, p=0.000), brushing teeth more than once a day (Odds Ratio =0.73, p=0.0l2), drinking boiled water (Odds Ratio = 0.49, p=0.000), collecting garbage at home(Odds Ratio=0.31, p=0.000) and in the school(Odds Ratio =0. 67, p=0.000). All these led to significant differences. As to taking milk(Odds Ratio = 1.50, p=0.000), taking care of eyesight(Odds Ratio=1.41, p=0.001) and getting physical exercise in(Odds Ratio = 1.33, p=0.0l9) and outside the school(Odds Ratio = 1.32, p=0.005), rural children had more desirable behavior which also revealed a significant difference. There was little significant difference in smoking, but the smoking rate of rural children(5.5%) was larger than that of urban children(3.9%). 3. Health status was analyzed in terms of absences, school health room-visits, levels of physical strength, and the degree of obesity, height and weight. Considering Odds Ratios of the health status of urban-rural children, the health status of rural children was significantly better than that of the urban ones in the level of physical strength(t=1.51, p=0.000) and the degree of obesity(t=1.84, p=0.000). The mean height of urban children ($150.4{\pm}7.5cm$) is taller than that of their counterparts($149.5{\pm}7.9$), which revealed a significant difference (t =2.47, p=0.0l4). The mean weight of urban children($42.9{\pm}8.6kg$) is larger than that of their counterparts($41.8{\pm}9.0kg$), which was also a significant difference(t=2.81, p=0.005). Considering the results above, we can recognize that there are significant differences in family environment, health behavior, and health status in urban-rural children. These results also suggestion ideas for health education. What we would suggest for the health program of elementary schools is that school health teachers should play an active role in promoting the need and importance of health education, develop the appropriate programs which correspond to the regional characteristics, and incorporate them into schools to improve children's ability to manage their own health management.

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