• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• 농업과학연구
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• 제8권2호
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• pp.203-211
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• 1981

수도작(水稻作) 기계화일관작업체계(機械化一貫作業體系)를 통(通)하여 이앙시기(移秧時期)의 노동(勞動)Peak를 해소(解消)하고 또한 소요노동력(所要勞動力) 절감(節減)으로 수도생도비(水稻生度費)의 절감(節減)을 위한 이앙작업(移秧作業)의 기계화(機械化)는 우리나라 현여건하(現與件下)에서 매우 시급(時急)한 과제(課題)이다. 본(本)연구(硏究)는 수도이앙작업(水稻移秧作業) 기계화(機械化)의 보다 적극적(積極的)인 추진(推進)을 위한 기초자료(基礎資料)를 얻기 위해 충청남도(忠淸南道) 일반농가(一般農家) 381호(戶)를 대상(對象)으로 이앙기(移秧機) 이용실태(利用實態) 및 소유성향(所有性向)에 대(對)하여 설문조사 및 청취조사를 실시(實施)하였다. 이 조사자료는 충남대학교(忠南大學校) 전자계산소(電子計算所)의 Computer로 통계(統計) Package인 STATS에 의(依)해 분석(分析)되었다. 이 연구(硏究)에서 밝혀진 중요(重要)한 결과(結果)는 다음과 같다. 1. 이앙기(移秧機) 소유(所有) 형태(形態)는 76.09%가 개인소유(個人所有)이나 앞으로 2~3년이내(年以內)에 구입희망농가(購入希望農家)는 52.27%가 공동소유(共同所有) 공동이용(共同利用) 희망(希望)하므로 공동(共同) 이용체제(利用體制)에 대(對)한 연구(硏究)가 보다 강화(强化)되어야 할 것이다. 2. 이앙기(移秧機)로 이앙(移秧)한 수도(水稻)의 수량(收量)은 응답자(應答者)의 91.33%가 증수(增收)되거나 별차(別差)가 없는 것으로 나타나 앞으로 수도이앙기(水稻移秧機)의 농촌보급(農村普及)이 증가(增加)될 것으로 전망(展望)된다. 3. 이앙기소유농가(移秧機所有農家)의 73.26% 산파묘(散播苗) 4조용(條用)을 보유(保有)하고 있으나 2~3년내(年內)에 구입(購入) 희망(希望)하는 농가(農家)의 25.0%가 띠묘(苗) 4조용(條用)을 희망(希望)하므로 띠묘(苗) 4조용(條用)에 대한 농촌보급문제(農村普及問題)도 그 기계(機械)의 특성(特性)으로 보아 재고(再考)되어야 할 것이다. 4. 이앙기소유농가(移秧機所有農家) 및 구입희망농가(購入希望農家)의 부락공동육묘(部落共同育苗)에 대(對)한 희망도(希望度)가 49.71~57.83%로 높으므로 공동육묘(共同育苗)에 대(對)한 기술지원(技術支援) 체제(體制)가 보다 강화(强化)되어야 할 것이다.

• 한국전통조경학회지
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• 제34권4호
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• pp.57-65
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• 2016

마을숲은 역사적, 문화적으로 한국 전통 마을경관의 핵심요소이다. 그러나 근대 이후 다양한 영향으로 많은 수의 마을숲이 소실되었거나 쇠퇴되고 있는 실정이다. 역사적, 문화적, 생태적 다양한 보전가치를 가진 마을숲의 체계적 보전 및 복원을 위한 관심과 노력이 필요한 시점이다. 본 연구는 한국 전역에 분포하고 있는 499개의 마을숲에 대하여 구성 식물종 및 서식처, 입지 특성 등을 바탕으로 국내 마을숲에 대한 생태학적 복원 및 지속가능한 이용과 관리 등에 관한 정보를 제공하고자 하였다. 마을숲 생태계를 위협하는 대표적인 6가지 범주의 위협요인을 발굴하고 각 요인별 영향력을 평가하였다. 마을숲 생태계 취약성에 미치는 영향의 정도에 대해 위협요인별 가중치 평가를 AHP 분석기법을 이용하여 보다 입체적으로 분석하였다. AHP 분석기법을 이용한 평가결과 6가지 범주 가운데 면적 축소가 국내 마을숲의 존립에 가장 큰 위협요인으로 지목되었다. 그 다음으로 지형, 토양환경 변화가 마을숲 생태계를 질적으로 변화시키는 위협 요인으로 고려되었다. 식생의 구조와 질적 변화는 서식처 변화보다 마을숲 소실 및 쇠퇴에 낮은 영향을 미칠 것으로 평가되었다. 각 요인별 가중치를 바탕으로 100점을 최고점으로 수치를 환산한 평가틀을 이용하여 마을숲에 대한 취약성 평가가 이루어졌다. 국내 마을숲의 취약성 평가결과 가장 빈도 높은 값을 보이는 등급은 III등급이며, 낮은 등급에서 높은 등급으로 정규분포 경향을 보였다. 높은 자연성을 보이는 I등급의 마을숲이 38개소 존재했으며, 취약요인들에 의해 마을숲 존폐를 위협받는 V등급의 마을숲도 10개소 확인되었다. 각 마을숲별 취약성 평가결과에서도 국내 마을숲의 지속가능성 보장을 위해 마을숲 고유의 면적 회복이 최우선 과제로 대두되었다. 국가 중요 생태자원으로서 각각의 취약요소별 국가수준의 생태적 대응전략 마련이 필요한 것으로 확인되었다.

• 농촌의학ㆍ지역보건
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• 제45권2호
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• pp.89-99
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• 2020

이 연구는 연령대를 성인, 전기 노인, 후기 노인으로 구분 후 신체활동과 인지된 운동장애요인과의 관련성을 보고자 하였다. 연구 대상자는 두 군데 면 지역에 거주하고 있는 주민들 1500명을 대상으로 실시하였으며 걷기실천율의 정의는 주 5회 이상, 한번 할 때 10분 이상, 하루에 30분 이상 하는 것으로 하였고, 인지된 장애요인은 시간부족, 사회적 지지 부족, 기력 부족, 의지력 부족, 부상에 대한 공포 등 5개의 영역으로 조사하였다. 연령대를 세 개 군(~64세 이하, 65-74세, 75세 이상)으로 구분했을 때 의지력 부족이 모든 연령대에서 유의하였고, 64세 이하의 경우는 시간부족이 관련이 있었으며, 65세 이상은 부상에 대한 공포가 관련 있었다. 결론적으로 의지력 부족과 시간부족에 대한 해결을 위해서 마을 내에서 일정한 시간대에 함께 걷기운동을 실시하여 이를 해결하도록 하고, 노인들에게는 낙상예방을 위하여 걷기운동과 같은 유산소운동을 권장할 때 근력운동을 병행해 실시하여 부상에 대한 공포를 줄여야 할 것이다.

• Parasites, Hosts and Diseases
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• 제58권3호
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• pp.267-278
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• 2020

The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.

• 자원환경지질
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• 제31권1호
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• pp.59-68
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• 1998

Gravity, magnetic and VLF surveys were carried out to investigate the dimension, nature and stability of the waste materials filled in the Seokdae landfill, Pusan. The Seokdae landfill, which is located in a former valley, was used as a dump for mainly domestic-type waste materials for 6 years from 1987. The landfill site is classfied into A, B, C and D areas according to the sequence of dumping period. The Bouguer gravity anomaly map shows maximum variation of 3.1 mgals on the landfill and its general appearance has close relation with the thickness of waste filled. The local variation of anomaly, however, reflect the degree of compactness of waste materials which may be affected by the nature of waste and dumping time. In the case of area A, where dumping process was terminated at the very last stage, most part show negative anomaly compared to other areas. We think that the composition of the waste materials in the area A is high in leftover food and paper trash and they are still in uncompacted condition. In area B, the general trend of variation of gravity anomaly is appeared to be high anomaly in northern part and decrease to the southern part. This is well matched with the prelandfill topography of the landfill site. The southern part of area B is located in the center of valley and its present surface is comparatively rugged, which may be due to the differential settlement of deep burried waste. The thickness of waste in area C is relatively thin, but the gravity anomaly appears to be low. Considering the present condition of surface, it can be inferred that low density wastes such as leftover food were mainly filled in this area. Area D, as in the case of area B, shows gravity anomaly that has close relation with the prelandfill topography. Magnetic data show the variation of total field intensity varies in the range of 46600~51000 nT, and reach maximum anomaly of 4400 nT. The overall pattern of magnetic anomaly well reflects the distribution of magnetic materials in the landfill. The result of VLF survey reveals several low resistivity zones, which may serve as underground passages for contaminant flow, in the area C located near the small Village.

• 농촌계획
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• 제21권2호
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• pp.11-21
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• 2015

This study carried out evaluation of vulnerability in accessability and functionality using road network that was extracted from Intelligent Transportation System(ITS) and digital map. It was built in order to figure out accessability that locational data which include community center, public facilities, medical facilities and highway IC. The method for grasping functionality are Digital Elevation Model(DEM) and land slide hazard map provided by Korea Forest Service. The evaluation criteria for figure out accessability was set to related comparison of average time in urban area. Functionality value was calculated by the possibility of backing the vehicle possibility of snowfall and landslides. At last, this research computed weighting value through Analytic Hierarchy Process (AHP), calculated a vulnerable score. As the result, the accessability of rural village came out that would spend more time by 1.4 to 3.2 times in comparison with urban area. Even though, vulnerability of the road by a snowfall was estimated that more than 50% satisfies the first class, however, it show up that the road were still vulnerable due snowing because over the 14% of the road being evaluated the fifth class. The functionality has been satisfied most of the road, however, It was vulnerable around Lake Daechung and Piban-ryung, Yumti-jae, Suriti-jae where on the way Boeun. Also, the fifth class road are about 35 km away from the city hall on distance, take an hour to an hour and a half. The fourth class road are about 25 km away from the city hall on distance, take 25 min to an hour. The other class of the road take in 30 min from the city hall or aren't affected of weather and have been analyzed that a density of road is high. In A result that compare between distribution and a housing density came out different the southern and the eastern area, so this result could be suggested quantitative data for possibility of development.

• 농촌계획
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• 제15권2호
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• pp.81-96
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• 2009

This study has found out the status of the environment ecology(topography structure. land-use, flora, plant community structure, wildbird) in 10 uninhabited islands(i.e. Kei island, Hadon island, Sangdon island, Daewa island, Hwanggang island, Naebi island, Oebi island, Prickly castor-oil tree island, Tongin island, Yuk island), Namhae-gun, Gyeongsangnam-do. Moreover, It has suggested ways of improving the environment ecology status by classifying the type of environment ecology about the degree of use and damage that based on the results of environment ecology survey. According to the results of topography structure survey, the survey site altitude was ranged within 1m$\sim$25m, otherwise, the radient was classified the rock area(.i.e. slope of less than $5^{\circ}$ the dead level) and the slope area where is steep slope. Moreover, there was showed evenly a variety of aspect. Land-use were divided the field(Kei island), dry native grasslands(Hadon island), naturalized grasslands(Sangdon island), Pinus thunbergii community(Dacwa island, Hwanggang island, Naebi island, Yuk island), the rock area(Oebi island, Prickly castor-oil tree island, Tongin island). As the results of flora survey, the number of plant species were 30$\sim$115 species and the naturalized species were found 2$\sim$12 species in each site. The results of plant community structure analysis, The dominant species were Pinus thunbergii and Pinus densiflora were in upper tree layer, furthermore, it were Pinus thunbergii, Eurya japonica, Prunus sargentii, Celtis sinensis, Morus bombycis, ect. in cannopy tree layer. In shrub layer, the dominant species were Rosa multiflora, Rubus crataegifolius, Parthenocissus tricuspidata, etc. The status of wildbird bird, had been found 42 species 938 individuals, especially, there were Bubo bubo kiautschensis(natural monument No. 324) and Haematopus ostralegus osculans(natural monument No. 326). According to these synthetic results, we are able to classify the 5 types of environment ecology such as the natural coast forest that composed of Pinus thunbergii and Pinus densiflora(Daewa island, Hwanggang island, Naebi island, Oebi island, Tongin island, Yuk island), the field in vegetation area(Kei island), vegetation succession area of fallow field type(Hadon island), vegetation damage area by the forest fire and disturbance elements(Prickly castor-oil tree island), dominant naturalized species grassland by grazing cattle(Sangdon island).

• 한국습지학회지
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• 제9권1호
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• pp.79-89
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• 2007

This paper provides a comprehensive overview of the present status of several environmental problems caused by emerging toxic substances such as persistent organic pollutants (POPs), endocrine disrupting chemicals (EDCs), and arsenic in various environmental media in Vietnam. Monitoring data reported during the 1990s demonstrated elevated contamination of DDTs in most of these compartments in Vietnam. Studies in frame of the Asia-Pacific Mussel Watch Program revealed that fish, mussels and resident birds from Vietnam contained higher concentrations of DDTs as compared to other countries in region, suggesting the role of Vietnamese environment as a significant emission source of DDT in the Southeast Asian region. The estimated dietary intakes of PCBs and DDTs for Vietnamese were relatively high among Asian developing countries, suggesting potential risk for humans posed by thesechemicals. Widespread contamination of some endocrine active compounds such as alkylphenols and phthalates was observed at various sites along the coasts of northern and middle Vietnam. The presence of significant source of bisphenol-A along Red River estuary was revealed with the concentrations comparable to those reported for developed nations. A case study on seasonal variation of alkylphenols and phthalates in surface water of river delta and estuary of north and middle Vietnam indicated the differences in distribution of these compounds between dry and rainy seasons. Higher concentrations of alkylphenols and phthalates were found in dry season in estuary; while the contrasting pattern was observed in the river delta, showing elevated residues in rainy season. This result suggests the different behavior of alkylphenols and phthalates in river delta and coastal environment. From ecotoxicological perspectives, concentrations of bis-phenol A and di(2-ethylhexyl)phthalates [DEHP] in surface water from some locations in Vietnam exceeded the guideline values for Ecotoxicological Effects and the Environmental Risk Limit, respectively, suggesting potential for toxic implications on aquatic wildlife. Widespread and elevated arsenic contamination was discovered inour recent surveys in groundwater in a large area of suburban areas of Hanoi city, the capital of Vietnam. The most recent investigation in 4 villages showed about more than 50 % of groundwater samples contained As concentrations exceeding 50 g/L (the WHO and Vietnamese standard). In particular, in Son Dong villages, 58 % of samples analyzed contained As concentrations higher than 200 g/L. Good correlations were found in As concentrations in water and hair and urine of peoples in corresponding families, suggesting the chronic exposure to As by people living in As-contaminated ground water areas. In Son Dong village, As levels in hair (mean: 1.7 mg/kg dry wt) and urine (g/g creatinine) exceeding the reference values recommended by WHO, suggesting potential for human risk posed by long term accumulation of As in human body. Future studies should be focused on the time trends of POPs and EDCs in biota in Vietnam in order to predict future trend of contamination and to reveal new clues for understanding possible toxic impacts on aquatic organisms. The issues of arsenic contamination in groundwater and their chronic toxic implications on human health should be systematically investigated in the future.

• 치위생과학회지
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• 제6권4호
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• pp.255-261
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• 2006

본 연구는 국민기초생활수급대상 65세 이상 노인들의 삶의질 향상과 구강건강을 유지, 증진 시키는데 필수적인 노인무료의치보철사업의 개선발전을 위하여 전국 각 구의 보건소 치과 위생사를 대상으로 노인무료의치보철사업의 현황을 파악하였으며 결과를 요약하면 아래와 같다. 현재 노인무료의치 보철사업의 홍보는 비교적 잘되고 있으며 대상자는 주로 동사무소에서 1년에 20~30명 정도를 선정하여 시행하고 있다. 대상치과는 47% 정도 치과의사협회와 연계하며, 주로 총의치를 많이 제작하고 있다. 제작 후 치과에 의존하고 있는 실정이라서 사후관리의 문제점이 많이 나타나고 있다. 또한 음식물섭취의 이로움과 무료시술이라는 점에서 64%의 높은 만족도를 얻고 있지만 의치장착 후 동통, 이물감 등으로 인해 불편함을 49%나 호소하는 것으로 나타났다. 이러한 결과를 토대로 노인의치보철사업의 문제점 및 만족도를 조사하여 향후 보다나은 노인 의료복지사업 중 하나인 노인무료의치보철사업의 앞으로 나아갈 방향에 대한 제언은 다음과 같다. 첫째, 의치 제작 후 지속적인 사후 관리가 이루어지기 위해서는 기초생활수급대상 노인들을 담당하는 방문 간호팀이나 사회복지사와 연계하여 의치 사용유무 및 관리상황 등을 점검하고, 의치관리법에 대한 교육이 시행되어야한다. 둘째, 의치가 가장 필요한 대상자에게 혜택이 주어질 수 있도록 대상자 선정 시 연령 기준이 하향 조정되어야하며, 보다 장기적인 대책으로 노인의치에 대한 보험급여화가 제기되어야한다. 셋째, 보다 양질의 무료의치보철사업을 수행하기 위해서는 환자의 구강 상태에 따른 정확한 수가 적용이 요구되며, 무엇보다도 무료의치보철사업을 시행하는 보건소 담당자와 치과의사의 봉사정신이 바탕이 되어야한다.