• Journal of Preventive Medicine and Public Health
• /
• 제30권3호
• /
• pp.630-642
• /
• 1997

60세이상 노인인구를 대상으로 '농촌지역 노인들의 우울 및 인지기능 장애에 관한 연구'를 한 이정애와 정향균의 연구대상 558명에 대해 농촌지역 노인들의 인지기능 장애와 사망과의 관련성을 살펴본 결과는 다음과 같다. 1) 3년동안 동안 전체 대상자의 사망률은 558명중 57명인 10.2%이었으며 353명의 정상 인지기능군 중 사망자는 30명으로 사망률 8.5%, 126명 의 경도 인지장애군중 사망자는 14명으로 사망률 11.1%, 79명의 중증 인지장애군중 사망자는 13명으로 사망률 16.5% 이었다(표 3). 2) 3년동안 전체 연구 대상자의 생존율은 0.91이었으며 정상, 경도, 중증 인지기능 장애군의 3년 생존율은 각각 0.92, 0.90, 0.86이었다. 로그 순위 검정법으로 인지기능 정상군과 경도 및 중증의 각 인지기능 장애군의 생존곡선을 비교한 결과 통계적으로 유의하지 않았다. 또한 인지기능 정상군과 경도 이상의 인지기능 장애군간 생존곡선을 비교한 결과도 유의한 차이는 없었다. 3) 혼란변인을 보정하지 않는 Cox의 비례위험 회귀 모형의 단변량분석의 결과 95% 신뢰구간(C.I. : Confidence Interval)에서 사망위험도가 유의한 변인은 연령, 월수입, 흡연습관, 신체장애 등이었으며, 인지기능 장애정도를 정상 그리고 경도 및 중증으로 분류한 분석에서는 정상군에 비해 경도 및 중증의 사망위험도가 유의하게 높지 않았으나, 인지기능 점수(MMSEK score)의 증가에 따른 분석 결과 사망위험도가 0.94로 유의하게 낮게 나타났다(표 4). 4) 잠재적 혼란변인들의 영향을 보정한 Cox의 비례위험 회귀모형의 다변량 분석의 결과 인지기능 장애정도 및 MMSEK 점수증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 5). 5) 남녀별로 각각 인지기능 장애와 사망위험도와의 관계를 알아보기 위해 다변량 분석을 시행한 결과 인지기능 장애정도 및 MMSEK 점수 증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 6, 표 7). 이상 본 연구는 농촌지역 노인들에서 인지기능 장애정도가 사망에 미치는 영향을 알아보고자 하였지만, 인지기능 장애정도가 사망에 미치는 영향을 통계적으로 유의하게 고찰하지 못하였다.

• Journal of Preventive Medicine and Public Health
• /
• 제22권2호
• /
• pp.290-301
• /
• 1989

This is preliminary report on anthrax epidemic occurred in an island with about 100 residents. Since 1982 there had been sudden deaths among all kinds of domestic animals including cattle, dogs, ducks, chicken and goat but only a few among cats in an isolated island about three hours distance away by ferry boat from Mokpo city. From 1986 through 1988 nine human deaths and four patients occurred, which made the government intervene for investigation on June 25 1988. The epidemiological investigation consisted of interview survey and medical examination, medical record analysis, laboratory work to isolate the pathogens under the direction of hypothesis derived from the study and further confirmation of the pathogens by international institute. The summarized results are as followings: 1. According to the interview survey there were many deaths among domestic animals usually in cold and dry season such as January through March and September through November; 36 heads of cattle leaving one head, more than 40 hogs(all), hundreds of chicken leaving few alive, goats that had taken home from mountain and two or three cats out of around 40 had sudden deaths from 1982 till 1985, when the residents stopped to purchase and take them into the island anymore. Also there were eleven persons who had experienced the similar syndrome complex to those of admitted and expired patients and four of them revealed typical chest X-ray findings; from one of these four patients(Rho) B. anthracis is isolated. 2. Medical record on patients who had been admitted, showed common characteristics of the disease course. On admission they had either gastrointestinal or upper respiratory infection symptoms which invariably progressed to septicemic nature with pulmonary interstitial infiltration and mediastinal widening/bulging, and then to deadly acute respiratory distress syndrome. At the end stage chest X-ray revealed multiple bullous emphysema. One of another characteristics was oral ulceration with bleeding occurred in about 50% of the patients. Laboratory test results in common were leukocytosis with left shift and abnormal liver and kidney functions, particularly at the later stage of the illness. 3. Epidemiological characteristics was striking in that both mortality and incidence rates were high: the mortality rate was 8.7% average, male being three times higher than females but there was no distictive clustering by age group. The incidence rate for both sexes was 28.2% and there was no sex difference although a tendency of higher incidence among older ages was noticed. The highest mortality and incidence were observed in Won village where the first death of animal occurred and with the highest frequency among three villages of the island. 4. Among twelve bacilli species isolated from various specimens, two strains, one from patient and the other from soil where the recently died cow is hurried, were confirmed as B. anthracis by Pasteur Institute and CDC of USA(strain from soil). CDC reported that the strain did not produce capsule in bicarbonate media but reacted with the bacteriophage and one of five sera taken from the patients. Mode of transmission as well as incubation period of the agent has not been established yet, which needs further investigation in relation to the antigenic structure of the variant when it is confirmed.

• 대한예방한의학회지
• /
• 제6권1호
• /
• pp.15-35
• /
• 2002

This study was conducted to provide basic data for policy of Oriental medicine by analyzing community resident's consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 2001 to May 31, 2001. The results of this study are summarized as follows. 1) The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 2) In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. 3) 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 4) According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it because persons around them recommended it. 5) 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain food should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 6) In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 7) 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 8) 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 51.9% does not know whether taking herb medicine in summer is effective or not because the effect is different according to their physical constitutions. 35.5% thinks that taking herb medicine is summer is effective because their physical stamina is weakened after sweated a lot, while 12.6% thinks that it is not effective because the effect of herb medicine disappears with sweat. 9) According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 10) According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

• 대한방사선기술학회지:방사선기술과학
• /
• 제29권3호
• /
• pp.185-195
• /
• 2006

목 적: 방사선 관련종사자들의 1995년 1월 6일 "진단용 방사선 발생장치의 안전관리에 관한 규칙"을 제정한 이후 방사선 노출로 인한 개인피폭선량의 실태를 조사 분석하여, 해당 의료기관과 방사선 관련종사자들에게 방사선피폭에 대한 경각심을 고취시키고, 안전관리에 도움을 주고자 한다. 조사대상 및 방법: 2000년 1월 1일부터 2004년 12월 31일까지 5년 동안 전국에 있는 검사기관, 교육기관, 군부대, 병원, 보건소, 산업체, 연구기관, 의원에서 근무하였거나 근무하고 있는 방사선종사자들의 개인 피폭선량 측정결과 판독기관에 등재(登載)된 대상자 57,136명에 대한 분기별 피폭선량 자료 149,205건을 대상으로 하여 판독수행기관에 직접 방문 하거나, 전화를 통하여 책임자에게 연구의 목적을 설명하고 긴밀한 협조를 얻어 수집하였다. 자료를 분석하는데 있어 SPSS ver 12.0을 이용하였으며, 분석방법으로는 연도별 분기별 성별 연령별 직종별 근무부서별 업종별로 심부선량과 표면선량으로 나누어 분석하였다. 빈도분석 one-way ANOVA two-way ANOVA를 시행하였다. 결 과: 5년간의 평균 피폭선량에서 심부선량과 표면선량의 평균값이 해마다 낮아지는 것으로 조사되었고, 성별 평균 피폭선량은 심부선량과 표면선량에서 남자가 여자보다 높게 나타났으며 연령별 평균 피폭선량에서 심부선량과 표면선량은 높은 연령군보다 낮은 연령군에서 높게 나타났고, 직종별 평균 피폭선량은 심부선량과 표면선량 모두에서 방사선사가 가장 높게 나타났으며 근무 부서별 평균 피폭선량은 심부선량과 표면선량에서 핵의학과가 가장 높게 나타났고, 업종별 평균 피폭선량은 심부선량과 표면선량에서 병 의원이 높게 나타난 것으로 조사되었다. 결 론: 이상의 결과에서 볼 때 최근 5년간 전국 지역에 있는 병원 의원 기타 등에서 근무하는 방사선 종사자들의 방사선 평균 피폭선량은 국제방사선방어위원회(ICRP)에서 권고하는 허용선량 기준치(20 mSv/년)를 초과하지 않는 범위의 피폭을 받고 있는 것으로 나타났다. 그러나 그것은 평균적인 수치이지 개인적으로 피폭선량에 있어 그 범위의 피폭을 초과하는 종사자들이 있는 것으로 나타나 상당히 우려가 되고 있는 실정이다. 따라서 방사선 관련종사자들이 각자가 개인별 관리에 더욱더 철저를 기하고 방사선으로 인한 피폭을 최소화 시키는데 있어 체계적인 교육 및 안전 불감증에 대한 지도가 지속적으로 유지되어야 할 것이다.

• 대한예방한의학회지
• /
• 제3권2호
• /
• pp.25-53
• /
• 1999

This study was conducted to provide basic data for policy of Oriental medicine by analyzing community residents' consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 1999 to May 31, 1999. The results of this study are summarized as follows. 1. According to general characteristics of the subjects, 52.3% of the subjects was 'female'; 25.0% 'fifties of age'; 21.4% 'forties of age'; 20.9% 'thirties of ages'; 69.1% 'married'; 60.1% 'resident in a big city'; 12.1% 'residents in a small town or village'; 39.0% 'highschool graduate'; 35.9% 'above college graduate'; 23.4% 'housewife'; 23.4% 'professional' 34.1% 'Buddhist'; 81.1% 'middle class'. 2. The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 3. In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. Taking herb medicine as a curative medicine appeared to be significantly higher in the groups of 'male', 'thirties of age', 'resident in a town or village', 'above college graduate', 'professional technician', 'Christian', and 'the upper class'. 4. 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 5. According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it. because persons around them recommended it. The preference for the herb medicine displayed significantly higher rate in the groups 'sixties of age', 'the unmarried', 'resident in a big city', 'office clerk', and 'the lower class'. 6. 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain foods should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 7. In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 8. 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 9. 14.2% of the respondents thinks health foods which contain herbs are good, while 16.8% thinks it is bad. 76.7% thinks that medicinal herbs in packages must be included in health insurance coverage, while only 3.0% thinks it needs not be included in health insurance coverage. 10. 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 11. According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 12. According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

• 농촌의학ㆍ지역보건
• /
• 제39권1호
• /
• pp.1-13
• /
• 2014

본 연구는 2008년 지역사회건강조사에 참여한 65세 이상 노인 43,049명을 대상으로 노인의 손상관련요인을 알아보기 위하여 수행하였다. 2008년 지역사회건강조사 자료 중 최근 1년 동안의 손상 경험 여부와 인구사회학적 특성, 건강관련 특성, 만성질환 이환 관련 특성 등을 이용하여 손상관련요인을 파악하였다. 자료분석은 SPSS Win 18.0(version)을 이용하여 카이제곱 검정, 다중로지스틱 회귀분석을 실시하였고, 통계적 유의성은 p<0.05로 하였다. 최근 1년 동안 노인의 손상경험률은 5.1%였으며, 추락 미끄러짐, 운수사고 등의 손상이 가장 많았다. 손상에 관련을 미치는 요인으로 확인된 것은 동거가족, 현재음주, 우울감, 주관적 건강상태, 뇌졸중, 골다공증이었다. 동거가족은 부부만사는 노인에 비해 혼자 사는 노인의 교차비가 1.23(95% CI: 1.05-1.43), 자녀나 기타 친인척과 사는 노인의 교차비가 1.16(95% CI: 1.02-1.32)이었다. 현재음주는 음주를 하지 않는 노인에 비해 음주를 하는 노인의 교차비가 1.19(95% CI: 1.05-1.35)이었고, 주관적 건강상태는 좋은 노인에 비해 나쁜 노인의 교차비가 1.72(95% CI: 1.43-2.08)이었고, 우울감은 없는 노인에 비해 있는 노인의 교차비가 1.23(95% CI: 1.05-1.43)이었다. 뇌졸중은 질병이 없는 노인에 비해 질병이 있는 노인의 교차비가 1.40(95% CI: 1.17-1.68)이었고, 골다공증은 질병이 없는 노인에 비해 질병이 있는 노인의 교차비가 1.45(95% CI: 1.26-1.66)이었다. 따라서 노인손상의 관련요인으로 확인된 수정 가능한 위험요인을 고려한 손상예방 프로그램 개발이 필요하며, 이를 노인들에게 적극적으로 중재하여 손상의 위험을 낮출 수 있도록 해야 할 것이다.

• 한국인구학
• /
• 제12권2호
• /
• pp.1-21
• /
• 1989

For the analysis of mortality differentials by socioeconomic factors based on death registration data, we have considered four variables : place of residence, educational attainment, marital status and occupation. The age range adopted were 5 to 64 years of age for place of residence, and 25 to 64 years of age for the other factors. The mortality differentials by socioeconomic variables were clear and in the expected direction: mortality levels among urban residents, better educated groups, and non- agricultural workers were lower than among the other sub- groups. The average mortality level in rural areas is much higher than in urban areas : the rural mortality levels were at least double the urban levels at ages below 40 years, but became smaller after age 40, and no clear differentials by urban I rural residence increased until 1974~76 for the both sexes, but since the then differentials have declined slowley for both sexes. This changing pattern of mortality differentials by place of residence can be explained by historical socioeconomic development : the development generally started in urban areas, and rural areas followed : in the course of socioeconomic development the differences between the death rates in the two areas became smaller and finally the mortality levels in the two areas became nearly the same, as is found in the developed countries nowadays. The inverse relationships between mortality and educational level became stronger between the periods 1970~72 and 1984~86, but showed the same atterns of mortality differentials in both period : larger differences among the younger age groups, and for males, than among the older age groups, and for females. The increasing mortality differentials in the fourteen-year period between 1970~72 and 1984~86 were caused by inadequate living standards of the non- educated, whose proportion in the total population, however, dropped sharply during that period. Also, the much lower proportions of low - educated groups or of persons with no formal education among males than females helped to establish the clearly pronounced differentials. The mortality differentials by marital status in Korea showed the usual pattern : the mortality rates of the married in each age and sex group were clearly lower than those of others during the fourteen-year period between 1970~72 and 1984~86. In Korean society which remotes universal marriage, the never married recorded especially high death rates, presumably mainly because of ill - health, but also possibly because of the stigma attached to celibacy. However, the mortality differentials by marital status changed with the changes in the proportionate distribution by marital status during the period : the differences between the death rates of the married and never married groups became smaller, the proportion of the never married group increased : in contrast, the differences between mortalities of the married and widowed / divorced / separated groups widened, with the decrease in the proportion of the later group ; this tendency was perticularly marked for females. Occupational groups also showed clear mortality differences : among four occupational groups mortality of males was highest among agricultural workers and lowest among 'professional, admi-nistrative and clerical workers, However, when the death rates were standardized by educational level, the death rates by occupation in age group 45~64 years were nearly the same (excet for the mixed group consisting of unemployed, students, military servicemen and unknown). Therefore, the clear mortality dfferentials by occupation in Korea resulted mainly from the differences in educational level between different occupation groups. Since socioeconomic characteristics are related to each other, the net effect of each variable was examined. Each of the three variables - ducational level, marital status and urban / rural residence affected significantly Korean adult mortality when the effects of the other variables were controlled. Among the three variables educational level was the most important factor for the determination of the adult mortality level. When male's occupation was added to the above three variables, the effects of occupation on adult mortality were notably smaller after control for the effects of the other three variables while the net effects of these three variables were nearly the same irrespectively whether occupation was included or not. Thus, the differences in educational level (mainly), place of residence and marital status bring out the clear differences in observed mortality levels by occupation.

• 농촌의학ㆍ지역보건
• /
• 제28권2호
• /
• pp.49-59
• /
• 2003

본 연구는 와병노인의 보건의료서비스구축을 위해 필요한 기초자료를 제공할 목적으로 농촌지역 재가 와병노인의 와병원인, 와병기간, 진료 및 개호의 실태를 파악하고, 성별 및 연령별로 그 특성을 밝혀보고자 하였다. 조사대상은 충청남도 공주시 11개 면(面)에 거주하고 있는 65세 이상 노인 중 2002년 9월 현재 집에서 와병 중인 노인 207명 전원을 대상으로 하였으며, 조사는 2002년 9월에 와병노인의 각 가정을 방문하여 미리 작성한 설문내용에 대해 면접조사를 실시하였다. 주요결과는 다음과 같다. 첫째, 재가 와병노인의 남녀별 분포는 남자가 37.7%, 여자가 62.3%이었다. 연령별 분포는 65-79세 군까지는 남자가 여자보다 많았고, 80대 이상 군에서는 여자가 남자보다 많았으나 유의한 차이는 없었다. 한편, 조사 대상지역의 65세 이상 인구 중 와병노인의 출현율은 1.61%이었으며, 성별로는 남자가 1.46%, 여자가 1.71%의 출현율을 보였고, 연령별로는 남녀모두 연령이 증가함에 따라 출현율이 높아지는 경향을 보였다. 둘째, 와병의 원인질환으로서는 고혈압 동맥경화증이 남자에서 43.6%, 요통 신경통 척추질환이 여자에서 40.3%로 가장 높은 비율이었고, 연령별로는 뇌혈관 질환, 고혈압 동맥경화증, 루머치스 관절염, 당뇨병 등은 60대의 저 연령층에서 높았으나, 호흡기질환, 요통 신경통, 노쇠 등은 80대의 고 연령층에서 높았다. 또한 와병 원인질환의 비율은 75세 이하 저 연령층은 남자가 많은 반면, 75세 이상 고 연령층은 여자가 많은 경향을 보였다. 셋째, 와병기간은 남자가 평균 4.81${\pm}$2.89년, 여자가 4.98${\pm}$2.89년으로 여자에서 더 길었으나 유의한 차이는 없었다. 연령별로는 남녀모두 연령이 높은 군일수록 와병기간이 길어지는 경향을 보였다. 넷째, 최근 1년간의 진료실태는 왕진이 남자 29.5%, 여자 27.9%로 남자가 여자보다 많았고, 외래진료는 여자가 60.5%, 남자가 50.0%로 여자가 남자보다 많았으며, 연령별로는 특히 80세 이상 군에서 남녀 모두 왕진이 50.0% 이상으로 많아진 반면, 외래진료는 저 연령층보다 감소하는 경향이었다. 다섯째, 와병노인에게 필요한 개호 종목은"목욕하기"가 가장 높은 비율이었고, 다음은 "화장실 이용" "옷갈아입기" "식사하기" 등의 순위였으며, 환자 1인당 개호 종목 수는 남자가 3.4종목, 여자가 3.5종목이었으며, 남녀 모두 연령이 높을수록 종목수가 많은 경향이었다. 이상의 결과를 종합하여 볼 때 고령화가 계속 진행 됨에 따라 와병환자도 증가하지만 만성질환의 이환율이 감소되는데는 한계가 있으므로 와병환자의 증가에 따른 보건의료서비스 수요의 증가에 대처할 적절한 대책이 요망된다.

• The Journal of Korean Physical Therapy
• /
• 제14권3호
• /
• pp.238-272
• /
• 2002

This study was intended to find out the factors affecting to the IADL, allowing objective assessment of physical function status of increasing elderly populations. The subjects of 635 elderly persons aged over 65 years old who live in Taejon metropolitan city were interviewed during the two-month period from June to July of 2000. The IADL of Older American Resources and Services(OARS), developed in Duke medical college of USA, was interpreted for use. The study results were statistically processed using SPSSWIN(ver 10.0) and conferred the following results: 1. Among the seven items of IADL, the women showed higher rates of 'yes' in items about using the telephone, getting to the places out of walking distance, going shopping for groceries, taking their own medicine while outnumbered by the men only in the item about managing their own money, without significant differences between them in items about preparing their own meals and doing their own housework. 2. In terms of IADL scores, $82.0\%$ of subjects showed the normal range of scores and $18.0\%$ were under the normal range, meaning dysfunction IADL. Specifications of general characteristics revealed that more dysfunctional were the male subjects, the higher age groups who are more than 75 years old, the higher educated groups, the groups who live in nursing homes, the groups without a spouse. 3. Based on daily activities, lower scores of IADL were found in the subjects who don't go out, who don't have recreational activities, who don't attend elderly gatherings in their neighborhood, who don't hold social meetings. Specifications of psychological traits revealed that more dysfunctional were IADL in the subjects who don't feel satisfied with their lives of the past or the present, who have a deep feeling of isolation, and who don't have the will to live. 4. Among 7 items of health habits, only the subjects who don't regular exercise had lower scores of IADL than those who do. According to HPI, the lower HPI, the more dysfunctional. 5. Based on the factors associated with IADL, the odds ratio of the subjects who don't live together with their families were 1.53 times that of the ones who do, who are educated 3.22 times that of the ones who are not, who don't have spouses 2.09 times that of the ones who do, who don't go out 4.35 times that of the ones who frequently go out, who don't recreational activities for an interest 2.64 times that of the ones who do, who don't attend elderly gatherings in their neighborhood 1.47 times that of the ones who do, who don't hold social meetings 2.23 times that of the ones who do, who don't feel satisfied with their present living 1.43 times that of the ones who do, who have a feeling of isolation 1.53times that of the ones who don'1, who have the weak will to live 3.21 times that of the ones who have the strong one, and who don't regular exercise 2.45 times that of the ones who do. 6. Logistic regression analysis of the study results found that such factors are significantly related as the degree of education, with/without spouse, social meetings, the will to live, and regular exercise, and that higher rates of dysfunctional subjects were in the more educated group, in the group without spouse, in the group who don't frequently go out, who don't have social meetings, who have the weak will to live, and who don't exercise.

• Pediatric Infection and Vaccine
• /
• 제13권2호
• /
• pp.115-123
• /
• 2006

목 적 : 국내에 7가 단백결합 백신이 도입된 이후 폐구균 혈청형 분포 및 항생제 내성률 등에 미친 영향을 평가하고자 하였다. 방 법 : 2001년 9월부터 2006년 8월까지 5년 간 세브란스병원에 내원한 환자 중 배양검사에서 폐구균이 검출된 363명으로부터 분리된 폐구균의 혈청형과 항생제 감수성을 조사하여 국내에 7가 단백결합 백신 접종이 도입된 시기를 기준으로 이에 대한 변화가 있는지 알아보았다. 결 과 : 폐구균 백신 도입 이전 143명과 그 이후 220명, 모두 363명의 환자의 검체에서 폐구균이 분리되었다. 2세 미만의 소아가 32명, 2세 이상 15세 이하 27명, 15세 초과의 성인이 304명이었다. 폐구균이 분리된 임상 검체는 객담(66.4%), 혈액(11.3%), 이루(9.6%), 인두도말(3.9%) 등 순이었고, 이중 15세 이하의 소아에서는 이루(49.2%), 혈액(18.6%), 인두도말(11.9%), 뇌척수액(6.8%) 등 순이었다. 분리된 폐구균 중 314주(86.5%)에서 혈청형 분석이 가능하였는데, 19F(14%), 19A(11%), 23F(7%), 6B(7%), 6A(6%), 3(5%), 9V(5%), 14(4%), 11A(4%), 4(3%), 29(3%), 18(2%) 순이었다. 연령대별 혈청형의 빈도순은 모든 군에서 유사하였으나, 각 군에서의 백신 혈청혈의 비율은 2세 미만(59.3%)과 2세 이상 15세 이하(63.0%)의 소아군에서 15세 초과 성인군(37.8%)에 비해 높았다(P=0.004). 연도별 혈청형의 분포는 차이가 없었으며 백신 도입 시기 전후를 비교해보았을 경우에도 차이가 없었다. 여러 항생제에 대한 비감수성 폐구균은 해마다 증가 추세에 있어, 페니실린 내성률은 2001년 58.8%에서 2006년 83.6%까지 증가하였다(P=0.046). 연령대별 항생제 내성 폐구균의 비율은 2세 미만의 소아에서 다른 연령대보다 높은 경향을 보였으며, 특히 페니실린과 trimethoprim-sulfamethoxazole에 대한 내성률은 각각 90.6%와 90.0%로 다른 연령대에 비해 유의하게 높았다(P<0.05). 혈청형별 페니실린 내성 폐구균의 비율은 23F(100.0%), 19F(96.0%), 9V(82.4%), 6B(75.0%), 14(68.8%), 4(60.0%) 등의 순이었으며, 이들 혈청형들을 포함한 전체 백신 혈청형의 페니실린 내성률은 84.2%였다. 결 론 : 아직 7가 단백결합 백신에 의한 혈청형의 분포 변화나 페니실린 내성균주의 감소는 확인 할 수 없었으나, 소아에서 분리되는 폐구균 중 백신 혈청형의 비율이 매우 높으므로 보다 적극적인 백신접종이 필요할 것으로 보인다.