• 제목/요약/키워드: State intervention

검색결과 670건 처리시간 0.028초

Problems and suggested improvement plans for occupational health service in Korea

  • Dongmug Kang
    • Annals of Occupational and Environmental Medicine
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    • 제35권
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    • pp.10.1-10.10
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    • 2023
  • The purpose of this paper was to review the problems relating to Korea's occupational health services and suggest ways to improve them. Korea can be classified as a welfare state type of conservative corporatism partially interwoven with liberalism. While experiencing compressed economic growth, the economic sectors of developed (excess areas) and developing (deficient areas) countries are interwoven. Therefore, it is necessary to perfect conservative corporatism along with a complementary reinforcement of liberal contents and to apply a multilayered approach focusing on complementing the deficient areas. It is essential to form a national representative indicator related to occupational health, and a strategy for selection and concentration is needed. The proposed central indicator is the occupational health coverage rate (OHCR), which is the number of workers who have applied for mandatory occupational health services under the Occupational Safety and Health Act in the numerator with the total working population in the denominator. This paper proposes ways to raise the OHCR, which is currently at the level of 25%-40%, to 70%-80%, which is the level of Japan, Germany, and France. To achieve this target, it is necessary to focus on small businesses and vulnerable workers. This is an area of market failure and requires the active input of community-oriented public resources. For access to larger workplaces, the marketability of services should be strengthened and personal intervention using digital health resources should be actively attempted. Taking a national perspective, work environment improvement committees with tripartite (labor, management, and government) participation for improvement of the working environment need to be established at the center and in the regions. Through this, prevention funds linked to industrial accident compensation and prevention could be used efficiently. A national chemical substance management system must be established to monitor the health of workers and the general public.

Muscle Mass Changes After Daily Consumption of Protein Mix Supplemented With Vitamin D in Adults Over 50 Years of Age: Subgroup Analysis According to the Serum 25(OH)D Levels of a Randomized Controlled Trial

  • Yeji Kang;Namhee Kim;Yunhwan Lee;Xiangxue An;Yoon-Sok Chung;Yoo Kyoung Park
    • Clinical Nutrition Research
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    • 제12권3호
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    • pp.184-198
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    • 2023
  • Early prevention of sarcopenia can be an important strategy for muscle maintenance, but most studies target subjects at slightly pre-sarcopenic state. Our previous paper describes the effect of protein supplements rich in leucine and vitamin D on muscle condition, and in this paper, we performed a sub-analysis to evaluate who benefitted the most in terms of improvement in muscle health. A 12-week randomized clinical trial of 120 healthy adults (aged 50 to 80) assigned to an intervention group (n = 60) or control group (n = 60) were analyzed. Subjects in the intervention group received, twice per day, a protein supplement containing (per serving) 800 IU of vitamin D, 20 g of protein (3 g of total leucine), 300 mg of calcium, 1.1 g of fat, and 2.5 g of carbohydrate. The subjects were classified into 'insufficient' and 'sufficient' groups at 25-hydroxyvitamin D (25[OH]D) value of 30 ng/mL. The skeletal muscle mass index normalized to the square of the skeletal muscle mass (SMM) height (kg/m2) increased significantly in the 'insufficient group' difference value of change between weeks 0 and 12 (Δ1.07 ± 2.20; p = 0.037). The SMM normalized by body weight (kg/kg, %) was higher, but not significantly, in the insufficient group (Δ0.38 ± 0.69; p = 0.050). For people with insufficient (serum 25[OH]D), supplemental intake of protein and vitamin D, calcium, and leucine and adequate energy intake increases muscle mass in middle-aged and older adults and would be likely to exert a beneficial effect on muscle health.

Constipation anti-aging effects by dairy-based lactic acid bacteria

  • Mohamad Hafis Jaafar;Pei Xu;Uma-Mageswary Mageswaran;Shandra-Devi Balasubramaniam;Maheswaran Solayappan;Jia-Jie Woon;Cindy Shuan-Ju Teh;Svetoslav Dimitrov Todorov;Yong-Ha Park;Guoxia Liu;Min-Tze Liong
    • Journal of Animal Science and Technology
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    • 제66권1호
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    • pp.178-203
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    • 2024
  • Constipation, which refers to difficulties in defecation and infrequent bowel movement in emptying the gastrointestinal system that ultimately produces hardened fecal matters, is a health concern in livestock and aging animals. The present study aimed to evaluate the potential effects of dairy-isolated lactic acid bacteria (LAB) strains to alleviate constipation as an alternative therapeutic intervention for constipation treatment in the aging model. Rats were aged via daily subcutaneous injection of D-galactose (600 mg/body weight [kg]), prior to induction of constipation via oral administration of loperamide hydrochloride (5 mg/body weight [kg]). LAB strains (L. fermentum USM 4189 or L. plantarum USM 4187) were administered daily via oral gavage (1 × 10 Log CFU/day) while the control group received sterile saline. Aged rats as shown with shorter telomere lengths exhibited increased fecal bulk and soften fecal upon administration of LAB strains amid constipation as observed using the Bristol Stool Chart, accompanied by a higher fecal moisture content as compared to the control (p < 0.05). Fecal water-soluble metabolite profiles showed a reduced concentration of threonine upon administration of LAB strains compared to the control (p < 0.05). Histopathological analysis also showed that the administration of LAB strains contributed to a higher colonic goblet cell count as compared to the control (p < 0.05). The present study illustrates the potential of dairy-sourced LAB strains as probiotics to ameliorate the adverse effect of constipation amid aging, and as a potential dietary intervention strategy for dairy foods including yogurt and cheese.

자극성-진정성 음악을 이용한 부적 정서 조절의 음악회상기법 (Music Recall Technique) : 신경성 식욕부진증 환자의 사례 연구 (Music Recall Technique for Affect Modification using Stimulative-Sedative Music : Case Study of Anorexia Nervosa)

  • 길수연
    • 인간행동과 음악연구
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    • 제2권1호
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    • pp.1-15
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    • 2005
  • 음악치료 연구에 있어 치료 세팅 내 적용 가능한 임상전략기법들을 개발한 연구는 다른 음악치료 관련 주제들에 비해 부족한 실정이다. 음악 감상을 이용한 부적 정서 조절은 계속 해서 연구되어 온 분야이기도 하나 실질적으로 임상 대상에게 적용되어 지지 않았다. 본 연구는 음악 감상을 이용한 음악치료기법인 동시에 부적 정서를 경감시키는 정서 조절 기제의 한 방안으로서 음악회상기법(Music Recall Technique)을 고안하고, 이것의 치료적 중재 과정과 효용성을 보는 데에 그 목적을 두었다. 더 나아가 음악치료사의 부재 시나 음악치료세션 외, 그리고 물리적 음악이 부재한 상황에서 대상자가 이 기법을 스스로 활용할 수 있는지를 보았다. 본 연구의 음악회상기법은 대상자의 강도 높은 부적 정서에 음악적 공감(musical empathy)을 부여하기 위하여 현대 음악(contemporary music) 중심의 높은 자극성 음악이 사용되었다. 또한 부적 정서의 경감 및 조절을 위하여 자극성-진정성 음악을 이용한 음악회상기법이 중점적으로 적용되었고, 자극성-진정성-격양성 음악을 이용한 음악회상기법은 부가적으로 적용되었다. 음악회상기법에는 이미 지각되어 있는 기존의 음악을 현재에 그대로 재현하여 회상하는 '음악회상(Music Recall, MR)'과 기존 음악을 변형 또는 조합하거나 기존 음악이 아닌 새로운 음악을 대상자가 스스로 생각하여 머리 속에서 현재화시키는 '창조적 음악회상(Creative Music Recall, CMR)'이 있다. 본 연구에서는 음악회상을 중심으로 하되 창조적 음악회상을 부가적으로 적용하였다. 연구는 단일 사례 연구로, 신경성 식욕부진증 환자의 불안, 분노, 우울의 부적 정서에 대한 부적 상황 목록을 작성하여 이에 대한 부적 정서를 회기 시간 내에 경감시켜나가고, 회기 시간 외 음악회상기법을 통해 실생활에 대한 실제 부적 정서를 경감시켜나갔다. 총 10회에 거쳐 음악회상기법이 적용되었고, 음악회상기록지를 제작하여 자극성-진정성, 또는 격양성 음악회상 내 부적 정서 변화 과정을 회기 시간 내와 회기 시간 외에 자기보고 하도록 하였다. 부적 상황에 관여된 부적 정서를 회기 시간 내와 전체회기에 대해 VAS 사전사후 검사를 통해 측정하고, 상태-특성 불안척도, 상태-특성 분노 표현 척도, 무망감 우울증 검사지를 통해 일반적인 부적 정서에 대한 사전사후 검사를 실시하였다. 연구 결과, 자극성-진정성 음악회상 과정 내 불안, 분노, 우울의 부적 정서가 모두 감소하였다. 불안, 분노, 우울 모두 자극성 음악회상에서 가장 많은 감소를 보였으며, 특히, 자극성 음악회상의 초-중반부에 가장 많은 감소를 보였다. 부적 상황에 대한 부적 정서의 VAS 측정에서도 회기 시간 내와 전체회기를 통한 사전사후 결과에서 모두 부적 정서가 감소하였다. 상태-특성 불안척도, 상태-특성 분노 표현 척도, 무망감 우울증 검사지의 검사 결과에서도 모두 부적 정서가 감소하였다. 본 연구는 강한 자극의 정도를 갖는 현대 음악 중심의 자극성 음악이 분노, 불안, 우울과 같은 부적 정서의 감소에 효과적으로 작용가능하며, 자극성 음악회상의 초-중반부가 부적 정서의 경감을 위해 중요한 자극 변수로 작용함을 시사한다. 결론적으로, 본 연구에서 고안된 음악회상기법은 부적 정서의 경감 및 정서 조절에 효과적인 하나의 대응 방안이 될 수 있다.

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자조집단 프로그램이 유방절제술 환자의 적응과 삶의 질에 미치는 효과 (The Effect of Self-help Group Program on Adaptation and Quality of Life of Mastectomy Patients)

  • 박영신;임난영
    • 재활간호학회지
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    • 제2권1호
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    • pp.61-71
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    • 1999
  • This quasi-experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up ; 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale(SDS, 1965), and Self-rating Anxiety Scale(SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self-help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention, Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, $X^2$-test, Mann-Whitney U test. Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows ; Hypothesis 1. "The experimental group with the self-help group program will have a higher score on adaptation state than control group." was not supported. But the post test score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2. "The experimental group with the self-help group program will have a higher score on quality of life than control group." was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3. "The higher adaptation state of mastectomy patients, the higher quality, of life." was supported(r=,80, p<.001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing inter vention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further re search on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.

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건강운동 프로그램이 여성노인의 신체 유연성 및 건강행위 이행에 미치는 효과 (The Effects of Stretching and Recreation Exercise Included Health Education on Physical Flexibility and Health Behavior Compliance of Elderly Women)

  • 원정숙;현경선;한상숙;김원옥;김귀분;이명희
    • 동서간호학연구지
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    • 제10권1호
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    • pp.75-85
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    • 2004
  • The purpose of this study was to examine the effects of the stretching and recreation exercise including health education on physical flexibility and health behavior compliance of women in elderly. Subjects included 28 women elderly who were residents of H Dong, Dondae moon-Gu, Seoul. The treatment intervention was applied during total 8 weeks as 5 times/week for stretching exercise with 2 times/weeks for health education. Data collection were from February to April, 2004. SPSS Window program was used by aims of this study for data analysis. The results were as following: 1. 75 old age above (39.3%) was the most of age in subjects. None education (42.9%) was the most of subjects in this study. Perceived health state was the most as 71.4% in moderate and good health state. 2. Physical flexibility of both shoulder(right z=-4.301, p=,000)(left z=-4.306), both arm(right z=-3.623, p=.0001)(left z=4.111, p=.0001), heel on both ankle(right z=-3.472, p=.0001) (left z=956, p=.0001), both before food(right z=-4.205, p=.0001)left(z=4.191, p=.0001) and both knee(right z=-4.118, p=.0001)(left z=4.082, p=.0001) was increased after 8 weeks more than before stretching and recreation exercise including health education were done. 3. Health behavior compliance(z=-4.073, p=.0001) was significantly on the effect. Therefore, it is confirmed that stretching exercise included health education is an effective nursing intervention for physical, mental, and psychological health management in elderly. Accordingly, authors are proposing that variously effective health management exercise programs must be developed for elderly, at the same time, the application and following up on the programs will be more important in the future.

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건강교육을 포함한 신장운동이 노인의 생리적인 지표와 자가증상 보고 및 운동 자기효능에 미치는 효과 (Effects of Stretching Exercise Included Health Education on Physical Health Index, Self-reported Symptoms, and Self-efficacy of Exercise in Elderly)

  • 김귀분;원정숙;김원옥;현경선;한상숙
    • 동서간호학연구지
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    • 제9권1호
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    • pp.25-34
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    • 2004
  • This was one experimental study, conducted to identify the effects of stretching exercise included health education on physical health index, self-reported symptoms, and self-efficacy of exercise in Elderly. Subjects included 28 women elderly who were residents of H Dong, Dondae moon-Gu, Seoul. The treatment intervention was applied during total 8 weeks as 5 times/week for stretching exercise with 2 times/weeks for health education. Data collection were from February to April, 2004. SPSS Window program was used by aims of this study for data analysis. The results were as following: 1. 75 old age above (39.3%) was the most of age in subjects. None education (42.9%) was the most of subjects in this study. Perceived health state was the most as 71.4% in moderate and good health state. 2. Stretching exercise included health education, significantly effected on the total Cholesterol, HDL-cholesterol, triglyceride (p=.009*; p=.043*; p=.006*). However, the body fat weight was no significantly on the effect of stretching exercise included health education (p=.991). Also, stretching exercise included health education, significantly effected on total self-reported symptoms (p=.001*) with joint pain, joint rigidity, fatigue, indigestion, elimination disorder, and sleep disturbance. However, indigestion (p=.129) was no significantly on the effect of stretching exercise included health education. Self efficacy of exercise (p=.000*) was significantly on the effect. As according to this results, physical health index (total Cholesterol, HDL-cholesterol, triglyceride) and self-reported symptoms (joint pain, joint rigidity, fatigue, elimination disorder, and sleep disturbance) were reduced through stretching exercise included health education. Self efficacy was improved by this exercise program. Therefore, it is confirmed that stretching exercise included health education is an effective nursing intervention for physical, mental, and psychological health management in elderly. Accordingly, authors are proposing that variously effective health management exercise programs must be developed for elderly, at the same time, the application and following up on the programs will be more important in the future.

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신생아의 행동반응에 대한 실무교육이 간호사와 신생아와의 유희적 상호작용에 미치는 영향 (The Effects of In-service Education of Newborn's Behavior Response on the Nurse-Newborn Play Interaction)

  • 양영옥
    • 부모자녀건강학회지
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    • 제5권1호
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    • pp.1-23
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    • 2002
  • The purpose of this study was to find out the effect of in-service education on the nurse-newborn play interaction. The research design adopted the pre-experimental design applied only for one pretest-posttest group and Barnard's mother-infant interaction model was used as a conceptual framework. The subjects were 26 nurses who were selected from 2 nurseries in general hospital in Pusan, and 52 healthy newborns who were after 4 days from birth during data collection period at the same hospital. The data were collected from June 1st to October 5th in 2001, by video-taping for the interactive behaviors between the nurse and the newborn, played for 5 minutes in nurseries 2 weeks before and after in-service education. The in-service education consisted of the newborn's behavior responses focused on the newborn baby's states, behavior, cues and state modulation, 3 times per 1 week, 90 minutes per 1 time, lecture, demonstration and hand out project. The experimental tool used for this research was Ha Young-Soo's Korean translation of the Maternal-Infant Play Interaction Scale by Thompson, Jody Baird, Sara Gordman, Bryant(1982), some parts of which were adapted to be suitable for the purpose of this research. Mother and baby scale by Wolke & James-Roberts(1987) was also modified and used as the criterion of nurse's perception of a newborn baby. The results of this study were as follows: 1. This result supported the major hypothesis : After the intervention of in-service education, the nurse and newborn play interaction was promoted. 2. After intervention of in-service education, the nurse perception of newborn, especially the criteria of newborn's reaction was promoted., The results of this research confirm that in-service education on the newborn's behavior responses such as states, behavior, cues and state modulation is an effective way to improve the interaction between the nurse and the baby. It elevated the nurse's sensitivities to the baby's needs. Therefore, in-service education can change the conditions of current nursing practice mostly centered on physical care into a better one in which nurses consider the emotional, social, and intellectual development stages of babies. Accordingly, in-service education contributed to promoting the effective nurse-newborn play interaction so positively.

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우울증 환자 가족들의 심리적 스트레스에 관한 연구 : 정신분열병 환자 가족과 비교 (A Comparison Study on the Psychological Stresses of Families of Patients with Either Depression or Schizophrenia)

  • 김진희;이은정;정성원;성형모;사공정규;김정범
    • 대한불안의학회지
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    • 제6권1호
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    • pp.17-23
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    • 2010
  • Objective : This study compared the psychological stresses of depressed patients' families with those of schizophrenic patients' families. We investigated the influence of depressive patients' clinical features and their families' demographic characteristics on the families' depressive symptoms and stresses. Methods : Participants were 23 family members of depressed patients and 20 family members of schizophrenic patients. We measured the patients' clinical features (duration of illness, number of previous hospitalizations, and satisfaction with medication), and each family member's socioeconomic status and psychological characteristics (depressive mood, anxiety, family stress, and stress response), analyzing the data via independent t-test, chi-square test, and correlation and hierarchical multiple regression analyses. Results : The depressed patients' average clinical global impression (CGI) was significantly higher than that of the schizophrenic patients. The depressed patients' family members showed stress responses significantly higher than those of schizophrenic patients' family members. Furthermore, in depressed patients, frequency of hospitalization was positively correlated with family members' stat anxiety. For both patient types, family stress was positively correlated with the patient's severity of illness and the family's state anxiety, trait anxiety, and stress response ; socioeconomic status was positively correlated with the family's depressive symptoms ; the family's state anxiety positively correlated with the family's trait anxiety and stress response ; and the family's trait anxiety positively correlated with the family's stress response. Socioeconomic status predicted the family's depressive symptoms, and socioeconomic, illness severity and stress response predicted family stress. Conclusion : These findings suggest that both depressed patients' families and schizophrenic patients' families suffer from psychological stress. The study data also have important clinical implications, in that families of depressed patients need psychiatric intervention, as well as the patients themselves. In particular, family intervention should focus on psycho-education and stress coping strategies.

교육 프로그램을 포함한 집단작업치료가 치매환자의 우울, 불안, 활동참여에 미치는 영향: 무작위 대조군 사전-사후 설계 (The Effects of Group Occupational Therapy Including Education Programs on Depression, Anxiety, and Participation of Activities in People With Dementia)

  • 함민주;김희
    • 대한작업치료학회지
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    • 제26권4호
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    • pp.97-109
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    • 2018
  • 목적 : 본 연구는 교육 프로그램을 포함한 집단작업치료가 치매환자의 우울, 불안감, 활동참여에 미치는 영향에 대하여 알아보고자 하였다. 연구방법 : 치매환자 19명을 모집하였고 실험군 10명, 대조군 9명으로 무작위 배정하였다. 실험군은 집단작업치료와 교육 프로그램을 병행하였고, 대조군은 집단작업치료만을 실시하였다. 중재기간은 8주간 주 2회, 하루 2시간씩 동일하였으나 실험군의 치매환자와 보호자에게는 4가지 주제의 교육 프로그램을 하루 30분, 8회기 동안 추가로 실시하였다. 중재 전 후의 비교를 위하여 한국판 노인 우울척도(Korean form of Geriatric Depression Scale; K-GDS), 해밀톤 불안검사(Hamilton Anxiety Scale; HAM-A), 상태-특성 불안검사(State-Trait Anxiety Inventory; STAI-X-1), 한국형 활동분류카드(Korean-Activity Card Sort; K-ACS)를 사용하였다. 결과 : 중재 전 후의 차이를 비교하였을 시, 교육 프로그램을 포함한 집단작업치료군의 우울과 불안이 통계적으로 유의미하게 감소하였다(p<.05). 결론 : 교육 프로그램을 포함한 집단작업치료는 치매환자의 우울과 불안을 감소시키는데 유의한 효과가 있었다. 향후에는 치매환자의 심리 정서적 측면을 강화할 수 있는 중재 프로그램 개발과 더불어 보호자 교육에 중점을 둔 작업치료 영역에서의 다양한 연구가 진행되어야 할 것이다.