• 한국노년학
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• 제31권4호
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• pp.1247-1263
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• 2011

현재 우리나라가 경험하고 있는 급속한 인구고령화 현상은 노년층 사이의 만성질환 및 의료서비스 이용의 증가로 연결된다. 의료서비스 이용은 궁극적으로 서비스 소비자들의 삶의 만족도에 영향을 준다. 하지만 노년기의 의료서비스 이용이 삶의 만족도에 미치는 영향이나 만성질환의 유무에 따라서 의료서비스 이용이 삶의 만족도에 미치는 영향이 상이한지에 대해서는 알려진 바가 많지 않다. 본 연구는 노년기 의료서비스 이용이 삶의 만족도에 미치는 영향에 대해서 살펴보고, 의료서비스 이용이 삶의 만족도에 미치는 영향이 만성질환 유무에 따라서 상이한지를 살펴보고자 한다. 이러한 목적을 달성하기 위해서 한국복지패널 3차년도 조사에 참가한 65세 이상 노인 3,944명을 대상으로 구조방정식(Structural Equation Modeling)과 다중집단 구조방정식분석(Multi-Group SEM)을 하였다. 관련변수들을 통제한 상태에서 주요결과는 다음과 같다. 노인 전체적으로는 외래서비스 이용이 많을수록 삶의 만족도 수준은 낮고, 입원일수가 많을수록 삶의 만족도 수준이 높은 반면, 건강검진 서비스 이용수준은 만족도와 유의한 관련성이 없었다. 하지만 의료서비스가 만족도에 미치는 영향은 만성질환의 유무에 따라서 상이하였다. 만성질환이 있는 사람들은 입원서비스 이용 수준이 삶의 만족도에 영향을 주지 않는 반면, 없는 사람들은 입원일수가 많을수록 삶의 만족도가 높았다. 질병이 있는 사람들은 건강 검진서비스 수준이 삶의 만족도에 영향을 미치지 않는 반면, 질병이 없는 사람들은 건강검진 서비스를 많이 받은 사람들의 만족도 수준이 낮았다. 외래서비스 이용이 만족도에 미치는 영향은 질명유무에 따라서 차이가 없었다. 이러한 결과는 노년기 의료서비스 이용이 삶의 만족도에 영향을 준다는 것과 의료서비스 이용이 만족도에 주는 영향이 만성질환이 있는 노인들과 없는 노인들 사이에 차이가 있을 수 있다는 점을 보여준다. 연구 결과를 토대로 이론적 실천적 함의에 대해서 논의하고 향후 연구의 방향에 대해서 제안하였다.

• 한국임상약학회지
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• 제28권2호
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• pp.117-123
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• 2018

Background: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. Methods: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. Results: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. Conclusion: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.

• Safety and Health at Work
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• 제3권1호
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• pp.11-16
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• 2012

Lead poisoning is one of the earliest identified and most known occupational disease. Its acute effects have been recognized from antiquity when this condition principally afflicted manual workers and slaves, actually scarcely considered by the medicine of that time. The Industrial Revolution caused an epidemic of metal intoxication, urging scientists and physician of that period to study and identify specific symptoms and organ alterations related to chronic lead poisoning. During the 20th century, the acknowledgment of occupational and environmental toxicity of lead fostered public awareness and legislation to protect health. More recently, the identification of sub-clinical effects have greatly modified the concept of lead poisoning and the approaches of medicine towards this condition. Nowadays, lead poisoning is rarely seen in developed countries, but it still represents a major environmental problem in certain areas. Consequently, it may appear as a paradigm of "occupational and environmental disease," and the history of this condition seems to parallel the historical development of modern "Occupational and Environmental Health" as a more complete medical discipline.

• 산업융합연구
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• 제20권12호
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• pp.39-47
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• 2022

본 연구는 지역사회 재가노인을 대상으로 우울과 연하장애의 수준과 그 관련성을 확인하기 위한 목적으로 시행한 횡단적 조사연구이다. 연구대상은 2개 도시에서 65세 이상의 노인 159명을 편의추출 방법으로 모집하였다. 수집된 자료는 기술통계, t-test, ANOVA, Pearson's correlation coefficient, Stepwise multiple regression으로 분석하였다. 분석결과에 의하면 대상자의 우울은 평균 4.56점이었고, 우울과 연하장애는 통계적으로 유의미한 정적 상관관계가 있었다. 또한 다중회귀분석을 통해 우울에 영향을 미치는 변수는 주관적 건강상태(𝛽=-.210, p=.019), 연하장애(𝛽=.202, p=.006), 만성질환 수(𝛽 =.188, p=.015), 구강상태(𝛽=-.174, p=.041)인 것으로 밝혀졌고, 이 변수들의 설명력은 23.9%였다. 그러므로 노인의 우울 감소를 위해 주관적 건강상태, 연하장애, 만성질환, 구강상태를 고려한 구체적이고 실질적인 건강관리 전략이 모색되어야 할것이다.

• Safety and Health at Work
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• 제10권3호
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• pp.362-369
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• 2019

Background: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods: We investigated 12 patients with indoor aire-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.

• 대한지역사회영양학회지
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• 제5권1호
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• pp.13-22
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• 2000

The study was curried out to collect information to establish a framework for nutrition education for the prevention of chronic degenerative disease. We analyzed differences in diet quality, food habits and health status of workers by work condition. Anthrometric parameters of height, weight and body fat were measured and biochemical parameters including glucose, total cholesterol, GOT, GPT and hemoglobin were determinded for 194 subjects. To assess the nutrient intake and diet quality of workers, dietary intake was measured by the day 24-hour recall method, Average daily nutrient intake, except for phos-phorous and vitamin C was lower than Korean RDA. The obesity related behavior score was significantly better in laborers than in office workers, while chronic degenerative diseases related to food habit score was significantly better in laborers than in office workers, while chronic degenerative diseases related to the food habit score was beet in offices workers than in laborers. Blood pressure, blood glucose levels were significantly higher in laborer than in office workers. Dietary variety score (DVS) food composition group score(FCGS), mean adequacy ratio(MAR) of office worker were better than those of labor workers. When diet quality was evaluated by FCGS(food composition group score) 16.0% of the subjects acquired 5 points and 14.4% of the subjects acquired 2 points.　MAR and INQ showed a significantly positive correlation with DVS and FCGS . This results indicated that the onset possibility of hypertension and diabetes mellitus among chronic degenerative disease was higher in laborers than in office workers, while the onset possibility of obesity was higher in office workers than in laborers. In conclusion the overall diet quality of office workers is betters than that of laborers, therefore, nutrition education for prevention of chronic degenerative disease of industrial workers needs to be more focused on the improvement of the health status of laborers.

• 셀메드
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• 제10권1호
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• pp.5.1-5.6
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• 2020

In the present highly changing era, every dimension from Technology to Education, Environment to Sanitation and from Agriculture to our Food basket is getting changed. Our experiences say that the most affected ethnic group from this rapidly changing pattern of our food intake, lifestyle are our adolescent. This is also a fact that our adolescent passes their 2/3 of time of a day in their schools. In this regard our school system needs to formulate their comprehensive approach to Health for our adolescents. On other hand Ayurveda, the ancient Indian system of Medicine had expressed views on a concept of Holistic Health thousand years ago. This research article is an attempt of borrowing this valuable concept from Ayurveda and suggesting to introduce them into our comprehensive school health programme such as concept of wellness, quality of life, Holistic Health and measures related to diet and lifestyle for preservation, promotion of health and prevention of disorders etc. This manuscript also evaluates the existing approaches of school health programmes towards current scenario. Now a day's our food habits, dietary intake and the life style are not at the level of satisfactory condition this lead to early onset of metabolic chronic disorder especially in our adolescents because on the basis of age-immunity relationship they are easily targeted. The chronic metabolic disorders results into overweight, obesity, anxiety, mental trauma, distress, over- fatigued, incapable for physical work, getting tired soon. This article provides a space to rethink and reformulate our school health programmes in light of our ancient tradition of medicine.

• 대한한의학회지
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• 제32권1호
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• pp.97-108
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• 2011

Objective: This study aimed to analyze the utilization of Oriental medical services and its determinants among the elderly. Method: Data from a Korean longitudinal study of aging was used. Regression analysis was used to find the determinants of the utilization of medical care. Results: People with low education and low income were more likely to use Oriental medical services. Determinants of using Oriental health service were sex, marriage, income, subjective health condition, activity restriction due to pain, and chronic disease. Among them, only subjective health condition and activity restriction due to pain were significant determinants of frequency of and expenditure on Oriental medical services. Especially, activity restriction due to pain was a significant factor in the use of Oriental medical services, but not in the use of Western medical services. Conclusion: Treatment related to pain was closely associated with Oriental medical services. These treatments need to be developed with scientific and clinical evidence.

• 대한간호학회지
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• 제32권1호
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• pp.28-39
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• 2002

The purpose of this study was to measure the prevalence of urinary incontinence (UI), urologic symptoms, chronic health problems they have, and to explore whether the differences in incidence of UI ware by age, sex, voiding pattern, and chronic health problems. Method: 298 subject were selected, age range from 60 to 94 years residing in one city, in republic of Korea. Data was collected presence of UI, urologic symptoms, chronic health problems, knowledge, and the discomfort with incontinent. Collected data was analyzed with frequency, percentage, t-test, and $\chi$2-test. Result: The results of this study are as follows: 1. Mean age was 71.4 years. Prevalent rate of UI was 17.0%, woman showed more than man. 2. UI incidence was significant in age (t=7.84, p=.000), sex ($\chi$2 =9.47, p=.002), and voiding frequency ($\chi$2=18.34, p=.000). Also, UI incidence was significant relationship with chronic health problem of heart disease ($\chi$2 =10.65, p=0.001), hypertension ($\chi$2=4.04, p= 0.046) and respiratory problem ($\chi$2=9.67, p=0.002). 3. The UI was grouped into urgent incontinence (45%), stress incontinence (33%), and combined (22%). UI occurred during the daytime 48% and 17% at night. 4. Only 9.8 % of the UI seek advice and/or treatment for their symptoms, almost 90 % remained untreated due to lack of knowledge or improper information. 5. The discomforts due to their UI was no significant difference in their condition, the urgent use of the rest room, leaking urine, and nocturia. Conclusion: This study suggests that 1 year and 3 year follow-up study is needed to compare health status of UI. Also suggests intervention study for urologic discomfort of incontinent and behavioral education for the elderly are needed.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.