• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.147-161
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• 2004

Objectives: There are many habitual drinking in rural area. So it is the key point of drinking control policy in rural community to understand the drinking behavior in leisure time and to have an appropriate screening method for problem drinking. CAGE and AUDIT are famous screening tools for problem drinking and alcoholics. Even though there are some studies to validate CAGE and AUDIT which translated in Korean, they were not studied with community based population but with hospital based patients. In this study we assessed the usefulness of CAGE and AUDIT for selecting problem drinking in a rural population, and compared problem drinkers with normal group about spending leisure, Methods: The study subjects were 120 residents over 20 years old who lived in 3 districts in Dong-San Myun near Chun-chon city. We made up questionnaire by interview from Feb. 13 to 19, 2004. Results: The mean age of study population was 66.01 .26 years old. Defining the problem drinking as more than 12 score in AUDIT and more than 2 score in CAGE, the proportion of problem drinker was 30.600 and 28.9% respectively. This proportions were higher than those of other national wide studies. There were significant difference in drinking frequency per week and amount per one episode between problem drinker and normal group. Experience about driving, accident, injury, disturbance in working and quarrel after drinking were also significantly different. Problem drinker were more tolerable to the bad social culture about drinking (eg. force to drink, bad drunken habit. overdrinking, drinking relay etc.) than normal group. Watching TV and playing with neighborhood were most frequent method of spending leisure in this study population, normal male group exercised more frequently in leisure time than problem drinker. Conclusions: It may be useful to use CAGE and AUDIT score for screening problem drinking in rural community. Appropriate utilization of leisure time may he important for control of problem drinking in rural area.

• Korean Journal of Health Education and Promotion
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• v.21 no.4
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• pp.121-135
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• 2004

This study aims to analyze the oral health status of the elderly. Study subjects were 9,340 elderly aged over 65 who took the health examination (the first) for the local insured when the National Health Insurance Corporation carried out its survey from January to December, 2002. The subjects took an oral examination and filled in the questionnaire. Major results from the analysis are as follows: 1. Analysis of Oral Health Behavior For oral health behavior, 38.2％ of total subjects had visited a dental hospital (or clinic) in the last one year in the order of the elderly of big cities (48.3％), the elderly of medium cities (43.9％), and the elderly of rural areas (29.0％)(P<0.001). Elderly men had a higher rate than elderly women, and the younger age had a higher rate(P<0.01). For experience of oral prophylaxis, 12.3％ of the total elderly had experienced it in the order of the elderly of big cities (18.8％), the elderly of medium cities (16.0％), and the elderly of rural areas (6.4％) (P<0.001). For elderly men, the younger age had a higher rate of oral prophylaxis. The number of toothbrushing in order was twice(47.5％), once (26.7％), three times (25.0％), and none (0.7％). The younger age brushed their teeth more often (P<0.001). 2. Analysis of Oral Health Status The rate of caries was 10.6％ of the elderly surveyed. By area, the elderly of rural areas had a higher rate of caries than the elderly of cities (p<0.001) and elderly men were higher than elderly women (p<0.001). By age, many elderly aged over 80 had more than two caries. For missing teeth, the elderly of rural areas had a higher rate than the elderly of cities (p<0.001) and the older age had a higher rate(p<0.001). The rate of periodontal disease was 43.2％ of the total elderly. By area, the elderly of big cities (46.2％) had a higher rate of periodontal disease than the elderly of medium cities (39.4％) and rural areas (43.6％)(p<0.001), and elderly men (46.4％) were higher than elderly women (40.2％)(p<0.001). By age, the lower age had a higher rate of peridontal disease (p<0.001). Dental abrasion was observed in 16.9％ of the total elderly. The elderly of cities (21.0％) had a higher rate than the elderly of rural areas (12.0％)(p<0.001) and elderly men (21.3％) were higher than elderly women (12.8％)(p<0.001). Also the lower age had more dental abrasion symptoms (p<0.001). For needing a denture, the rate among the elderly was 48.5％ and was higher for the elderly of rural areas(20.9％), than the elderly of big cities(7.0％) and medium cities (10.5％)(p<0.001). For the rate of denture wearing, the elderly of rural areas(41.8％) were higher than the elderly of big cities (27.7％) and medium cities (28.2％ )(p<0.001). For the relation of drinking and smoking to oral health, the elderly who had a higher frequency of drinking, had a higher rate of caries (p<0.001)periodontal disease(p<0.001) and missing teeth(p<0.001) Smokers had a higher rate of caries (p<0.001), periodontal disease (p<0.05), and missing teeth (p<0.001) than nonsmokers.

• Journal of agricultural medicine and community health
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• v.36 no.4
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• pp.227-237
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• 2011

Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.209-220
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• 1996

This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

• Journal of agricultural medicine and community health
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• v.29 no.2
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• pp.265-285
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• 2004

Objectives: The acute toxic effects of pesticide are well known. Concern has also been expressed that long-term exposure may result in damage to the central nervous system. This study was conducted to test the hypothesis that central nervous system symptoms might occur due to pesticide exposure. Methods: In a cross-sectional study, first, cumulative exposure index (CEI) was estimated. Neurologic symptoms (Q-16 questionnaire) for 541 farmers (exposed to pesticides) were compared with 119 non-exposed persons in spraying season nine rural areas in Korea. Results: The pesticides poisoning rates for last 3 months were 67.2% for orchard farmers, 55.3%for dry field farmers, and 20.5% for husbandry farmers, respectively, showing significant difference (p<0.001). Compared with non-exposure group, exposure groups (especially, orchard farmers) reported significantly more neurologic symptoms and had a higher overall neurological symptoms score (p<0.001). Factors related to the positive neurological symptoms (answers "yes" to six or more of Q-16 questionnaire) adjusted for age, sex, education level, smoking and alcohol drinking were type of farming (OR 3.08, 95% CI 1.50-6.30 in orchard farmers vs non-exposure group), CEI (OR 2.75, 95% CI 1.12-6.78 in Q3 vs Q1), past poisoning (OR 1.97, 95% CI 1.21-3.20 vs normal), current mild poisoning (OR 3.03, 9500 CI 1.47-6.22 vs normal) and current moderate poisoning (OR 6.34, 95% CI 3.03-13.25 vs normal), respectively. Conclusions: These results suggest that long-term exposure to pesticides appears to be associated with subtle changes in the central nervous system.

• Journal of agricultural medicine and community health
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• v.35 no.1
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• pp.13-20
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• 2010

Objectives: This study was conducted to be identify the effects oral hygiene improvement of the elderly by caregiver in a rural. Methods: It recruited Fifty three elderly patients were recruited who admitted at a long-term hospital located in Mokchon city, Chungchungnam-do province. as the intervention group. Fifty two elderly patients group were selected another one long-term care hospital in Daegu city as control group. study was conducted for seven months. long-term care hospital. for seven months from Dec. 2007 to June 2008. For three months, the caregivers provide tooth brushing and cleaning artificial teeth once a day, to intervention group. once a day for three months. Results: Before the program there was no significant difference between the control and the intervention groups in general characteristics, prevalence rates of diseases, oral sanitary condition. Dental plague score was decreased significantly(p<0.001) before and after intervention in the intervention group. Using analysis of covariance for evaluation of the effect of the intervention, a significant difference was observed between the intervention group and the control group(p<0.01). Conclusions: These results were thought to be used as important basic data to develop oral health management program for elderly patients who needed long-term care.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.91-101
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• 1999

The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

• Pediatric Infection and Vaccine
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• v.6 no.1
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• pp.107-115
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• 1999

Purpose : Enterobiasis is probably one of the most common parasitic infection world-wide. Human is the only known host of Enterobius vermicularis. Children are more commonly infected with Enterobius vermicularis than adults and infections are commonly recurred. In Korea, there is a high prevalence. So, we performed this study to evaluate the present status of Enterobius vermicularis infection among children in the Masan, Changwon areas and to determine the efficacy of flubendazole against this parasitic nematode. Methods : From November to December, 1997, urban and rural elementary school children and urban preschool children were examined for the presence of Enterobius vermicularis egg. All the children were examined once by an adhesive cellotape anal swab technique in the early morning at home by their parents guided by specific instructions for the technique. Results : 1) A total of 644 adhesive cellotape anal swab specimens was collected from 205 urban elementary school children, 290 rural elementary school children and 145 urban preschool children. Among them, 114(17.7%) were positive for Enterobius vermicularis eggs. There was no significant differences in the rate with regard to sex. 2) In the preschool children, the egg detection rate was 42(29.0%) out of 145 children. This rate was significantly higher compared with 72(14.4%) of 499 school children. 3) The egg detection rates in the rural and urban school children were 15.2, 13.7% respectively. There was no significant difference in both groups. In the 3rd grade and below in elementary school children, there was a higher rate compared with above 4th grade group. 4) In day care center where egg detection rate was high as 41%, the children were given two doses of 100mg flubendazole every 3 weeks, including staffs and family members. After treatment, egg detection rate fatted as 6%. Conclusion : Our data demonstrated that there was high prevalence of Enterobius vermicularis infection. In the light of these results, it is necessary to examine and treat children as soon as possible.

• Journal of agricultural medicine and community health
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• v.2 no.1
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• pp.65-72
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• 1977

This study was made with 1394 clinical records obtained by a mobile charity health team in a rural Korea for 10 days from July 23 to Aug. 1, 1977 to see the disease pattern of the rural population in Korea. The health team consisted of 7 physicians in different clinical departments of the St. Mary's Hospital tried to cover as many as patients in that area by giving full informations and instructions before starting health services. which supposed to minimize the omissions of patients visits in that area. The proportion of each disease as well as its order in terms of the number of patients was reviewed by matching with age and sex distribution of patients, and with the duration of illness (complaints). Major findings obtained in this analysis were as follows; 1. Among 1394 patients, 536 (38.5%) was male and 858(61.5%) was female. As to the age distribution of the patients. those who are in the age group of 10-19 showed the highest proportion of 15.6% and those who are in the age group of 5-9 and 40-49 was the next with the proportion of 15.4% and 15.2% respectively. 2. The most prevalent cause of general morbidity were diseases of digestive system, diseases of nervous system and sensory organs, diseases of respiratory system, and diseases of skin and subcutaneous tissue in order. And their proportions among all patients were 21.8%, 20.7%, 14.5%, and 12.4% in respectively. The order of the diseases ranked by the number of patiens was slightly different in female population from that of total population, i. e. diseases of nervous system and sensory organs was the first. diseases of digestive system was the second, and the diseases of circulatory system was the third. 3. 23.2% of all patients were found to have had symptoms relating to their illness for more or less 5 years, and 18.3%, for more or less 6 months. Looking at the duration of illness by diseases, 28.6% of digestive tract disease patients and had the relating symptoms for about 1 week while 24.3% had had the symptoms for about 5 years, and in diseases of nervous system and and sensory organs, many(33.7%) had had symptoms for relatively long period (more than one year). On the other hand, in diseases of respiratory system, those who had had the relating symptoms for about 1 month was 24.3 % among all patients in this category and those who had had the symptoms for less than 1 week was 32.2%. 4. The duration of illness (complaints) was longer in females than in males and shorter in younger age groups than in older age groups.

• Journal of Preventive Medicine and Public Health
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• v.36 no.2
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• pp.101-107
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• 2003

Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.