• 농촌의학ㆍ지역보건
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• 제19권1호
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• pp.31-39
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• 1994

We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.405-415
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• 2019

Objectives: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. Methods: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants' frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. Conclusions: More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.179-186
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• 2019

Purpose: Information about overweight and obesity among students in rural areas of Thailand is limited. Therefore, we aimed to determine overweight and obesity prevalences and associated factors among school-aged children in a rural community of Thailand. Methods: We selected 9 public schools through cluster sampling in 2 provinces located in central Thailand in 2016. Anthropometric measurements were measured using standard techniques, classified as overweight (>1 standard deviation [SD]) and obese (>2 SD) with respect to their age and sex using 2007 World Health Organization reference charts. Standardized questionnaires on risk factors were sent to parents to be completed together with their child. Results: Among 1,749 students, 8.98% had overweight and 7.26% had obesity. Mean age (range) was 11.5 years (5-18 years). Independent factors associated with overweight and obesity included primary school student (reference as secondary school) (adjusted odds ratio [aOR], 2.25; 95% confidence interval [CI], 1.24-4.08; P=0.07), mother's body mass index (aOR, 1.07; 95% CI, 1.02-1.12; P=0.001), self-employed father (aOR, 1.99; 95% CI, 1.12-3.55; P=0.018), number of siblings (aOR, 0.61; 95% CI, 0.47-0.81; P=0.001), having sibling(s) with obesity (aOR, 1.82; 95% CI, 1.20-2.77; P=0.005), more than one (aOR, 7.16; 95% CI, 2.40-21.32; P<0.001), consuming 2-3 ladles of rice/meal (aOR, 2.14; 95% CI, 1.38-3.32; P=0.001), consuming >3 ladles of rice/meal (aOR, 2.69; 95% CI, 1.11-6.46; P=0.27), watching <2 hours of television/day (aOR, 2.18; 95% CI, 1.19-4.01; P=0.012), and watching >2 hours of television/day (aOR, 2.60; 95% CI, 1.36-4.96; P=0.004). Conclusion: Many sociodemographic, dietary, and behavioral factors were related to overweight and obesity among school-aged children not only in urban but also rural communities of Thailand.

• 융합정보논문지
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• 제11권5호
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• pp.38-49
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• 2021

본 연구는 농촌 지역에 거주하며 치매안심센터에 등록된 노인을 대상으로 태블릿을 활용한 웹 기반 인지훈련 프로그램이 인지와 우울에 미치는 영향과 효과를 확인하고자 시행된 단일군 전후 설계 연구이다. 대상자는 치매 고위험 노인과 경도 치매 노인 18명으로 웹 기반 인지훈련 프로그램은 주 1회, 1시간, 10회기 동안 제공되었다. 자료는 SPSS 24.0을 이용하여 Wilcoxon 검정의 비모수검정 방법으로 분석하였고, 프로그램 종료 후 시행한 면담은 분류과정을 거쳐 분석하고 서술하였다. 연구 결과, 대상자의 인지 점수는 유의하게 상승(Z=-3.35, p=.001) 되었고, 우울 점수는 유의하게 감소(Z=-3.13, p=.002) 되었다. 또한, 면담에서도 인지와 우울에 긍정적인 효과를 확인하였다. 따라서 본 연구를 바탕으로 시간과 장소에 제한을 받지 않도록 스마트 기기 접근 환경을 보완하고, 인지 수준별 다양한 종류의 웹 기반 프로그램이 개발, 적용되어야 한다. 그러면 농촌 지역의 치매 예방과 관리를 위한 정보통신 기술이 융합된 인지훈련 프로그램으로 활용될 수 있을 것으로 기대된다.

• 농촌의학ㆍ지역보건
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• 제48권2호
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• pp.118-131
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• 2023

본 연구는 한국에 거주하는 베트남 가임기여성과 베트남에 거주하는 베트남 가임기여성의 산전건강관리 지식과 산전건강관리 실천행위 및 우울정도를 파악하여 베트남 이주여성의 산전건강관리 중재프로그램 개발에 기초적 자료를 제공하는데 목적을 두고 시행된 서술적 조사 연구이다. 베트남 가임기여성(한국거주 여성 113명과 베트남거주 여성 196명)을 대상으로 하였다. 연구결과 연구대상자의 산전건강관리 지식은 한국거주 가임기 여성이 높았으나 통계적으로 유의하지 않았다. 한국거주 및 베트남거주 모두 통계적으로 유의하게 기혼여성의 지식점수가 높았다. 연구대상자의 산전건강관리 실천행위 분석결과 결혼 유무 및 거주지역에 따른 유의한 차이는 보이지 않았다. 항목별로 보았을 때 '병원에서 산전진찰을 규칙적으로 받을 것이다.'는 베트남거주 기혼여성이 미혼보다, 농촌여성이 도시여성보다 유의하게 낮았다. 가장 낮은 점수를 보인 것은 한국거주여성의 '임신과 출산정보를 찾아볼 것이다' 이었다. 연구대상자의 우울정도는 베트남 거주여성의 경우 기혼여성이, 농촌에 거주 하는 여성이 유의하게 우울점수가 높게 나타났다. 베트남 결혼이주 여성을 위한 산전관리 중재를 개발 할 때 베트남 본국 농촌에서 이주하는 경우는 좀더 특별한 관심이 필요하며, 산전건강관리의 중요성과 정신건강을 위한 요소가 포함되어야 할것으로 사료된다.

• 농촌의학ㆍ지역보건
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• 제31권2호
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• pp.187-208
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• 2006

본 연구는 인도네시아 농촌지역의 가임여성들을 상대로 구순구개열 발생에 영향을 미치는 환경요인들을 분석하고자 하였고 아울러 농촌 주민들의 수질환경, 영양상태에 관한 계략적인 지역조사를 함께 실시하였다. 환자군은 무료 구순구개열 수술을 받으러온 11명에 대해 부모를 상대로 혈액 검사와 함께 환경요인들을 조사하였고, 대조군은 농촌마을 2개 지역에서 환자군의 부모와 같은 연령대의 가임 여성 56명을 상대로 조사를 실시하였다. 아울러 농촌 마을 4개 지역 총 19가정을 방문하여 생활환경 관찰과 수질검사를 실시하였다. 환자군과 대조군의 비교에서 기존 논문들에 보고 된 항목들과는 달리 식수원의 차이가 유의성이 있었다. 즉 강물을 식수로 사용하는 사람들이 다른 종류의 식수를 사용하는 사람들과 비교해서 구순구개열의 odds ratio가 17.9(3.9-82.8, p=0.00)로 나타났다. 따라서 다음연구에서 잘 선정된 control을 통하여 한번 더 유의성을 확인해야 할 필요가 있지만 강물의 오염성분으로 강력 하게 추정되는 Nitrate-N과 Mercury에 대한 추가 연구가 필요함을 알 수 있었다. 대조군을 대상으로 한 조사와 해당 농촌지역의 가구들을 방문함으로서 인도네시아 농촌지역의 생활환경을 알 수 있었다. 식수원은 수무르와 지하수, 강물, 빗물 등이었고 84%가 웅덩이 형태의 수무르에서 식수를 채수하였는데, 수질검사결과 일반세균, 대장균군 세균의 오염이 매우 심각하였으나 아질산성질소, 질산성질소는 거의 관찰되지 않았다. 말라리아나 티푸스 같은 수질환경과 관련된 질병을 임신기간 중 경험한 응답자도 23%나 되었다. 특이한 점은 정부의 보건교육의 성과로 물은 항상 끊여 먹었는데 문제는 그 끊인 물도 세균 오염이 심각한 것을 관찰할 수 있었다. 이는 아직 수정되지 않은 그들의 용변습관으로 말미암아 언제나 오염되어 있는 손에 의한 주거환경오염 때문일 것으로 추정된다. 십여 미터의 깊이에 펌프를 이용하여 지하수를 채수하는 가정들의 경우는 세균오염이 관찰되지 않았으므로 농촌 지역에서 비교적 바람직한 식수원으로 여겨진다. 영양적 측면에서는 전체적으로 식사량이 작고 식단의 종류도 단순하며 채식위주의 식단이었으나 항상 팜유에 채소를 복아서 먹음으로써 전체적으로는 영양이 불충분한 것으로 생각된다. 평균키도 151.2cm(CI 95%, 150.0, 152.4)로서 한국여성에 비해 단신이었으나 BMI를 통해서 볼 때, 21.1( 95%CI = 20.2, 22.0)로서 정상체중 범위였다. 음주나 흡연은 회교전통에 따라 여성들의 경우 대부분 음주력, 흡연력이 없었다.

• 농촌의학ㆍ지역보건
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• 제14권1호
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• pp.16-29
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• 1989

The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

• 인터넷정보학회논문지
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• 제19권5호
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• pp.97-105
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• 2018

In this paper, we present our recent effort on the development of a portable OCS system (SCH-mOCS), which provides minimal but essential functionalities of conventional OCS systems. SCH-mOCS is targeted for the environment where Internet connection is not available and fast processing of essential patient information is needed. The main usage could be found at the outdoor environment, such as voluntary medical services at challenged regions. The target of the first usage of the system is in the rural area of Cambodia where medical service and ICT infrastructure is poor. We have been conducting voluntary medical services for 15 years in Cambodia, where the services usually run for 3 days and include outpatient diagnosis/consultation, medication, and simple surgeries. This medical service started in 2002, where about 20 SoonChunHyang University Bucheon Hospital staffs (doctors, nurses, and pharmacists) participated. We realized that a system like SCH-mOCS is needed: we have to consult many patients in a short period, so that a prompt response and prescription to the patients are very important. However, the conventional OCS system is not suitable, because the service is usually conducted outdoor environment where Internet connected computers cannot be installed. Moreover, since the service needs only a subset of the conventional hospital information system and fast system response, application of a full OCS is not practical. The adequate system is a bare minimal OCS system, with very simple and quickly manageable patient admission, consultation, and prescription functionalities. In this paper, we describe hardware as well as the software aspect of a mini-OCS we have developed for the purpose. We named the system SCH-mOCS (SoonChunHyang mini-OCS). We also describe the usage scenario of SCH-mOCS in order to demonstrate that the system is general enough to apply for other similarly challenged regions.

• Parasites, Hosts and Diseases
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• 제56권3호
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• pp.229-236
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• 2018

Cutaneous leishmaniasis (CL) has been one of the most common parasitic diseases in Saudi Arabia. This study exhibits the clinical features, diagnosis, cytokine profile and treatment of CL patients in Al-Taif province. Ninety CL suspects at a tertiary care general hospital were enrolled in one-year study. Patients were interviewed, clinically-examined, and subjected to laboratory tests: skin scraping smear microscopy, OligoC-TesT commercial PCR (Coris BioConcept) and kinetoplast DNA (kDNA) PCR for Leishmania diagnosis. Interferon-gamma (RayBio; Human $IFN-{\gamma}$ ) and nitric oxide (NO) levels in patients' sera were evaluated before treatment with sodium stibogluconate (pentostam) with 20-day intramuscular drug regimen. Positive rates of microscopy, commercial PCR and kDNA PCR were 74.4%, 95.5% and 100%, respectively. Patients came to hospital mostly in winter (45.0%). CL was frequently exhibited in Saudi patients (78.8%), male gender (70.7%), age <20 years (50.0%), rural-dwellers (75.5%) and patients with travel history (86.6%). Lesion was mostly single ulcer (93.3%), occurred in the face (67.7%). Upon pentostam treatment, 85.1% of ulcers showed rapid healing signs. Levels of $IFN-{\gamma}$ and NO were significantly higher in the healing than the non-healing cases (P<0.001). The kDNA PCR proved more sensitive than microscopy and OligoC-TesT commercial PCR. Our results open perspectives for $IFN-{\gamma}$ use as a biomarker predicting treatment response.

• Annals of Geriatric Medicine and Research
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• 제20권3호
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• pp.114-117
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• 2016

A research project, the "Construction of Frailty Cohort for Elderly and Intervention Study," funded by the Ministry of Health and Welfare, has been ongoing since December 2015. The Korean Frailty and Aging Cohort Study (KFACS) aims to identify risk factors for adverse outcomes associated with frailty in community-dwelling older adults, as well as means of prevention. KFACS is a multicenter, longitudinal study, with the baseline survey being conducted in 2016-2017. The sample (n=3,000) consists of those aged 70-84 years, stratified by age and gender, recruited from urban and rural regions nationwide. An in-person interview and health examination are performed every 2 years. This project is also conducting many intervention studies. Project interventions focus on nutrition and exercise. The nutritional intervention study compares the effects of 1.2 g/kg versus 1.5 g/kg daily protein intake on sarcopenia and frailty in older Koreans. The exercise trial examines the effectiveness of an information and communication technology-based program in preventing or reducing frailty.