• 대한간호학회지
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• 제15권2호
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• pp.5-15
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• 1985

This study was conducted for the purpose of fin-ding out the variance explaining the medical facilities utilization behavior, which is defined adaptation behavior Process by focal, contextual, residual stimuli in Roy's Adaptation Model. What kinds of characteristics can explain adaptation behavior in Roy's Model? And which is the relative importance of input variables? For this analysis, stepwise multiple regression and path analysis was used. The data come from the 1981 Baseline Household Interview Survey in remote rural area. The findings of the analysis can be summarized as follows: First, Total variance of independant variables for adaptation behavior, that is medical facilities utilization including clinic, drug store, health center, herb medicine was shown 16.2 percent. The most important variable which explain the dependent variable was the occurance of illness with the Ra of value 0.112. The illness symptom, living level, regular care source was shown important variables with relatively high the R²value and significant beta coefficient. Second, in the path analysis of variables which is selected important variables, the occurance of illness was shown variable which has the highest direct effect which 0.297 path coefficient. Also the education level of household was shown variable which has the highest indirect effect through living level and the occurance of illness in causal model. Third, This analysis suggests that the occurance of illness belonging focal stimuli are more influenced than others. To sum up, It is seem to the occurance of illness, illness symptom belonging focal stimuli have high explanation ability through direct effect, education level of household among contextual stimuli have explanation ability through indirect effect.

• 동의생리병리학회지
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• 제23권4호
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• pp.789-798
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• 2009

In Sasang constitutional medicine, I have researched the process of visceral structure in the Eight Constitutionals under circulation of the five elements and the formation of primary source of illness. From this research, I could draw following conclusions through combination of the auxiliary psycho-formulas by applying the constitutional acupuncture therapy on the five elements diagnostic calculation. Since the arrangement for the five dimensions of organs in the eight constitutions has been formulated by circulation of the five elements in Sasang constitutions, if the five elements begin circulating count-clockwise from the reference point at the organs in Sasang constitutional medicine, the positive constitutional arrangement of organs is built up such as, the positive constitution of metal, earth, wood and water, while begin circulating clockwise, the negative constitutional arrangement of organs is formulated, such as the negative constitutions of metal, earth, wood and water. The source of illness results from imbalance of the organic force being generated by transfer of the five elements from compatibility to incompatibility when the five elements circulate. Hence, it has been acknowledged that if the source of illness comes from the strongest organ, it is the time when circulation of the five elements progresses from the second organ (the second strongest) in incompatibility, and if the source of illness comes from the weakest organ, it is the time when circulation of the five elements progresses from the third organ (the middle) in incompatibility. It is considered proper to diagnose meridians of the pericardium and the Triple Burners rather than to diagnose meridians of the heart and the small intestine which forms the visceral arrangement of the eight constitutions. For instance, the auxiliary psycho-formula obtains its prescription by attenuating the first organ (the strongest) while augmenting the fourth organ (the second weakest) when the axis of incompatibility in the five elements circulation crosses the second and the third organs, and it gets its prescription by attenuating the second organ(the second strongest) while augmenting the fifth organ(the weakest) when the axis of incompatibility in the five elements circulation crosses the third and the fourth organs. In addition, when medicating, the $4{\sim}5$ times of repeated performance can be assumed to represent the amount of an energy that each organ bears depending on the phase in the arrangement of the eight constitutional organs.

• 사회복지연구
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• 제41권2호
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• pp.35-65
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• 2010

본 연구는 최근에 이루어진 '건강보험 보장성 확대' 정책의 효과를 개인의 의료이용 및 건강수준을 중심으로 평가하였다. 2005년부터 시행된 건강보험 보장성 확대 정책은 암 등의 중증질환자에 대한 본인부담 경감, 입원환자 식대의 급여전환, 비급여항목의 급여전환, 본인부담상한제 시행 등을 주요 내용으로 한다. 이러한 정책 변화에 대해 만성질환을 보유하고 있어 의료욕구가 일반적으로 높은 제도의 주요 수혜집단에 비해 급성질환 등으로 의료서비스를 이용한 집단의 입원이용이 상대적으로 증가한 것과 제도의 직접적인 수혜집단인 중증질환자 집단의 입원이용이 상당 정도 증가한 것을 확인하였다. 또한 이러한 건강보험제도의 변화가 입원이용에서 혜택을 누린 중증질환자의 단기간의 건강평가지표인 2주간 이환경험 면에서 긍정적인 개선을 이끌어내고 있음을 확인하였다. 본 연구는 건강보험제도가 의료이용 및 건강수준에 인과적인 효과를 나타내고 있음을 확인하였고, 이후 건강보험 보장성 확대의 정책설계에 대한 정책적 함의를 제공한다.

• 대한간호학회지
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• 제29권3호
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• pp.639-655
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• 1999

An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregivers. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire (MSQ), Social Support Inventory Stroke Survivors (SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidemilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective burden. Professional support was found significantly related to patient's IADL & depression. Illness intrusiveness as a mediating variable was a sig nificantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients. As a result, patient's age, cognitive function, illness intursiveness and professional support significantly predicted the level of IADL ; patient's cognitive function, illness intrusiveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive funtion were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.

• 보건행정학회지
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• 제4권2호
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• pp.58-76
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• 1994

In order to study factors affecting the use of the ambulatory physician services. Andersen's model for health utilization was modified by adding the health behavior component and examined with three different approaches. Three different approaches were the multiople regression model, logistic regression model, and LISREL model. For multiple regression, dependent variable was reported illness-related visits to a physician during past one year and independent variables are variaous variables measuring predisposing factor, enabling factor, need factor and health behavior. For the logistic regression, dependent variable was visit or no-visit to a physician during past one year and independent variables were same as the multiple regression analysis. For the LISREL, five endogenous variables of health utiliztion, predisposing factor, enabling factor, need factor, and health behavior and 20 exogeneous variables which measures five endogenous variables were used. According to the multiple regression analysis, chronic illness, health status, perceived health status of the need factor; residence, sex, age, marital status, education of the predisposing factor ; health insurance, usual source for medical care of enabling factor were the siginificant exploratory variables for the health utilization. Out of the logistic regression analysis, health status, chronic illness, residence, marital status, education, drinking, use of health aid were found to be significant exploratory variables. From LISREL, need factor affect utilization most following by predisposing factor, enabling factor and health behavior. For LISREL model, age, education, and residence for predisposing factor; health status, chronic illess, and perceived health status for need factor; medical insurance for enabling factor; and doing any kind of health behavior for the health behavior were found as the significant observed variables for each theoretical variables.

• 한국축산식품학회지
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• 제41권1호
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• pp.1-7
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• 2021

This mini review focuses on foodborne illnesses and outbreaks caused by food-producing animals because statistical information of the foodborne illnesses is important in human health and food industry. Contaminated food results in 600 million cases of foodborne diseases and 420,000 deaths worldwide every year. The world population is currently 7.8 billion, and 56 million people die every year; of these, every year, 7.69% of people experience foodborne diseases, and 7.5% of annual deaths (56 million deaths) was died by foodborne illness in the world. A majority of such patients are affected by norovirus and Campylobacter. Listeria monocytogenes is the most fatal. In the United States, except for those caused by Campylobacter, the number of foodborne diseases did not decrease between 1997 and 2017, and cases caused by Toxoplasma gondii are still being reported (9 cases in 2017). The percentage of foodborne illnesses caused by food-producing animals was 10.4%-14.1% between 1999 and 2017 in the United States. In Europe, foodborne illnesses affect 23 million people every year and cause approximately 5,000 deaths. Europe has more Campylobacter- and Salmonella-related cases than in other countries. In Australia, the highest number of cases are due to Campylobacter, followed by Salmonella. In Korea, Escherichia coli followed by norovirus. Campylobacter- and Clostridium perfringens-related cases have been reported in Japan as well. This review suggests that Campylobacter, Salmonella, L. monocytogenes, and E. coli, which are usually isolated from animal-source food products are associated with a high risk of foodborne illnesses.

• Journal of Microbiology and Biotechnology
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• 제27권10호
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• pp.1753-1762
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• 2017

Sea cucumber (Apostichopus japonicus) is a popular seafood source in Asia, including South Korea, and its consumption has recently increased with recognition of its medicinal properties. However, because raw sea cucumber contains various microbes, its ingestion can cause foodborne illness. Therefore, analysis of the microbiota in the whole body of sea cucumber can extend our understanding of foodborne illness caused by microorganisms and help to better manage products. We collected 40 sea cucumbers from four different sites in August and November, which are known as the maximum production areas in Korea. The microbiota was analyzed by an Illumina MiSeq system, and bacterial amounts were quantified by real-time PCR. The diversity and bacterial amounts in sea cucumber were higher in August than in November. Alpha-, Beta-, and Gammaproteobacteria were common dominant classes in all samples. However, the microbiota composition differed according to sampling time and site. Staphylococcus warneri and Propionibacterium acnes were commonly detected potential pathogens in August and November samples, respectively. The effect of experimental Vibrio parahaemolyticus infection on the indigenous microbiota of sea cucumber was analyzed at different temperatures, revealing clear alterations of Psychrobacter and Moraxella; thus, these shifts can be used as indicators for monitoring infection of sea cucumber. Although further studies are needed to clarify and understand the virulence and mechanisms of the identified pathogens of sea cucumber, our study provides a valuable reference for determining the potential of foodborne illness caused by sea cucumber ingestion and to develop monitoring strategies of products using microbiota information.

• 보건의료기술평가
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• 제6권2호
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• pp.123-132
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• 2018

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

• Journal of Preventive Medicine and Public Health
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• 제51권2호
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• pp.100-108
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• 2018

Objectives: Family members are often cancer patients' primary source of social and emotional support and make a major contribution to how well patients manage their illness. We compared the prevalence of depression in the family members of cancer patients and the general population. Methods: This study used the data from the fourth, fifth, and sixth rounds of the Korea National Health and Nutrition Examination Survey. The variable of interest was the presence of a cohabitating cancer patient in the family and the dependent variable was the presence of diagnosed depression. Results: The odds of having medically diagnosed depression in those with a cohabitating cancer patient in the family were significantly higher than among those who did not have cancer patients in their families (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.12 to 2.17; p=0.009). The OR for females was 1.59, and this increase was statistically significant (95% CI, 1.09 to 2.31; p=0.02). Conclusions: We need to invest more effort into diagnosing and managing depression in the family members of cancer patients. This will have an impact both on their quality of life and on the well-being of patients, as supporters and caregivers play an instrumental role in helping patients manage their illness.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.10-16
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• 2000

Objectives : This study was carried out to investigate the sources of infection and modes of transmission of an outbreak of shigellosis that occurred among students of B middle and high school in Bonghwa, Korea from May 1 to 21, 1999. Methods : We conducted questionnaires to 468 students, 38 stalls and 9 food handlers twice times (May 6, May 21) for follow up and secondary attack rate. Personal details and history of illness and exposure to particular foods were sought. And we conducted rectal swab for culture to 243 students, 33 staffs and 9 food handlers. Bacteriological examinations of water in the school were done. Cases were identified as subjects who had diarrhea (two or more loose stools in a 24-hour periods) on or after May 1. Results : A total of 307 cases (attack rate: 59.6%) of 515 subject were identified, including 50 confirmed (46 students and 4 staffs) by S. sonnei. All 9 food handlers denied illness and were had rectal swab for culture at May 6 that were negative for S. sonnei. 146 of 307 reported fever, 156 had tenesmus, 44 reported vomiting, and only 5 of 307 reported blood in the stool. The median duration of diarrhea was 4 days (range: 1-18 days). The mean incubation period until onset of diarrhea was 63 hours (range: 46-144 hours) and the secondary attack rate was 2.8% (43 cases of 1,561 family members). Risk for illness was higher among students who had eaten watered kimchi at March 30 than among those who did not [301(72.7%) of 417 versus 5(9.6%) of 52; RR=7.51;95% CI=3.26-17.31]. Conclusion : The source of infection was estimated to be contaminated watered kimchi by ore or two food hardier who is presumed to be carrier.