Pneumococcal Vaccination Rate and Related Factors in Older Adults in Republic of Korea / 農村醫學 地域保健

Objectives@#This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. @*Methods@#The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. @*Results@#The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. @*Conclusions@#In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country's infection control policy.

Investigation of adverse events following bacille CalmetteGuérin immunization using immunization safety surveillance system in Korea Centers for Disease Control and Prevention

Purpose@#The report of adverse events following immunization (AEFI) in Korea has continued since 1994, and the most frequently reported cases of AEFI of Korea Centers for Disease Control and Prevention (KCDC) is bacille Calmette-Guérin (BCG). Meanwhile, various inoculation methods and strains have been used in the past 6 years in Korea. Therefore, we investigated AEFI of BCG by strain types and inoculation methods using immunization safety surveillance of KCDC. @*Materials and Methods@#We reviewed BCG AEFIs registered in the KCDC from January 2013 to June 2018. @*Results@#There were 336 AEFI cases during the period, and average time interval from vaccination to symptom onset was within 2 months. AEFI proportion was 6.4 cases per 100,000 doses for BCG percutaneous Tokyo strain, 41.6 cases per 100,000 doses of BCG intradermal Danish strain, and 25.9 cases per 100,000 doses of BCG intradermal Tokyo strain. Intradermal type was more reported AEFI than percutaneous type in the same strain. The most common adverse events were local reaction like BCG lymphadenitis and severe adverse reactions such as osteomyelitis or disseminated BCG disease were 0.1 to 0.2 cases per 100,000 doses which are correlated with the range of World Health Organization published AEFI rates. @*Conclusion@#The AEFI reporting rate does not equal the actual proportion of AEFI occurrence. Because AEFI monitoring is a passive surveillance system, various factors might influence the number of events reported. Nevertheless, it is important to analyze BCG AEFI by vaccine strains and inoculation method using surveillance data of KCDC.

Investigation of adverse events following bacille CalmetteGuérin immunization using immunization safety surveillance system in Korea Centers for Disease Control and Prevention

Purpose@#The report of adverse events following immunization (AEFI) in Korea has continued since 1994, and the most frequently reported cases of AEFI of Korea Centers for Disease Control and Prevention (KCDC) is bacille Calmette-Guérin (BCG). Meanwhile, various inoculation methods and strains have been used in the past 6 years in Korea. Therefore, we investigated AEFI of BCG by strain types and inoculation methods using immunization safety surveillance of KCDC. @*Materials and Methods@#We reviewed BCG AEFIs registered in the KCDC from January 2013 to June 2018. @*Results@#There were 336 AEFI cases during the period, and average time interval from vaccination to symptom onset was within 2 months. AEFI proportion was 6.4 cases per 100,000 doses for BCG percutaneous Tokyo strain, 41.6 cases per 100,000 doses of BCG intradermal Danish strain, and 25.9 cases per 100,000 doses of BCG intradermal Tokyo strain. Intradermal type was more reported AEFI than percutaneous type in the same strain. The most common adverse events were local reaction like BCG lymphadenitis and severe adverse reactions such as osteomyelitis or disseminated BCG disease were 0.1 to 0.2 cases per 100,000 doses which are correlated with the range of World Health Organization published AEFI rates. @*Conclusion@#The AEFI reporting rate does not equal the actual proportion of AEFI occurrence. Because AEFI monitoring is a passive surveillance system, various factors might influence the number of events reported. Nevertheless, it is important to analyze BCG AEFI by vaccine strains and inoculation method using surveillance data of KCDC.

Analysis of Medical Expenses Structure for Patients on Percutaneous Coronary Intervention by Medical Security Type / 農村醫學 地域保健

OBJECTIVES@#The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention.@*METHODS@#Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses.@*RESULTS@#In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses.@*CONCLUSIONS@#Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

Factors Associated with the 2017–2018 Seasonal Influenza Vaccination Coverage among Elementary, Middle, and High School Students

PURPOSE@#During the 2017–2018 season, influenza vaccination among elementary, middle, and high school students was not supported by the government. As vaccines that are not included in the national immunization schedule are not registered in the computerized national immunization registry, vaccination rates in these groups during this season remain unknown. Thus, the aim of this study was to estimate the vaccination rate among elementary, middle, and high school students during the 2017–2018 influenza season.@*METHODS@#A total of 1,910 student's parents (690 elementary school students; 611 middle school students; 609 high school students) participated in this survey. The survey involved a computer-assisted telephone interview (CATI). The following information related to participants' 2017–2018 seasonal influenza vaccination status were collected: date, type, provider, and data source. Other data collected included student's sex, grade, area of residence, and birth order, and parent's age, educational level, and job status.@*RESULTS@#The influenza vaccination rate for the 2017–2018 season was 70.1%, 48.9%, and 35.9% for elementary, middle, and high school students, respectively. Factors that were significantly related to the influenza vaccination rate in the 2017–2018 season were student's sex, grade, area of residence and birth order, and parent's age, educational level, and job status.@*CONCLUSION@#In the future, it will be necessary to conduct regular assessments of the rate of seasonal influenza vaccination to inform national policy development regarding seasonal influenza infectious diseases control or as an evaluation tool for vaccine programs.

Rotavirus Vaccine Coverage and Related Factors

PURPOSE: The vaccination level of rotavirus vaccine not supported by the government is not known. As vaccines not included in the national immunization schedule are not registered in the computerized national immunization registry system, their vaccination rate cannot be calculated according to the same method used in government-supported vaccines. Therefore, this study aimed to measure the status of the vaccination rate of rotavirus not included in the national immunization schedule. METHODS: The target population is the 0-year-old cohort. The survey population was composed of registered children born in 2017 enrolled in the Immunization Registry Information System. The survey was conducted through a computerized telephone survey method. The survey variables were as follows: vaccination order and date, provider, and data source. Factors related to complete vaccination were the child's sex, residence, birth order, and parents' age, educational level, and job status. RESULTS: Children's vaccination rates for the rotavirus vaccine by 2017 were 88.0%, 86.9%, and 96.6% for the first, second, and third doses, respectively. The rate of complete vaccination was 85.6%. The factors related to rotavirus complete vaccination were the child's sex and birth order, area of residence, parents' age and job status, and father's education level. CONCLUSION: In the future, it is necessary to conduct regular investigations on the rate of rotavirus vaccination as a tool for the development of the rotavirus infectious diseases control policy or as an evaluation tool for vaccine programs.

Suicidal Ideation of Elderly Living Alone in Urban and Rural Areas, its Related Factors / 農村醫學 地域保健

OBJECTIVES: This study used data of urban and rural elderly living alone to compare the general characteristics of the elderly who have had suicidal ideation, and to investigate the suicidal ideation of urban-rural elderly with varying degrees of emotional support status, health status, and health behavior. METHODS AND MATERIALS: The research participants included 2,750 elderly aged 65 or above, of which 1,487 were from dong unit and 1,263 were from eup·myeon units according to the raw data of 2011 Survey on Elderly Status. All collected data were analyzed using cross tabulation of SPSSWIN(ver 21.0) program and multivariate logistic regression. RESULTS: The results were as follows. First, the factors that influenced the suicidal ideation of urban and rural elderly living alone included degree of depression, experience of abuse, and nutritional management status. Second, the suicidal ideation of urban elderly living alone was affected by the emotional support of their children who live apart and their grandchildren. Third, the suicidal ideation of rural elderly living alone was affected by the emotional support of their kin (including siblings).

Investigation of Children with No Vaccinations Recorded on the National Immunization Registry Information System

PURPOSE: To improve the quality of the vaccination program, analyze the cause and identify the influencing factors for not being registered in the National Immunization Registry Information System even once. METHODS: We conducted one-on-one household visit interview surveys after, using a list supplemented with addresses from the Ministry of the Interior. We identified the basic respondent information, information on relevant children (those born in 2012), the reasons for omission from computerized vaccination registration, and the actual residence of the registered children. RESULTS: The total number of unvaccinated children born in 2012 was 1,870. The final contact result of the household surveys was 1,254 successful contacts, 51 refused to be interviewed, and 565 were not found. The reason for missed vaccination registration was 928 cases of long-term stay overseas, 241 cases of missing registration owing to intentional refusal of vaccination, and 57 cases of illness. A comparison of complete vaccination rates between non-registrants and those of computerized registrants revealed rates of 17.9% and 96.3% for the 3 doses hepatitis B vaccine, 14.9% and 95.6% for the 4doses DTaP vaccine, 16.1% and 97.4% for the 3 doses polio vaccine, and 3.9% and 92.5% for the 3 (or 2) doses Japanese encephalitis vaccine, respectively. CONCLUSION: Vaccination is the most effective national health policy and one of the most remarkable accomplishments in medical history. Through great effort, Korea has started to transcribe vaccination records since 2000, and the records are now reaching a considerable level. However, there is an unregistered population of around 0.3%. Several measures can be taken to improve the registration rate in the vaccination records, such as managing non-registrants through education and interviews, and sharing vaccination data with foreign countries. The non-registrant management plan should include periodically compiling a list of children who are not registered in the National Immunization Registry Information System, conducting of household visits using survey forms, and data analysis to establish appropriate measures.

Development of Models for Regional Cardiac Surgery Centers

BACKGROUND: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. METHODS: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts. RESULTS: After partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the ‘independent regional cardiac surgery center’ model, the ‘satellite cardiac surgery center within hospitals’ model, and the ‘extended cardiac surgery department within hospitals’ model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually. CONCLUSION: The operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.

Effects of Job Participation on Intention to Leave among Physicians Working in Public Health Center / 보건행정학회지

BACKGROUND: Intention to leave was an important managerial issue among physicians working in public health centers. This study was conducted to explore the relationship between job participations and intention to leave among physicians working in health centers. METHODS: A cross-sectional questionnaire survey was conducted to gather information about job participation, intention to leave and demographics among physicians (n=243) in public health centers in Korea. Job participation was measured by 15 items categorized 3 dimensions. Multiple regression analysis was performed to determine the effect of job participation on intent to leave among physicians working in public health center. RESULTS: Participation of medical treatment and administrative job were significantly associated with intention to leave adjusted for sex, age, income, working area, working duration, tenure, and overall job satisfaction. Therefore, physicians who actively participated in administrative job showed a lower turnover intention. Physicians who actively participated in medical treatment job had a higher quit intention. CONCLUSION: To retain qualified physicians in public health center, education should be reinforced to physician for administrative capacity building.

Factors Related to Physical Activities of Elderly with Hypertension between Urban and Rural Areas / 農村醫學 地域保健

OBJECTIVES: This study was performed to find the differences in physical activity according to general characteristics and factors related to physical activity between the elderly over 65 with hypertension living rural and urban areas. METHODS: This study included 681 participants (221 rural, 460 urban) with hypertension from The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). The collected data were analyzed through an chi2-test to examine the differences in physical activity and multiple logistic regression to assess factors related to physical activity between the elderly over 65 with hypertension living rural and urban areas. RESULTS: The significant statistical factors related with physical activities for the urban hypertension group were education level, activities of daily living, and quality of life. However, the related factors for rural residents were activities of daily living and limitation of activity. CONCLUSIONS: The study results indicated that the factors that affected the level of physical activity revealed difference in case hypertension between the urban and rural groups. An awareness of the importance of physical activity will have a positive influence on improving the physical function and quality of life for elderly people with hypertension.

Health Impact Assessment of Free Immunization Program in Jinju City, Korea / 예방의학회지

OBJECTIVES: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. METHODS: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. RESULTS: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. CONCLUSIONS: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.

The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study / 예방의학회지

OBJECTIVES: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. METHODS: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. RESULTS: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. CONCLUSIONS: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

Epidemiological study of clonorchiasis and metagonimiasis along the Geum-gang (River) in Okcheon-gun (County), Korea

The endemic status of clonorchiasis and metagonimiasis along the Geum-gang (River) in Okcheon-gun (County) in Korea was examined. From February to December 2000, stools of total 1,081 inhabitants living in 5 villages were examined. Each stool specimen was examined by both the cellophane thick smear method and the formalin-ether sedimentation technique. Egg-positive cases were further analyzed by Stoll's egg-counting technique, and praziquantel was administered to positive cases. The egg-positive rates for Clonorchis sinensis and Metagonimus species were 9.3% and 5.5%, respectively, and the double infection rate was 3.5%. The numbers of eggs per gram (EPG) of feces of C. sinensis and Metagonimus sp. were 918 +/-1.463 and 711+/-947, respectively. The egg-positive rates for C. sinensis and Metagonimus sp. in the riverside area were 14.2% and 8.4%, respectively, which were significantly higher than those of the inland area (3.2% and 1.7%, respectively). The egg-positive rates of C. sinensis and Metagonimus sp. in males (16.7% and 10.0%) were significantly higher than those of females (3.5% and 1.8%). However, there were no significant differences of EPG values between localities and sexes. The prevalence of clonorchiasis and metagonimiasis in this survey was significantly lower than that in the previous reports. However, there is still a high prevalence of infection with C. sinensis and Metagonimus sp. in this region, especially in the riverside area.

The Relationship between Treatment Intention and Compliance in Newly Detected Hypertensive Patients / 예방의학회지

OBJECTIVES: To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. METHODS: The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. RESULTS: Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11- month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. CONCLUSION: Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.

Difference of Perception around Emergency Circumstances between 119 Rescuer and Utilizer

This study was performed to investigate satisfaction of 119 rescue users and to know how much different in perception around emergency circumstance between 119 rescuers and users. We reviewed emergency care records of users who were transported by 119 rescue of six agencies in Chungnam province from July 13, 1998 to August 8, 1998, and in order to find real utilization pictures and users' satisfaction, we analysed 113 mail questionnaires with perfect address and answers at January, 1999. The difference about perception around emergency circumstances between users and rescuers were as follows, degree of coincidence about mental state was 28.6% in alert, 61.9% in stupor, 28.6% in coma. Also, the degree of coincidence about patient 's severity was 50.0% in emergent, 64.1% in urgent, 19.4% in nonurgent. Difference between rescuers and users about duration from 119 call receipt to scene arrival The reason of satisfaction about 119 rescue service was 94.7% in kindness, 79.6% in equipment and facilities. Factors about dissatisfaction were delayed time(25.0%), insufficient equipment(19.2%), etc.

Smoking status and the related factors of high school students

BACKGROUND: Although the rate of smoking in adults is decreasing, its rate in adolescents keeps increasing gradually. Especially, smoking in adolescents is a serious problem that may be deeply related to drug abuse and is the main cause of a number of diseases. Anti-smoking program is essential to prevent this matter. Therefore, analysis of smoking status and its related factors in adolescents in a region where such a program was performed may be useful. METHODS: Questionnaire-survey was performed on 1,516 students of six high schools in a city who wished to participate in the anti-smoking program and analyzed the results concerning smoking status and the related factors on 1,380 students which consisted of 862(62.5%) males and 518(37.5%) females who completed the questionnaire. RESULTS: Smoking prevalences were 40.1% in males and 17.6% in females. Height, weight, educational level of parents and occupation of father were assessed. In the case of male students, the taller they were the more they smoked. In the case of female students, the higher their mother's educational level the more they smoked. Siblings' and close friends' smoking status had influence on smoking in both males and females. Drinking status affected smoking status in both males and females. The total mean of knowledge and attitude score was 1.39 and 1.32, respectively. There was a significant difference in men's knowledge and attitude score and in women's attitude score categorized by smoking status. The men's knowledge and attitude scores were significantly higher than women's. In the results of regression, the knowledge score had a negative coefficient and the attitude score had a positive coefficient as the dependent variable was smoking status in males, and the same results were shown in females. The attitude score, drinking status and close friends' smoking status were factors that influenced smoking in males and the knowledge score, the attitude score, drinking status, close friends' smoking and siblings' smoking in females. CONCLUSION: If we apply these results in school-based anti-smoking program, it will be an effective program for high school students.

Characteristics of Traffic Accident for the Primary School Students and Its Affecting Factors / 예방의학회지

For the purpose to analysis the characteristics of traffic accidents(TA) and investigate the relationship between traffic accidents and children attention problem rating scale(CAP) and, family environment scale(FES), this questionnaire survey was conducted to the 16 primary school students in Taejon from July 14 to August 26, 1997. The number of study subjects who had an experience of traffic accidents from July 1, 1996 to June 30, 1997 were 195, and the number of control subjects were 512. The main results were as follows; 1. The traffic accident rates was 0.9% as a whole, but those were 1.4% in boys, 0.7% in girls, 1.3% in low (1st-3rd) grade, and 0.8% in high (4th-6th) grade. 2. The rates of traffic accidents were high in spring, friday, afternoon and a driveway around home. TA occurred during walking with friends most frequently. 3. In CAP the score of inattention was lower in TA group than control group, and hyperactivity was higher in TA group but they didn't showed significantly different. In FES, cohesion score was higher in TA group than control group, but Conflict score and Expressiveness score were in control group, but they didn't showed significantly different. 4. In CAP the odds ratio of inattention score for TA group was 0.84, but that of hyperactivity score was 1.15. In FES, the odds ratio of cohesion score was 1.06, but that of expression score and conflict score was 0.94 and 0.96, respectively. In conclusion, the relationships between TA and CAP, TA and FES in this study were not clear to explain personal characteristics and environmental conditions.

Study on the Exposure Levels of Organic Solvents and Subjective Symptoms of Dry-cleaning Workers / 예방의학회지

To investigate the exposure levels of organic solvents and subjective symptoms of dry-cleaning workers, 77 male and 52 female dry-cleaning workers who had been worked in a small city of Chungnam province, and a large city, Taejon were selected for the study group. Air concentrations of organic solvents in the working environment were analyzed, and subjective symptoms of dry-cleaning workers were surveyed, from July to August 1996. The results obtained were as follows: 1. The concentrations of organic solvents in the working environment were within permissible TLV-TWA limits. 2. For the 13 symptom clusters, the most frequently complained symptom clusters were fatigue as 71.3%, and followed by depression and urinary disturbances as 53.5% and 51.9%. Other symptom clusters complained were below 50%. 3. Positive response rates of subjective symptoms were significantly higher in worker groups such as lived in a large city, female, higher education level, more frequently alcohol drinking, higher concentration of organic solvent in working environment, work in alone. 4. Workers who had used solvent B showed 2.3 point higher scores of subjective symptoms than those of solvent A. Of the subjective symptoms scores, amnesia and nervousness were higher in solvent B user group than solvent B user group. 5. As a result of factor analysis, 3 factors such as depression, urinary disturbance and neurologic disturbance were selected. 6. As a result of the logistic regression analysis, sex, the number of fellow workers, working time, region, job tenure, smoking, alcohol drinking, ventilating system, concentration of organic solvent in working environment and place of residence were selected for the related variables For the conclusion, even though the concentrations of organic solvents in the working environments of dry-cleaning workers were within permissible limit of TLV-TWA, many dry-cleaning workers complained symptoms, such as fatigue, depression, urinary disturbances and so on. And the factors affecting to the symptoms of dry-cleaning workers were the number of fellow workers, work hours, region, job tenure, smoking and alcohol drinking.

Patients' Evaluation on Foodservice in University and General Hospitals / 대한지역사회영양학회지

This study was conducted to investigate and to improve the actual condition of food service for patients in hospitals. For this purpose, were distributed to 283 patients admitted to a university hospital and three general hospitals between January 27 and February 15, 1997. The department participated in the study included internal medicine, surgery, obstetrics, orthopedics and so forth. For meal time, 61.1% of patients wanted to eat breakfast at 8 am, 55.8% lunch at noon, and 73.5% dinner at 6 pm. The patients complained about unsatisfactory hospital food itself by 37.8%, about insufficient food amount by 19.6%, about menu with no choice by 41.2% and about low variety of the meals by 32.7%. Sixty two point nine percent of the subjects enjoyed snacks between meals because of poor appetite at meal time(46.1%), delayed food service(39.9%) and others(11.2%). The types of diet were mainly regular ones(58.6%) with some high protein(12.4%) and diabetic sensitive ones(7.1%). As eating place, the patient's prefered bed(51.9%), room-table(27.2%) and dining room(17.7%). Fifty-five percent of them also wanted hospital foods available to their caring relatives.