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- 저자 : 이무식(Lee, Moo-Sik) (검색결과 212 건)
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이무식,김은영,김건엽,이진용,장민영,홍지영,Lee, Moo-Sik,Kim, Eun-Young,Kim, Keon-Yeop,Lee, Jin-Yong,Jang, Min-Young,Hong, Jee-Young 한국농촌의학지역보건학회 2012 농촌의학·지역보건 Vol.39 No.4
이 연구는 지역단위 예방접종률 시범조사를 통해 획득한 다양한 예방접종 자료를 분석하여 예방접종의 수진 관련 요인을 파악, 분석하였다. 2005년 2월부터 4월까지 일개 도농복합 지역사회 영유아 전수를 대상으로 해당 연령의 영유아들이 거주하는 가구를 조사자가 직접 방문하여 보호자를 대상으로 설문조사하였으며, 접종조사력에 대한 확인은 예방접종수첩자료를 우선적으로 하고, 없을 시에는 보호자의 기억력에 의존하여 조사하였다. 또한 2005년 5월부터 7월까지 지역 가구조사에서 확인된 예방접종 의료 기관을 대상으로 예방 접종력 확인 조사를 실시하였는데, 논산 및 대전지역 병의원에 대해서는 조사자가 직접 방문하였고, 타지역의 경우 우편 설문조사를 시행하였다. 예방접종수첩에 근거한 국가필수예방접종률은 DTaP 4차(79.3%)를 제외하고 92.7~96.4%였으며, 국가예방접종 완전접종률은 74.0%, 4:3:1 시리즈 완전접종률은 77.1%였다. 국가필수예방접종의 완전접종은 주 양육자가 부모인 경우(19개월 이상 영유아에서 교차비 0.59, 95% 신뢰구간 0.39-0.87), 출생순위가 셋째 이상에 비해 빠를수록(24개월 이상 영유아에서 교차비 1.79, 95% 신뢰구간 1.05-3.03) 접종률이 유의하게 높았다. 4:3:1 시리즈 완전접종은 19개월 이상 영유아에서 주양육자가 부모인 경우(교차비 0.58, 95% 신뢰구간 0.38-0.88), 출생순위가 첫째아일수록(교차비 1.94, 95% 신뢰구간 1.21-3.14) 접종률이 높았으며, 24개월 이상 영유아에서는 출생순위가 첫째아에서(교차비 2.23, 95% 신뢰구간 1.27-3.91) 유의하게 높았다. 90% 미만의 예방접종률을 보인 부적절한 수준의 예방접종에 대한 대책이 필요하며, 완전접종률을 높이기 위해서는 양육하는 부모의 존재와 출생순위 파악과 이에 대한 중재대책이 필요할 것이다. Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.
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미래 보건문제 발생에 대응ㆍ대비를 위한 역학조사관제도 개선방안
이무식 ( Moo-sik Lee ) 한국보건행정학회 2018 보건행정학회지 Vol.28 No.3
The development and management of epidemiology intelligence service (EIS) officer with more specialized competence to cope with and prepare for health threats, including pandemic of emerging and re-emerging infectious diseases, is a high priority policy issue in Korea. First of all, we need to establish the training goal of EIS officer. It is necessary to establish manpower training and management system with at least three tiers including quantitative and qualitative targets. Second, at least 50% of all EIS officer must secure a physician and secure expertise and competence for epidemic. Third, for the ultimate purpose of EIS officer, the establishment of a public health expert should expand the scope of epidemiologist’s work to health and medical care, occupational environment, and various disasters. Fourth, it is essential to expand the epidemiologist training and education program to the level of advanced countries. Especially, the training course should be expanded at least twice of current times. Fifth, it is necessary to independently install and operate the ‘EIS Officer Training Center’ as a mid- and long-term goal. Stewardship and governance are secured with the organization, personnel, etc. that can fully manage the planning, management, and evaluation of the EIS system. In the future, it will be necessary to establish a systematic and phased operational base of education and training programs for EIS officer, and establish a sustainable implementation system for strategy development. In addition, it is urgent to revise the guidelines for training public health professionals and strengthening competencies, and for establishing professional educational institutions.
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일부 밤 농사 및 가공 종사자의 밤바구미 훈증제 이황화탄소 사용실태 및 인식
이무식(Moo-Sik Lee),김은영(Eun-Young Kim),이재림(Jae-Lim Lee),손기연(Gi-Yeon Sohn) 한국농촌의학 지역보건학회 2016 농촌의학·지역보건 Vol.41 No.2
Objectives: We surveyed the awareness and current status of using fumigant carbon disulfide for exterminate Curculio sikkimensis among chestnut farmers in Chungnam Province to suggest directions for health education and public relations. Methods: We designed questionnaires to evaluate recognition of fumigant carbon disulfide. We conducted a questionnaire survey to assess recognition and recognition level of fumigant carbon disulfide by the study variables. Results: The recognition status for fumigant carbon disulfide was 74.5%, but the recognition level was low (know well 27.5%). The path of recognition was 45.1% and 15.7% for neighbor and rural technology center, respectively. The recognition status for warning label of fumigant carbon disulfide was 52.9%. Recognition for warning label of fumigant carbon disulfide was tended to increase with high educational attainment, bigger owning land area. Recognition on the content of warning label were 29.4%, 27.5%, 21.6%, and 21.6% for inflammability, toxicity, hazard, and explosiveness, respectively. Using personal protection equipment was tended to increase with the high status of awareness on fumigant carbon disulfide. Conclusions: Health education programs for using fumigant carbon disulfide are needed for chestnut farmers. In addition, publicity information activities about prevention and protection of carbon disulfide poisoning are needed for high risk farmers.
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일부 60-64세 농촌 거주자에서 혈압과 인지기능 장애와의 관계
이무식,전종찬,이충원,Lee, Moo-Sik,Chun, Jong-Chan,Lee, Choong-Won 대한예방의학회 2000 예방의학회지 Vol.33 No.2
이 연구는 노인 인구에서의 혈압과 인지기능과의 관련성을 조사하기 위하여 대구광역시 달성군에 거주하고 있는 만60-64세의 노인을 대상으로 1996년 4월 부터 9월까지 면담조사를 실시하였다. 최종분석에 이용된 대상자는 원래 목표 한 1,329명에서 932명으로 70.1%이었다. 인지기능의 측정은 한국판 간이정신상태검사법(MMSEK)을 사용하였으며, 인지기능장애는 점수가 23점 이하인 자로 정의 하였다. 혈압은 누운 상태에서 측 상완부를 휴대용 자동혈압계로 1회 측정하였다. 남자에서 인지기능에 대한 단일변수 지수회귀분석의 결과에서 수축기 혈압은 통계적으로 유의한 비차비를 보이는 혈압 범주는 없었다. 확장기 혈압은 80-89 mmHg를 기준으로 79 mmHg 이하, 90-94, 95 mmHg이상 모두 1보다 큰 비차비를 나타내었으며 특히 79mmHg 이하는 1.68(95% 신뢰구간 1.02-2.75)로 통계적인 유의성을 나타내었다. 여자에서 수축기 및 확장기 혈압 모두 통계적인 유의성을 나타낸 비차비는 없었다. 연령, 교육 수준, 흡연, 음주, 비교체중, 죽상경화증을 시사하는 질환, 고혈압 약 투약력 등의 공변수를 통제한 다변수 지수회귀분석에서 남자의 수축기 혈압은 단일변수 분석과 비교하여 비차비의 변화가 거의 없었으며 통계적인 유의성도 없었다. 확장기 혈압에서 기준 혈압 범주에 비교해서 79mmHg 이하는 비차비가 2.01(95% 신뢰구간 1.15-3.52)로 증가하였다. 여자에서 수축기 혈압은 단일변수 분석과 비교하여 거의 차이가 없었으며 통계적인 유의성도 없었으나, 반면에 확장기 혈압에서 기준 혈압 범주에 비교하여 79 mmHg 이하는 비차비가 0.72에서 0.57 (95%신뢰 구간 0.37-0.89)로 유의하게 증가하였다. 이들 결과는 혈압과 인지기능 장애와의 관계는 수축기 혈압보다는 확장기 혈압이 연관성을 나타내며 확장기 혈압과 인지기능 장애간의 관련성의 방향이 성별간에 차이를 나타내어 혈압과 인지기능사이에 좀더 복합적인 관계가 있음을 시사해 준다. Objectives : Face-to-face interviews were conducted to investigate the relationship between blood pressure and the impairment of cognitive function in rural elderly (N=932) aged 60-64 in Dalsung County, April to September in 1996 Methods : Impairment of cognitive function was defined as a score of less than 23 by the Korean version of the Mini-Mental State Examination (MMSEK). Blood pressure was measured once in each subject using a portable automatic sphygmomanometer. Results : By univariate logistic regression on males, no category of systolic blood pressure bore statistical significance. Groups with diastolic blood pressures of, less than 80 mmHg, 90-94 mmHg, and more than 95mmHg had odds ratios of more than one compared with the reference group (80-89 mmHg). This was most significant in the group with blood pressures lower than 80 mmHg, which had a statistically significant odds ratio of 1.68 (95% confidence interval CI; 1.02-2.75). No category of blood pressure was statistically significant in females. Multivariate logistic regression for males, with adjustment for age, educational attainment, smoking, alcoholic drinking, body mass index, atherosclerotic disease, and antihypertensive medication use, did not alter the odds ratios significantly in terms of systolic blood pressure. However, the group with diastolic blood pressure of less than 80 mmHg had an increased odds ratio of 2.01 (95% CI; 1.15-3.52) compared with the reference group. In females, systolic blood pressure did not alter the odds ratio, but the group with a diastolic blood pressure of less than 80 mmHg had a statistically significant odds ratio of 0.57 (95% CI; 0.37-0.89). Conclusions : These results suggest that the relationship between blood pressure and cognitive function status is stronger diastolic than systolic blood pressure and that there is a complex relationship between blood pressure and cognitive function by sex.
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