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주영수,김대성,강종원,성주헌,강대희,조수헌,백도명,Ju, Yeong-Su,Kim, Dae-Sung,Kang, Jong-Won,Seong, Joo-Heon,Kang, Dae-Hee,Cho, Soo-Hun,Paek, Do-Myung 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.4
This study was conducted to develop and evaluate the reliability and the validity of a questionnaire in order to determine the applicability as a screening tool for estimating environmental exposure and health effects related to air pollution. The questionnaire was developed with adopting some items of others such as ISAAC or ATS-DLD. And then we performed test-retest to 89 middle school students and their mothers at interval of three months. Cohen's Kappa values, weighted Kappa values, Spearman's correlation coefficients, and Pearson's correlation coefficients for each item were computed as reliability coefficients. The validity coefficients and validity coefficient bounds were also obtained by simply using these reliability coefficients. As results, Kappa ranged broadly from 0.10 to 0.61 of the items 'diet', $0.52\sim0.79$ of the environmental tobacco smoke, $0.39\sim0.44$ of the functional categories of surrounding environment, and $0.39\sim0.44$ of the using transportation systems; these items were regarded as confounding factors. For items related to health outcomes, Kappa ranged from -0.02 to 0.37 in the respiratory system of past medical history, and from 0.11 to 0.55 in the current health status. But Kappa of the others were over 0.60. In conclusion, if some items can be corrected or modified, the questionnaire developed in this study can be used as a tool for evaluating environmental exposure and health effects associated with air pollution.
Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.
Background: Aircraft noise is a major environmental noise problem. This study was conducted in order to investigate the relationship between sleep disturbance and exposure to aircraft noise on the residents who are living near an airport. Methods: There were 3308 residents (1403 in the high exposure group, 1428 in the low exposure group, and 477 in the non-exposure group) selected as the subjects for this study. The Insomnia severity Index (ISI) and Epworth Sleepiness Scale (ESS) questionnaires were used to evaluate sleep disturbance. Results: The mean ISI and ESS scores were 6.9 ± 6.4 and 5.5 ± 3.7, respectively, and the average scores were significantly greater in the aircraft noise exposure group, as compared to the non-exposure group. The percentage of the abnormal subjects, which were classified according to the results of the ISI and ESS, was also significantly greater in the noise exposure group, as compared to the control group. The odd ratios for insomnia and daytime hypersomnia were approximately 3 times higher in the noise exposure group, as compared to the control group. Conclusions: The prevalence of insomnia and daytime hypersomnia was higher in the aircraft noise exposure group, as compared to the control group. Further study is deemed necessary in order to clarify the causal relationship.
Objectives : To evaluate the hypothesis that increasing ambient levels of ozone or particulate matter are associated with increased emergency room visits for asthma and to quantify the strength of association, if any, between these. Methods : Daily counts of emergency room visits for asthma, air quality, and weather data were collected from hospitals with over 200 beds and from monitoring Stations in Seoul, Korea from 1994 through 1997. Daily counts of emergency mom visits for asthma attack were analyzed using a general additive Poisson model, with adjustment for the effects of secular trend, seasonal variation, Sunday and holiday, temperature, and humidly, according to levels of ozone and particulate matter. Results : The association between daily counts of emergency room visits for asthma attack and ozone levels was statistically significant in summer(from June to August), and the RR by unit inclement of 100 ppb ozone was 1.30(95% CI = $1.11\sim1.52$) without lag time. With restriction of the period from April to September in 1996, the RR was 1.37(95% CI = $1.06\sim1.76$), and from June to August in 1995, the RR was 1.62(95% CI = $1.12\sim2.35$). In the data for children$(5\sim14yr)$, the RR was 2.57(95% CI = $1.31\sim5.05$) with restriction of the period from April to September in 1997. There was no Significant association between TSP levels and asthma attacks, but a slight association was seen between PM10 levels and asthma attacks in a very restricted period. Conclusion : There was a statistically significant association between ambient levels of ozone and daily counts of emergency room visits for asthma attack. Therefore, we must make efforts to effectively minimize air pollution, in order to protect public health.