this study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less opportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the sicioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child heath, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean- while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision a s the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendant (8%) by maternity aid in study area. But, I expect that more maternity aids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I an sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if such facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and past-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a "notification" system instead of formal registration system, it would be improved significantly compared to present system. B. Effect of the project. Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't wont to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculation, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate int he former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.
Birth Rate ; Cause of Death ; Child ; Child Health* ; Child* ; Communicable Diseases ; Contraception ; Surveys and Questionnaires ; Family Planning Services* ; Female ; Follow-Up Studies ; House Calls ; Humans ; Infant ; Infant Mortality ; Korea ; Mortality ; Mothers ; Motivation ; Organization and Administration ; Parturition ; Persuasive Communication ; Pneumonia ; Population Growth ; Pregnancy ; Pregnant Women ; Prenatal Care ; Tetanus

this study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less opportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the sicioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child heath, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean- while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision a s the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendant (8%) by maternity aid in study area. But, I expect that more maternity aids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I an sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if such facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and past-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a "notification" system instead of formal registration system, it would be improved significantly compared to present system. B. Effect of the project. Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't wont to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculation, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate int he former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.
Birth Rate ; Cause of Death ; Child ; Child Health* ; Child* ; Communicable Diseases ; Contraception ; Surveys and Questionnaires ; Family Planning Services* ; Female ; Follow-Up Studies ; House Calls ; Humans ; Infant ; Infant Mortality ; Korea ; Mortality ; Mothers ; Motivation ; Organization and Administration ; Parturition ; Persuasive Communication ; Pneumonia ; Population Growth ; Pregnancy ; Pregnant Women ; Prenatal Care ; Tetanus

To estimate the impact the discontinuance of regular exercise on serum lipids, we selected 90 healthy young adults who were recruited and completed their training course as scheduled(5-week basic physical training and 4-week indoor education) during the period February 1995 to April 1995. Serum lipids, height, and weight were measured three times(Time I: before training, Time II: after 5-week training, Time III: after 4-week detraining). Ninety study subjects were classified as underweight, normal and overweight based on the criteria of Katsura equation. Of 17 underweight subjects, two were weight maintainers and 15 were weight gainers. There was no significant change in serum lipids after detraining among 15 weight gainers. Of 64 normal weight subjects, three were weight losers, 12 weight maintainers and 49 were weight gainers. There was significant increase in total cholesterol after detraining among 12 weight maintainers(P<0.01). In addition to this, there was also significant increase in total cholesterol(P<0. 01), LDL- cholesterol(P<0. 01) and HDL-cholesterol(P<0.05) after detraining among 49 weight gainers. This might be due to the harmful effect of detraining except HDL-cholesterol change. Of nine overweight subjects, only one was weight loser and eight were weight maintainers. There was significant increase in HDL-cholesterol after detraining among 7 weight maintainers (P<0.05). However, there were no significant changes in total cholesterol, triglyceride, LDL-cholesterol and MI index. The harmful effect of detraining was not observed in overweight subjects. In conclusion, the harmful effect of detraining was observed in weight maintainers and weight gainers among normal weight subjects after regular exercise.
Cholesterol ; Humans ; Overweight ; Thinness ; Triglycerides ; Weight Gain ; Young Adult

This study was conducted to evaluate the relationship between change in obesity indices and change in serum lipids in adult male workers. Two-hundred-eight adult male workers of an industry in Taegu city were followed-up from 1991 to 1995. Height, weight, circumferences of hip and waist, blood pressure were measured and serum lipids were analysed. Data on life style were obtained using self-administered questionnaires. Mean differences of anthropometric measurements between 1991 and 1995 were as follows; 1.63kg in weight, 3.61cm in waist circumferences, 4.23cm in hip circumferences, 0.52kg/m2 in BMI and -0.021 in WHR. Those of lipids were as follows; 15.09mg/dl in total cholesterol, 20.43mg/dl in triglyceride, 9.40mg/dl in HDL-cholesterol, 2.87 in MI-index(p<0.01) and 350mg/dl in LDL-cholesterol. The changed value of BMI and Katsura index were strongly correlated with that of total cholesterol(r=0.174, p<0.05), the changed value of BMI correlated with that of triglyceride(r=0.374, p<0.01) and the changed value of weight correlated with that of MI index(r=-0.173, p<0.05). The changed value of WHR was significantly correlated with that of total cholesterol(r=0.162, p<0.05), however, was not significantly correlated with HDL-cholesterol, LDL-cholesterol, triglyceride and MI index. The changed value of weight, BMI and Katsura index were correlated with that of triglyceride(r=0.262, p<0.01; r=0.267, p<0.01; r=0.258, p<0.01) and the changed value of MI index(r=-0.143, p<0.05; r=-0.158; r=-0.144, p<0.01), adjusting the pattern of change in life style. The changed values of HDL-cholesterol and MI index between 1991 and 1995 in low WHR group were significantly higher than those in high WHR group(p<0.05, p<0.01), adjusting the baseline value of them. Similar pattern was observed when considering Katsura index. When stratifying by BMI value of 1991, in low BMI group, the changed value of HDL-cholesterol and MI index showed the same pattern as above, however the of triglyceride was statistically higher in obese group than in non obese group(p<0.05). In conclusion BMI might be a better indicator to predict serum lipids change than other obesity indices.
Adult* ; Blood Pressure ; Cholesterol ; Daegu ; Hip ; Humans ; Life Style ; Male* ; Obesity* ; Surveys and Questionnaires ; Triglycerides ; Waist Circumference

A case-control study was conducted to investigate the risk factors (Part of job, Obesity, Alcohol, Smoking, Milk, Salt, and Family history) for hypertension. We selected 330 hypertension cases (male; 247, female; 83) and 1,336 controls (male; 887, female; 449) from employees in Taegu city from 1 May to 30 November, 1988. Data was analysed using a logistic regression model. Statistically Significant elevated odds ratio were noted for alcohol (odds ratio=3.23), obesity (odds ration=2.31), salt (odds ratio=1.75) in male (P<0.05) and those in female were noted for alcohol (odds ratio=16.49), family history (odds ratio=3.70), obesity (odds ratio=1.74) and salt (odds ratio=1.73) (P<0.05). Statistically significant reduced odds ratio was noted for milk in both sexes (odds ratio=0.69 for male and 0.65 for female) (P<0.05) and the dose-response relationship between milk intake and hypertension was confirmed (P<0.05). Therefore, milk seems to be preventive factor for hypertension. Smoking was not significantly associated with hypertension in both sexes. The part of job was significantly associated with hypertension in female by simple analysis (P<0.05) but the relationship was disappeared when multivariate analysis (logistic regression analysis) was done.
Case-Control Studies* ; Daegu ; Female ; Humans ; Hypertension* ; Logistic Models ; Male ; Milk ; Multivariate Analysis ; Obesity ; Odds Ratio ; Risk Factors* ; Smoke ; Smoking

No abstract available.

A case-control study was conducted to identify the specific risk fatctors for hemorrhagic fever with renal syndrome(HFRS) in Korean soldiers. The case group consisted of 196 confirmed HFRS patients who were admitted to the Capital Armed Forces General Hospital between I November 1989 and 15 January 1992 and were 25 years old or younger. The control group consisted of 258 non-HFRS patients who were admitted to the same hospital and meeting following conditions; onset of symptom was within five days before or after the onset date of case, had regular military activities up to the onset of symptom, and no noticeable signs for the diagnosis. Most of the cases and controls came from the units located in Kyonggi province (61.7% of cases, 75.9% of controls) and Kangwon province (31.6% of cases, 15.5% of controls). The distribution of places where the cases and controls had moved into during 60 days period prior to admission was similar to that of the base units. Among 196 cases, 89.3% occurred in October through December and 46.9% in November. Significant risk factor was the field living condition. The odds ratio (OR) for sleeping in a tent vs not sleeping in a tent during 60 days period prior to admission was 1.55 (95% CI=1.07-2.25) and that for sleeping on the bare ground or in a vehicle was 3. 63 (95% CI=1.48-8.86). Other statistically significant risk factors were advanced tac tical training (OR=1.51, 95% CI=1.02-2.24), drinking surface water (OR=1.83, 95% CI=1.21-2.77), exposure to indoor dust (OR=1.58, 95% CI=1.05-2. 37), fixing trench (OR=1.63, 95% CI=1.12-2.37) and having seen Apodemus in the outdoors (OR=4. 61, 95% CI=2.12-10.02). Most of these risk factors were related with camping (field living condition) and thus the interaction between each risk factor and camping was examined by cross tabulation. None of the ORs for five risk factors was statistically significant for the cases who had no camping. However all of the ORs for the cases who had camping were increased and statistically significant ;2.27 for advanced tactical training, 2.64 for drinking surface water, 2.14 for exposure to indoor dust, 2.91 for fixing trench, and 7.58 for having seen Apodemus in outdoors. It was revealed in this study that the highest risk factor for HFRS is camping in the area where the Apodemus inhabits.
Adult ; Animals ; Arm ; Camping ; Case-Control Studies* ; Diagnosis ; Drinking ; Dust ; Fever ; Gangwon-do ; Gyeonggi-do ; Hemorrhagic Fever with Renal Syndrome* ; Hospitals, General ; Humans ; Military Personnel* ; Murinae ; Odds Ratio ; Risk Factors* ; Social Conditions ; Water

This study was conducted to investigate the relationship of body fatness indicators and serum lipids (total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein(LDL) cholesterol, triglycerides, myocardial infarction(MI) index) to find anthropometric indicators of body fat distribution that are strongly associated with serum lipids. 347 adult male workers of an industry in Kyungpook province were selected and data on the general characteristics were obtained using questionnaire from June 26 to June 29, 1991. Serum lipids were tested with 5 ml fasting blood and height, weight, circumferences of waist, hip and mid-thigh, five subcutaneous fat thickeness(biceps, triceps, supscapular, suprailiac, thigh) were mea sured using Ultrasound type A TATT. Waist circumference, waist/hip circumference ratio and subcutaneous fat thickness of suprailiac area are significantly increased with increasing age, but thigh circumference is significantly decreased (P< 0.05). These results suggest that central obesity is closely related to age and waist circumference may be the best indicator of body fatness or body fat distribution in men. In younger age group(below 40 year old), the result of canonical correlations analysis suggests that circumferences(0.501) was slightly closely related to serum lipids than subcutaneous fat thickness(0.493), however, in older age group (above 40 year old), subcutaneous fat thickness(0.528) were more strongly associated with serum lipids than circumferences(0.419). Weighted canonical analyses suggest that biceps and suprailiac areas in younger age group and sub scapular area in older age group are stronger indicators of serum lipids among .subcutaneous fatness measurements. Of the circumferences, waist is the most strongest indicator of serum lipids in both age groups. Therefore, it is recommended that circumference of waist and subcutaneous fat thickness of subscapular area should be measured to estimate the degree of central obesity for preventing cardiovascular disease in men.
Adipose Tissue* ; Adult ; Body Fat Distribution* ; Cardiovascular Diseases ; Cholesterol ; Fasting ; Gyeongsangbuk-do ; Hip ; Humans ; Lipoproteins ; Male ; Obesity, Abdominal ; Subcutaneous Fat ; Thigh ; Triglycerides ; Ultrasonography ; Waist Circumference ; Surveys and Questionnaires

To investigate the incidence and risk factors of needle stick injury(NSI) and the association between NSI and hepatitis B infection in hospital personnel, a prospective cohort study was conducted at a university hospital in Pusan city from April 1, 1994 to September 30, 1994. Of five hundred and thirty hospital personnel, 38.7 percent reported one NSI or more. The annual person incidence rate of NSI was 81.3 per 100 person and annual spell incidence rate was 144.3 per 100 persons. The annual incidence rate in registered nurses(192.8 cases per 100) was the highest, followed by physicians(115.4 cases per 100), nurse aids(75.5 cases per 100) and laboratory technicals(51.8 cases per 100) (p<0.05). Risk factors significantly associated with needle stick injuries were being interns higher than residents(p<0.05) for physicians, the incidence rate decreased as length of employment increased (p<0.05) for registered nurses and working in operating room and central supply room higher than working in surgical department(p<0.05) for nurses aids. The most common device related to needle stick injuries was disposable needles(49.7%), the most frequent activity related to needle stick injuries was recapping needle(35.7%), and most of the needle stick injuries occurred in nurse station(40.9%) and patient room (34.1%). The vaccination rate for hepatitis B virus was 40.2 percent. Of the non-vacciness, 4.5 percent were positive for hepatitis B surface antigen and 69.2 percent were serologically positive for hepatitis B viral markers at the beginning of this study. Of 80 negative personnel for for all hepatitis B viral markers, 27 persons experienced needle stick injuries during study period. Three out of 27persons were positive for hepatitis B markers at the end of follow-up. However, all of 53 persons who had no experience of needle stick injuries were negative. Therefore, NSI was significantly associated with HBV infection and the annual incidence for hepatitis B virus infection was as 8.0 per 100 in hospital personnel. These findings suggest that hospital personnels are at a high risk group for needle stick injuries. Particulary interns, novice registered nures (length of employment less than 1 year), and nurse aids who are working at operating room and central supply room are the highest risk group. It is recommended that NSI prevention program for hospital personnel should be developed to minimize the risk of needle stick injuries in the hospital.
Biomarkers ; Busan ; Cohort Studies ; Employment ; Follow-Up Studies ; Hepatitis B ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Incidence* ; Needles* ; Needlestick Injuries ; Operating Rooms ; Patients' Rooms ; Personnel, Hospital* ; Prospective Studies ; Risk Factors* ; Vaccination

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Risk Factors*