To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviewed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per 100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.
Abortion, Induced ; Abortion, Spontaneous ; Adult ; Birth Intervals ; Birth Rate ; Child ; Condoms ; Contraception ; Family Planning Services ; Female ; Fertility* ; Follow-Up Studies* ; Humans ; Korea ; Live Birth ; Menstruation ; Middle Aged ; Parturition ; Pregnancy Rate ; Pregnancy* ; Pregnant Women ; Primary Health Care ; Spouses

PURPOSE: To compare the incidence of twin births with the length of first birth interval (LFBI: from marriage to first birth) among primiparous women. METHODS: The birth certificated data of Korea Statistics from 2010 to 2015 were used for this analysis. There were 1,356,204 births of primiparous women from total birth cases (2,736,296 births). The data involving multiparous women, teenage birth, extra-marital birth, and triplet birth cases were excluded from all analyses. Odds ratio and 95 percent confidence intervals were calculated from logistic regression to examine the risk of twin birth by LFBI adjusted for year of birth, maternal age, paternal age, age difference between couples, and maternal education and occupation. RESULTS: The frequency of LFBI was 41.5 percent in ≤12 months, 30.7 percent in 13~24 months, 13.1 percent in 25~36 months, and 2.1 percent in LFBI of ≥85 months. The mean LFBI was 21.5 months. The incidence of twin birth increased with prolonged LFBI. The twin birth rates per LFBI were 0.8 percent, 3.1 percent, 7.9 percent, and 11.0 percent in LFBI of ≤12 months, 25~36 months, 49~60 months, and 73~84 months, respectively. Odds ratio of twin births rate by LFBI were 1.510 (95% confidence interval: 1.449~1.574) for the LFBI of 13~24 months, 9.839 (9.390~10.309) for 49~60 months, and 13.244 (12.458~14.080) for ≥73~84 months, each compared with LFBI of ≤12 months. Odds ratio of twin birth rate in LFBI of ≤72 months was higher in women aged 35 and older, as compared to women aged ≤34 years. Odds ratio of twin birth rate by maternal age (≤34 years versus ≥35 years) reversed in LFBI of ≥73 months. CONCLUSION: The risk of twin birth increased significantly with prolonged LFBI. There is a need to understand the factors (fertility therapy and etc.) to increased risk of twin birth in prolonged LFBI.
Birth Intervals* ; Birth Order* ; Birth Rate ; Education ; Family Characteristics ; Female ; Humans ; Incidence* ; Korea* ; Logistic Models ; Marriage ; Maternal Age ; Occupations ; Odds Ratio ; Parturition* ; Paternal Age ; Triplets ; Twins*

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

PURPOSE: This study was conducted to analyze the association between health literacy and health behavior and the effect of health literacy on health behavior in late school-age children. METHODS: Data were obtained from 333 participants who were 5th and 6th-grade students sampled from 8 elementary schools in Busan. Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen) and Newest Vital Sign (NVS) was used for assessing linguistic and functional health literacy, and the health promotion behavior score was measured for health behavior. RESULTS: The percentage of those with limited linguistic and functional health literacy was high (47.1%, 56.8%). Linguistic health literacy (r=.38, p<.001) and functional health literacy (r=.11, p=.048) had a correlation with health behavior. Health behavior was significantly associated with perceived health status (beta=1.94, p<.001), number of times of health education (beta=0.18, p<.001), academic achievement (p<.001), home literacy environment (beta=0.13, p=.016), perception of changes after health education (p=.011), and linguistic health literacy (beta=0.23, p<.001). CONCLUSION: The results of this study indicate that children with adequate health literacy are more likely to do health behaviors. Therefore, it is important to develop educational strategies to raise children's health literacy level and consequently to induce them to perform more health behaviors in daily life.
Adolescent ; Busan ; Child* ; Health Behavior* ; Health Education ; Health Literacy* ; Health Promotion ; Humans ; Linguistics ; Vital Signs ; Child Health

PURPOSE: Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. METHODS: We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. RESULTS: Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. CONCLUSION: We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors.for example, good mental health, balanced nutrition, and more exercise.
Adolescent ; Birth Rate ; Child ; Developed Countries ; Family Characteristics ; Growth and Development ; Hematologic Tests ; Humans ; Infant ; Korea ; Life Style ; Mass Screening ; Mental Health ; Obesity ; Primary Prevention ; School Health Services ; Urinalysis

Introduction: Clinical decision making becomes difficult when clinical and methodological heterogeneity does not permit synthesis of results of multiple small studies. Aim: For studies done in Malaysia, to identity the sample sizes and heterogeneity present in the various studies which used p16 in evaluating lesions of the cervix. To evaluate if it would be possible for a single study to answer the various questions posed by the original authors. To highlight areas where the design features of future studies can be optimised. Materials and Methods: Various databases were searched using synonyms for p16 AND cervix AND Malaysia. These were assessed for broad conformity to a Diagnostic Test Accuracy format. Methodological and clinical heterogeneity indicators were extracted into standardised fields. Results: There were 5 studies eligible for inclusion. Each sought to study different aspects of the disease such as diagnostic grade stratification and pathogenesis. The study type broadly conformed to a Diagnostic Test Accuracy format. The study design used was either consecutive or non-consecutive. Sample size ranged from 75 to 201. Clinical heterogeneity was present in the choice of controls with some using normal and some using inflamed tissue. Methodological heterogeneity in applying the reference test, index test and different antibody clones were present. Conclusion: There was both clinical and methodological heterogeneity making synthesis of studies difficult. It is possible to design a study which would be able to answer all the questions posed by the original authors with internal validity while at the same time increasing sample size.
heterogeneity

OBJECTIVETo analyze the level of mortality of brain tumor and its changes at different periods in China.

METHODSDeath records for tumor of brain and central nervous system, which the code of international classification of diseases-10 (ICD-10) were C70-C72, were extracted from the database of the Third National Retrospective Sampling Survey of Death Causes in China during 2004 to 2005. The corresponding population data was linked to the data of death records, that the total population was 142 660 482 person years (72 970 241 person years in male, 69 690 241 person years in female). Then crude death rate, age-specific death rate, the constitute proportion to all death caused by tumor and the age-standardized death rate were calculated by taking reference of Chinese standard population or the world standard population. The indexes of mortality were compared with that of previous retrospective surveys of death causes at 1973 - 1975 and 1990 - 1992.

RESULTSThe result showed that during 2004 to 2005, the number died from brain tumor was 4463 and the crude death rate in China was 3.13/100 000, which accounted for 2.30% of the all number died from tumor (193 841 cases). The age-standardized death rate by Chinese standard population was 2.37/100 000 and the age-standardized death rate by the world standard population was 2.90/100 000. Of which, there were 2556 death cases for males with crude death rate of 3.50/100 000. While for females, the crude death rate was 2.74/100 000 (1907 death cases). Age-standardized death rates by Chinese standard population in male and female were 2.71/100 000 and 2.03/100 000 respectively. The age-standardized death rate by world standard population was 3.31/100 000 for male and for female that was 2.48/100 000. The age-specific death rate of brain tumor in China was increasing as age growing. The crude death rates were 3.78/100 000 (1809/47 899 806), 2.80/100 000 (2654/94 760 676), and the age-standardized death rates by Chinese standard population were 2.71/100 000 and 2.20/100 000 for urban and rural area respectively, and the crude death rates of brain tumor in east, middle and west region were 3.60/100 000 (1894/52 556 694), 3.14/100 000 (1565/49 781 225), 2.49/100 000 (1004/40 322 563). The age-standardized death rates by Chinese population were 2.57/100 000, 2.43/100 000 and 2.02/100 000. Compared to the data in the first survey during 1973 to 1975, in which the crude death rate was 1.13/100 000 and age-standardized death rate by Chinese standard population was 1.10/100 000, the crude death rate and age-standardized death rate by Chinese standard population were increased by 176.99% and 115.45% respectively. While compared with the second survey during 1990 to 1992, that crude death rate was 1.89/100 000 and age-standardized death rate by Chinese standard population was 1.74/100 000, the rising percent of the rates were 65.61% and 36.21% respectively.

CONCLUSIONThe level of mortality of brain tumor has been changing with an increasing trend from the period of 1973 - 1975 to the period of 2004 - 2005. The rate in male was higher than that of female with great diversity in different areas in China.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Neoplasms ; epidemiology ; mortality ; Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Death Certificates ; Female ; Health Surveys ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult

OBJECTIVETo understand the life expectancy of residents in Xinjiang production and Construction Group, from 1997 to 1999.

METHODSStratified cluster sampling method was used to obtain mortality rate, sequence of death causes, life expectancy, life eliminated major cause of deaths, years of potential life lost (YPLL) and level of long life. These indeices were used to compare and analyze health status on residents in the area.

RESULTSThe life expectancy on residents in the area was 75.61 years old for all residents, 72.73 years old for males, 80.02 years old for females from 1997 to 1999. The life expectancy for people living in agricultural and livestock farms was lower (73.97 years old). It was found that life expectancy was parallel to the level of economy. Life expectancy of northern residents was higher than those living in the southern and eastern parts of the area. The annual average mortality rate of the residents was 5.17 per thousand (standard mortality rate 4.02 per thousand ). The sequence of major causes of death was shown as below: malignant tumors, cerebrovascular diseases, respiratory system diseases, cardiac diseases, accidental deaths, infectious diseases, certain conditions originated in the perinatal period. In the life eliminated major cause of deaths, respiratory system diseases and certain conditions originated in the perinatal period were higher than others. In both sequences of YPLL and SYPLL for major causes of death, accidental death was always in the leading place. There was a higher longevity on residents from the better economic area.

CONCLUSIONSHigher life expectancy in the area was noticed, but the differences among the different area were bigger. In order to improve the level of health on all residents in the area, it is necessary to strengthen the administration on social and natural environment of the area. Furthermore, decreasing accidental deaths, controlling respiratory system diseases (especially for infant) and improving health care of infants in perinatal period are very important tasks in the area.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; trends ; Child ; Child, Preschool ; China ; Data Collection ; Female ; Health Status ; Humans ; Infant ; Infant, Newborn ; Life Expectancy ; trends ; Longevity ; Male ; Middle Aged ; Mortality ; trends ; Sex Factors ; Socioeconomic Factors

OBJECTIVETo analyze the cervical cancer mortality and distribution profiles by areas and population in 2004 - 2005 and the changes in the last 30 years.

METHODSThe demographic information and cervical cancer death data came from the Third National Retrospective Sampling Survey of Death Causes which including 158 sampling areas (including 61 cities and 97 villages; 52 in the east region, 49 in the middle region and 57 in the west region) covered 31 province-level regions in the interior of China by multiple stage stratified clustering sampling. The total number of the samples were 142 660 482 person years (72 970 241 person years in male and 69 690 241 person years in female). The crude and age-specific death rate was calculated. The standardized death rate was calculated by using 5 years interval from the census data of 2000. In addition, the mortality data was compared with the two previous national death surveys in 1970's and 1990's, respectively.

RESULTSIn the sampling region of the third retrospective death causes survey from 2004 to 2005, the crude death rate of cervical cancer was 2.86/100 000 (1995/69 690 241), which accounting for 2.86% (1995/69 667) and ranking 9th of all cancer death causes in female population. The crude death rates of cervical cancer were 2.88/100 000 (1326/46 091 419) and 2.83/100 000 (669/23 598 822) for rural areas and urban areas, respectively, the Chinese population adjusted death rates of rural and urban areas were 2.01/100 000 and 1.67/100 000, respectively. The standardized death rates of cervical cancer in 1973 - 1975 and 1990 - 1992 were 11.10/100 000 and 3.25/100 000, respectively, which accounting for 17.91% and 4.86%, respectively; in 2004 - 2005, the crude death rates increased by age, rose remarkably from the age of 40 and arrived the peak of 20.83/100 000 (82/393 624) at the age of 85. The mortality among 35 - 44 year-old group was higher than those in 1990's. The crude death rates of the middle, west and east areas were 3.41/100 000 (827/24 225 738), 3.25/100 000 (636/19 563 647) and 2.05/100 000 (532/25 900 856), respectively, the Chinese population adjusted death rates of the middle and west areas were about twice that of the east (2.35/100 000 in the middle, 2.38/100 000 in the west, and 1.19/100 000 in the east).

CONCLUSIONThe mortality of cervical cancer was higher in rural areas than that in urban, as well as higher in the middle and west areas than that in east area in the interior of China in 2004 - 2005. Younger trend of cervical cancer death was observed; the mortality of cervical cancer and constituent ratio in the female tumor death continued to decline compared to those in 1973 - 1975 and 1990 - 1992.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; trends ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Health Surveys ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Neoplasms ; Uterine Cervical Neoplasms ; epidemiology ; mortality ; Young Adult