• Clinical and Experimental Pediatrics
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• 제65권4호
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• Safety and Health at Work
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• 제14권4호
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• pp.375-383
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• 2023

Background: Working despite feeling ill - presenteeism - is a widespread behavioral phenomenon. Previous research has shown that presenteeism is influenced by various work-related and personal factors. It's an illness behavior leading to a range of negative but also positive consequences. Due to coronavirus disease 2019 (COVID-19) pandemic, remote work has become the "new normal" for many employees. But so far, little is known about presenteeism in remote work. This study aims to investigate presenteeism in remote work by looking at the extent of remote presenteeism, differences to presenteeism in on-site work, and associated factors. Methods: A nationwide cross-sectional online survey was conducted in Germany with N = 233 participants. Data were analyzed using descriptive statistics, t-tests, and correlation analysis. Results: The results reveal that presenteeism is prevalent in remote work x = 4.13 days (Md = 3; D = 2; s = 4.95). A low ability to detach from work (r = -.17; p = .005) and low supervisor support (r = -.14; p = .02) is associated with more remote presenteeism days. Remote working conditions seem to facilitate presenteeism. Conclusion: This study provides empirical insights into a subject area of great societal relevance. The results show that awareness should be raised for presenteeism in remote work. It should be regarded as a behavior that can be functional or dysfunctional, depending on the individual situation. Supervisor support and detachment should be fostered to help reduce dysfunctional presenteeism. Promotion of health literacy might help remote workers to decide on a health-oriented illness behavior. Further research is vital to analyze to what extent and under which circumstances presenteeism in remote work is (dys)functional and to derive clear recommendations.

• Journal of Preventive Medicine and Public Health
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• 제10권1호
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• pp.109-117
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• 1977

The improvement of civil registration reguires continuous study rather than periodic efforts. More and better statistics, however, are urgently required to formulate development programs and planning. Data obtainable from the civil registration are usually marred by errors of omission which are difficult to correct. This study aimed at finding out the problems occuring when a set of crude birth registration data in a rural area is used. Data Sources of this study are: 1) For birth registration: government birth registration records obtained from myun office and other government offices. 2) For the actual number of births: birth and child records from the Kang Wha Community Health Project The study area is Sunwon Myun and Naega Myun in Kang Wha Gun, Gyunggido. The referrance period for the accumulated data is one full year: Jan. 1st 1975-Dec. 31st 1975 Major findings are as follows: If the number of registered births is compared with the actual number of births which occured in the target area, the former is far greater than the latter. The general assumption usually is, that the actual number of births exceeds the registered number of birth in Korea. The observation from this specific study in this specific target area, shows the opporsite trend. The number of births which were registered is 550. This is more than two times as much as the number of births which actually occured during the year of 1975 in the study area namely 256. The difference comes mainly from the fact that many cases of births from other areas were registered in the target area. In other words birth is not registered where it occured but where the permanent residence adress is. Among 550 births registered in the target area 66% did not occur in the target area. Only one third of all registered births were registered within the legal period for birth registration which is 2 weeks. 34% of the registered births actually occured in 1974, but were registered in 1975. In 55% of the cases a difference was observed between the actual date of birth and the registered date of birth. From the 256 births which occured in the target area, only 153 births (59%) were registered at the myun office and the remaining 130 births (41%) were not resistered there in the year of study. 6% of the 550 cases listed as registered have no seperate registration sheets. Nevertheless, they definitly have been registered in the birth list at the myun office. 3% of the 550 cases are not recorded in this list but have a separate registration sheet at the myun office. In conclusion, birth registration data have many errors and problems. Their usefulness as. a source for vital and other statistics should be reconsidered. A series of sound methological studies will be necessary to establish their actual usefulness. A continuous and permanent compulsory system of birth recording is needed.

• 보건행정학회지
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• 제26권4호
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• 응용통계연구
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• 제6권2호
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• pp.201-215
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• 1993

산업보건연구의 통계학적 분석은 작업환경측정에 대한 평가방법과 산업보건에 특유한 혼란 변수의 통제 등 건강상태와의 연관성을 분석하는 평가방법에 있어 다른 보건통계분야와 구 별되는 특성을 지니고 있다. 본 논문에서는 주물공장 근로자들의 호흡기 건강상태와 작업환 경에서 폭로되는 유해물질에 대한 조사를 통하여 산업보건연구에 사용되는 통계학적 분석에 대한 기술을 하였다. 조사된 환경측정결과의 일부는 허용폭로기준을 초과하고 있었는 바, 폭 로기준의 준수여부를 판정하기 위하여 작업환경측정결과와 그들의 대수변환치들로부터 얻은 산술평균과 대수평균들이 폭로기준과 다른지에 대한 t-검정을 실시하였다. 환경측정을 비롯 한 위험요인들과 그들로 인한 건강상태와의 관계 분석을 위해, 범주적 건강측정 변수인 경 우에는 $\chi$-square 검정과 다변량 logistic분석을 시행하였고, 연속적 변수인 경우에는 다 변량 회귀분석을 시행하였다. 작업환경내의 오염물질의 농도는 그 측정장소와 측정시점에 따라 매우 가변적이다. 이러한 작업환경의 측정결과를 평가하는데 있어 사용될 수 있는 서 로 다른 여러 지수들의 장단점과 가변적 측정결과들로 인한 오차를 보정할 수 있는 통계학 적 분석방법에 대한 논의를 하였다. 본 조사의 폐기능검사 결과는 직업에서 폭로되는 정도 와 아무 연관성을 보이고 있지 않은 바, 이는 “건강한 그로자 효과”에 기인한 것으로 추정되고 있다.

• 한국인구학
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• 제16권2호
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• pp.84-110
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• 1993

This study aims at identifying the recent change in marriage behaviors in Korea. The data used here is the vital statistics compiled from the vital registration system of which registration form is put on one from together with the civil registration form. According to the results of this analysis, since 1970 the number of marriages has steadily increased from about 300, 000 in the former of 1970s to about 400, 000 in the latter of 1980s, appproximately coincided with the change in population size at the marriageable age span. The few exceptions that can be seen in the 1970s seem to result from the impact of social upheavals during 1950s; since the birth cohorts affected by the low fertility during the Korean war and the post-war baby-boom generations chracterized by the high fertility entered the marriage market in the 1970s. However, the marriage rate shows a little increase from around 7 in the former of 1970s to around 9 in the latter of 1980s, indicating that the marriage prevalence has been more or less inconsiderably changed during this period. It is also found that the proportion of remarriage to the total marriages has increased to around 10 per cent in 1989, while decreasing that of first marriage. This fact can be attributable to the higher prevalence of divorces and the collapsing of the Confucianism ethic which contributed to expediting the remarriage of widows. Although this proportion is insignificant compared with that of the of more developed countries, it is not difficult to say that the proportion of remarriages will continue to increase in future. The age first at first marriage(AFM) which directly affects the span exposed to the risks pregnancy has increased to the age about 28 for male and about 25 for female in recent years. However, big difference in AFM between urban and rural areas has narrowed, resultant from the increasing involuntary postponement of marriage of rural young population who have met difficulties in seeking their bride or bridegroom in rural areas characterized by the heavy out-migration of young, particularly female, population. The present study shows the reverse relationship between AFM and educational attainment; i.e, the higher the educational attainment the lower the AFM. The conditions which are taken into considerations were the class and the family in the past time but which are, educational attainment, job and personal characteristics. With regard to the age condition, in recent years the male prefers the female younger than himself on the average by 3 years and vice versa, which is reduced form 4-5 years in beginning of 1970s. The age difference bride and bridegroom tends to decrease with the educational attainment increase. This may be attributable to the fact that the persons with the higher educational attainment prefer the love marriage and hence are more likely to choose their counterparts in the about same age. The education condition is characterized by the bridegroom having the higher educational level than bride. It is also significant to note that the proportion of love marriage has increased, whereas that of traditional arranged marriage has decreased. This is true in the urban areas than the rural areas, indicating that rights as well as responsibilities for marriage have been handed over the young population from their parents. In conclusion, the change in the marriage behaviors in Korea are characterized by increasing tendency for the postponement of first marriage, higher prevalences of divorces and a result remarriages, increase of love marriages, narrowing age difference between bride and bridegroom, etc. which are the main results of rapid industrization, increase in educational and economic activity opportunities and change in the ideals of marriages during the past decades. These phenomena prevailing in Korean society would affect not only the family structure that will become less proliferiated but the population size and structure. The most important is that the changes in marriage behaviors of Koreans and their impact on the society with respect to norms, values, morals, of individual and family in the social aspect, change in population size and structure in the demograpic aspects, and economic development in the economic aspects should be integrated into the plannings towards to the future.

• 대한지리학회지
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• 제49권5호
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• pp.728-746
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• 2014

이 연구는 젊은 연령집단의 선별적 이동 및 세대에 걸쳐 진행되는 단계적 이동이 농촌과 도시의 출산력 변화와 지역의 인구성장에 파급되는 과정을 시계열적으로 분석하는 것이 목적이며, 전라북도 14개 시군이 사례지역이다. 분석에 활용된 자료는 1970 1990 2010년 20-34세 연령집단의 지역 간 인구이동 O-D 행렬과 같은 기간의 20-34세 연령집단과 가임 여성인구 분포 및 출생 사망의 동태자료이다. 분석 결과, 첫째 각 시점의 젊은 연령집단은 큰 규모로 출생지에서 이출하는 선별적 이동을 했다. 둘째 세대별로는 앞선 세대는 과거 전라북도 농촌에서 도시로, 뒤따르는 세대는 현재 전라북도 도시들에서 수도권으로 이동하는 단계적 이동이 존재했다. 셋째 젊은 연령집단의 선별적 이출은 출산 가임인구 축소, 저출산과 고령화 그리고 자연적 인구감소라는 과정을 수반되는데, 단계적 이동에 따라 과거 농촌에서 이러한 과정이 진행되었고, 현재는 전라북도 도시지역에서도 진행되고 있다. 실제로 전라북도 대부분 군 지역은 1980년대 후반부터 연간 사망자수가 출생아수를 상회하는 자연적 인구감소가 나타났고, 2000년대 초반에는 도시 지역에서도 이 같은 현상이 확인된다. 따라서 단계적 이동은 비수도권 중소도시 인구성장을 결정짓는 주요한 원인이며, 결과적으로 정주계층을 따라 단계적 과소화로 이어지고 있다.

• 한국응급구조학회지
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• 제3권1호
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• 디지털융복합연구
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• 제10권10호
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• pp.347-352
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• 2012

본 연구에서는 2011년1월1일부터 2011년 6월 30일까지 6개월 동안 대학병원 응급실로 방문하여 내과로 입원한 환자 889명을 조사대상으로 응급의료센터에 방문한 환자의 주호소와 주진단에 대한 분포를 확인하고, 기존의 질병분류 방법인 ICD와 일차 진료를 세부 분류하는 방법인 ICPC를 비교하고자 하였다. 분석방법으로는 환자들의 인구통계학적인 측면을 살펴보기 위해 빈도분석이 시행되었으며, ICD와 ICPC에 따른 주호소 분포를 알아보기 위한 교차분석을 시행하였다. 다음과 같이 분석을 시행한 결과 주증상중 Abdominal pain이 17.7%, dyspnea가 13.5%, Fever가 12.5% haematemesis가 9.8%로 주로 일차의료에서 사용되는 주호소 증상이 전체의 54.5%를 차지하는 것으로 나타나 응급의료센터에서 일차 진료 분류법을 사용하는데 적합한 것으로 예상되었다. 또한 진단명중 abdominal pain의 경우 ICD에서 R10으로 116(18.7%)명이 분류되었지만 ICPC에서는 epigastric(11.5%)과 general(5.8%)로 나뉘어 분류되어 세분화 되는 것으로 나타났다. 즉, 현재 병원에서 시행되고 있는 ICD 분류법 보다는 일차 진료 분석에 초점이 맞춰진 ICPC 분류법이 좀 더 세분된 환자분류에 용이하다는 것을 알 수 있다. 비록 본 조사에 사용된 자료가 1개 병원에 그치고 있어서 자료의 대표성이 확보되기는 어렵지만, ICPC가 응급의료에 있어 분류가 가능하고 기존의 분류법 보다 세분된 환자분류가 용이하다는 점에서 그 의의가 있다.

• 간호행정학회지
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• 제12권1호
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• pp.63-75
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• 2006

Purpose: This study was aimed to specify roles of nurses from the anesthesia and recovery room by analyzing nursing activities as well as anesthesia nursing during surgery. Method: The objects were 12 RNs working in the recovery room of a university hospital located in Incheon. Self-report was performed by measuring stop-watch for five days from May 17th to May 21st in 2004. Research method was designed to record the time and frequency of the nursing activity from anesthesia and recovery room based on nurses' statement and other references for five days. The data were analyzed with descriptive statistics, ANOVA, and t-test via SPSS Win 10.0 program. Result: Nursing activities in anesthesia recovery room were classified into two different characteristics such as direct and indirect nursing activity. The activities consisted of 11 direct nursing areas and 39 nursing activities in anesthesia preparation room. The indirect nursing was classified into 8 nursing areas and 32 nursing activities. The direct nursing was classified into 12 nursing areas and 55 nursing activity. Also, the indirect nursing was classified into 7 nursing areas and 21 nursing activities in recovery room. In terms of prevalence of nursing activities in the anesthesia preparation room, observation and cooperation of anesthesia was the most prevalent activity, drug and eqipment management the second prevalent, and drug administration the third. On the other hand, in the recovery room, the most prevalent activity was vital sign checking and observation, the second most prevalent activity informative activity, and the third body temperature control. Nursing activity time was recorded according to the nursing characteristics. In the anesthesia preparation room, the direct nursing spent for 8092.20 minutes was larger than the indirect nursing spent for 7198.50 minutes. Also, in the recovery room, the direct nursing spent for 2361.16 minutes was larger than the indirect nursing spent for 1134.13 minutes. 4. Nursing activity time was compared to duty shifts. In the anesthesia preparation room, the direct nursing was more prevalent on day shift and the indirect nursing was prevalent on evening shift. However, in the recovery room, both direct and indirect nursing activities were prevalent on day shift. Conclusion: The role of anesthesia and recovery room nurses was analysed according to the time, frequency, and its characteristics.