산후 1, 6개월 완전모유수유율과 영향 요인

하범만(Beomman Ha),김선호(Seonho Kim) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.5

본 연구는 산후 1개월 및 6개월 완전모유수유율을 파악하고 이에 영향을 미치는 요인을 파악하기 위해 수행하였다. 본 연구는 서술적 조사연구로, 연구자료는 2015년 전국 출산력 및 가족보건복지실태 조사 원시자료를 이용하였다. 연구대상자는 조사 완료된 기혼여성 중 2013년 1월부터 조사시점에 추산 후 6개월이 경과한 2015년 2월 사이에 자녀를 출산한 1,839명이었다. 자료분석은 SPSS 25.0 프로그램을 이용하여 기술통계분석, 카이제곱분석 및 다중로지스틱분석을 실시하였다. 연구결과 분만 후 1개월 및 6개월 완전모유수유율은 각각 54.0%, 9.4%로 월령이 증가함에 따라 완전모유수유율이 감소하였다. 산후 1개월 완전모유수유율에 영향을 미치는 요인은 산모의 나이, 아기의 출생순위, 분만형태, 분만 후 1시간 이내 모유수유 여부였으며, 산후 6개월 완전모유수유율에 영향을 미치는 요인은 산모의 나이, 거주지역, 아기의 출생순위, 산후 1개월 완전모유수유 여부였다. 본 연구결과 완전모유수유에 영향을 미치는 요인은 출산 후 시기에 따라 다른 것으로 확인되었다. 따라서 완전모유수유율 향상을 위해 출산 후 각 시기별 완전모유수유에 영향을 주는 요인을 고려한 맞춤형 중재가 필요하다. The objective of this study is to observe the exclusive breastfeeding(EBF) rate and to identify factors which influence EBF by postpartum period. The data were obtained from the 2015 National Fertility Survey, Family Health and Welfare in Korea, and secondary data analysis were employed for 1,839 mothers who gave birth to baby between January 2013 and February 2015. Data were analyzed using SPSS 25.0 program with descriptive statistics, chi-square test and multiple logistic regression. The EBF rate at the 1st and 6th month of postpartum were 54.0%, 9.4% respectively. The significant influencing factors on the EBF at the 1st month of postpartum were age of mother, baby’s birth rank, type of delivery, breastfeeding within 1 hour after delivery. The significant influencing factors on the EBF at the 6th month of postpartum were age of mother, living area, EBF in the first month. We found that the influencing factors on EBF differed by postpartum period. In order to improving the rate of EBF, it is recommended that taioed interventions is needed considering the factors affecting the EBF by postpartum period.

징병신검과 입영신검과의 연관성 및 추이분석

하범만 ( Ha Beomman ),고성민 ( Ko Sungmin ),정신 ( Jeong Shin ) 국군의무사령부 2016 대한군진의학학술지 Vol.47 No.1

Objectives: The purpose of this study is to analyze the shift of men who are deferred to be recruited at physical examination held in the conscription agency and in the enlisted unit. Methods: The subjects of study are 542,828 men who have all received physical examination after being enlisted in army between January 2013 and June 2015. Data received from the ROK Army Personnel Command and Miliary Manpower Administration was utilized for the study. Results: The main results of this study was, firstly, men who were deferred from recruitment among total men enlisted were 2.1%. Secondly, the deferred rate based on time period between the point of physical examination held at the Military Manpower Administration and physical examination held at the enlisted unit showed increasing trend as time elapsed. Particularly, the rate increased drastically after 6 years. Thirdly, departments for treatment mostly visited by deferred men were psychiatry, orthopedics, neurological surgery and dentistry in order. Conclusions: he result of this study strongly suggests the need to transform the current physical examination policy which divided the examination into conscription physical examination and enlistment physical examination and such policy can arose confusion in those who are subject to be enlisted and negatively affect trust against military. Therefore, it is in dire need to abolish current policy of physical examination for enlisted soldiers or to replace it to provisional examination, and also require research and decisions of policies regarding plan to hold physical examination at the Military Manpower Administration before enlisting into army.

야전군인의 응급처치 지식수준 실태 및 교육 요구도 조사

하범만 ( Ha Beomman ),박지훈 ( Park Jihoon ),김원희 ( Kim Wonhee ) 국군의무사령부 2012 대한군진의학학술지 Vol.43 No.1

Objective : This study conducted to examine soldier's knowledge level and education needs of first aid. Methods : Questionnaire was made through literature review and pilot study. Data were collected from 990 solders from August to September, 2011. Results : The main results of this study are summarized as follows. First, 452 soldiers(45.7%) and 490 soldiers(49.6%) has experience of first aid and CPR education before enter the military service respectively. 943 soldiers(95.3%) and 922 soldiers(93.2%) has experience of first aid and CPR education after enter the military service respectively. Second, 948 soldiers(95.8%) and 882 soldiers(95.1%) has needs for education of first aid and CPR respectively. Third, Score of knowledge level of first aid was 69.5±10.9 on the basis of 100 points and there were significant differences in the variables of education, mother's education level, socioeconomic status, numbers of siblings, experience of feeling needs for first aid, education experience of first aid before and after enter the military service, needs for education of first aid in military service. Conclusion : Although soldiers felt usefulness and needs for education of first aid, it was found that their actual knowledge level of first aid were low. Therefore the continuous and qualified education should be given.

노인의 일상생활 수행능력 장애 발생과 영향요인 : 전기노인과 후기노인 비교

하범만(Beomman Ha),김지순(Jisoon Kim),김선호(Seonho Kim) 한국산학기술학회 2022 한국산학기술학회논문지 Vol.23 No.10

본 연구의 목적은 전기노인(65-74세)과 후기노인(75세 이상)의 도구적 일상생활수행능력(IADL) 장애 발생을 조사하고, 장애 발생에 영향을 미치는 요인을 확인하는 것으로 한국고령화연구패널 7차(2018년)와 8차(2020년) 기본조사 자료를 사용하였다. 연구대상은 2018년 당시 IADL 장애가 없고 연구에 사용된 변수 누락이 없는 65세 이상 노인 3,314명이었다. 자료분석은 SPSS 20.0을 활용하여, 다중로지스틱 분석을 이용하여 분석하였다. 연구결과, 2018년에 장애가 없는 노인 중 2020년에 장애가 발생한 노인은 전기노인에서 3.4%, 후기노인에서 14.1%였다. 전기노인과 후기 노인에서 IADL 장애 발생에 영향을 미치는 변수는 달랐는데, 전기노인의 경우 남성에 비해 여성에서 장애 발생이 높았다. 반면, 후기노인의 경우에는 주관적 건강상태가 나쁠수록, 인지기능 장애가 있을수록 IADL 장애 발생 위험이 높았다. 이러한 결과는 향후 노년기를 연령대별로 세분화하고, 각 연령대별로 장애 발생을 예방하고 관리할 수 있는 중재전략이 달라야 함을 시사한다. This study was undertaken to identify the incidence of instrumental activity of daily living (IADL) disability and its correlates in older Korean adults categorized by age group (young-old vs old-old). The sample included 3,314 subjects aged 65 and more who participated in the 7<SUP>th</SUP> and 8<SUP>th</SUP> waves of the Korean Longitudinal Study of Ageing, reported no limitation in IADL at baseline(2018), and had complete data on other covariates. Data were analyzed using multiple logistic regression. Results indicate that the 2-year incidence of IADL disability in young-old and old-old subjects with no disability at baseline was 3.4% and 14.1%, respectively. We further determined that the incidence of IADL disability in young-old people was higher in men, and increased in old-old subjects with poor subjective health status and cognitive impairment. These findings indicate that the incidence and correlates of IADL disability vary with age. These results suggest that the age of subjects needs to be considered when developing interventions to prevent the onset of IADL disability and to prolong the deterioration of IADL disability in older adults.

군복무 중 발생한 복합부위통증증후군 환자의 특징

하범만 ( Ha Beomman ),박대화 ( Park Dae Wha ),이도형 ( Lee Do-hyeong ) 국군의무사령부 2017 대한군진의학학술지 Vol.48 No.1

Objectives: The aim of this study was to estimate the prevalence and clinical characteristics of patients with complex regional pain syndrome(CRPS) among ROK army servicemen. Methods: A total subjects of 72 patients who have been diagnosis with CRPS at the Armed Forced Hospitals from year 2011 to 2015. As for the data, socio-demographic characteristics (age, rank, educational level, body mass index), durations among enrollment, 1st symptoms and medically discharges, characteristics of CRPS(symptoms, sign, criteria of medically discharge) were investigated. Results: 1.5-6.5 per 100, 000 ROK army servicemen were medically discharges due to CRPS. 60 patients(81.8%) had CRPS type 1, and Crush injury(58.1%) was common cause of CRPS patients. 43 patients(60.8%) had pain on right side, and lower extremities(78.4%) was more commonly affected than upper extremities(18.9%). The mean duration between enrollment and 1st CRPS symptom, between 1st CRPS symptom and medically discharge were 29.4 weeks and 37.6 weeks, respectively. Most common symptoms and signs were abnormal vasomotor include temperature asymmetry and skin color change Conclusions: Earlier diagnosis is important in CRPS, and suspicion of CRPS is more important. It is necessary for miliary doctors to educate the contents of CRPS during education program at Armed Forced Medical School.

육군 내 급사의 원인 : '07∼'14년 군 장병 사망 분석을 통해

고성민 ( Ko Sung Min ),하범만 ( Ha Beomman ),강동원 ( Kang Dong Won ),이도형 ( Lee Do-hyeong ) 국군의무사령부 2016 대한군진의학학술지 Vol.47 No.1

Objectives; The purpose of this study was to investigate characteristics and causes of sudden death in young, healthy adults of ROK Army. Methods; We performed a retrospective study based on mortality data in the army from January 2007 to December 2015. Cases falling into sudden death criteria were included in the study. Results; Of total 1088 deaths, 107 were classified as sudden death, and autopsies were conducted for 90 cases. Syncope(54.2%) was the most common prodromal symptom of the sudden deaths, and dyspnea(24.5%), chest pain(11.2%), and vomit(5.6%) followed. The exercise(36.4%) was the most common activity at the time of sudden death, and resting(30.8%) such as sleeping, activities of daily living(30.8%) followed. Autopsy results showed that coronary artery disease was frequent in a group with 35 years of age or older, and unexplained sudden death and hypertrophic cardiomyopathy were frequent in a group younger than 35 years old, which was statistically significant. Conclusions; In order to prevent sudden deaths in the army, we should try to screen for unexplained death and hypertrophic cardiomyopathy among soldiers younger than 35 years old. For soldiers with 35 years of ages or older, we need to focus on screening for coronary artery disease.

데이터마이닝을 이용한 육군 간부의 스트레스 원인 분석

문호석 ( Moon Hoseok ),하범만 ( Ha Beomman ),박임희 ( Park Imhee ) 국군의무사령부 2017 대한군진의학학술지 Vol.48 No.1

Objectives: The purpose of this study is to analyze the causes of stress in the Republic of Korea Army (ROKA) officers by using data-mining. Methods; We use multiple regression and decision tree as the methods of data-mining. Results: The results of the causes of stress in ROKA officers show two important things. First, working environment and personal problem are the main factors of the causes of stress in ROKA officers. Second, women in ROKA officers have more stress than men generally. Especially if personal problem and working time are not controlled, these officers may be easy to be the person who has high level stress.

정신과 질환으로 조기 전역하는 육군 병사에 대한 고찰

이도형 ( Dohyeong Lee ),하범만 ( Beomman Ha ) 국군의무사령부 2020 대한군진의학학술지 Vol.51 No.1

Objectives; This study aimed to analyze the prevalence data of South Korea conscript soldiers who were prematurely discharged from military services due to mental illness. Methods; All demographic data, distribution of primary psychiatric diagnoses for medical discharge were collected retrospectively from Republic of Korea (ROK) Army Headquarters. Our data included 7,902 disabled soldiers and 24,733 maladjusted soldiers who were prematurely discharged from ROK army between January 1, 13 and December 31, 2018. Results; Soldiers with psychiatrical disabilities tend to decrease, but the number of maladjusted soldiers has increased continuously since 2013. In both cases, the most frequent rank was in the private class. Soldiers with psychiatrical disabilities reported high frequency of developmental disorders, schizophrenia, bipolar disorder and maladjusted soldiers showed adjustment disorder, depression, personality disorder, and anxiety problems. Conclusion; The number of maladjusted soldiers is increasing, and most of them are reported diagnostic names that require long-term care. Systemized epidemiologic, long term cohort studies are crucial to providing military-related mental health assessment and treatment.

2019~2021년 육군 군부대 말라리아의 역학적 특성: 매개체 감시활동을 중심으로

최지완 ( Jeewan Choi ),김유진 ( Yujin Kim ),하범만 ( Beomman Ha ),신현일 ( Hyunil Shin ),이버들 ( Buddle Lee ),주영훈 ( Younghoon Joo ),김재형 ( Jaehyung Kim ) 국군의무사령부 2022 대한군진의학학술지 Vol.53 No.1

Objective: Military malaria patients continuously occur despite the preventive efforts, and the ROK Army started the malaria vector surveillance program co-operated with the Korea Disease Control and Prevention Agency (KDCA) since 2019. This study was performed to investigate malaria-epidemiological characteristics through malaria-vector surveillance during 2019∼2021. Method: Anopheles spp. were collected from the surveillance military units for 22 weeks from May to September during 2019∼2021. The ratio of Anopheles spp. was calculated, and Anopheles spp. infected with Plasmodium vivax were identified by nested polymerase chain reaction (nPCR). Correlations between the number of Anopheles spp. and the number of military patients were analyzed using the Pearson correlation test. Results: A total of 5,513 Anopheles spp. were collected, 2,866 in 2019, 1,500 in 2020, and 1,147 in 2021. The ratio of Anopheles spp. in total mosquitoes was 62.4%, and numbers of infected Anopheles spp. were 29 pools (17 in 2019, 11 in 2020, and 1 in 2021). There was a strong positive correlation between the number of Anopheles spp. and the number of military malaria-patients by year, but there was no correlation by month except for Paju-si in 2020. Conclusion: Military units had a higher ratio of Anopheles spp. than civilian region, and infected Anopheles species were also continuously collected, so it was necessary to comply with malaria prevention rules including chemoprophylaxis. From our study, we concluded that malaria vector surveillance is crucial and should be continued, and through malaria-vector surveillance, it could be possible to predict the occurrence of military malaria-patients.

일부 육군 장병의 체질량지수와 체격에 관한 연구

김미랑 ( Mirang Kim ),유정아 ( Jeonga Yu ),배은경 ( Eunkyoung Bae ),석웅 ( Woong Seok ),하범만 ( Beomman Ha ),최병섭 ( Byungseop Choi ) 국군의무사령부 2020 대한군진의학학술지 Vol.51 No.1

Objective; This study aims to check adequacy of current obesity classification in Korea among young male soldiers. Method; We surveyed 316 military personnel who agreed this study with structured questionnaire. They answered voluntarily the questionnaire and also wrote down their data of medical examination, body composition and army physical fitness test. Results; Subjects were classified as by Body Mass Index(BMI): underweight(<18.5) 1, normal(18.5-22.9) 129(40.8%), overweight(23-24.9) 91(28.8%), obese(25-29.9) 78(24.7%), severe obese (30≤) 17(5.4%). Obesity rate was 30.1% by BMI 25, 14.6% by Body fat(25%) and 18.7% by waist cimcumference(90cm), respectively. This classification by BMI presents 87% of sensitivity, 79.6% of specificity based on 25% Body fat. When we analysed BMI ROC curve by Body fat(25%), sensitivity and specificity were 80.4% and 90% at the point of BMI 26.05. Almost two-third(67%) of Overweight group and one-third(30.8%) of Obese group showed more than 45% of muscle ratio. All of them had less than 25% body fat. In the over obese group, there were statistically significant differences when analyzing the abnormality of medical examination and passing the physical fitness test by dividing into 45% muscle ratio and 25% body fat, respectively. Conclusion; This study shows that it may be appropriate to reclassify some of overweight(23≤BMI<25) and Obese(25≤BMI<30) young men as normal or overweight in Republic of Korea Army considering possibility of muscle excess. If we study more subjects in the future, new and appropriate cut-off values from normal to obese could be suggested.