• Title/Summary/Keyword: Maternity services

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The NHS litigation scheme related to Maternity Services in UK: its experiences and implications (영국 NHS의 모성서비스 관련 의료과오보상제도의 경험과 그 함의)

  • Han, Dong-Woon;Hwang, Jung-Hye
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.181-208
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    • 2010
  • Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

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Needs assessment for maternal health care in Ermera, Timor-Leste (동티모르 에르메라 지역의 모성보건사업 요구 분석)

  • Kim, Soo Jeong;Kim, Seong Min;Cho, Kyoung Won
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.2
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    • pp.53-67
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    • 2019
  • Objectives: The purpose of this study is to obtain the basic data for the development of maternal health care by analyzing the status and needs of service target persons in Timor-Leste. Methods: The subjects were selected through the non-probability sampling method applying the FGI. Researchers interviewed 3 maternal health service managers, 6 midwives at Gleno and Railaco Health Centers and 2 women between 15 and 45 years of age. Results: In the results of on-site visit of the delivery facility and the FGI, we found poor sanitation in delivery room, lack of medical equipment related to antenatal consultation and delivery. In the case of the health center manager, the public health center provides various maternity health services, but the lack of the staff has difficulty in providing the service and managing the subjects. Midwives asked for regular maintenance education. Women in child bearing age living in mountainous areas had poor access to delivery facilities and lack of awareness of delivery services. Conclusions: It is necessary to increase the maternity management rate through regular maternity and maternal health check service and application to maternal management database, to improve the sanitation of the maternity clinic in the public health center, to strengthen the midwife competency program.

Supporting plan of disabled welfare center for the Disabled in Securing the Maternity Rights (Pregnancy·Childbirth·Child Rearing) of Disabled Women from a Gender-Sensitive Perspective (성인지적 관점의 여성장애인 모성권(임신과 출산,자녀양육)보장을 위한 장애인복지관의 역할)

  • Choi, Sun-kyoung
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.97-107
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    • 2018
  • According to the 2017 national survey of the disabled persons conducted by the Ministry of Health and Welfare, rehabilitation centers for the disabled appeared to be the service agency that disabled women use the most. This means that rehabilitation centers for the disabled hold an important role in securing the maternity rights of disabled women. However, in the practice of welfare for the disabled, programs for securing maternity rights are inadequate, and the actual condition is not being surveyed. As a result, programs related to maternity rights based on the legal basis exist, but actual support services for resolving the difficulties related to maternity rights that disabled women experience are inadequate. Thus, the study suggests that rehabilitation centers for the disabled should pay a central role in establishing the maternity rights of disabled women and provide support services such as developing a manual on basic information about pregnancy, childbirth, and child rearing, offering childbirth-related counseling, activating a self-help group, providing an individualized program for families, connecting with medical institutions, and supporting case management.

A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning (농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究))

  • Yeh, Min-Hae;Lee, Sung Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.57-95
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    • 1972
  • 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 apportunity 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 socioeconomic 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 health, 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 as 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 attendance (8%) by maternity aid in study area. But, I expect that more maternity sids 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 am 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 suck 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 post-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 ststem, 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 want 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 calculaton, 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 in the 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.

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Long Noncoding RNA MHRT Protects Cardiomyocytes against H2O2-Induced Apoptosis

  • Zhang, Jianying;Gao, Caihua;Meng, Meijuan;Tang, Hongxia
    • Biomolecules & Therapeutics
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    • v.24 no.1
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    • pp.19-24
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    • 2016
  • Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. The exploration of new biomarkers with high sensitivity and specificity for early diagnosis of AMI therefore becomes one of the primary task. In the current study, we aim to detect whether there is any heart specific long noncoding RNA (lncRNA) releasing into the circulation during AMI, and explore its function in the neonatal rat cardiac myocytes injury induced by $H_2O_2$. Our results revealed that the cardiac-specific lncRNA MHRT (Myosin Heavy Chain Associated RNA Transcripts) was significantly elevated in the blood from AMI patients compared with the healthy control ($^*p<0.05$). Using an in vitro neonatal rat cardiac myocytes injury model, we demonstrated that lncRNA MHRT was upregulated in the cardiac myocytes after treatment with hydrogen peroxide ($H_2O_2$) via real-time RT-PCR (qRT-PCR). Furthermore, we knockdowned the MHRT gene by siRNA to confirm its roles in the $H_2O_2$-induced cardiac cell apoptosis, and found that knockdown of MHRT led to significant more apoptotic cells than the non-target control ($^{**}p<0.01$), indicating that the lncRNA MHRT is a protective factor for cardiomyocyte and the plasma concentration of MHRT may serve as a biomarker for myocardial infarction diagnosis in humans AMI.

Patient navigation in women's health care for maternal health and noncancerous gynecologic conditions: a scoping review

  • Jiwon Oh
    • Women's Health Nursing
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    • v.30 no.1
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    • pp.26-40
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    • 2024
  • Purpose: This study investigated the scope of patient navigation studies on women's health care for maternal health and noncancerous gynecologic conditions and aimed to report the characteristics of the identified patient navigation programs. Methods: A scoping review was conducted following Arksey and O'Malley's framework. Five electronic databases were searched for relevant studies published in English: PubMed, Embase, Cochrane Library, CINAHL, and PsycInfo. There were no restrictions on the publication date and the search was completed in July 2023. Results: This scoping review included 14 studies, which collectively examined seven patient navigation programs. All selected studies were related to maternal health issues (e.g., perinatal health problems and contraception for birth spacing). Close to two-thirds of the patient navigation services were provided by women (n=9, 64.3%) and half by lay navigators (n=7, 50.0%). The majority incorporated the use of mobile health technologies (n=11, 78.6%). All of the patient navigation programs included in the review coordinated the necessary clinical and social support services to improve women's access to care. Conclusion: Patient navigation appears to be in its nascent phase in the field of maternal health. The results of this study suggest that the implementation of patient navigation services could potentially improve access to care for socially disadvantaged women and families. Furthermore, providing patient navigation services that are specifically tailored to meet women's needs could improve the quality of maternity care.

A Study on the Technical Change and Maternal Touch in Child Care (보육 산업의 발달과 아동의 모성접촉으로부터의 소외)

  • Kim, Sung-Hee
    • Korean Journal of Human Ecology
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    • v.19 no.6
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    • pp.933-943
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    • 2010
  • This study was carried out to investigate the effect of changes in child care technology on mother-child contact by using all sorts of literature such as diaries, documents or statistical data. Child care technologies began to change during the 1960's. Diverse goods and services such as baby dry milk, paper diapers and child care centers have made child care easier and saved a great deal of time. This has also allowed women to participate in labor markets easily despite rearing children. But maternal contact with children have declined due to new goods and services and this trend is especially prevalent in early childhood. It could be supported that the convenience of rearing rather than the needs of children like as attachment to maternity primarily was considered in technological change. From this results it was suggested that we should develop the alternative child care technologies which better reflect children's needs.

A Survey on the Utilization of Maternity and Child Health Service, and Service Requirement (보건소 모자보건실 서비스 이용실태 및 요구도 조사 연구)

  • Cho, Seong-Min;Kim, Il-Ok
    • Korean Parent-Child Health Journal
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    • v.6 no.1
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    • pp.1-17
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    • 2003
  • Thus, I studied Health services supplied by local health centers and the requirements of the inhabitants visiting the health care facilities. The purpose of this study was to provide basic material for the establishment of Health care policy and the development of health care businesses. The target places for this study were 4 health centers; Chungrang-Gu, Nowon-Gu, Eunpyung-Gu, Songpa-Gu, with 509 mothers who were visiting the Centers. The question items of this study concerned a total of 124 health-related services provided by the Health Centers. The data was collected for a total of 92 days; July 1st~September 30th, 1999. 800 questionaries were distributed and 559 answered, 509 were analyzed finally. The collected data were processed using the SAS program to get mean, standard deviation, percentage. Open questions were made to reveal the opinions of mothers using the health care center. The results were as follows : 1. Among the participants of the study, 49.7% were 25~29 years of age, 84.3% were house wives by current occupation, 56.2% were from 4~6 person households. 52.1 were educated at a high school level, and 43.6% were educated at a collage level. 2. The highest percentage(53.6%) of the users were spontaneous in their utilization of health care center. The major reason for using the Health care center is that it is free to 65.8% of those covered and of low cost to 19.3% of those covered. 3. The satisfaction level of those using the health care center appeared to be generally high. The general average value showed up as $3.027{\pm}0.519$. 4. The level of recognition of the value of the heath care center services was high, particularly in the basic item of diagnoses of pregnancy, particularly in the basic item of diagnoses of pregnancy. However, the satisfaction level of health care education In pregnancy is low at 20~40%. In the meantime, the level of recognition in breast- feeding benefits is high at 76.8%. 5. The rate of realizing health care center's service campaign was generally low at 10~20%. 41.3 of the people knew the advertizing material of the health care centers. 32.4% of the people knew the advertizing material of the health care centers. 32.4% of the people knew the campaign of health care center for importance of breast-feeding benefits. 30.1% of the people knew the campaign for testing congenital mechanism disease. In the meantime about 50% was recognised the health care centers campaign for the importance and time of infants vaccination. 6. The need for enhancement of health care center services was shown to be high as $3.266{\pm}0.676$ as an average, chicken pox vaccination being the most highly requested at $3.565{\pm}0.587.$. 7. Among the open questions, the additional service to be provided were as follows ; increase of campaign of health care center services, furnishing advertizing books in public locations, providing shuttle bus service to the health care centers, extension of desire for preventative injections, rest and play areas for the children of the families serviced, consultation rooms, etc.

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A study on the Balance between work and family according to the experience of child care support policy (돌봄노동의 사회적 지원 정책을 통해 본 일-가정 양립 실태에 대한 연구 : 학령전기 자녀를 둔 기혼취업여성의 경험을 중심으로)

  • Song, Hyerim;Yoo, Arang
    • Journal of Family Resource Management and Policy Review
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    • v.17 no.4
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    • pp.101-125
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    • 2013
  • Recently family policy and social policy have focused on the balance between the work and family of working parents. The purpose of this study is to analyze the status of the work-life balance of married working women. For this purpose the eight married working women who care for 1 or more pre-school child(ren) were interviewed. The questionnaire used was consisted of 4 themes : 1) child care, 2) working situation, 3) the work-life balance and 4) the need to improve related policies. Through the interviews and data analysis we found the following : 1) Accessibility to educarecenter was considered the most important factor for working moms when they choose an educarecenter. In order to improve accessibility of educarecenters we have to install more educarecenters with various level. 2) All respondents look maternity leave and they evaluated that other services were very weak in terms of quality, usefulness and accessibility. 3) Many childcare services aid in creating work and family balance, however they are not effective. Therefore future policies should focus on providing more options for working women for appropriate services according to childcare needs, working conditions and preferences.

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Evaluation of Organizational Effectiveness as to Types of Maternal-Child Health Management Program in Public Health Centers (보건소 모성과 어린이 건강관리사업의 조직유형별 효과성 평가)

  • Hwang, Na-Mi;Park, Hyun-Tae
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.1
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    • pp.109-120
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    • 2004
  • Purpose: The purposes of this study are; to classify executive organizations engaged in MCH programs at 23 advanced public health centers according to each characteristic; evaluate the effectiveness of organizations engaged in MCH programs. Method: This study analyzes me data on the present conditions and evaluates the organizational effectiveness of MCH workers at 23 advanced public health centers. The organizational effectiveness of MCH organization is assessed by both MCH workers and clients who have received MCH services at the three health centers selected from me 23 advanced public health centers. Finally, this study seeks to obtain consensus among experts in the field of MCH. Results: The results are as follows. The executive organizational systems for MCH services are classified into three types: Type I (provides MCH and HP services by MCH org.); Type II(provides MCH and HP Services by HP org); and Type III(provides MCH Services by MCH org. and HP services by HP org.) at leading MCH Health Centers. The evaluation of the organizational effectiveness of MCH org. shows that Type II is the most effective in terms of teamwork, autonomy, service quality, and resource utilization. According to clients' evaluation of organizational system in the field of MCH, Type II is also me most effective. Conclusion: This study suggests that the executive organization for the MCH and HP services for maternity and children should be established in accordance with lifetime health programs in order to efficiently utilize the limited MCH and HP resources at public health centers.

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