• Journal of Environmental Health Sciences
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• v.37 no.6
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• pp.440-449
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• 2011

Objectives: This study was designed to determine the levels of polybrominated diphenyl ethers (PBDEs) in breast milk and to evaluate the relations with factors affecting these levels. Methods: The congener levels of PBDE in 22 samples of breast milk were analyzed using a high resolution gas chromatograph with a high resolution mass detector. In accordance with our standard operating procedures, the recoveries of internal standards had to range between 68% and 118%. Since the distribution of PBDE concentrations is close to log-normal, the data were logarithmically transformed before analysis. Test subjects were healthy primipara and multipara mothers with a mean age of 32 (SD = 2.7) in 2006. Results: Seven PBDE congeners (BDE-28, 47, 99, 100, 153, 154, and 183) were detected and identified in all of the pooled breast milk samples, indicating widespread contamination from PBDEs in the environment in Korea. Residue levels of total PBDEs (sum PBDEs from tri- to hepta-BDE) ranged from 0.84-13.1 ng/g lipid with median and geometric mean levels of 2.6 ng/g lipid and 2.74 ng/g lipid, respectively. PBDE congeners 47, 99 and 153 markedly predominated and accounted for about 75% of the amount of the PBDE congeners analyzed. BDE-47 was the dominant congener in most samples, whereas BDE-153 was predominant in a few (n = 7/22). BDE-47 was highly correlated with total PBDEs (r = 0.987, p < 0.01). In analyses of the differences of the means of log transformed breast milk PBDE levels for groups of potential covariates, only breast milk BDE-47 and BDE-99 levels were significantly associated with fish (p < 0.05) and meat consumption (p < 0.01). However, we did not find significant correlations between PBDE levels and maternal age, body mass index (BMI), parity, job presence and smoking status. Conclusions: Our findings are mainly limited due to the small sampling size and low doses of PBDEs exposure. Background and human exposure data of PBDEs is lacking, and longitudinal investigations into the environment and biota are encouraged to determine the health impact on future populations in Korea.

• Journal of Korean Academy of Nursing
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• v.21 no.1
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• pp.89-116
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• 1991

The purpose of this study was to describe mother -infant interacting behavior patterns related to newborn infant feeding and to explore the mother's cultural belief about their infant. The data collection was conducted by observation and interview. Twenty-five mothers and their newborn infants who were normally delivered and were also planned to breast feed were comprised as the subjects of this study. All subjects were interviewed and observed individuaily at 1 to 5 days after the delivery at the hospital, mid -wife's clinic, Maternal Child Health Center and their home throughout the country from remote area to big city, The observation data were recorded with symbolic letter on a recording sheet newly developed as a result of preliminary study. The interview data were taperecorded and then recorded in narrative form. Mother - infant interaction behaviors in early feeding period were analyzed based on 19 analytic sub-categories and their composing elements. Unit of analysis were mother, infant and mother -infant dyad. 8 analytic categories draw from the data. Each were preparation, instrument, interaction inducing, evaluation referred to mother's behavior, preparation, instrument, interaction inducing referred to infant's behavior and synchronic behaviors referred to mother - infant dyad. Frequencies of behavior items based on the categories were converted to percent. The result showed that in mother's preparation behavior, the breast condition of Korean mother can be an affecting factor for mother - infant interaction during feeding, and vocalization behavior was observed most frequently in interaction inducing behavior while the least frequent behavior observed was contacting. Subcultural characteristics of mother - infant interaction behaviors were analyzed for their relationships between groups of mothers who have lived in remote area vs urban area, and who were multipara vs primipara. Using a chi -square test, there were statistically significant relationships in the activity of psychological readiness in preparation behavior and the movement of extremities for the position of instrumental behavior in both groups. However, interaction inducing behaviors were not related with statistical significance in any set of groups. Accomplishment of marriage, bonding and emotional mediation of family members were the categories related to mother's cultural belief about the infant in aspect of functional values. Infant at birth is considered little more than a biological organism without social capabilities. Although the newborn infant is still be attached to his mother, he makes his mother extend her territoriality. The mother's interacting behavior toward her infant based on those beliefs appeared task oriented, separative behavioral series. On the other hand, it was seen that infant reacted independently to his mother's behavior by the in-nate perceptual abilities. Those independent behavioral series of mother and infant on the feeding situation were synchronized at any moment. Nurses are In a unique position to teach mothers about their infant's capabilities and help reducing some of uncertainty about infant's behaviors. Study results indicated that the informations infant's social capabilities and breast feeding should be given to the mothers. The results of this study have several implications for nursing. First, the study results will be used as fundamental resources for the development of the assessment tool about the early mother - infant interaction. Second, the results could be a relevant information in the fied. I of maternal child nursing education as real and useful data. Third, the behavioral patterns of early mother - infant interaction which were classified based on the qualitative analysis could be used for nursing theory development as very fundamental data.

• Korean Parent-Child Health Journal
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• v.5 no.2
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• pp.129-144
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• 2002

This longitudinal quasi-experimental research was conducted to develop parent role education program and to evaluate the effect of this program for mother-infant interaction, childrearing environment and infant development. The subjects were the healthy infants weighing over 2,500gm at birth, whose gestational age was more than 37weeks, and their healthy mothers. The sample consisted of eighteen mother-infant dyads for intervention group and sixteen dyads for control group. Data were collected from March 15th in 1999 to Jun 20th in 2000. The intervention group received programmed education consisted of discharge education, telephone counselling, and home visiting care. But control group were collected data without programmed education. In this study, the Nursing Child Assessment Teaching Scale(NCATS) devised by Barnard was used to determine the mother-infant interaction, HOME was used to determine the childrearing environment, and Griffiths mental development scale was used to determine the infant development. The data were analyzed using SPSS Win using chi-square test, t-test, and repeated measure ANOVA. This study was focused on the results of twelve months time point. Summaries of the results were as follows: 1. There was no significant difference in mother-infant interaction(NCATS) between intervention group and control group. But both of two groups showed significantly higher in interaction score at twelve months than at six months in the subscales of social-emotional growth fostering, and responsiveness to caregiver. 2. There was no significant difference in childrearing environment(HOME) between two groups at twelve months. But when each subscale of HOME was examined, intervention group showed higher scores in the dimensions of maternal involvement with child(p=.001), and maternal emotional-verbal responsivity(p=.048). 3. There was no significant difference in GQ of the Griffiths mental development scale between two groups, although significant difference was found in performance subscale. 4. Infant development at twelve months showed significant correlation with mother-infant interaction and childrearing environment at six months, although mother-infant interaction and childrearing environment at twelve months did not show significant correlations with infant development at twelve months. 5. Developmental scores at six months showed significant correlations with variety in daily stimulation, and mother's emotional, verbal responsivity, whereas developmental scores at twelve months showed significant correlations with acceptance of child behavior at six months, and appropriate play material at twelve months. In conclusion, the maternal education program for primipara showed long term effect in some categories in organizing the childrearing environment, and fostering the infant development. We suggest further study and implications of parent role education program for high risk parents such as parents in low economic status or with premature babies.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.141-157
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• 1971

The peripheral infection is one of the major causes of maternal death, and although it is preventable through an effective prenatal as well as postnatal care its morbidity is increasing due to bacterial resistant to an effective antibiotics. The primary purpose of this study was to investigate the peripheral morbidity of 949 parturients who were admitted to the Obstetrics and Gynecologic department of Ewha Woman's University Hospital from January 1971 to September 1971. Among the 949 parturients, especially 40 normal parturients were selected (20, control soup was given complete aseptic care during labor and delivery and post delivery: 20, compare group was given the ordinary care practiced during labor and delivery and maternal ward of Ewha Woman's University Hospital) for bacteriologic test on vaginal flora twice, on admission and on complete cervical dilatation of each parturient. The results obtained from this study were as follows; 1. Majority of parturients age were 21 to 35 years old(90.83%), and educational level of 949 parturients was above high school. A large number of parturients socioeconomic level (according to their husbands' job) were moderate. 2, Among the 949 parturients, multipara (55.9%) were a little more than primipara (44. 1%) and 38.84% of parturients had experienced aborition. 3. In deliverty types, normal deliveries (804 cases) were more than cesarean section deliveries (145 cases) The peripheral morbidity after normal deliveries was 0.5%, and cesarean section deliveries, 23.45%. 4. Among 949 parturients incidence of hemorrhage eases (500cc or more bleeding) showed the higher peripheral morbidity (24.86%) than other cases (bleeding less than 500cc, 7.83%). 5. The majority of parturients (81.03%) had teen taking antenatal care, but most of them were taken irregular antenatal care. On the other hand, on admission, the parturients with complication were 30.32%, and their peripheral morbidity showed much higher (7.02%) than those with no complication (2.71%). 6. The incidence of peripheral morbidity in premature ruptured membrane was higher (10.91%) than normal parturienta (1.73%). 7. In the result of aseptic care during labor and delivery and post delivery, the number of cultured bacteria was legs in control group than Compare group (in control group, on admission 17, on complete cervical dilatation 12: in compare group, on admission 21 on complete cervical dilatation 21) . The most common bacteria were Staphylococcus (control group 14 on admission, compare group 16 on admission), and next Streptococcus, E- Coil, Bacillus Subtilis, in order. Also in control group the number. of colony were reduced (43%) more than in Compare group. Transient temperature elevation from 37℃ to 37.4℃ were noted in compare group (50%) than in control group (30%), and there was no one indicated above 38℃. In conclusion, the aseptic care is the test way of preventing peripheral infection as well as decreasing the puerperal morbidity. Therefore the most important nursing care is the aseptic care for each parturient during labor and delivery and peat delivery and also all the instruments must be cleaned and sterilized.

• 모자간호학회지
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• v.2 no.1
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• pp.5-20
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• 1992

This study was undertaken to identify the levels and affecting factors of the maternal role attainment(MRA) in the primipara during the postpartum period. The healthy ninety primiparous from the one university hospital and two local clinics in KwangJu city were selected and two Semantic Differential Scales (SD-Myself as Mothers, SD-My Baby) and the Pharis Self Confidence Scale were used in this study. Questionnaires were distributed at the 3rd days and the 4-6 weeks of the primiparous not showing any complication after normal delivery. The data collected were analysed statistically using t-test, Pearson's Product Moment Correlation Coefficient and ANOVA. The results obtained were summarized as follows; 1) On the 3rd day after the delivery, the scores of SD-myself as mother, SD-baby and Pharis Self Confidence were 70.6 points, 73.6 points and 78.6 points, respectively, showing the low level of MRA. 2) On the 4-6 weeks after delivery, the score of SD-myself as mother, SD-baby and Pharis Self Confidence were 72.8 points, 77.9 points, and 86.9 points, respectively, indicating the moderate level of MRA. 3) The mean scores of the SD scale and the Pharis Self Confidence during the postpartum periods were higher than those of the 3rd days, showing the SD-myself as mother (t=-2.09, P<.05), SD-baby(t=-4.12, P<.001), Pharis Self Confidence(t=-6.59, P<.001), respectively. 4) Positive correlations (r=.24$\sim$.69) were shown in the concepts related to the MRA and the cognitive-motor skill components and cognitive-affective skill components of the MRA became harmonious over time. 5) The relationships between the score of the MRA and the demographic and obstetric variables were as follows ; a) the score of the MRA in the twenties was higher than those of the thirties. b) the group with higher educational background showed higher MRA socres than the group with lower one. c) those who wanted pregnancy sustenance had higher MRA scores than those who did not. d) the group that did think of festus-feature represented higher MRA scores than those who did not. e) the group of mothers who have the daughters showed higher MRA scores than those who have boys. It can be concluded from the results that the MRA in the primiparous increased gradually, and that the cognitive-motor skills and cognitive-affective skills became harmonious over time. The level of the MRA was affected partly by the mothers general, obstetrical variables. Following suggestion were made oil the basis of the present study ; a) The longitudinal study on the MRA is needed. b) Multivariate analyses should be done for the identification of the factors influcening on the MRA. c) Education program for primiparous mother should be designed and developed to improve the MRA.

• Women's Health Nursing
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• v.1 no.1
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• pp.5-27
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• 1995

One of the important tasks for new parents, especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the health development of the child and the well-being of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. The purpose of this longitudinal descriptive correlational study is to investigate the changes of the mother - infant interactions from postpartum 1 day to postpartum 8weeks of the transition to parenthood. The aim was to contribute to the development of theoretical under standing on which to base care toward promoting the quality of maternal - infant interaction. Data were collect ed directly by the investigator and at rained from Jul, 1, 1990 to Jun 8, 1991, Subjects were a random sample of 44 mothers, 44 who had a normal delivery (but with out other perinatal complications) at four general hospitals in Seoul. Instruments used were the Stainton Parent-infant Interaction Scale (1981). The first observations were made in the delivery room, followed by day 1, day 2, day 3 and 2 weeks, 4 weeks, 6 weeks and 8 weeks after, birth, for a total of 8 contacts. Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was don by computer using as SPSS program and included, Paired t-test, t-test and Pearson Correlation coefficient ; the results were as follows. 1. The daily maternal-infant interaction score for the initial contact ofter birth to 8 weeks postpartum had the lowest average score 5.21 and the highest 8.02(in a range of 0-10). This subject group of mothers needed Extra nursing supporting to promote their maternal-infant interaction. 2. The daily scores for the maternal-infant interaction tended to rise, showing a gradual improvement over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day (p=0.000) and from the fourth to sixth weeks ofter birth.(p=0.000) 3. When the seven items of maternal-infant interaction were evaluated items of maternal-infant inter action were evaluated separately, "Care taking for the baby" had the highest average score, 1.60(in a range of 0-2) and "Speaks to baby" the lowest, 0.8. All items, suggested the subjects' need of nursing intervention to promote maternal-infant interaction 4. There were positive correlations between certain general characteristics, namely, both a higher economic status (p=0.027) and breast feeding (p=0.021) and maternal-infant interaction.

• Journal of Life Science
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• v.20 no.3
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• pp.356-364
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• 2010

This study was carried out to investigate the exposure pathway of PBDEs in human breast milk collected from new mothers residing in Chuncheon, a comparatively clean area in Korea. The congeners of PBDE in 22 human breast milk samples were analyzed using a high resolution gas chromatography with a high resolution mass detector. The residue level of ${\sum}PBDEs$ was higher in primipara subjects than in multipara subjects (p<0.05). The levels in this study were similar to those of people in some Asian and European countries, but were lower than those of people in north America. In the congener profiles, BDE-47 (mean contribution=36.1%) was predominant, followed by BDE-153 (27%), BDE-99 (11.7%), BDE-100 (11.1%), BDE-28 (7.9%) and BDE-183 (3.5%). The sum of BDE-47 and BDE-153 accounted for more than 50% of ${\sum}PBDEs$ in most samples. BDE-47 was highly correlated with ${\sum}PBDEs$ (r=0.94, p<0.001). No strong trend was observed between PBDE levels and a number of key biological factors (women's age, weight, height and body mass index) examined in this study, however, weak correlations were observed in PBDE levels measured against dietary habits, particularly in fish consumption frequency. It seems that Korean people might be exposed to multiple sources including products of PBDEs, and particularly food resources.

• Journal of Korean Society of Environmental Engineers
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• v.34 no.1
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• pp.7-15
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• 2012

The levels of indicator PCBs were determined in 132 human milk samples (Colostrum, 30th days after delivery, 60th days after delivery) collected in 2006 according to World Health Organization's (WHO) protocol. In addition, concentrations of indicator polychlorinated biphenyls (PCBs) were measured by the isotope dilution method with high resolution gas chromatograph/high resolution mass detector (HRGC/HRMS), which gave accurate and precise data for estimations of international trend and comparisons. Average daily intakes (ADIs) of all analytes were calculated. The median level of total indicator PCBs was 14 ng/g lipid, which is significantly lower than the level found in individuals from other countries. PCB congeners 138, 153 and 180 accounted for about 65% of the sum of the indicator congeners analyzed. The concentration of the most abundant PCB 153 is positively correlated with the concentration of the sum indicator PCBs (p<0.001). In this study, concentrations of total indicator PCBs significantly decreased with increasing number of children for a mother, indicating that parity and breast-feeding period an important role in the accumulation and elimination of these compounds in lactating women. The ADI for the median of total indicator PCBs for an infant was evaluated at $0.077{\mu}g/kg{\cdot}bw/day$ from birth to 6 months of age. The present study shows that concentrations of PCB 118 primipara breast milk have decreased 25~35 since 1998, and that this trend is continuing.

• Environmental Analysis Health and Toxicology
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• v.27
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• pp.3.1-3.4
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• 2012

Objectives: The current use of humidifier detergent and its harmful impact on humans has arisen as a societal environmental health issue. Therefore, in this study we aimed to explore the relationship between demo-socio characteristics and humidifier use, as well as the monthly usage changes in pregnant women; thus, we report the actual status of humidifier usage of Korea's pregnant population. Methods: From a birth cohort of a Mothers and Children's Environmental Health (MOCEH) study, 1,144 pregnant women who responded through questionnaires including demo-socio characteristics, obstetric status and household environment including whether they use humidifier and frequency of use were included in this study. Statistical analyses were performed to explore the relationship between maternal characteristics and the relevance of the use of humidifiers was performed using a chi-square test, a t-test and univariate logistic regression analysis. The monthly usage rate was demonstrated in the graph. Results: The humidifier usage rate in pregnant women was 28.2%. The average frequency of humidifier usage was 4.6 days per week, 7.3 hours per day. The usage rate was higher in the multipara group and the above the age of 34 age group than in the primipara and below the age of 34 groups. Seoul showed a higher usage rate than Cheonan and Ulsan and as the education level and income increased, the usage rate of humidifiers among pregnant women also increased. In the monthly trend of usage rate, the winter season showed the highest usage rate of over 45% and the lowest in late summer and beginning of fall with a value of 12% or less. Conclusions: During pregnancy, the mother's body is especially vulnerable to hazardous environmental exposure that not only affects the pregnant woman but also the fetus. Further research is still needed to elucidate the route and effect of environmental risk factors. Therefore, based on precautionary and preventive principles, special interest and caution in harmful environments are strongly needed not only at an individual level but also at a national level.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.168-174
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• 1997

Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.