• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.17-29
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• 2002

The purpose of this study was to examine the application of the Activity-based Costing(ABC) system to analyze the cost of nursing services in the delivery room in a major medical center.The results of this study are as follows;1. In order to calculate the cost of nursing activities, 67 activities of staff nurses on a delivery room were identified and classified as direct nursing activities(45.2%), the indirect activities(32.1%), general management activities(13.9%) and others(8.8%).2. Nursing cost in the delivery room was classified into activity cost(29.9%) and common cost(70.1%). Activity cost involved direct activity cost of staff nurses. The common costs were categorized into indirect activity & general management cost of staff nurses, management cost of the head nurse and activity cost of assistants.3. The final cost objects of nursing services in the delivery room were nursing service for women who had normal vaginal deliveries and nursing service for women who had preterm labor.The total cost of nursing service for a woman who had a normal vaginal delivery was 165,710 won (100.0%). The cost incurred through direct activity cost of staff nurses(58,242 won, 35.1%), indirect activity & general management cost of staff nurses (55,643 won, 33.6%), management cost of head nurse (16,211 won, 9.8%), activity cost of assistants (35,614 won, 21.5%).If the number of days of hospitalization was presumed to be 14 days, the total cost of nursing service for woman who had preterm labor would be 1,845,901 won (100.0%). The cost incurred by direct activity cost of staff nurses in the activity cost (341,349 won, 18.5%), indirect activity & general management cost of staff nurses in the common cost(779,002 won, 42.2%), management cost of head nurse(226,954won, 12.3%), activity cost of assistants in the common cost(498,596 won, 27.0%).In this study, the cost of the nursing services in the delivery room was calculated based on the ABC system. The results of this study showed that resources are assigned to the nursing activities in the delivery room and the mechanisms for assigning the cost of activities for nursing services.

• Clinical and Experimental Reproductive Medicine
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• v.23 no.3
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• pp.327-331
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• 1996

Normal fertilization and pregnancy by round spermatid was achieved from nonobstructive azoospermia patient to be believed untreatable. Therefore, it is suggested that application of round spermatid in human ART program seems to be new treatment of male infertility. Also, it will be needed further research for evaluated fertilization mechanism by round spermatid injection.

• Women's Health Nursing
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• v.11 no.3
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• pp.202-208
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• 2005

Purpose: This study was conducted to discover the related factors of neonatal suckling in the initiation of breastfeeding in primiparous mothers and to provide basic data for promoting nursing intervention strategies to improve the practice of breastfeeding. Method: The subjects of this study were 71 primiparous mothers who had normal vaginal deliveries at one obstetric hospital in P metropolitan city and one delivery center in J city. The collected data was analyzed using the SPSS program. Result: The average IBFAT(Infant Breastfeeding Assessment Tool) score was 9.6$\pm$2.3. The general characteristics studied that had a significant influence on neonatal suckling in the initiation of breastfeeding were the place of delivery (ex: Hospital, Postnatal Unit), whether oxytocin was used, no usage of analgesic medication, amount of satisfaction after the first breastfeeding weight of the newborns and the Apgar score at one minute. Conclusions: A higher IBFAT score was related to primiparous mothers who had a hospital delivery, received oxytocin, received maternal labour analgesics, neonatal weight, Apgar score at one minute, and satisfaction after the first breastfeeding.

• The Journal of Korean Obstetrics and Gynecology
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• v.21 no.4
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• pp.139-149
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• 2008

Purpose: The purpose of this study was to examine the relationships between variety pregnancy related factors and postpartum BMI change. Methods: Analyzing the BMI of 125 postpartum women in oriental medical hospital of O O university from March, 2008 to May, 2008. Age, pregnancy period. type of delivery, parity, pregravida(PG) BMI, weight and BMI gain during pregnancy, gestational maximum(GMx) BMI were recorded. BMI also checked on each postpartum 7days(P7d), 14days(P14d), 90days(P90d), And we distinguished into Sasang Constitution by QSCC II. Results: The following results were obtained: 1. Age. pregnancy period were not correlated to postpartum BMI change. 2. PG BMI were lower in normal delivery group than caesarean delivery group. 3. PG BMI was lower in primipara group than multipara group. Weight and BMI gain during pregnancy. P90d BMI were lower in multipara group. 4. PG, GMx, P7d, P14d, P90d BMI were significally high in Taeumin. 5. PG BMI were correlated to GMx, P7d, P14d, P90d BMI. 6. Weight and BMI gain during pregnancy were correlated to GMx BMI and P7d, P14d, P90d BMI, BMI loss. Conclusion: This results suggested that weight and BMI gain during pregnancy have the best relationship with postpartum weight change.

• Korean Journal of Community Nutrition
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• v.6 no.2
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• pp.192-204
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• 2001

Osteoporosis and other related conditions pose a growing public health problem, especially in postmenopausal women. The main purpose of the study was to investigate the correlations among BMD, maternal factors, and life styles, and intake of nutrients in postmenopausal women. One hundred participants in Kyungge-do were divided into three groups according to their BMD measurements measured by DXA. Dietary analysis, anthropometric measurements, and questionares were administered to these women. The percentage of the osteoporosis, osteopenia(Osteopinia), and normal groups were 32%, 48%, and 20% respectively. The average age was significantly the highest in the osteoporosis group. The average age at menopause was 47.2. Osteoporosis group's age at menopause was significantly the lowest. The sleeping hours of the osteoporosis and osteopenia group were significantly longer than the normal group. The intake of vitamin B$_2$was positively correlated with the BMD of femoral neck. The BMD of these two sites was positively correlated with weight, BMI, waist, and hip size and negatively correlated with the length of the menstrual cycle, duration after menopause, the age at the last delivery, and sleeping hours. Spinal BMD positively correlated with hours of outdoor activity. Therefore, maternal factors, lifestyles, and intake of nutrients contribute to BMD.

• Journal of Korean Academy of Nursing
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• v.48 no.1
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• pp.38-49
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• 2018

Purpose: This study aimed to develop an instrument to assess the quality of childbirth care from the perspective of a mother after delivery. Methods: The instrument was developed from a literature review, interviews, and item validation. Thirty-eight items were compiled for the instrument. The data for validity and reliability testing were collected using a questionnaire survey conducted on 270 women who had undergone normal vaginal delivery in Korea and analyzed with descriptive statistics, exploratory factor analysis, and reliability coefficients. Results: The exploratory factor analysis reduced the number of items in the instrument to 28 items that were factored into four subscales: family-centered care, personal care, emotional empowerment, and information provision. With respect to convergence validation, there was positive correlation between this instrument and birth satisfaction scale (r=.34, p<.001). The internal consistency reliability was acceptable (Cronbach's alpha =.96). Conclusion: This instrument could be used as a measure of the quality of nursing care for women who have a normal vaginal delivery.

• Women's Health Nursing
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• v.8 no.3
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• pp.412-423
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• 2002

This study was designed to evaluate the effect of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal vaginal delivery. The data were collected from November 1999 to April 2000 at a university hospital located in Seoul, Korea. Out of 49 women with normal vaginal delivery, 25 of experimental group(with exercise) and 24 of control group(without exercise) were questioned about lower urinary symptoms, discomfort during sexual intercourse and daily life. The maximum pressure of pelvic floor muscle contraction(MPPFMC) and duration of pelvic floor muscle contraction(DPFMC) were measured at pre-treatment, the end of treatment and 8 weeks after a treatment program. The pelvic floor muscle exercise program(using biofeedback and electrical stimulation) was applied to the experimental group twice a week for 4 weeks at the incontinence clinic and the pelvic floor muscle exercise at home for that time and more 8 weeks. Data were analyzed by t-test, $x^2$-test, Fisher's exact test and the repeated measures ANOVA. The results were as follows; 1) MPPFMC(p=0.000) and DPFMC(p=0.021) were significantly increased in the experimental group. 2) In the lower urinary symptoms, daily frequency(p=0.001), nocturia(p=0.002), incontinence episode(p=0.016), stress incontinence(p=0.012), quantity of incontinence(p=0.026), straining(p=0.041), and strength of stream(p=0.009) were significantly decreased in the experimental group. 3) Discomfort during sexual intercourse had not a significant difference between the two groups, which was not significantly decreased as time passed. 4) In the discomfort during daily life, activity restriction(p=0.042), exercise restriction (p=0.008), interpersonal relationship restriction(p=0.046), and discomfort of general life(p=0.027) showed a significant difference between the two groups, which were not significantly decreased as time passed. In conclusion, it is suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for the improvement of postpartum pelvic muscle contraction.

• Women's Health Nursing
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• v.15 no.3
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• pp.177-185
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• 2009

Purpose: This study was done to examine the effects of an incontinence prevention program on postpartum women. Methods: The study design was a nonequivalent control pretest-posttest design. The subjects were 49 postpartum women with a normal vaginal delivery, 25 in the experimental group and 24 in the control group. Data was collected from lune 1. 2007 to April 30. 2008 at a postpartum women's care center located in Jeonju, Korea. For the experimental treatment, an incontinence prevention program was carried out for 24 weeks. Measures included maximum pressure of pelvic floor muscle contraction and duration of pelvic floor muscle contraction at pre-treatment, 5 weeks postpartum and 24 weeks postpartum. Data was analyzed by Repeated ANOVA using the SPSS/WIN 14.0 program. Results: The mean maximum pressure of pelvic floor muscle contraction (F = 8.95, p < .001) and mean duration of pelvic floor muscle contraction (F = 22.01, p < .001) were significantly different between the groups, and significantly increased as time passed. Conclusion: Practice of an incontinence prevention program is considered an effective intervention for the results of fewer urinary incontinence symptoms in postpartum women.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.169-174
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• 2015

Cervical cancer (CxCa) is the most common cancer in women and a prominent cause of cancer mortality worldwide. The primary cause of CxCa is human papillomavirus (HPV). Radiation therapy and chemotherapy have been used as standard treatments, but they have undesirable side effects for patients. It was reported that gallic acid has antioxidant, antimicrobial, and anticancer activities. Gold nanoparticles are currently being used in medicine as biosensors and drug delivery agents. This study aimed to develop a drug delivery agent using gold nanoparticles conjugated with gallic acid. The study was performed in uninfected (C33A) cervical cancer cells, cervical cancer cells infected with HPV type 16 (CaSki) or 18 (HeLa), and normal Vero kidney cells. The results showed that GA inhibited the proliferation of cancer cells by inducing apoptosis. To enhance the efficacy of this anticancer activity, 15-nm spherical gold nanoparticles (GNPs) were used to deliver GA to cancer cells. The GNPs-GA complex had a reduced ability compared to unmodified GA to inhibit the growth of CxCa cells. It was interesting that high-concentration ($150{\mu}M$) GNPs-GA was not toxic to normal cells, whereas GA alone was cytotoxic. In conclusion, GNPs-GA could inhibit CxCa cell proliferation less efficiently than GA, but it was not cytotoxic to normal cells. Thus, gold nanoparticles have the potential to be used as phytochemical delivery agents for alternative cancer treatment to reduce the side effects of radiotherapy and chemotherapy.