• Clinical and Experimental Reproductive Medicine
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• v.2 no.2
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• pp.27-36
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• 1975

The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.241-248
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• 2008

Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.2
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• pp.259-279
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• 2000

This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

• Journal of Digital Convergence
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• v.11 no.8
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• pp.219-225
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• 2013

The purpose of this study was to retrospectively investigate the contributing factors in facial soft tissue injuries among children. A record-based analysis was carried out on 126 patients with facial lacerations who visited I hospital in the dept of plastic surgery from April 2010 to May 2011. Through all age group showed a significant difference in incidence rate for male and female.(p<.05). Overall, 49% of injuries occurred outdoors and the most frequent cause of injury was slip-down (42%), followed by being struck (40%). In general, the frequency of injuries peaked summer(30.2%) and increased between 12pm and 4pm. 105 patients (83.3%) arrived at the emergency room within an hour. The forehead(26%) was the most commonly injured area. The depth of soft tissue injuries was mostly subcutaneous(54%), and 1~2cm was the length of injury with the highest incidence(46%). Most children (40%) needed local anesthesia and only 4 children (1.53%) suffered associated fractures. Facial injuries require special attention because of their potential threat in inducing permanent scar or disfigurement. For the safety of children, the preventive measures to reduce facial soft tissue injuries must be improved.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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• pp.19-33
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• 2009

Purpose : To check the legal relation between rescue team and patient as well as legal responsibility for patient's damage intentionally or erroneously caused by rescue member, a public official, in the performance of relevant job ; to prevent legal dispute over rescue team and to present program for fair settlement of dispute and equitable and feasible burden of damage. Method : First, the legal principle of Civil Law, Criminal Law and Administrative Law related to the theme of this research will be investigated around research by literature. Second, the case of dispute related to rescue team will be introduced. Result: 1. If 119 rescue members as a public official intentionally or erroneously cause damage to patient in the performance of job, they shall bear civil, criminal and administrative responsibility. They shall bear civil responsibility for indemnity for damage due to default or tort. The typical criminal responsibility includes accidental homicide arising out of duty, preparing falsified official document, dereliction of duty, etc. In the administrative side, the state is responsible for indemnity for peculiar status of the rescue member, public official. 2. Though raising civil petition or legal dispute over unsatisfactory rescue service may be reasonable to guarantee the right of nation, such action may cause stress to rescue member as well as may lead to mental shrinking and defensive attitude only to take the basic first aid treatment which has low possibility of mistake instead of active first aid treatment so as to avoid legal responsibility. 3. The program that may prevent legal dispute over 119 rescue team includes expansion of manpower specialized in first aid treatment, enhancement of education on legal environment, development and application of standard job guideline, formation of mutual trust with patient, detailed explanation, preparing and keeping minute record, improvement of the rescue members' ability of first aid treatment and development of medical instruction mode. Conclusion : The best policy is to prevent legal dispute. If it is impossible to basically exclude the possibility of dispute, however, we need to make effort to minimize the occurrence, settle fairly and divide damage equitably and feasibly. To improve the preventible death rate of our first aid system to the level of advanced country, 119 rescue team which is in charge of the stage before hospital needs to positively enforce special first aid by improving the qualitative level of rescue service and to strive to prevent legal dispute that may occur in the process.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.91-102
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• 2015

Objective : The purpose of this study is to find out the possibility of application to herbal medicine's report form for adverse drug reaction (ADR) by reviewing and analyzing Asian countries's ADR report forms. Method : We investigated, compared, and analyzed ADR report forms (ADR-RF) of Asian countries's ADR institutions (ACAI), such as, Korea institute of drug safety & risk management and Dongguk university Ilsan oriental hospital (DUIOH) in Korea, national center for ADR monintoring (NCAM) in China, pharmaceuticals and medical devices agency (PMDA) in Japan, Ministry of Health and Welfare (MOHW) in Taiwan, and drug office, department of health, the government of the Hong Kong special administrative region (GHKSAR) in Hong Kong. Results : ADR-RF for ACAI included common contents, such as, patients information (name(initial), gender, age, weight), adverse event (AE)'s report information (Recognition and report for AE occurrence, first or follow up report, Severe AE), the detailed information of AE (the title of AE, onset & closing date of AE symptoms, the progress & results detailed test of AE), the information of AE's medicine (the types of medicine, product name, ingredient name, suspected or combination drug, single dose & frequency, dosage form, administration route, dealing for AE-suspected medicine), and AE reporter's information (reporter's information, institution's information). Taiwan had ADR-RF and the department exclusively for herbal medicine (HM), but others (except DUIOH) had not only no ADR report form but also contents for HM. Conclusion : ADR-RF for HM have to include the common contents of ACAI at least, as well as HM information related to ADR, such as the title, composition and types of HM, history related to HM's ADR, and the contents of drug-induced liver injury and so on. In addition, the main department of government for HM's ADR will be needed.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.1066-1077
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• 2000

The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by x$^2$ and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

• Korean Journal of Clinical Pharmacy
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• v.22 no.2
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• pp.103-112
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• 2012

Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

• Imaging Science in Dentistry
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• v.49 no.4
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• pp.295-299
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• 2019

Purpose: This clinical pilot study was performed to determine the effectiveness of dual-energy cone-beam computed tomography (DE-CBCT) in measuring bone mineral density (BMD). Materials and Methods: The BMD values obtained using DE-CBCT were compared to those obtained using calibrated multislice computed tomography (MSCT). After BMD calibration with specially designed phantoms, both DE-CBCT and MSCT scanning were performed in 15 adult dental patients. Three-dimensional (3D) Digital Imaging and Communications in Medicine data were imported into a dental software program, and the defined regions of interest (ROIs) on the 3-dimensional surface-rendered images were identified. The automatically-measured BMD values of the ROIs (g/㎤), the differences in the measured BMD values of the matched ROIs obtained by DE-CBCT and MSCT 3D images, and the correlation between the BMD values obtained by the 2 devices were statistically analyzed. Results: The mean BMD values of the ROIs for the 15 patients as assessed using DE-CBCT and MSCT were 1.09±0.07 g/㎤ and 1.13±0.08 g/㎤, respectively. The mean of the differences between the BMD values of the matched ROIs as assessed using DE-CBCT and calibrated MSCT images was 0.04±0.02 g/㎤. The Pearson correlation coefficient between the BMD values of DE-CBCT and MSCT images was 0.982 (r=0.982, P<0.001). Conclusion: The newly developed DE-CBCT technique could be used to measure jaw BMD in dentistry and may soon replace MSCT, which is expensive and requires special facilities.