Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.
Purpose : This study conducted a systematic review and meta-analysis to evaluate the clinical effectiveness of laser acupuncture for each condition using information from laser acupuncture trials registered on clinicaltrials.gov from January 2013 to June 2023. Methods : We quantitatively and qualitatively analysed the results of 16 clinical trials of laser acupuncture whose research results were confirmed. A risk of bias assessment was also carried out to assess the quality of each clinical trial. Results : A meta-analysis including three clinical trials was conducted to evaluate the comparative effectiveness of laser acupuncture and sham laser acupuncture in reducing pain and found that the laser acupuncture group had a statistically significant reduction in pain compared with the sham laser acupuncture group. In addition, 11 of the 13 trials not included in the meta-analysis showed a positive effect of laser acupuncture. Conclusion : Although laser acupuncture has a long history of clinical use and a lot of research, there is still some scepticism due to the lack of a clear mechanism of action and inconsistent reports of clinical effectiveness. In addition, there is a significant lack of systematic reviews of clinical evidence for major disease specific, and ongoing research is needed to establish an objective evidence base for the clinical effectiveness of laser acupuncture.
Food safety is a term broadly applied to food quality that may adversely affect human health. These include zoonotic diseases and acute and chronic effects of ingesting natural and human-made xenobiotics. There are two major areas of concern over the presence of residues of antibiotics in animal-derived foodstuffs with regard to human health. The first is allergic reactions. Some antibiotics, such as penicillins can evoke allergic reactions even though small amounts of them are ingested or exposed by parenteral routes. The second is development of antibiotic resistance in gut bacteria of human. Recently multi-resistant pneumococcal, glycopeptide-resistant enterococci and gram negative bacteria with extended-spectrum $\beta$-lactamases have spread all over the world, and are now a serious therapeutic problem in human. Although it is evident that drugs are required in the efficient production of meat, milk and eggs, their indiscriminate use should never be substituted for hygienic management of farm. Drug should be used only when they are required. In addition to veterinary drugs, environmental contaminants that were contaminated in feed, water and air can make residues in animal products. Mycotoxins, heavy metals, pesticides, herbicides and other chemicals derived from industries can be harmful both to animal and human health. Most of organic contaminants, such as dioxin, PCBs and DDT, and metals are persistent in environment and biological organisms and can be accumulated in fat and hard tissues. Some of them are suspected to have endocrine disrupting, carcinogenic, teratogenic, immunodepressive and nervous effects. The governmental agencies concerned make efforts to prevent residue problems; approval of drugs including withdrawal times of each preparation of drugs, establishment of tolerances, guidelines regarding drug use and sanitation enforcement of livestock products. National residue program is conducted to audit the status of the chemical residues in foods. Recently HACCP has been introduced to promote food safety from farm to table by reducing hazardous biological, chemical and physical factors. Animal Production Food Safety Program, Quality Assurance Programs, Food Animal Residue Avoidance Databank are para- or non-governmental activities ensuring food safety. This topic will cover classification and usage or sources of chemical residues, their adverse effects, and chemical residue status of some countries. Issues are expanded to residue detection methodologies, toxicological and pharmacokinetic backgrounds of MRL and withdrawal time establishments, and the importance of non-governmental activities with regard to reducing chemical residues in food.
Korean Journal of Construction Engineering and Management
/
v.16
no.1
/
pp.35-43
/
2015
It is important to have enough design and construction duration for infrastructure projects. However, recent water resource project in Korea shows several problems caused by their fast-tract schedule. National Audit Committee report several water resource projects have quality problems caused by insufficient project duration. Especially, water resource projects such as dam and water pipeline construction should have proper time to secure their structure quality. Normal project duration for these projects should be estimated based on previous similar projects' historical data analysis. However there is no standard model which can estimate normal project duration for water resource projects in Korea. There are several normal project duration estimation models for building project developed by public(LH) and private construction companies. However, there is no proper model for water resource projects. So, this study developed normal project duration model for dam and water pipeline projects using historical data and show application of models.
This study, targeting KOSDAQ-listed companies, examined the relationship between variability of accruals and corporate characteristics. First, the analysis results show that executives of companies with high debt ratios are more likely to violate debt contracts, so there is a strong temptation to use discretionary accrual items. Second, for companies with large volatility in operating cash flows, Executives of these companies are strongly inclined to utilize accruals for the purpose of abuse of discretion. Third, the larger the company, the more sensitive it is to political costs, so it is less tempted to use the accruals item than a smaller company. Fourth, the corporate age is thought to be the maturity of the company, Executives of such companies have little room to use accruals to abuse their discretion. Fifth, in the case of profit dummy variables, the companies reporting losses have more temporary accrual items than those reporting profits, so this increases the uncertainty in their accounting information than the latter. Sixth, for those companies that are indicated as inappropriate as a result of audit, the more likely their executives are to use the accrual items, and the lower the quality of their accounting profits is. Lastly, Companies audited by 4 Big domestic accounting firms have less discretionary accrual fluctuations than companies audited by non-big 4 accounting firms. Thus, it was found that the accrual amount allows the discretion of corporate executives differently according to the characteristics of the company.
The physical access or control of records with material entities is relatively easy. However, in the case of electronic records, due to its heightened applicative aspect that allows anyone with the authority to have access over the data, it requires an appropriate standard and stability to ensure the authenticity and integrity of electronic records. This study performed functional evaluation by extracting the minimum critical items from the national functional requirements documents and standards to explore the access control function that play an important role for the standard records management system to maintain quality requirements of electronic records. Based on this checklist, it evaluates whether the standard records management system properly carries out the access control function and investigates the current condition of application to practical records management work. Records managers generally do not use access control function, which may be because they do not feel the necessity, since the application of records management system is not yet actively promoted. In order for the standard records management system to be developed to become a more active system, it requires system improvement as well as considerations for below factors: First, although the necessity of establishing access control conditions is already recognized, it requires a clear stipulation of the regulation. Second, measures must be taken to implement access control in the records management system through document security solution. Third, it requires self-reflection of records manager, who utilizes the records management system. Instead of placing all responsibility on the National Archives, which established the system, professionals must further develop the system through continuous evaluation and improvement. Finally, a general discussion is required to publicize the issue of functional improvement of records management system. Although there is a bulletin board already created for this purpose, its users are extremely limited and it only deals with current problems. A space in online as well as in offline is required to solve the fundamental problems and exchange opinions.
The CAMS(Central Archives Management System) of NAK(National Archives of Korea) is an important system which receives and manages large amount of electronic records annually from 2015. From the point of view in database design, this paper analyzes the database schema of CAMS and discusses the direction of overall improvement of the CAMS. Firstly this research analyzes the tables for records and folders in the CAMS database which are core tables for the electronic records management. As a result, researchers notice that it is difficult to trust the quality of the records in the CAMS, because two core tables are entirely not normalized and have many columns whose roles are unknown. Secondly, this study suggests directions of normalization for the tables for records and folders in the CAMS database like followings: First, redistributing the columns into proper tables to reduce the duplication. Second, separating the columns about the classification scheme into separate tables. Third, separating the columns about the records types and sorts into separate tables. Lastly, separating metadata information related to the acquisition, takeover and preservation into separate tables. Thirdly, this paper suggests considerations to design and manage the database schema in each phase of archival management. In the ingest phase, the system should be able to process large amount of records as batch jobs in time annually. In the preservation phase, the system should be able to keep the management histories in the CAMS as audit trails including the reclassification, revaluation, and preservation activities related to the records. In the access phase, the descriptive metadata sets for the access should be selected and confirmed in various ways. Lastly, this research also shows the prototype of conceptual database schema for the CAMS which fulfills the metadata standards for records.
As Korea declared that the entire country is free from ISA (Infectious salmon anaemia) based on the OIE aquatic code in 2019, it is necessary to improve the import quarantine system that meets the level of ISA management in Korea. Currently, Korea imports Atlantic salmon and rainbow trout from countries which have history of ISA outbreak such as Norway and the United States, so there is a constant possibility that trade with these countries will bring ISAV (Infectious salmon anaemia virus) into Korea. Therefore, some amendments to the Aquatic Life Diseases Control Act (ALDCA) are needed to prevent the entry of ISAV into the Korea through international trade. The amendment to the ALDCA should contain a list of countries, zones or compartments that the Korean competent authority has allowed or banned imports of ISA-susceptible fish. In addition, the subordinate statutes or administrative rules of the ALDCA need to be revised so that on-site inspections/audit can be conducted for the evaluation of the ISA management system in exporting countries. After the revision of the subordinate statutes or administrative rules, it is necessary to strengthen the present import conditions in line with those that meet the level of ISA management in Korea. As for the strengthened import conditions, the competent authorities of exporting countries must export only salmonid fish produced in zones or compartments declared freedom of ISA to Korea, and must prove through lab-testing that ISAV should not be detected in the fish exporting to Korea. In addition, official veterinarians/fish health professionals of the exporting country should check the health status of the fish within 72 hours prior to export. Also, competent authorities of the exporting countries must attest that fish storage containers and water, ice and other equipment used for transportation should be cleaned and disinfected to avoid contamination with pathogens, including ISA. Therefore, the proposed measures presented here will further improve the current import condition for salmonid fish and assist decision-making on strategies to reduce the risk of ISA introduction into Korea. Also, it is expected to contribute to maintain the status of ISA-free country.
The purpose of this study has been performed to investigate the possibility of external audit program using thermoluminescence dosimetry for electron beam in korea. The TLD system consists of LiF powder, type TLD-700 read with a PCL 3 reader. In order to determine a calibration coefficient of the TLD system, the reference dosimeters are irradiated to 2 Gy in a $^{60}CO$ beam at the KFDA The irradiation is performed under reference conditions is water phantom using the IAEA standard holder for TLD of electron beam. The energy correction factor is determined for LiF powder irradiated of dose to water 2 Gy in electron beams of 6, 9, 12, 16 and 20 MeV (Varian CL 2100C). The dose is determined according to the IAEA TRS-398 and by measurement with a PTW Roos type plane-parallel chamber. The TLD for each electron energy are positioned in water at reference depth. In this study, to verify of the accuracy of dose determination by the TLD system are performed through a 'blind' TLD irradiation. The results of blind test are $2.98\%,\;3.39\%\;and\;0.01\%(1\sigma)$ at 9, 16, 20 MeV, respectively. The value generally agrees within the acceptance level of $5\%$ for electron beam. The results of this study prove the possibility of the TLD quality assurance program for electron beams. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.
Purpose: We report the results of an external audit on the absorbed dose of radiotherapy beams independently performed by third parties. For this effort, we developed a method to measure the absorbed dose to water in an easy and convenient setup of solid water phantom. Materials and Methods: In 2008, 12 radiotherapy centers voluntarily participated in the external auditing program and 47 beams of X-ray and electron were independently calibrated by the third party’s American Association of Physicists in Medicine (AAPM) task group (TG)-51 protocol. Even though the AAPM TG-51 protocol recommended the use of water, water as a phantom has a few disadvantages, especially in a busy clinic. Instead, we used solid water phantom due to its reproducibility and convenience in terms of setup and transport. Dose conversion factors between solid water and water were determined for photon and electron beams of various energies by using a scaling method and experimental measurements. Results: Most of the beams (74%) were within ${\pm}2%$ of the deviation from the third party's protocol. However, two of 20 X-ray beams and three of 27 electron beams were out of the tolerance (${\pm}3%$), including two beams with a >10% deviation. X-ray beams of higher than 6 MV had no conversion factors, while a 6 MV absorbed dose to a solid water phantom was 0.4% less than the dose to water. The electron dose conversion factors between the solid water phantom and water were determined: The higher the electron energy, the less is the conversion factor. The total uncertainty of the TG-51 protocol measurement using a solid water phantom was determined to be ${\pm}1.5%$. Conclusion: The developed method was successfully applied for the external auditing program, which could be evolved into a credential program of multi-institutional clinical trials. This dosimetry saved time for measuring doses as well as decreased the uncertainty of measurement possibly resulting from the reference setup in water.
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