• Title/Summary/Keyword: CARE guideline

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Safety Assessment of Foods Produced Using Recombinant DNA Techniques

  • Toyoda, Masatake
    • Toxicological Research
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    • v.17
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    • pp.167-171
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    • 2001
  • The introduction of genetically modified crops has raised concerns regarding safety issues over the insertion of foreign genes into plant genomes using recombinant DNA technology. Since 1991 in Japan, 29 foods and 6 food additives have been evaluated, based on the "Guideline for Safety Assessment", before these foods were marketed. The MHW, however, decided that safety assessment of such foods and food additives should be legally imposed. because soon such foods and food additives are expected to circulate globally and a new system for assessing safety of such foods and food additives at a pre-market stage is necessary, in order to avoid the distribution of any genetically modified foods that have had no safety assessment. The MHW published relevant announcements to amend existing regulations on 1 May 2000. "Standards for safety assessment of seed plant" is established based on a concept of substantial equivalence, and applicable to the products which are regarded as equivalent to the existing products used as foods and food additives. The characterization of the food products entails consideration of the molecular characterization. phenotypic and compositional characteristics, key nutrients and toxicants, and toxicity and allergenicity of the introduced proteins, and if there are indications of unintended effects of the modification, whether further safety testing (animal studies etc.) is needed should be considered. Safety and wholesomeness studies with whole foods should be care fully designed in order to avoid nutritional imbalances causing artifacts and uninterpretable results as was the case of Dr. Pusztaiis report. A case study of genetically modified soybeans (glyphosate-tolerant soybeans) on the immune system of rats and mice is shown. Chemical compositions were also compared with those of the non-GM soybeans. The studies failed to detect any differences in immuno-toxic activity.muno-toxic activity.

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Cost-effectiveness Analysis of Pharmacologic Treatment in Hypercholesterolemia (고콜레스테롤혈증 치료 약물들에 대한 비용-효과 분석)

  • 정경래;문옥륜
    • Health Policy and Management
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    • v.9 no.3
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    • pp.70-94
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    • 1999
  • This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil. bezafibrate, lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients' travel expenses and time loss as well as resource consumption in the health care sector. Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of ₩31.400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(₩33,100 per percent reduction). Chole styramine(8g/d) was least efficient at ₩90,200. For low-density lipoprotein cholesterol. simvastatin(10mg/d) was most efficient, at ₩23,200 per percent reduction, followed by lovastatin(20mg/d) at ₩28,000. Gemfibrozil was least efficient at ₩77,800 per percent reduction. For high-density lipoprotein cholesterol. bezafibrate(400mg/d) was most efficient at ₩39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at ₩514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk. The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient's needs This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.

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Hospital Nurses' Knowledge and Compliance on Multidrug-resistant Organism Infection Control Guideline (일 대학병원 간호사의 다약제 내성균 감염관리지침에 대한 지식과 수행정도)

  • Kang, Ji-Yeon;Cho, Jin-Wan;Kim, Yu-Jung;Kim, Dong-Hee;Lee, Ji-Young;Park, Hey-Kyung;Jung, Sung-Hee;Lee, Eun-Nam
    • Journal of Korean Academy of Nursing
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    • v.39 no.2
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    • pp.186-197
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    • 2009
  • Purpose: This study was done to investigate nurses' knowledge of, and compliance with the multidrug-resistant organism (MDRO) infection control guidelines. Methods: A survey questionnaire was developed based on the institutional and national guidelines and was administered to a convenience sample of 306 nurses in a university hospital. Results: The mean score for knowledge was 33.87 (percentage of correct answers: 82.61%). The percentages of correct answers for basic concepts, route of transmission, hand washing/protective devices and environment management were 74.27%, 94.29%, 92.90% and 75.54% respectively. The mean compliance score was 4.15 (range: 1-5). The compliance scores for education, communication, contact precaution, disinfection, surveillance culture, and hand washing were 3.29, 4.05, 4.20, 4.50, 4.40 and 4.48 respectively. Nurses indicated "lack of time (30.06%)", "lack of means (10.78%)" and "lack of knowledge (9.48%)" as reasons for noncompliance. Conclusion: While most educational programs have focused on hand washing or use of protective devices to prevent transmission of MDRO in acute care settings, hospital nurses' knowledge of the basic concepts of MDRO and environmental management has remained insufficient. Nurses are relatively non-compliant to the guidelines in the areas of education (staff, patient, family) and communication. Comprehensive educational programs are needed to decrease hospital infection rates and to improve the health of patients.

An Integrative Care Model of Clinical Pathway Approach for Acute Pain after Back Surgery: A Protocol for Clinical Trial (요추 수술 후 급성기 통증 환자에 대한 통합의학 표준임상경로 임상시험 프로토콜)

  • Kim, Byung-Jun;Shin, Byung-Cheul;Hwang, Man-suk;Shin, Kyung-Min;Heo, In;Lim, Kyeong-Tae;Park, In-Hwa;Son, Dong-Wuk;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.111-119
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    • 2017
  • Objectives Clinical pathway (CP), is management plans that display goals for patients and have led to improve outcomes for many diseases. In Korea, Interest in Korean medicine's stabilization (Clinical pathway, Clinical Practice Guideline) is increasing, But the number of studies is scare. Method and Analysis This trials composes nonequivalent control group pretest-posttest design to conduct clincal pathway trial for the acute pain after back surgery. The subjects were 10 control patients with back surgery, and 10 experimental patients with application of integrative CP. Each group patient will observed 6 weeks. We check validation of CP. Also we compared the patient's status using the pain, function, Quality of life index between the two groups. Discussion This trial is the first CP for the acute pain after back surgery using integrative medicine concepts. Aim of this trial is to find the effectiveness and validity of clincal pathway for acute pain after back surgery.

An Improvement Plan with Assessment of Therapeutic Drug Monitoring Service for Vancomycin (Vancomycin Therapeutic Drug Monitoring 운영 실태 조사와 업무 개선 방안)

  • Kim, Hae-Sook;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.120-130
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    • 2009
  • The objective of this study was to analyze and to improve therapeutic drug monitoring(TDM) service of vancomycin in a local hospital. Patients with TDM service between September 2005 and December 2008 were included and the data were collected for vancomycin use and components of TDM. During that period, 421 cases of TDM service of vancomycin in 236 patients were retrospectively reviewed. The first dosages of vancomycin were appropriate in 135(57.2%) patients and administration of vancomycin was discontinued in 126(53.4%) patients due to therapeutic failure or adverse drug reaction. MRSA was identified in 191(80.9%) patients and 135(70.7%) samples for the identification were sputum. According to the TDM reports, 232(55.1%) serum samples were obtained at the steady-state conditions and 55.5% of the samples that were drawn before the steady-state was due to the physician's inappropriate knowledge about the steady-state. Based on the time of vancomycin administration, 35.8% of the samples were not obtained at the recommended sampling time. For the patients in general wards, the most common reason for the incorrect samples was routine serum sampling by the laboratory medicine phlebotomists between 6 and 8 a.m. except sunday. In contrast, samples drawn by nurses or physicians at inappropriate time were the most common reason for the incorrect samples with patients in the intensive care units. Physicians accepted 68.5% of the recommendations for vancomycin dosage and administration. In conclusion, TDM service of vancomycin needs to be improved in inappropriate sampling time and vancomycin dosage. For solving these problems, current team made of TDM pharmacists and physicians of laboratory medicine can be expanded to include a physician of infectious diseases, nurses and laboratory medicine phlebotomists as new members. Through the TDM service of vancomycin by the new team, we can settle the problems and make the guideline for the scientific controversies associated with therapeutic monitoring of vancomycin.

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A Prioritizing for the Evidence-Based Nursing Practice Guidelines Development (국내 근거기반 임상간호실무지침 주제의 우선순위 결정)

  • Gu, Mee Ock;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Eun, Young;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.39-51
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    • 2012
  • Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.

Development of the Treatment Algorithm for Panic Disorder(1) - Background, Organization, Principles, Future Plan and Methods of Algorithm Development (공황장애 치료에 대한 한국형 알고리듬 개발(1) - 배경, 조직구성, 알고리듬 개발의 원칙, 개발계획, 개발방법)

  • Lee, Sang-Hyuk;Yu, Bum-Hee;Kim, Chan-Hyung;Yoon, Se-Chang
    • Anxiety and mood
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    • v.3 no.2
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    • pp.77-90
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    • 2007
  • In this special article, we presented the organization of the work group, basic principles of the algorithm, future plan and methods for developing a treatment algorithm for panic disorder in Korea. The psychiatrist work group from the Korean Association of Anxiety Disorders began to develop a treatment algorithm designed to improve the management of Korean patients with panic disorder by incorporating better evaluation techniques and treatment procedures. We have reviewed the treatment guidelines and algorithms for panic disorder published thus far, including the Practice Guideline for the Treatment of Patients with Panic Disorder established by the American Psychiatric Association, the Management of Anxiety (Panic Disorder, with or without Agoraphobia, and Generalized Anxiety Disorder) in Adults in Primary, Secondary and Community Care established by the National Institute for Clinical Excellence, and the Clinical Practice Guidelines established by the Canadian Psychiatric Association. We developed the basic materials to be used in the treatment algorithm for the management of panic disorder in Korea. Therefore, in this special article, we intro-duce the goal of the algorithm and the details of the algorithm development.

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Pair Programming in Programming Lab: The Effects, Limits, and Guidelines Based on the Student Receptivity (프로그래밍 실습수업에서의 짝 프로그래밍: 학생들의 수용성(受容性)을 중심으로 본 효과와 한계, 운영 방안)

  • Jeong, Choong-Kyo
    • Journal of Digital Contents Society
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    • v.19 no.9
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    • pp.1663-1669
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    • 2018
  • Pair programming is a software development technique in which two programmers work together at one computer. One writes code while the other reviews the code, and they switch roles frequently. Pair-programming practice in school programming lab is expected to improve the learning performance, provide collaboration experience, and promote interactions between students. This work finds out how students accept pair-programming, what make students reluctant to join pair-programming by repeated questionnaire surveys in a college programming lab class. Based on these findings aome guidelines for school pair-programming are provided. First, students should be allowed to choose to do pair-programming or not. Second, various obstacles that make students hesitate to switch roles should be removed. Third, the pair matching should be made with great care.

A Review of Renal Dialysis Unit Environment for Infection Prevention - Focused on Evidence Based Design (감염 예방을 위한 인공신장실 의료 환경에 대한 고찰 - 근거 기반의 디자인 중심으로)

  • Han, Su Ha;Yoon, Hyungjin
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.49-57
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    • 2018
  • Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.

Correlation Analysis between Space Integration and Natural Light in K Senior Hospitals (K 노인전문병원의 공간 통합도와 자연광의 상관관계 분석)

  • Moon, Sun-Young;Lee, Hyun-Soo
    • Korean Institute of Interior Design Journal
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    • v.24 no.2
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    • pp.189-196
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    • 2015
  • In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.