• Title/Summary/Keyword: clinical guidance

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Biosafety and Biosecurity Programme: Its Implementation, Requirements and Continuous Development at the Nanyang Technological University in Singapore

  • Tun, Tin;Preiser, Peter Rainer
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.2
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    • pp.77-84
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    • 2018
  • In Singapore, biosafety and biosecurity measures are controlled by the Biological Agents and Toxins Act (BATA) and other requirements by regulatory agencies. The law prohibits and otherwise regulates the possession, use, import, transhipment, transfer, and transportation of biological agents, inactivated biological agents, and toxins that are of public health concern. The law also defines the facility requirements for high risk biological agents and toxins. The containment facility (BSL 3) is a minimum requirement to handle biological agents that falls under Schedule 1 (Risk Group 3). The Nanyang Technological University School of Biological Sciences Biosafety Level 3 Facility (NTU-SBS BSL 3) was designed specifically for research involving potential hazardous biological materials. The facility requires yearly re-certification by an approved facility certifier to meet the local requirements and international biosafety standards for a containment facility in many instances. On the other hand, most NTU researchers conduct biological projects involving biological agents with low or moderate risk groups (Risk Groups 1 and 2 or biological agents described in schedule 3 and 4 of BATA) and GMOs, which need only a BSL 2 laboratory. BSL 2 laboratories are yet to be legally certified or registered in Singapore. Institutional Biosafety Committee (IBC) identifies the requirements; defines a minimum standard in the safe control of biological risks and registers all BSL 2 laboratories in the NTU. Therefore, under the guidance of the IBC, the University Biosafety and Biosecurity Programme includes the audit and certification program as a unique and an internal exercise to bring NTU biosafety to a higher level.

Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report (심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례)

  • Kim, Seong-A;Noh, Kwantae;Pae, Ahran;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.79-87
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    • 2017
  • The open bite malocclusion is a common clinical entity and has multifactorial causes. Development of effective treatment plan and management is dependent on proper diagnosis. The skeletal open bite patient requires a coordinated orthodontic and orthognathic surgical approach to achieve stable occlusion, acceptable esthetics, and improved function. But in case of open bite with severely decayed dentition, restoration in the entire dentition is necessary. Using the facial analysis and diagnostic wax-up, the most effective treatment was prosthetic rehabilitation. The provisional restorations were fabricated to satisfy esthetic and functional requirements, which result in the uniformly distributed occlusal force, anterior and canine guidance. The inter-arch relationship, labio-dental harmony, and the soft tissue aspect, which is important to estimate the longevity were evaluated. Definitive restorations of monolithic zirconia were made by replicating provisional restorations by using the latest CAD/CAM technology. They were delivered to the patient and clinical follow-up observation was satisfactory.

Survey of Life and Dietary Styles on Patients with Gastroesophageal Reflux Disease (역류성 식도질환 환자의 생활습관 및 식습관 조사연구)

  • Kim, Hyun-Soo;Sohn, Minji;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.248-254
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    • 2014
  • Objective: It was surveyed how to help patients get better treatment for their disease by making complements based on the survey outcomes when the pharmacists guide how to administer medicine. Methods: A total of 142 gastroesophageal reflux disease (GERD) patients answered the self-answering questions consist of 15 items about their general characteristic, lifestyle and dietary style. The frequency of survey materials was analyzed to find out specific figures of surveyed patient's general characteristic, lifestyle and eating habits. Results: Based on the outcomes on analysis there was no difference between female and male patients. The characteristic based on the age group, as ones grow older, the number of GERD patients also increased. In case on the characteristic in lifestyle, many patients had improper habit to treat GERD. The items were smoking habits, stress control habit, sleeping postures and the way in wearing outfits. In case of postures after having a meal, they had right lifestyle. Patients had improper habit in eating food. They enjoyed pungent food and drinks which can hinder the treatment. In case of the time of having meal, eating habit of meat and vegetables and eating food less than an hour before go to bed, this research showed that they have the right lifestyle. Conclusion: This research indicate that pharmacists give guidance GERD patients to stop smoking that is causative of GERD and guide patients have mental stability, and patients avoid pungent food and drinks such as coffee, soda, chocolates and mint candies.

Review of Traditional Chinese Medicine Studies on The Effect of Pediatirc Tuina Massage Concomitant Treatment on Children's Epilepsy (소아 뇌전증 (전간(癲癎))에 소아 추나 동시 치료가 미치는 영향에 대한 중의학 연구 고찰)

  • Park, Jem Ma
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.4
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    • pp.112-124
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    • 2021
  • Objectives The aim of this study is to examine the effects of Pediatric Tuina Massage (PTM) as a treatment of Chlidren's Epilepsy (CE) and to seek guidance for future follow-up studies and the use of Pediatric Tuina Massage (PTM) in clinical setting. Methods The articles were obtained from the China National Knowledge Infrastructure (CNKI) from 2000 to 2021 by key words 'epilepsy', '癲癎', '癲癎病', 'infantile spasm', '婴幼儿痉挛', '小儿发作', '婴幼儿痉挛' and '推拿', '按摩', 'Tuina', 'Chuna', 'massage' in cross combination way. Results Seven articles were selected and analyzed by authors, years published, characteristics, diagnostic criteria, treatment methods and contents, treatment periods, evaluation criteria and research results. Also, stability and side effects were reviewed, and the qualities of the randomized controlled trials (RCT) were evaluated according to Risks of Bias 2 (RoB 2). All studies using Pediatric Tuina Massage (PTM) treatment have achieved effective therapeutic results for treating Children's epilepsy (CE). Conclusion Pediatric Tuina Massage (PTM) is economical, safe without side effects and non-invasive, but still produce a good effect. Also, it is a good treatment option for children who feels anxious of ordinary Korean Medical treatment such as acupuncture, moxa, herbal medicine, which also results in good compliance with the treatment. In addition, it is possible to enhance therapeutic effect by combining it with pharmacological therapies in treating children's epilepsy (CE). Therefore, Pediatric Tuina Massage (PTM) provides an essential clinical basis in guiding further studies for the treatment of CE.

Development and Evaluation of the Utility of a Respiratory Monitoring and Visual Feedback System for Radiotherapy Using Machine Vision Technology

  • Kim, Chul Hang;Choi, Hoon Sik;Kang, Ki Mun;Jeong, Bae Kwon;Jeong, Hojin;Ha, In Bong;Song, Jin Ho
    • Journal of Radiation Protection and Research
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    • v.47 no.1
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    • pp.8-15
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    • 2022
  • Background: We developed a machine vision technology program that tracks patients' real-time breathing and automatically analyzes their breathing patterns. Materials and Methods: To evaluate its potential for clinical application, the image tracking performance and accuracy of the program were analyzed using a respiratory motion phantom. Changes in the stability and regularity of breathing were observed in healthy adult volunteers according to whether the breathing pattern mirrored the breathing guidance. Results and Discussion: Displacement within a few millimeters was observed in real-time with a clear resolution, and the image tracking ability was excellent. This result was consistent even in the sections where breathing patterns changed rapidly. In addition, the respiratory gating method that reflected the individual breathing patterns improved breathing stability and regularity in all volunteers. Conclusion: The findings of this study suggest that this technology can be used to set the appropriate window and the range of internal target volume by reflecting the patient's breathing pattern during radiotherapy planning. However, further studies in clinical populations are required to validate this technology.

Development of pre-procedure virtual simulation for challenging interventional procedures: an experimental study with clinical application

  • Seong, Hyunyoung;Yun, Daehun;Yoon, Kyung Seob;Kwak, Ji Soo;Koh, Jae Chul
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.403-412
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    • 2022
  • Background: Most pain management techniques for challenging procedures are still performed under the guidance of the C-arm fluoroscope although it is sometimes difficult for even experienced clinicians to understand the modified three-dimensional anatomy as a two-dimensional X-ray image. To overcome these difficulties, the development of a virtual simulator may be helpful. Therefore, in this study, the authors developed a virtual simulator and presented its clinical application cases. Methods: We developed a computer program to simulate the actual environment of the procedure. Computed tomography (CT) Digital Imaging and Communications in Medicine (DICOM) data were used for the simulations. Virtual needle placement was simulated at the most appropriate position for a successful block. Using a virtual C-arm, the authors searched for the position of the C-arm at which the needle was visualized as a point. The positional relationships between the anatomy of the patient and the needle were identified. Results: For the simulations, the CT DICOM data of patients who visited the outpatient clinic was used. When the patients revisited the clinic, images similar to the simulated images were obtained by manipulating the C-arm. Transforaminal epidural injection, which was difficult to perform due to severe spinal deformity, and the challenging procedures of the superior hypogastric plexus block and Gasserian ganglion block, were successfully performed with the help of the simulation. Conclusions: We created a pre-procedural virtual simulation and demonstrated its successful application in patients who are expected to undergo challenging procedures.

Development and Usability Evaluation of a Mobile Physical Therapeutic Diagnosis Application (모바일 물리치료 진단 어플리케이션 개발 및 사용성 평가)

  • Min-Hyung Rhee;Jong-Soon Kim
    • PNF and Movement
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    • v.21 no.1
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    • pp.129-137
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    • 2023
  • Purpose: The physical therapy diagnosis process requires high-level background knowledge, the ability to obtain added information from patients, accurate examination skills, and a framework for transforming thoughts into a diagnostic decision. Thus, the physical therapy diagnostic process is highly complicated and difficult work. To function as autonomous professionals, physical therapists must develop effective clinical diagnosis skills. As such, mobile application aids can help with accurate and scientific diagnoses. Therefore, this study aims to develop and evaluate the usability of a mobile application for physical therapy diagnoses. Methods: In this study, a diagnostic application was developed using App Inventor, the development environment was the Chrome web browser for Windows 10, and the mobile application was run on a Google Pixel 5. The developed application was evaluated for usability by 20 physical therapists with more than 5 years of clinical experience in the musculoskeletal physical therapy field, and a usability evaluation was conducted using a 5-point Likert scale for accuracy, convenience, satisfaction, and usability. The collected Likert scores were converted into percentages and analyzed as descriptive statistics. Results: The graphical user interface consisted of an initial screen with program guidance, 18 screens presenting the algorithm, and 12 screens presenting the estimated diagnosis based on the algorithm. As such, the usability evaluation of the developed application was as follows: accuracy 100%, convenience 90%, satisfaction 91%, and usability 88%. Conclusion: The newly developed mobile application for physical therapeutic diagnoses has a high accuracy, and it will aid in building an easy and reliable physical therapy diagnosis system.

Feasibility of Percutaneous Pancreatic Stent Placement in Postoperative Pancreaticojejunostomy Stenosis

  • Juil Park;Kichang Han;Joon Ho Kwon;Man-Deuk Kim;Jong Yun Won;Sungmo Moon;Gyoung Min Kim
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1241-1248
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    • 2023
  • Objective: To evaluate the role of percutaneous pancreatic stent placement in postoperative pancreaticojejunostomy stenosis (PJS). Materials and Methods: This retrospective single-center study included seven procedures in five patients (four males and one female; median age, 63 years) who underwent percutaneous pancreatic stent placement for postoperative PJS between January 2005 and December 2021. The patients were referred to interventional radiology because of unfavorable anatomy or bowel abnormalities. The pancreatic duct was accessed under ultrasound and/or computed tomography guidance. A stent was placed after balloon dilatation of the PJS. Moreover, plastic stents were placed for the first two procedures, whereas bare-metal stents were used for the remaining five procedures. Technical success was defined as the successful placement of stents for the PJS, meanwhile, clinical success was defined as the normalization of pancreatic enzymes without recurrence of pancreatitis. Results: Pancreatic duct access and stent placement were successfully performed in all patients (technical success rate: 100%). All the procedures initially yielded clinical success. However, recurrence of pancreatitis was observed after two procedures that used plastic stents because of stent migration at 0.3 and 3 months after the procedure. In contrast, no instances of recurrent pancreatitis were noted after metal stent placement for a follow-up duration of 1-36 months. No serious procedure-related adverse events were observed. Conclusion: Percutaneous pancreatic stent placement may be a viable option for patients with postoperative PJS in whom an endoscopic approach is not feasible. Metal stents may be considered over plastic stents for the management of PJS, considering the possible lower stent migration and infeasibility of frequent endoscopic stent exchange due to the altered anatomy.

Practice-based Evidence for Health Promotion in Underserved Clients with Hypertension in Primary Health Care Settings

  • Hong, Woi-Hyun
    • Research in Community and Public Health Nursing
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    • v.26 no.4
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    • pp.390-397
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    • 2015
  • Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.

Effects of Image-Use Medication Education on Knowledge, Self-Efficacy, and Misuse of Medication in Elderly Inpatients (이미지 활용 약물교육이 노인환자의 약물지식, 복약자기효능감 및 복약오류에 미치는 효과)

  • Kim, Hyo Jung;Kim, Kon Hee
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.56-66
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    • 2018
  • Purpose: This quasi-experimental study was done to develop image-use medication education for older inpatients and to evaluate the effects on their knowledge, self-efficacy, and misuse of medication. Methods: Fifty nine elders (experimental group - 30, and control group - 29) received medication education once a week for 3 weeks. Data were collected before (pretest), right after (post 1), and 4 weeks after the program finished (post 2). Drug Use Knowledge Scale, Self-efficacy for Appropriate Medication Use Scale, and Drug Misuse Scale were used. Analysis included descriptive statistics, $x^2$ test, repeated measured ANOVA. Results: Findings showed significant differences in knowledge of medication and drug misuse between groups according to time(pretest, post 1, and post 2). At post 1 and post 2, knowledge and self-efficacy levels were significantly higher and misuse scores were lower in the experimental group compared to the control group. Conclusion: Findings indicate that elder-tailored medication education consisting of group education and individual guidance with images is effective and practical for medicine safety in elderly inpatients. Moreover, it could lead to a healthier life for elders, even elders with multiple chronic diseases and taking several medications.